Information Technology Report to Medical Executive Committee

Transcription

1 November 13, 2012 Information Technology Report to Medical Executive Committee Contents 1 Meaningful Use Stage 1 Attestation Results 1 Med Rec Optimization Task Force Update Cerner Code Upgrade Results 2 ios 6 Connectivity to the Guest Network Update 2 Physician Documentation Project 2 onechart Data and Reporting Tools 4 Medication Clinical Decision Support 4 mpages 5 Orders Update Effective in October 6 PowerChart Enhancement Pathology Report Number Indicator 6 Radiology and Cardiology PACS Request for Proposal 6 Windows XP Replacement Project 7 Appendix 1 Meaningful Use Stage 1 Compliance Status 8 Appendix 2 CPOE Inpatient and ED Adoption Rates (January 2012 September 2012) 9 Appendix 3 Planned vs. Unplanned Downtime 10 Appendix 4 Quarterly Chart Search and mpage Usage Graphs Meaningful Use Stage 1 Attestation Results All Methodist hospitals successfully completed the attestation of Stage 1 for Meaningful Use in October at the conclusion of a 90-day EHR reporting period. Completion of Stage 1 allows the organization to receive the incentive payments and begin work on Stage 2 for Meaningful Use. Medication Reconciliation (Med Rec) Optimization Task Force Update The Med Rec Core Team has completed the future state design of the entire medication reconciliation workflow. The team s proposal to use dedicated teams of pharmacy technicians to obtain med history at each facility for all inpatient and observation admissions was approved by Senior Strategy and the CEO Council on October 26, The Core Team and Task Force are now focusing on the training and go-live strategy. The Clinical Education Services and Medical Informatics trainers have engaged with the Med Rec Core Team to being developing training content for caregivers. The training strategy for physicians and caregivers will be finalized within the next month. Additional Core Team tasks for the November timeframe include 1) reviewing all MLH med rec-related policies to determine which ones need to be deactivated or modified, and 2) preparing to integration test the new med rec functionality in early December Cerner Code Upgrade Results The system was released to end users at 6:51a.m. October 13, 2012 with minimal issues recorded. There were comments from some physicians that performance seemed improved especially with Medication Reconciliation. There were some complaints on the new color scheme. However, some medical staff liked the new color scheme. MLH is currently installing packages for testing to correct some of these issues, but we cannot be assured that all issues will be addressed.

2 PAGE 2 ios 6 Connectivity to the Guest Network Update With the release of ios6, Apple changed the way that the Auto-Login feature operates. This modification prevented devices installed with ios6 from connecting to the GUEST network. To resolve this issue, the Information Sciences Department made changes to the Guest network to support ios6 on Sunday, October 21. As part of this change, all ios devices, regardless of operating system version, are now required to authenticate with either your My Apps credentials or the 1visitor account. To provide a better customer experience, the timeouts for the GUEST network sessions were also extended to the following: Active Sessions: 12 Hours you will need to login again when network session exceeds 12 hours. Inactive Sessions: 4 Hours you will need to login again after 4 hours of inactivity (no network traffic). NOTE: Apple recently released an update, ios 6.0.1, and it is recommended to upgrade your device to resolve several issues with wireless connectivity and calendar appointments in Microsoft Outlook/Exchange. Physician Documentation Project Status On October 24, 2012, a physician documentation training module became available that includes instruction on use and personal modification of PowerNotes as well as Clinical Notes. Transition to PowerNote or Clinical Note is voluntary during this phase of the project. Physician Analysts will be available to assist any physician who is interested in taking advantage of these electronic tools to streamline workflow and improve communication. Reports on the adoption of online physician documentation will be included in future editions of this report. Stage Two Meaningful Use requires that greater than 30% of physician progress notes be only electronic AND the content is searchable. 3 onechart Data and Reporting Tools Occasionally a Physician or Associate will wish to access data related to volumes and outcomes related to patient care. With the full implementation of onechart we are able to harvest a significant amount of data from onechart for the purpose of improving patient care and complying with initiatives such as Meaningful Use. In recent weeks it has become evident that medical and clinical managers are not aware of the existing reporting capabilities within onechart and how they can use the existing reports or how to request a new report if one is not available or suitable. In the effort to provide one Chart users with the information either from existing report sources or through new report development, we are implementing a Report Request process. Through our Change Request structure the various teams (IT, Clinical Decision Support, etc.) handling data

3 PAGE 3 processing can evaluate a request and direct the request to the proper team for design and/or fulfillment. Report requests should go through your facility s Clinical Technical Advisory Group (CTAG) or your Clinical Standardization Group (CSG) with the assistance of your facility s Physician Analyst. If you have a request for a report, contact your Physician Analyst initially. He or she can identify if a report already exists. There are a variety of tools that collect and compile data from Cerner. Report sources available to you include: InfoView an application that is part of Cerner s PowerInsight suite of products. It primarily functions as a report viewer and scheduler for pre-built reports. Any Methodist Associate or Physician can request access after completing online training. Some examples of InfoView reports used by facility leadership include: o CPOE Adoption o ED Order Communication Weekly o Unsigned VO&TO by Physician o Indwelling Urinary Catheter Documentation Report o Chlorehexidine Cloth Bath Report PowerInsight Cerner s product suite that incorporates applications used to retrieve data from the Cerner database that holds all of our patient information. Any Methodist Associate or Physician can request access after completing a training program that has been available for over a year. If there is sufficient interest from medical staff, IT will apply for CME credits for the PowerInsight training modules. Explorer Menu a report listing available from the Cerner tool bar, from within a patient s chart and from My Apps. These reports are pre-designed and used as part of the physician s daily work such as rounding lists. Access to these reports is determined by your role in Cerner (i.e. physician, nurse, etc.). Some examples of Explorer Menu Reports used by facility leaders include: o Provider Group List o Physician Favorites o Orderset Usage All o Nursing Communication Order report o Active Restraint by Nurse Unit

4 PAGE 4 Medication Clinical Decision Support Drug-Drug Interaction and Drug-Allergy Checking Alert Changes With the upgrade of our Cerner system to the code, which was completed on October 13th, Methodist deployed a new medication clinical decision support (mcds) alert screen. The new mcds alert screen utilizes mpage technology to provide a more consistent and intuitive look and feel to the clinical decision support process. In addition to the new look and feel, the mpage-based alert screen provides for improvements to the drug interaction workflow such as: Ability to discontinue interacting drug from within alert screen Ability to filter override reason codes by alert type Additional allergy filtering capabilities Ability to create filters through custom programming An enhancement of particular note is the filtering of interaction alerts between medications entered for administration and those documented as home medications (different care venues). Providers are no longer interrupted regarding interactions unless both the new and interacting medication orders are for the same venue of care. This filtering has reduced the number of alerts significantly. mpages The mpage team is currently testing and validating the latest content for the Cerner standard mpages. Improvements include load time decrease across multiple components, new functionality on the order entry component, custom mpage views using a mix of standard components and custom components, and filtering of the mpage view by encounter type.

5 PAGE 5 Orders Update Effective in October New ED Observation Services Process The Syncope Observation PowerPlan will be piloted at Germantown ED starting October 30, This project is a pilot that will target patients presenting with Syncope of Unknown Etiology. Purpose: Reduce inappropriate admissions due to Syncope of unknown etiology Reduce regulatory vulnerabilities and compliance issues with inappropriate patient status. EMR Solutions utilized: PowerNote ED Suggested PowerPlans Discern Alerts PowerForm Name Change Pneumonia Admission Orders (Care Set) All Adult Facilities - Physician & Physician Related Roles The Pneumonia Admission Orders will be renamed to Pneumonia Orders. The orders are intended for use upon admission or if a patient develops pneumonia during the encounter. New Order- All Facilities PowerChart Enhancement Microbiology Culture and Susceptibility Results On November 6, 2012, a new PowerChart result tab for Microbiology Cultures and Susceptibilities was implemented. This enhancement is in addition to the existing culture and sensitivity results found in the laboratory result flowsheet. Result Preview

6 PAGE 6 The enhanced view offers several new features for viewing culture and sensitivity results. Custom filtering options for orders and results Color indicators for susceptibility results Current and discontinued antibiotic orders Preview option for quick viewing of results Personal antibiogram for the patient Special thanks to Dr. Bryan Simmons, Dr. Heather Swanson, and Dr. Kerry Cleveland for their design input. PowerChart Enhancement Pathology Report Number Indicator In November, a change to the Pathology report case number display on the Lab result flow sheet will be implemented. A report number indicator will be added to replace multiple case numbers appearing in one cell. When multiple case numbers qualify for the same cell, only one of the case numbers will populate. The single case number will additionally display an appended number in brackets. The bracketed number represents the number of additional cases populating the cell. Drill down on the cell to view all of the reports by using the Next and Previous buttons. Bracketed 3 indicating three reports populate in the cell Radiology and Cardiology PACS Request for Proposal Update FUJI and McKesson delivered Radiology and Cardiology proposals in late October. In concert with Radiology and Cardiology leadership, the proposals will be assessed and a recommendation developed for the next Board Meeting. Windows XP Replacement Project Status The Windows XP replacement project is on track with all 2012 funded replacements completed at IT headquarters at Summer Trees, North, University, Le Bonheur, and South. Following is the schedule for the remaining sites for 2012: Sutherland Cardiology and Alliance Home Health s Windows XP replacements will take place in December.

7 PAGE 7 Appendix 1 Meaningful Use Stage 1 Compliance Status The 90-day, 30-day, and 7-day Meaningful Use Stage 1 Compliance data for the Memphis hospitals and Fayette Hospital is posted on MOLLI. This list is titled Meaningful Use and is found on the MOLLI home page under the Quick Links left navigation list: 1%20Compliance/Meaningful%20Use%20Requirements.aspx

8 PAGE 8 Appendix 2 CPOE Inpatient and ED Adoption Rates (January 2012 September 2012) IP GOAL: 85.00% Balanced Scorecard SEP 2012 YTD: University 85.31% South 86.71% North 87.09% Germantown 82.13% Le Bonheur 95.32% ED GOAL: 95.00% Balanced Scorecard SEP 2012 YTD: University 97.75% South 97.12% North 95.55% Germantown 98.57% Le Bonheur 95.03%

9 PAGE 9 Appendix 3 Planned vs. Unplanned Downtime The following table depicts the Cerner Production system uptime and planned and unplanned downtime in minutes from January 1, 2012 September, Note: This table does NOT include network downtimes that may have impacted access to onechart. Total Minutes Planned Downtime Unplanned Downtime Total Uptime % Cerner Uptime % January , % % February , % % March , % 99.57% April , % 99.55% May , % % June , % % July , % 99.26% August , % % September , % % Total 394, % 99.82%

10 PAGE 10 Appendix 4 Quarterly Chart Search and mpage Usage Graphs Chart Search is the last option on the Menu located within the patient chart. It allows providers to search a patient s record for previous medical history and returns a list of results. For example, a provider s search may yield results from notes, vital signs, laboratory results, and allergies. It will not return scanned documents or orders. A variety of filters are available to narrow or expand a search. A chart search will return results for all of a patient s encounters within the defined search parameters. When you enter a word or phrase into the Search Bar, Chart Search will offer helpful words or phrases related to the search. This feature is Search Assist. Click one of the Search Assist choices or click the Search button. For additional instruction on Chart Search, click on onechart Learning, a site within PowerChart accessible from the Toolbar in both the organizer and patient chart views. If onechart Learning is not visible on the Toolbar, click the first drop down arrow located on the Toolbar to select it.

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