F 5 STANDING COMMITTEES. Finance and Asset Management Committee. UW Medicine Clinical Transformation Project INFORMATION

Transcription

1 STANDING COMMITTEES F 5 Finance and Asset Management Committee UW Medicine Clinical Transformation Project INFORMATION This item is being presented for information only. Attachment Clinical Transformation F 5/206-18

2 UW MEDICINE INFORMATION TECHNOLOGY SERVICES CLINICAL TRANSFORMATION LISA BRANDENBURG CHIEF HEALTH SYSTEM OFFICER JACQUELINE CABE CHIEF FINANCIAL OFFICER JOY GROSSER CHIEF INFORMATION OFFICER ATTACHMENT Page 1 of 23

3 UW MEDICINE CLINICAL TRANSFORMATION Journey of Clinical Transformation supports and enables our UW mission to Improve the Health of the Public One Patient, One View, One Story across the health system Not an IT project The journey will be led by our clinical and business leaders and enabled by technology 2

4 UW MEDICINE CLINICAL TRANSFORMATION Working with Clinical and Business Leaders across UW Medicine to improve: Patient Engagement Physician/Practitioner Experience Patient Care Staff workflow and build efficiencies Business and Operating Efficiencies through development of Foundational Systems 3

5 CLINICAL TRANSFORMATION BENEFIT FRAMEWORK Patient Care Staff Experience & Efficiencies Care Quality Patient Engagement & Experience Business & Operating Efficiencies Patient Safety Physician Experience & Efficiencies 4

6 PROJECT OBJECTIVES Patient Engagement and Experience: Develop a single online patient portal for all activities between the patient and UW Medicine. Develop more online service opportunities and easy navigation. Create more opportunities for communication between the patient and their care team. Physician Experience and Efficiencies: Streamlined documentation. Immediate access to relevant information. Ease of access to clinical information created at other organizations. Expanded population management toolset. Allow increased time to focus on the patient. 5

7 PROJECT OBJECTIVES (CONT.) Patient Care Staff Experience and Efficiencies: Create workflows that are optimized to each member of the care team. Develop standards of care across UW Medicine. Provide a platform for interdisciplinary coordination and communication. Streamlined documentation. Allow for information continuity across the care continuum. Business and Operating Efficiencies: Revenue Cycle Management Improvements. Simplification and standardization across operations and IT. Optimized resource utilization. Platform development for future opportunities for centralized clinical and administrative services. 6

8 Surgical Workflow Current vs. Future State 7

9 SURGICAL WORKFLOW: CURRENT VS. FUTURE STATE Current State: Following the Flow of a Surgical Patient Today Patient seen by UW Med PCP, referred to UW Med Neurologist UW Med Neuro refers to Spine MD Spine MD determines surgery is needed Patient signs consent Preanesthesia H&P completed Preanesthesia assessment completed (RN, MD, ARNP) Surgeon & Anesth enter pre op orders Patient arrives, RN initiates orders Patient goes to OR Patient leaves OR, Anesth enters PACU orders, closes case in Docusys Anesth & Surgeon face to face handoff to PACU RN Post op floor orders entered Patient transferred to inpatient bed, RN initiates orders Patient discharged home Patient sees PCP Paper scanned into both EHRs PCC/RN transposes paper surgical packet into the electronic surgical packet ESP RN or MD updates ESP ESP RN or MD updates ESP ESP Circulating RN Circulating RN Discharge summary & patient instruction Transition of care: MD reviews discharge summary MINDSCAPE Patient info entered into Docusys (RN, MD, ARNP Anesthesia info entered into Docusys PDF sent to OCRA/Cerner Length of Stay Planning Initiated Retail Pharmacy dispense Transition of care: MD reviews discharge summary ETRBY Transition of Care MD dictates in ORCA Physicians and Care Teams document and search for clinical information in many systems Cerner portal contains inpatient Discharge Summary My Chart: After Visit Summary from clinic visits only 8

10 SURGICAL WORKFLOW: CURRENT VS. FUTURE STATE Clinicians Access All Patient Information in One System Across All Care Settings Patient seen by UW Med PCP, referred to UW Med Neurologist UW Med Neuro refers to Spine MD Spine MD determines surgery is needed Patient signs consent Preanesthesia H&P completed Preanesthesia assessment completed (RN, MD, ARNP) Surgeon & Anesth enter pre op orders Patient arrives, RN initiates orders Patient goes to OR Patient leaves OR, Anesth enters PACU orders, closes case in Docusys Anesth & Surgeon face to face handoff to PACU RN Post op floor orders entered Patient transferred to inpatient bed, RN initiates orders Patient discharged home Patient sees PCP Single EHR Peer Organization Benefits: Single EHR System Consolidation Produced Significant Gains across Surgical Departments Lowered Surgical Costs by $9.42M On Time Starts Improved 16% OR Turnover Reduced by 11 minutes Credited use of a single system across of all surgical workflow to decrease clinician time and improve data visibility. Improved On Time Starts by 47% Case Cancellation Rate Decreased 9% Case Volume Increased by 4% 9

11 Patient Portals Current vs. Future State 10

12 PATIENT PORTAL EXPERIENCE: CURRENT STATE 4 Clinical Portals 8+Billing Portals 11

13 PATIENT PORTAL EXPERIENCE: FUTURE STATE Patients will have one portal... for all clinical and billing needs 12

14 Peer Organization Benefits 13

15 PEER ORGANIZATION BENEFITS PATIENT FLOW AND READMISSION IMPROVEMENTS 34% 11% 13% 2 Day 31% 52 min Decrease in LOS, saving ~$2.5M/year Decrease in LOS Reduction in ED Visits Decrease in LOS for All Sepsis Patients Decrease in 30-Day Hospital Readmissions Decrease in ED Visit Time per Patient with integrated Care Everywhere 14

16 CLINICAL TRANSFORMATION: A FOUNDATION FOR EXTENDED PROJECT FIT OPPORTUNITIES Revenue Generation Infrastructure Cost Savings Clinical Service Growth Maximize Capacity Rev Cycle Improvements Philanthropy Labor Mix & Prod. Supply Chain Property/Space Admin Efficiencies EHR Child Birth Center at NWH Appropriations Through Clinical Transformation, the EHR infrastructure investment enables magnified Revenue Generation and Cost Savings opportunities identified through Project FIT. 15

17 IT SERVICES BENEFITS - $131.2M Reduced IT staffing costs Reduced hardware and software costs Elimination of NWH software & services contract Clinical Transformation has the potential to consolidate 70+ systems onto one platform 16

18 ADDITIONAL PROJECT BENEFITS AND EFFICIENCIES Revenue Cycle Benefits - $22.8M (net revenue enhancements) Reduction in preventable denials Improved documentation and charge capture Improved point-of-service and online cash collections Physician and Clinical Staff Efficiency - $22.1M Meds, allergies and problem list duplicate review and reconciliation Clinical data located across multiple systems, multiple logins, etc. Transfer of data from one system to another Health Information Management Efficiency - $7.6M Reduction in scanning Reduction in number of required staff Efficient release of information Other potential benefits to be determined during design phase 17

19 QUANTITATIVE BENEFITS SUMMARY Category Description Benefits (FY21-27) IT Services Benefits Revenue Cycle Management Benefits Physician and Clinical Staff Efficiencies* Health Information Management Efficiencies Other Cost Management Benefits Additional Clinical Benefits Software and Hardware Cost Reductions Staffing Reductions NWH Software & Services Contract Elimination Improved Documentation and Charge Capture Reduction in Preventable Denials Improved Point-of-Service and Online Cash Collection Meds, Allergy, and Problem List Review and Reconciliation Review of Clinical Data in Multiple EHRs Transcription of Clinical Data from EHR to EHR Scanning, Request of Information, Coding Staff Reductions Reduction in Adverse Drug Events Reduction in Surescripts Transaction Costs Specific benefits related to clinical quality and patient safety to be defined Total $131.2M $22.8M $22.1M $7.6M $7.5M TBD $191.2M * Benefits identified may only be realized if throughput is improved 18

20 CLINICAL TRANSFORMATION BUDGET* BY CATEGORY Category FY19 FY20 FY21 FY22 FY23 Total Labor Internal Labor $19.0 $25.2 $11.9 $- $- $56.1 External Labor $14.9 $26.4 $8.7 $- $- $50.1 Non-Labor Additional EHR Software Licenses $0.8 $1.6 $3.5 $3.2 $2.4 $13.3 Vendor Services $2.3 $3.8 $5.0 $4.7 $3.5 $19.3 Other Software $2.8 $5.9 $0.3 $0.4 $0.3 $6.0 Hardware $- $1.5 $- $- $- $1.5 Other Non-Labor $1.2 $4.5 $2.6 $1.7 $1.4 $13.2 Direct Project Total $41.0 $68.9 $32.0 $10.0 $7.6 $159.5 Direct Medical Center Ops Cost $1.6 $12.0 $7.2 $- $- $20.8 Grand Total $180.3 * All figures in millions 19

21 CLINICAL TRANSFORMATION BUDGET $ in Millions FY19 FY20 FY21 FY22 FY23 FY24 FY25 FY26 FY27 Total Project Costs Non-Recurring Capital $82.80 Operating $76.70 Total Non-Recurring $ Direct Medical Center Costs $20.80 Total Cost of Completing the Project Project Benefits IT Services Cost Reduction Revenue Cycle Management Benefits Clinical Staff Efficiencies HIM Cost Reduction Other Cost Management Benefits $7.54 Total Project Benefit $

22 ESTIMATED FUNDING Clinical Transformation was included in our financial stability plan (Project FIT) approved in November as follows: $180M project cost, including expenses of $20M to cover resources while our staff is trained on the new system Assumed borrowings at $130M, 4.5% interest Project benefits were not specifically included but represent a tactic to achieve FIT savings UW Medicine is working with Central Administration to support due diligence and develop a funding plan that we plan to bring to the Regents in July 21

23 CLINICAL TRANSFORMATION PROPOSED SCHEDULE 22

24 CLINICAL TRANSFORMATION PROGRAM STRUCTURE Program Executive Steering Committee UW Medicine Vice Presidents and Senior Leaders including: CMO, CFO, CHSO, CIO, UW- IT VP, UWP President, Executive Director(s) Transformation Leadership Transformation Executives representing Physician, Clinical, Business/Revenue Cycle, and Information Technology Operations Leadership Program committee chairs and functional leaders Program Committees Multi-disciplinary teams made up of subject matter experts, operational leaders, and IT staff. Committees defined by functional areas (e.g., Clinical Inpatient, ED, OR/Anesth, Pharmacy, Access/Reg/Sched, Patient Engagement, etc ) 23