Information Technology Report to Medical Executive Committee

Transcription

1 July 10, 20 Information Technology Report to Medical Executive Committee Contents 1 Medicare Meaningful Use 1 Drug/Drug Interaction Alert 2 Leapfrog Group 2 My Apps Icon/Shortcut 2 NHIQM Project 3 mpages 3 onechart Learning 4 Ambulatory EMR Selection 5 Network Updates 5 Physician Password Expiration 5 Complete Function Message Center 6 Medications Process 6 PathNet Changes 6 Radiology and Cardiology PACS 6 Radiology Speech Recognition 7 Windows XP Replacement Project 8 Appendix 1 Memphis and Fayette June 20 Meaningful Use Results 10 Appendix 2 Enhancement Request Management Appendix 3 Planned vs. Unplanned Downtime Appendix 4 onechart Search and mpages Utilization Statistics 15 Appendix 5 Second Quarter CPOE Inpatient and ED Adoption Rates Medicare Meaningful Use MLH began Stage 1 Medicare Meaningful Use 90-day attestation on July 1. This includes all Memphis Hospitals and Fayette Hospital. Hospital Leaders and Information Technology are monitoring compliance to the MU requirements. All leaders are encouraged to pay special attention to: Summary of Care: Provide summary record at transitions in care for more than 50% of transitions in care. Problem List: More than 80% of patients have at least one entry or an indication that no problems are known Electronic copy of Discharge Instructions: - Provide discharge instructions electronically when requested for greater than 50% of requested patients. The rolling 30-day and 7-day status of requirements with specific measurements will be posted at This "Meaningful Use" can also be accessed under the QuickLinks on the MOLLI home page. See Appendix 1 for Meaningful Use compliance for the month of June. Clinical Alert Drug/Drug Interaction Alert The Drug/Drug Interaction alerts have been firing to providers during the medication order entry process since April 17. For the month of June, 1,487 drug/drug alerts fired to providers placing medication orders. 100% of these alerts were overridden. This number does not include alerts firing to pharmacists. The same interaction pairs continue to be the majority of alerts: ketorolac/ioversol and ketorolac/nsaids.

2 PAGE 2 Leapfrog Group - Preventing Medical Errors All Methodist Adult Hospitals have achieved the Substantial Progress score for Preventing Medical Errors with the Leapfrog Group s recent CPOE evaluation test. Methodist is the only multi-hospital system in the Memphis community to achieve this goal. One recent improvement, the implementation of drug-drug interaction checking, led to a 25% improvement in our 20 scores. The test was recently completed for all Methodist Hospitals except for Le Bonheur. Due to significant feedback to Leapfrog in the last year by pediatric hospitals, Leapfrog has postponed the requirement for pediatric hospitals to complete the test. The test consists of several patient scenarios to determine the effectiveness of the CPOE system in alerting prescribers to common, serious prescribing errors. Results are expected to be published by early July. Additional information about the test, the scoring and how Methodist compares to other hospitals is available at My Apps Icon/Shortcut In response to medical staff requests, an icon/shortcut to My Apps login screen will be placed on the desktop computers in the facilities as listed. This change will allow physicians (and other clinical staff) to access My Apps without having to open MOLLI. Germantown (includes Sutherland) 6/28/20 Alliance 7/2/20 South 7/5/20 North 7/9/20 Fayette, Corporate (includes RAP, PFS and Print Shop) 7//20 Le Bonheur 7/16/20 University 7/19/20 NHIQM Project North and South recently implemented the National Hospital In-Patient Quality Measures Dashboard for AMI. Process issues were identified for AMI, Stroke, and VTE related to capturing reason not given orders, i.e. the reason anticoagulation therapy not prescribed at Discharge. A focus group is evaluating methods to improve these processes. The rollout of AMI will continue at University, Germantown, and Fayette hospitals at a later date.

3 PAGE 3 mpages Pulmonary Summary The Pulmonary Summary mpage was implemented on June 5 to all the physician and physician-like positions as well as respiratory therapy. This mpage provides respiratory specific information including ventilator monitoring, respiratory assessment, respiratory treatments, and apnea/bradycardia/ desaturation events. It also includes a new graph feature that allows the graphing of up to three data elements on the same graph. See utilization graphs in Appendix 4 (Pulmonary Summary, page 14). ED Summary Planned for implementation to physician and physician-like position, the ED Summary mpage will be implemented in July. This mpage provides information for the ED physician around the ED processes. mpage Next Steps There are several mpages currently being tested or reviewed for possible implementation in the future: Lab Console (Status: Review) Geared toward lab technologists, this mpage provides a dashboard view of work to be done. For physicians, a Clinicians Guide to Laboratory Procedures is a part of this solution with descriptions, preparation instructions, and reference ranges for all lab procedures. Physiology View (Status: Review) Designed with the critical care patient in mind, this mpage provides a flow sheet view of data along with tab navigation to view body system specific information such as cardiac/pulmonary, neurology, endocrinology, etc. onechart Learning Coming July 10, 20 onechart Learning is a site within PowerChart that can be accessed from the patient chart toolbar or from the Organizer Toolbar. The site contains just in time quick reference in PDF and /or video format. Reviewing either content takes one to two minutes. The design enables the physician to get immediate information while still in the patient chart. It

4 PAGE 4 also includes a search function which provides access not only to the visible materials but to all onechart physician training content. The categories initially available, selected based on feedback from physicians, support teams and help desk calls, include: Spotlight Video This video will provide information on new functionality or Need to Know information. Fundamentals/CPOE, FirstNet/PNED, Admission/Transfer/Discharge onechart Announcements Additional Resources The format, categories and topics available will be adjusted as physicians use the materials and provide feedback. onechart Learning provides the ability to monitor the number of times a topic is accessed which will assist in modifying available information. Beginning July 10 a physician can access onechart Learning by clicking the option in the Organizer Toolbar or from the Toolbar within a patient chart. If onechart Learning is not visible on the Toolbar, click the first drop down arrow located on the Toolbar and select. When the information in onechart Learning is selected, it will open in a web browser. If onechart Learning is opened from within a patient chart, the window may be resized and the user may easily toggle between the chart and onechart Learning. Ambulatory EMR Selection for Academic Pediatric and Adult Specialty Practices Methodist Le Bonheur Healthcare IT in partnership with UT Medical Group (UTMG) IT conducted a detailed RFP process for an ambulatory EMR. A critical requirement for academic specialty practices is integration of patient information between their practice and the hospital EMR. After due diligence was completed both IT Divisions have recommended to the Board of Trustees of Methodist Le Bonheur Healthcare that Cerner ambulatory EMR be awarded the contract. The Board will make their final decision at their meeting in August 20. Providing the Board approve the ambulatory EMR project will kick off in September, 20 and will complete by

5 PAGE 5 Q Cerner Corporation will be responsible for hosting both the acute and ambulatory EMRs in their Kansas City remote hosting center. This Spring there were considerable recurring performance issues with the Acute care EMR. The MLH and UTMG negotiating team used the ambulatory contract to negotiate more stringent service level agreements for both the acute care and the ambulatory EMR performance. A high level overview of the new and old service level agreements is shown below: The maximum penalty on Cerner commences when the planned up time falls below 97.5% (old level was less than 95% uptime) First penalty payment from Cerner will be at 3% of monthly fees (old level was 2%) and rise to a maximum penalty of 50% of monthly fees (old maximum was 20%) Penalties will be accumulative and run over three months (old was no accumulative penalty and each month was a clean slate) Network Updates IT Technical Services completed upgrades to improve security for wireless Guestnet for all Methodist locations. On August 5th, North Hospital will have a planned network and Cerner downtime for one hour from 2:00 a.m. to 3:00 a.m. to install new equipment. All hospitals will have a two hour non-cerner downtime from 2:00 a.m. to 4:00 a.m. to perform data center maintenance. During the non-cerner downtime the network P: (private drive) and G: shared drives will not be available. Physician Password Expiration Information Technology will begin a project designed to increase the strength of users passwords. This will start in August 20 and continue into 2013, to improve the security of Methodist Le Bonheur Healthcare s computing environment, Starting on July 2, Physicians Analysts will begin contacting physicians who have not changed their passwords since September 2009 to assist them in resetting their passwords. Complete Function Message Center - All Facilities On June, 20, the Complete function for Documents to Dictate was removed from Message Center. Physicians can no longer remove items from their Documents to Dictate folder. These items will be removed by standard HIM processes.

6 PAGE 6 On July 17, 20, column changes will be made with the Message Center Documents folder. These changes will allow providers to determine if a document has been signed by the author, prior to signing the note. Column additions will include Result Status, Description-Subject, and Author. Column removals will include From and Subject. Medications Process Enteric Coated Tablets Becoming Delayed Release Tablets - All Facilities The Cerner Multum United States (US) content now updates the term Enteric Coated Tablet to Delayed Release Tablet beginning with the next installation of monthly content. The dosage form EC Tablet will also be updated to DR Tablet to be consistent with the change in nomenclature. The change will occur over a period of several days in the month of August. NOTE: This update is in accordance with the United States Pharmacopeia (USP) change from 'enteric coated' to 'delayed release', which was then adapted for use by the US Food and Drug Administration (FDA) and the National Library of Medicine. PathNet Changes Mg Level - All Emergency Departments - Adult Facilities Effective June, 20, a required order detail of Reason for Testing will be added to the order, Mg Level and will only be applicable when ordering in the Emergency Department. PT and PTT - Emergency Departments at University, South, North and Fayette Effective June, 20, a required order detail of Reason for Testing will be added to the orders, PT / PTT and will only be applicable when ordering in the Emergency Department. Radiology and Cardiology PACS Radiology and Cardiology PACS vendor demonstrations were completed in May and June respectively. Reference calls and site visits are in progress. Radiology Speech Recognition The contract for PowerScribe 360 has been signed. Project planning including setting a Go-Live date will begin in July.

7 PAGE 7 Windows XP Replacement Project Status The Windows XP replacement project officially launched at North Hospital on June 4. To date, contractors from ProTech, led by the Methodist IS Desktop Support Projects Team, have replaced over 180 PCs, laptops, and tablets with new Windows 7 devices. The initiative has been an overwhelming success with few issues reported post-installation. The North phase of the project was completed a week early, so the project team is now turning its attention to University where approximately 800 devices will replaced between July 2 and August 31. Following University, XP devices will be replaced at Le Bonheur in September and Sutherland Cardiology in October. The remainder of the 20 replacement schedule is to be determined pending budget approval for the remaining facilities.

8 PAGE 8 Appendix 1 Memphis and Fayette June 20 Meaningful Use Results Core Objectives Required for Compliance MLH Memphis Hospitals June 20 Actual Fayette Hospitals June 20 Actual Record Demographics 50% 97% 98% Record Vital Signs 50% 92% 91% Medication Allergy List 80% 99% 99% Smoking Status 50% 93% 93% Problem List 80% 87% 93% Medication List 80% 96% 97% CPOE 30% 96% 97% Drug-Drug, Drug- Allergy Checks Clinical Decision Support Rule Clinical Quality Measures Reporting Provide Patients Electronic Copy of Health Information 50% 100% Attestation of Adoption Adopted Adopted Attestation of Adoption Adopted Adopted Attestation of Adoption Adopted Adopted Provide Patients Electronic Copy of Discharge Instructions 50% 92% Exchange Information Among Providers Electronically None Requested (100% by default) 30 days of data not available due to go live date Attestation of Adoption Adopted Adopted Protect Electronic Health Information Attestation of Adoption Adopted Adopted Menu Objectives MU Threshold Adoption Status Drug Formulary Checks Deferred to Stage 2 Deferred to Stage 2 Deferred to Stage 2 Lab Test Results in EHR 40% 98% 98% Generate Lists of Patients with Specific Conditions Attestation of Adoption Adopted Adopted Record Advance Directives 50% 99% 100% Patient Education 10% 88% 86% Medication Reconciliation Deferred to Stage 2 Deferred to Stage 2 Deferred to Stage 2 Provide Summary of Care Record 50% 58% 67% Submit Electronic Data to Immunization Registries Deferred to Stage 2 Deferred to Stage 2 Deferred to Stage 2

9 PAGE 9 Core Objectives Submit Lab Results to Public Health Agencies Submit Syndromic Surveillance Data to Public Health Agencies Required for Compliance MLH Memphis Hospitals June 20 Actual Fayette Hospitals June 20 Actual Attestation of Adoption Adopted Adopted Deferred to Stage 2 Deferred to Stage 2 Deferred to Stage 2

10 PAGE 10 Appendix 2 Enhancement Request Management Requests for enhancements to onechart (Cerner) coming from hospital Clinical and Technology Advisory Groups, Clinical Service Groups, Pharmacy and Therapeutic Groups and other governance groups are now entered into a Healthcare Information Systems (HcIS) Share Point site which allows the requesting user and HcIS Associates to track the status of the enhancements. Share Point automatically s the requesting user when the request is initially submitted. The user has the option to be notified by when there has been a change in the status of the enhancement request. For the month of June: Total Enhancement Requests submitted: 8 Total Physician Enhancement requests submitted: 6* Total Enhancement Request closed: 71 Total Physician Enhancement requests closed: 2* *Physician requests submitted through governance groups are not currently reported in physician total.

11 PAGE Appendix 3 Planned vs. Unplanned Downtime The following table depicts the one Chart or Cerner Production system uptime and planned and un-planned downtime in minutes from January 1, 20 May 31, 20. Note: This table does NOT include myapps, MOLLI, or network downtimes that may have impacted access to onechart. Planned Downtime (minutes) Un-planned Downtime (minutes) Uptime Excluding Planned Downtime Total Uptime Percent January % 100% February % 100% March % 99.17% April % 99.5% May % 100%

12 PAGE Appendix 4 onechart Search and mpages Utilization Statistics

13 PAGE 13 Appendix 4 onechart Search and mpages Utilization Statistics (continued)

14 PAGE 14 Appendix 4 onechart Search and mpages Utilization Statistics (continued)

15 Percentage Percentage PAGE 15 Appendix 5 Second Quarter CPOE Inpatient and ED Adoption Rates (May 20 May 20) CPOE Inpatient Adoption Rates By Hospital May 20 - May % 95% 90% 85% 80% 75% 70% 65% 60% May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- University South North Germantow n Month CPOE ED Adoption Rates By Hospital May 20 - May % 95% 90% University South North Germantown Le Bonheur 85% May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Month