Meaningful Use: A Practical Approach. CSO HIMSS Spring Conference 2013
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1 CSOHIMSS 2013 Slide 0 May 17 th, 2013 Meaningful Use: A Practical Approach Jay Brown Sr. VP & CIO, UC Health Rick Haucke Manager, IS&T, PMO, UC Health Ajay Sharma FHIMSS, Sr. Manager, Sogeti USA, LLC CSO HIMSS Spring Conference 2013
2 Agenda About UC Health History with EMR & Technology UC Health EMR Implementation Project Governance Project Organization Roles and Responsibilities Implementation Timeline Challenges Outcomes Accomplishments EMR Wave Program What s next? CSOHIMSS 2013 Slide 1 May 17 th, 2013
3 About UC Health Tripartite Mission: Patient Care, Research, and Education Governance: President s Policy Council CEO UC Health CEO UC Physicians (MD) Dean UC College of Medicine (MD) CEO West Chester Hospital (MD) CEO University Cincinnati Medical Center (MD) CFO UC Health VP Education UC Health - Senior Associate Dean for Academic Affairs UC College of Medicine (MD) VP Research UC Health - Senior Associate Dean for Academic Affairs UC College of Medicine (MD) CSOHIMSS 2013 Slide 2 May 17 th, 2013
4 About UC Health Research Number of Grants Awarded 677 Total Dollars Awarded $169.5 Million Education College of Medicine: 1,000 Residents and Fellows CSOHIMSS 2013 Slide 3 May 17 th, 2013
5 About UC Health Number of Employees: 10,000 Number of Physicians: 900 Hospital Locations: University of Cincinnati Medical Center (612 to 650) West Chester Hospital The Drake Center (166 LTAC, 103 Skilled Nursing, 102 A.L.) University Pointe Ambulatory Locations: physical locations 180 Clinics CSOHIMSS 2013 Slide 4 May 17 th, 2013
6 About UC Health Drake Center Beds (166 LTAC, 103 Skilled Nursing) Assisted Living (102 beds) Full-service Conference Center for people Outpatient Services OT, PT and Speech Therapies CSOHIMSS 2013 Slide 5 May 17 th, 2013
7 About UC Health Drake Center Tenants HealthSouth Rehabilitation Hospital Inpatient rehab for patients VITAS Inpatient Unit Innovative hospice care Cincinnati Children s Hospital Medical Center Outpatient rehabilitation therapies for children Mercy Health Physicians Family Medicine Dialysis Center, Inc. (DCI) CSOHIMSS 2013 Slide 6 May 17 th, 2013
8 History with EMR & Technology Well established enterprise best of breed applications 1997 to Centralized Clinical (e.g. PACS, RAD, LAB, OR, Pharmacy) CPOE at UH (Bio-Authentication for Ohio Board of Pharmacy certification) Bar Code Medication Administration at West Chester Hospital Ambulatory EMR (7 years with over 20 places on paper) Solid IT foundation for clinical processes Best Practices PMO for IS&T led initiatives Clinical/Bio-Medical Engineering team as part of IS&T CSOHIMSS 2013 Slide 7 May 17 th, 2013
9 UC Health EMR Implementation Why Big Bang? Time to market Physician Stage 1 incentives in 2012 Manage Costs More accurately predict, minimize and control Legacy Platform unsupported Experience with past phased implementation approach Why Single Solution vs. Best of Breed Clinical Integration between Ambulatory and Inpatient Minimize Training Costs for organization Improved communications between care providers and patients CSOHIMSS 2013 Slide 8 May 17 th, 2013
10 Project Governance CSOHIMSS 2013 Slide 9 May 17 th, 2013
11 Project Organization CSOHIMSS 2013 Slide 10 May 17 th, 2013
12 CSOHIMSS 2013 Slide 11 May 17 th, 2013 Roles & Responsibilities Sponsoring the Charter, lead Steering Committee Executive Co- Sponsors Provide strategic direction, authorize work of program, allocations resources and defining scope of work for each project within the overall program and spread buy-in. Steering Committee must reinforce adherence to IT governance Steering Committee Implement scope of work outlined by the Steering Committee. Develop, maintain and distribute project planning documents. Lead project management team to complete tasks and deliverables Program Manager Complete tasks and deliverables outlined and directed by the Program Manager Project Managers
13 EMR Project Timeline Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Board Approval Contract Signed Hire Internal Resources Start 1 st EMR Certification Acquire Legacy Support System Design January, 2011 February, 2011 March, 2011 March - May, 2011 March, months July - November, 2011 Registration & Scheduling System Build December, 2011 April, 2012 Ambulatory System Build/Unit Test Ambulatory Integrated Testing Inpatient System Build December 2011 to June end months December, 2011 October, 2012 April 2012 to June 2012 *Reg/Sched Go Live *Ambulatory Go Live Inpatient Integrated Testing *Inpatient Go Live EMR Optimization April 12, 2012 July 10, 2012 August 2012 to October 2012 *Each Go live was accompanied with Command Center operations that included at the elbow support for two weeks and increased Helpdesk staffing October 27, 2012 October 27, 2012 till date CSOHIMSS 2013 Slide 12 May 17 th, 2013
14 CSOHIMSS 2013 Slide 13 May 17 th, 2013 Challenges Don t know what you don t know. Key Resources hard to find Tool specific Adoption of new technologies New Interface Engine Medical Device Interfaces Tap Badge At the Elbow Go Live support Overwhelming scale of project Epic WAVE
15 Challenges Device setup Printers (can t adequately test before go live) Bar Code Scanners 1447 Tap Badge Readers Replacing Bio-Authentication with Tap Badge process Medical Equipment Integration: 54 Anesthesia machines integrated to EMR 146 Ventilators integrated to EMR 12 Dialysis machines integrated to EMR 400 Bedside patient monitors ECGs, Blood Pressures, Vitals CSOHIMSS 2013 Slide 14 May 17 th, 2013
16 Outcomes Access to a common record by multiple users from anywhere Improved communications: Between care providers. Between providers and patients. Clinical integration of: Inpatient with Outpatient. Physicians with Hospitals. UC Hospitals with each other. Competitiveness with others in the marketplace. CSOHIMSS 2013 Slide 15 May 17 th, 2013
17 Accomplishments Accomplished: Project was on-time, on budget & achieved Stage 1 MU in 2012 Conversion of legacy patient information Total Records converted 57,781,560 million Error rate % Aligned IS&T support structure with appropriate clinical and business departments (e.g. Revenue Cycle - Medical Records) CMIO was integrated into the organization. CSOHIMSS 2013 Slide 16 May 17 th, 2013
18 Accomplishments Meaningful Use: providers attested Expecting 2 hospitals and 496 providers to attest Ambulatory Operational Scope: 180+ locations / 1,000+ providers 21,088 Patients using myuchealth Inpatient locations: University Hospital (now UCMC) Holmes & Deaconess West Chester Hospital (University Pointe) The Drake Center CSOHIMSS 2013 Slide 17 May 17 th, 2013
19 CSOHIMSS 2013 Slide 18 May 17 th, 2013 Rick Haucke & Ajay Sharma The EMR Wave A Practical Approach
20 Why call it the EMR Wave Program? CSOHIMSS 2013 Slide 19 May 17 th, 2013
21 CSOHIMSS 2013 Slide 20 May 17 th, 2013 What was the EMR Wave Program The Wave Program kept track of progress of non-emr projects, but related to the EMR initiative of 2011/2012. The Project Manager (PM) of each one of the projects in the EMR Wave Program followed certain protocols and procedures as part of the Project Management Office at UC Health that set the stage for: 1. Weekly Project Status Report 2. The Program Team Dashboard 3. Weekly Check Points that were required to manage and oversee their specific projects.
22 UC Health Project Lifecycle Project Lifecycle Introduction Defining the Project Purpose, Business Need, Brief Work Description, Funding Source, Areas of Concerns & Sponsorship. PDR (Project Deliverable Review) Review of items listed above plus in-scope and out of scope, Assumptions, Risks and Issues, Detailed WBS, BAA, DR Plan, Master Test Plan, Audit Log use. PLA (Project Launch Assessment) Present items above in PDR to IT Leadership and Business Sponsorship. IPR (In Process Reviews) Anytime between 30 and 90 days of PLA. Checkpoint and Health Status Project Closing (Conclusion Review) Official Closing of Project, Finalize Financials, Lessons Learned, Closed issues and risks. Sponsor sign off. CSOHIMSS 2013 Slide 21 May 17 th, 2013
23 Development & Timeline of the Program Started with 5 projects September 2011 DataCaptor - Medical Device Integration of Vital Signs Capture Imprivata - Single Sign On Solution PC Deployment UC Physicians - Integration Disaster Recovery & Business Continuity for new EMR System February/March Program Manager came on board. Consolidated projects into the EMR Wave Program By Ambulatory Go Live, Wave Scope had grown to 12 projects By Inpatient Wave Scope had grown to 18 projects CSOHIMSS 2013 Slide 22 May 17 th, 2013
24 Infrastructure Projects in the Wave CSOHIMSS 2013 Slide 23 May 17 th, 2013 Disaster Recovery and Business Inpatient Standardization Continuity UC Health Surgical Hospital DataCaptor Standardization PC Deploy - Bedside PC Deploy ED, NICU, SICU, OR Streamline - Added at TDC Imprivata Imprivata Tap Badge Enrollment Epic Production Support The Drake Center and West Chester Hospital Bar Code Scanner Replacement UC Physicians Integration UC Physicians Standardization Outpatient Pharmacy Upgrade Inpatient Downtime BCA Dragon Microphones Printer and Workstation Build UCMC Bar Code Scanner Replacement
25 Wave Program Project Repository CSOHIMSS 2013 Slide 24 May 17 th, 2013
26 Wave Program Reporting CSOHIMSS 2013 Slide 25 May 17 th, 2013
27 Wave Program Accomplishments EMR Wave accomplished the following Objectives Report out the Progress and Issues Used a Single Dashboard view to report to EMT Mimicked EMR project reporting standards Collaboration & Communication between projects was facilitated. Plan for Project Risks better as there were interdependencies between the various projects. Leadership was able to leveraged a Single Project Repository to view Project Status Reports Used for Weekly Report to EMT for decision making purposes. CSOHIMSS 2013 Slide 26 May 17 th, 2013
28 Wave Program Summary In summary, The EMR Wave Program with the organizational strategy to establish a balanced, executable plan that will help achieve goals. We were able to support that strategy by: Maintaining program alignment with the EMR implementation Budgeting and Allocating financial resources appropriately Allocating human resources where required Measuring component project contributions Managing strategic risk CSOHIMSS 2013 Slide 27 May 17 th, 2013
29 What s Next? EMR Upgrades MU Stages to end of decade Continuous Physician Practice Integration ICD-10 Once in a generation project Clinical Informatics Support of BYOD CSOHIMSS 2013 Slide 28 May 17 th, 2013
30 CSOHIMSS 2013 Slide 29 May 17 th, 2013
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