New Hanover Regional Medical Center

1
New Hanover Regional Medical Center

• 2007
• IS Business Plan Review
• October 2006 September 2007

2
Governance
CEO
Information Systems Steering Committee
Technology Requests
Avery Cloud Ed Ollie Mary Ellen Bonczek Donna
Bost Sam Spicer John Gizdic Keith Strawn
Sets Priorities, Selects Projects, Allocates
Resources
NHHN Dollars
NHHN Resources
NHHN Strategy
Information Services Management Team
HIPAA Core Team
CIO Directors Managers
Physician IS Committee
Assesses Needs, Manages Project
Portfolio, Promotes Learning
Clinical Informatics Committee
Medical Records Committee
Financial Planning Committee
3
Business Goals

• Highest quality safest medical practice
• Supplement limitations of human brain
• Most satisfying patient family experience
  possible
• Efficient effective environment for physicians
  Nurses
• Maximize physician and hospital earnings
• Maintain and grow market share and reach

4
Method For Achieving Goals

• Promote Service Excellence through the
  implementation and skillful use of paperless
  clinical financial information systems by
  2010.
• Clinical Initiatives (MEDNET)
• Financial Initiatives (LAWSON)
• Education and training to produce high level of
  skill using automated systems.
• Metrics to measure impact of changes.

5
Project Portfolio Mix
Six categories of IT projects are being pursued
simultaneously as represented by the six swim
lanes. Coordination must be achieved across all
swim lanes and resources balanced. NEEDS TO BE
RATIONALIZED AGAINST ALL NHRMC INITIATIVES.
Clinical Lane
50 Projects
Financial Lane
4 Projects
Business Administrative Lane
17 Projects
Infrastructure Lane
19 Projects
Construction Lane
12 Projects
Organizational Initiatives Lane
6 Projects
6
Progress
The position of the swimmers indicates the
approximate level of completion implementing
necessary systems to achieve automation goals.
However, this does not necessarily indicate how
effective the enabling technologies are being
used. Skillful use goals can only be achieved by
on-going education and training.
Clinical Lane
Financial Lane
Business Administrative Lane
Infrastructure Lane
Construction Lane
Organizational Initiatives Lane
7
Physician Related Initiatives

• Heartlab
• Powerscribe
• Other Voice Recognition Products
• Alerts, Warnings, Reminders (Knowledge Mgmt)
• Protocols, Order Sets (Knowledge Mgmt)
• Interactive Realtime Reference (Knowledge Mgmt)
• Anesthesia Documentation
• Remote Access
• Admin Rx
• PACS Expansion
• Patient Equipment Tracking
• Centralized Scheduling
• ASP Ambulatory Care
• ED system
• Going filmless
• RHIO
• Perinatal Care System
• OB images integration
• Physician Computer Areas

8
Portal Downtime ReductionAug 2004 thru Sept 2006
Great success achieved fixing physician primary
complaint of Portal downtime.
9
FY07 Major Initiatives
Divided By Swim Lanes Follows.
10
Acronym Index

• HED
• HPF
• HSM
• HAD
• HEO
• HAC
• HPP
• HEC
• HPC
• HBF
• HBI
• PCA
• PCON
• PHS
• Care Alerts
• Admin RX
• Series

• Horizon Expert Documentation (Nursing
  documentation)
• Horizon Patient Folder (Electronic Patient
  Records)
• Horizon Surgical Manager (Surgery Documentation)
• Horizon Anesthesia Documentation
• Horizon Expert Orders (CPOE (Computerized
  Provider Order Entry))
• Horizon Ambulatory Care (Clinic Electronic
  Patient Record)
• Horizon Practice Plus (Clinic Scheduling and
  Registration)
• Horizon Emergency Care (ED patient documentation)
• Horizon Perinatal Care
• Horizon Business Folder (Business Office
  Scanning)
• Horizon Business Insights (Clinical Reporting and
  Measures)
• Pathways Compliance Advisor
• Pathways Contract Management
• Pathways Hospital Scheduling
• Clinical Alerts, Reminders, Protocols
• Barcoded Medication Administration
• Hospital Patient Registration and Billing

11
Clinical Swim Lane
12
Admin RX

• Timeline for implementation to be decided by
  Admin RX steering committee

13
Surgical Services Initiatives

• Horizon Surgical Manager roll-out at New Hanover
  campus
• Horizon Surgical Manager v 11.1 upgrade
• Provides Clinical Integration with HED
• Provides Allergy Integration with HED
• Horizon Business Insight Upgrade

14
Horizon Ambulatory CarePlanned kick-off 6/2007,
Go-live November 2007

• Implementation timeline dependent on Integration
  with Horizon Patient Folder scheduled for v9.5.0
  release in 3rd quarter 2007
• Problems, Allergies, Medications planned for ER
  10.1 release

15
Horizon Enterprise Release 7.8Planned Date for
release Spring 2007

• This release is a pre-requisite to Horizon
  Perinatal Care
• Provides the ability to print the Medication
  Reconciliation report from Physician Portal
  v12.1(to be implemented in the future)
• Will provide fixed column and row headers in the
  Physician Portal v 12.1 flowsheet view

16
Physician Portal Build 58

• Provides the following features
• Mom/Baby Link
• Hide patients from your census (goes to inactive
  status)
• Station census will have unit plus description
• Visual indicator available in Data Monitor view
  on census page for critical/high/low/new LAB and
  RAD values
• Pull up Physician by Specialty on Locator tab

17
Horizon Expert Documentation

• Will continue to update system with quarterly
  patches
• ER 7.8 release will provide a charting link with
  Alerts so documentation will remove the alert
• Migration to new Hardware and Database structure

18
Horizon Clinical Alerts

• Delayed until May 2007
• Software fix planned for March 2007 to address
  the issue with Alerts removal after viewed by
  user. Alerts currently remain for all clinicians
  to address at every shift.

19
Horizon Anesthesia Documentation

• No integration with Physician Portal access the
  anesthesia documentation by all providers will
  not be possible unless viewed through HAD
• Requires Horizon Surgical Manager v11.1 for
  Pre-admission testing data to pass to HED for
  Medication Reconciliation across all 3 products
  HSM, HAD, HED.
• Prioritization Needed

20
Horizon Perinatal Care

• The first release of this product will be with
  the Enterprise Release level ER7.8
• Generally Available to all customers Spring 2007
• Dependency for this implementation is the
  successful completion of the ER 7.8 upgrade
• Prioritization Needed

21
Horizon Emergency Care

• Triage Documentation
• Nursing Documentation
• Discharge Documentation
• Integrated with Horizon Clinicals
• Integrated with Horizon Orders Management
  McKesson provided a retro fit to our current
  ER7.6 sp2 version
• Prioritization Needed

22
PACS

• 3.1.1 Upgrade Workflow and image processing
  enhancements
• Content Switch Load Balancing of Image Storage
• Common View Database share with Delaney
• Ortho View Ortho templating will reduce film
  printing for Ortho
• Power Scribe Upgrade Workflow enhancements
• PACS Expansion Complete OR Rollout
• Remote Access

23
Cardiology

• Heartlab Remote Access Web-based product more
  like native client
• Heartlab -Easy access to Report on Portal
• Witt Replacement Evaluation
• Heartlab Replacement???

24
LAB

• Instrument Manager Updates code for instrument
  interfaces
• Co-Path Upgrade Support expires Dec 2006 for
  current version
• Co-Path Visual Writer to Microsoft Word
  Conversion lays the groundwork for VR
• Lab 6.2 Upgrade - Support expires Dec 2006 for
  current version
• Core Lab Automation - Integration of analyzers
  with LIs through middleware automation and
  tracking application

25
Infrasctructure Swim Lane
26
Environment

• 70 IT employees
• 80 dedicated to daily maintenance
• 20 to new projects
• 86 Medical Records employees
• IT Budget - 16 million
• 7 million in annual recurring maintenance
• 300 software/hardware maintenance contracts
• Medical Records Budget 4 million

27
Environment

• 3,400 desktop laptop PCs
• 650 printers
• 300 servers
• Gigabit ethernet (sufficient)
• 13,530 typewritten pages per second
• Clinical areas wireless (11 megabits)
• Nortel phone network (5 PBXs)

28
Data Center

• Current Location Redesign Position current data
  center for future through 2010 or beyond
• PPD Location Create future disaster recovery
  center and Test Center

29
Security

• Enterprise Password Mgt Strategy Standardize
  user login format
• Identity Manager Centralized Login and Password
  Mgt
• User Assignments to Internet Ability to trace
  Internet activity by user Will require all
  users to enter login / password to access
  Internet sites

30
Misc. Infrastructure

• Remote Access CITRIX
• VMWare Server Virtualization / Consolidation
  Increase capacity / decrease footprint
• System Monitoring Vantage Realtime monitoring
  of servers and infrastructure equipment
• Software Distribution Windows Server
• Wireless Upgrade Required for Admin Rx
• Blade PC Conversion

31
Disaster Recovery

• Business Impact Analysis Refresh
• Disaster Recovery Planning
• Enterprise Storage Replication
• Enterprise Storage Upgrade
• TSM Tape Storage Upgrade

32
Communications

• SwitchBoard Automation
• VideoConferencing to Cape Fear
• Vocera OR, ASU, PACU

33
Performance Stats

• 67 projects completed
• 68 projects carried over
• 40,353 help desk tickets closed.
• 155 per business day
• 36,741 tickets opened
• 141 per business day
• 35 per person per day

34
Business / Admin Swim Lane
35
New AgeAlerts, Core Measures

• Alerts
• Phase I (No dependencies work with New Age to
  abstract Care Manager data planned for late Feb
  07 go-live)
• Phase II (Dependent on the Care Manager Alerts
  availability from McKesson tentative kickoff in
  May 07)
• Core Measures
• Planning stages (Need to look into Midas CPMS
  functionality and align requirements/goals)

36
New AgeBed Control Phase II

• Are in planning stages currently (Working with
  David Long to determine project team)
• ED/PACU waiting Q, Pending transfer, Rapid Admit
  Discovery for ADT people process
• Transport module in early discussions
• Go-live planned for June 07

37
Lawson EnvironmentLBI 9.0, LSF 9.0

• LBI 9.0
• Lawson Business Intelligence (Upgrade to
  eBroadcast, SmartNotes, and Lawson reporting
  services)
• Kickoff in Feb 07 with completion late May 07
• Need funding (approx 120K)
• LSF 9.0 Lawson Environment
• Dependent on LBI 9.0
• Tentative dates are Jan 08 May 08
• Lawson to decommission 8.0.3 environment in July
  08 (support will no longer be available)
• Will require new hardware and web services
• Will allow security restructuring (reduction of
  logins per user)

38
Lawson ApplicationsMSS, Absence Mgmt, 9.0
Upgrade

• MSS Manager Self Service
• Training in December with go-live Jan. 8, 2007
• Automation of Personnel actions and Labor reqs
• To include remote access for managers, directors,
  VPs
• Position Manager Integration Jan Mar 07
  (once funding source is determined)
• Absence Mgmt
• Kickoff in March 07 with go-live late June 07
  pending agreement with HR and Payroll
• Lawson 9.0 Apps Upgrade
• Dependent on LBI 9.0 LSF 9.0 completion
• Kickoff planned for Dec 08 with completion in
  Apr 09

39
AvegaADS, AFM, DecisionPoint, KPI

• Major upgrade to Avega system combining ADS AFM
  databases
• Migration to Linux available
• Planned kickoff in Nov 07 with go-live in late
  March 08 (coordinate with Business Analysis
  Planning and Fiscal Services)
• Key Performance Indicators Need to develop
  strategy for dashboards (HBI, Lawson,
  DecisionPoint)

40
Patient Financial Services

• Imaging Link Engine
• Patient documents can be captured at registration
  and automatically indexed to the patients record,
  eliminating the risk of being misplaced and
  ensuring they are available when needed
• Integration with your HIS ensures the security of
  protected health information
• Billing and collections personnel can view source
  documents and financial information online
• Allows for electronic capture of patient
  signature at time of registration
• Roll out to begin Dec 5 2006 Jan 2007

41
Patient Financial Services

• PCON Upgrade Jun Aug 07
• Need to upgrade from V10.0 to V12.0 prior to
  Denials Appeals
• PCON Denials Appeals Sept Dec 07
• Boost revenue recovery by efficiently
  identifying, tracking and managing denied claims
• Improve processes and monitor payors based on
  executive reports
• Provide a centralized repository of denial
  information, making the necessary claim detail
  readily available to support communication with
  payors during the recovery process
• Reduce collection timeframes by working within
  your receivables management system to prioritize
  recovery efforts and track appeal status

42
Patient Financial Services

• Series 12.0 Upgrade Jul Nov 07
• Horizon Business Folder Dec Mar 08
• Minimizes self-pay bad debt write-offs and
  improves patient satisfaction by enabling an
  accurate review of financial responsibility
  before service is delivered
• Improves business office productivity by reducing
  the labor expense needed to support a paper-based
  claim system
• Reduces the document materials and storage
  expenses generated from a manual, paper-based
  claim system  

43
NursingAnsos, Optio, Discharge Call Manager

• Ansos Upgrade to include Bid-a-Shift
  functionality. Also referred to as eShift.
• Ansos/Payroll Integration Prior to nursing
  using the shift bidding features, IS will need to
  work with Payroll to define and develop this
  interface
• Optio Housewise rollout FY07 capital to replace
  all PT650 label printers with Optio printers.
  Nursing will have the capability to reprint
  labels through Series/IBAX and have them print on
  a Laser printer.
• Discharge Call Manager Inpatient satisfaction
  team driving continuing rollout of this Studer
  product. IS working in a technical support and
  security role only.

44
Food Nutrition - CBORD

• Credit card module Allows patients and families
  to use credit cards in Kona and cafeteria (March
  April 07)
• CBORD Upgrade May August 07
• Room Service Cape Fear
• Roll-out to coincide with reconstruction of Cape
  Fear cafeteria (July Oct 07)
• Room Service New Hanover
• Roll-out to coincide with tower reconstruction

45
Food Nutrition - CBORD

• Other Projects (FY07 FY08)
• TempTrak monitoring system
• NetNutrition module
• Tube Feeding module
• Dates to be determined

46
Financial Swim Lane
47
Financial

• Documentation Integrity Process Improvement
  Navigant engagement
• PCA(Claims Admin)/EC2000 V12.0 Upgrade Jan
  Mar 07
• UB-04 bill form effective Apr 07 (will replace
  UB-92)
• Regulatory updates will be required in Series for
  UB-04

48
Organizational Initiative Swim Lane
49
Organizational

• Equipment Construction on Hwy 17
• Equipment WOG Building
• Pender IS Support
• Transcription Joint Venture NH Pitt Memorial
• PACS Partner Integration (Dosher, Pender,
  Physician practices, Clinics, etc.)

50
Construction Swim Lane
51
Construction

• PPD Move
• Cape Fear

52
END