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New Hanover Regional Medical Center


New Hanover Regional Medical Center 2007 IS Business Plan Review October 2006 September 2007 Governance Business Goals Highest quality & safest medical practice ... – PowerPoint PPT presentation

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Title: New Hanover Regional Medical Center

New Hanover Regional Medical Center
  • 2007
  • IS Business Plan Review
  • October 2006 September 2007

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

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

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
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
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
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

Portal Downtime Reduction Aug 2004 thru Sept 2006
Great success achieved fixing physician primary
complaint of Portal downtime.
FY07 Major Initiatives
Divided By Swim Lanes Follows.
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
  • Horizon Patient Folder (Electronic Patient
  • 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
  • Horizon Emergency Care (ED patient documentation)
  • Horizon Perinatal Care
  • Horizon Business Folder (Business Office
  • Horizon Business Insights (Clinical Reporting and
  • Pathways Compliance Advisor
  • Pathways Contract Management
  • Pathways Hospital Scheduling
  • Clinical Alerts, Reminders, Protocols
  • Barcoded Medication Administration
  • Hospital Patient Registration and Billing

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

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

Horizon Ambulatory Care Planned 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

Horizon Enterprise Release 7.8 Planned 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

Physician Portal Build 58
  • Provides the following features
  • Mom/Baby Link
  • Hide patients from your census (goes to inactive
  • 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

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

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.

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

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

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

  • 3.1.1 Upgrade Workflow and image processing
  • 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

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

  • Instrument Manager Updates code for instrument
  • 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

Infrasctructure Swim Lane
  • 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

  • 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)

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

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

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

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

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

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

Business / Admin Swim Lane
New Age Alerts, 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)

New Age Bed 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

Lawson Environment LBI 9.0, LSF 9.0
  • LBI 9.0
  • Lawson Business Intelligence (Upgrade to
    eBroadcast, SmartNotes, and Lawson reporting
  • 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)

Lawson Applications MSS, Absence Mgmt, 9.0
  • 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,
  • 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

Avega ADS, AFM, DecisionPoint, KPI
  • Major upgrade to Avega system combining ADS AFM
  • 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,

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

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

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  

Nursing Ansos, 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
  • 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.

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

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

Financial Swim Lane
  • 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
  • Regulatory updates will be required in Series for

Organizational Initiative Swim Lane
  • 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.)

Construction Swim Lane
  • PPD Move
  • Cape Fear