One Size Fits All? Enterprise vs. Best of Breed Systems

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One Size Fits All?Enterprise vs. Best of Breed
Systems

• Todd Rothenhaus, MD FACEP

Chief Medical Information Officer Caritas Christi
Health Care System Attending Emergency
Physician St. Elizabeths Medical Center,
Boston Co-chair, Emergency Care Special Interest
Group Health Level 7 Co-chair, Emergency Care
Special Interest Group Health Level 7
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EDIS Evaluation and Selection

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Hospital Vendor Strategies

• Single vendor strategy
• Core vendor strategy
• Best of Suite
• Best of Cluster
• Best of Breed
• 165 systems ? less than 100

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Vendor Selection

• Selection process is a collaborative process
• ED is better at determining
• How system will integrate with workflow
• Impact on efficiency and flow
• Potential Revenue increase
• IT is better at determining
• Vendor health
• System design and maintainability
• Long term costs
• Neither is perfect at predicting ROI
• Consider consultancy to help with selection
• Listen to each other

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ROI and TCO

• Clinical documentation ? charge capture
• Patient throughput and LWOBS
• Be wary of huge claims
• Initial Capital expense
• Implementation costs
• Local expertise
• Consultancy

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The EDs Place in the HIS Queue
CPOE
Clinical Applications
Nursing Doc
eMAR
Order Entry (Clerical)
Document Management Scanning
EMR (Results Reporting)
Core Applications
Radiology Information System
Pharmacy
Lab
Pathology
Billing/ Accounts Receivable
Scheduling
Registration/ Admissions
General Finance
Materials Management
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It wont be integrated

• Common myth
• Self fulfilling prophecy
• Lack of integration duplicate data entry
• Amount of critical legacy data in HIS
• Pharmacy
• Order Entry

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The Three Is

• Integration desirable state of affairs where
  information flows between systems
• Interfaces a mechanism to achieve integration
• Interoperability the ability of a systems
  exchange data

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Integration
HIS System Or CDR
Registration
EDIS
Physicians Offices
Radiology Results
Hospital Pharmacy
Lab Results
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Integration
RHIO
EMS
HIS System Or CDR
Registration
EDIS
Physicians Offices
Radiology Results
Hospital Pharmacy
Lab Results
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Other Considerations

• Customization
• Time to deployment
• Easy win small project
• Non-integrated, single vendor

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Answers vs. Solutions

• No perfect answer
• Pilot HIS Tracking Module
• Consider plug in Physician Clinical
  Documentation Product with ADT and Inbound Labs