Developing Criteria For

1. Eastern Medical Center Developing Criteria For Selecting a Final Vendor to Deliver the IC Product and Service

2. Background – Why EMC is in the Process of Choosing an Infection Control Vendor

3. Will the new IC process will impact the work flowin cross department areas surgery and ICU ?

4. Improving Patient Care and Reimbursements The Center for Disease Control approximates that two million hospital patients each year contract infections unconnected to the conditions for which they were admitted. These infections cause roughly 90 thousand deaths and escalate patient-care costs by 4.5 to 5.7 billion annually.

5. Evaluating Infection Control Vendors for EMC EMC has reached the final stages of evaluating and selecting a Infection control vendor

6. The Political Environment and Change Management

7. Political Drivers to Reduce HAIs at EMC • CMS • National Patient Safety Goals (NPSG)/Joint Commission • CDC/National Healthcare Safety Network (NHSN) • Health Care-Associated Infection Prevention and Control Act 52 of 2007 • HHS Action Plan for HAI Prevention • The American Recovery and Reinvestment Act (ARRA) • Pennsylvania Health Care Cost Containment Council (PHC4)

8. The Successful Vendor’s Software Must • Assist in the detection and prevention of infections • Have systems in place to provide timely infection control surveillance and reporting. • Be CDC NHSN data submission ready as well as allow for data submission to state and payer mandated programs.

9. Change Management Plan • The Project Manager will be responsible for supervising the change management process. • Minor changes within scope can be approved by the Project Manager. • Any change affecting an external contractor/sub-contractor would need to be reviewed with that contractor in regards to any necessary contract revisions and/or payments, etc. • Changes of scope and contract revisions would require the approval of the ICI Change Control Board).

10. Change Management Plan…continued • The decision whether to accept or reject a change would be based on the following criteria: • Is the change unavoidable (i.e. legislative changes, mergers, acquisitions, etc)? or • Does the change increase the overall benefit to our organization (taking into account any impact on the costs, benefits, timescales and risks)? Additionally,   • Is the Project Team able to make such a change?...and • Is the change best done now, or would it be more beneficial to defer it until the current work is complete?

11. Vendor Response, Analysis, Evaluation and Ranking

12. Response Analysis • 2 separate rating systems • Vendor Evaluation • Vendor Ranking • Reduced likelihood of blanket answers • Delphi Method • Anonymous responses from EMC participants • Averaged together

13. RFP Responses 7 Vendors were approached with a RFP 2 Vendors Declined • Premier • RL Solutions 5 Vendors Completed a RFP • VecnaMedical • Quantros • Theradoc • BD • CareFusion

14. Vendor Evaluation

15. Vendor Ranking

16. Estimated Budgets and Costs For the Implementation

17. Preliminary Budget Estimates and Other Costs Associated with the Implementation • Annual Subscription Fee: $150 X 300 licenses beds = $40,000 (Includes unlimited seats and support)  • Implementation Fees:  $15,000  •  Interfaces -$25,000 • ADT • Lab • Pharmacy • Surgery

18. Preliminary Budget Estimates and Other Costs Associated with the Implementation • 1 - 5 year cost estimates  • 1st Year Costs: $80,000  • Year 2 - 5: $40,000

19. The Role Each of The Constituencies had in The Decision • Clinical (ICP) : Evaluation of each vendor response,  • participation in onsite visits and reference calls  • participation in vendor demos  • make recommendation of best fit based on clinical needs 

20. The Role Each of The Constituencies had in The Decision  • IT - Evaluation of each vendor response • review of IT requirements and interface specs • Review of support agreement • participation in demo and reference calls • provide recommendations for best vendor fit based on IT requirements and resources needed

21. The Role Each of The Constituencies had in The Decision  • Finance -review of responses to pricing  • determination of operating versus capital budget • review of Return on Investment from the vendor • Recommend best vendor fit based on pricing and payment methods (monthly versus annual) 

22. The Role Each of The Constituencies had in The Decision • Legal -review RFP responses and provide guidance prior to contract negotiation

23. The Role of Acceptance Testing 

24. Technical Considerations • No EMR • Interface with EMC’s: • Sunquest Laboratory (Lab/Microbiology) • WindoPath (Pathology) • ORSOS One-Call (Surgery) • Meditech Pharmacy • Meditech ADT • Software as a Service (SaaS)

25. Technical Considerations • Data • Systems • Type • Devices • Testing and Validation • Implementation

26. Vendor Size Consideration • Explosion of Customer Base • Appropriate staff availability • Implementation Resources to Support • Desire Large Partner • Niche Specific • Comprehensive division of Large Vendor

27. The Role of Acceptance Testing  • Assess software with respect to requirements • We will require acceptance testing and withhold 25% of the payment until we sign off on acceptance testing. • How? • Process for acceptance testing • Installation testing • Interface testing • Component/Module Testing • Final System testing • Time commitment • Resources needed • Test script • Key areas of information updates

28. The Role of Acceptance Testing  • When? • After test environment is set up and clinical signoff • Part of the test environment or live environment • Unacceptable results during acceptance testing? • Preliminary result vs final result updates, resistance and sensitivity testing on antibiotics • Does not dovetail precisely with the infection control processes • Makes processes more difficult to do than before • Causes infection control processes to take longer than previously • Makes additional infection control processes necessary, while making other processes obsolete

29. Our Final Infection Control Vendor Selection

30. EMC Choose 2 Finalists

31. The Featured Benefits of Quantros IC Insight Rules based engine ……….. Issue smart alerts ………….. Fast implementation ………… “Always On” surveillance …… Provide secure data access … Easy to use, with access to more than 1,000 rules, via the community library Minimize alert fatigue, ensure active relevance Quickly up and running in a comprehensive medication surveillance system Transparently monitors 24/7 to ensure medication safety at all times A HIPAA compliant secure SSL, Point-to Point system ensures secure data transfer

32. Centralized Dashboard Presenting Suspected Cases From One Intuitive Screen • http://www.quantros.com./pdf/QTS-SS-ICInsight.pdf

33. Cardinal MedMined • Has a solution feature that sends the hospital data off-site to be compiled and analyzed by Cardinal’s epidemiologists. This analysis implements a form of quality control, training and guidelines set by Cardinal’s epidemiologist instead of the hospital Infection Control Practioners.

34. Quantros IC Insight was EMC’s Final Selection • It uses a list of rules as defined by the hospital to look for variances by using this feature departmental variances and conflicts can be diminished. • This will improved infection workflow management • The clinicians will be empowered to anticipate, identify and prevent infections. This will ensure adherence to best practices. •  Dashboard feature present’s monitoring suspected cases on screen.

35. Was The Least Costly Vendor Chosen ? • EMC’s Vendor Choice was not based on the Least costly Vendor, it was based on two things specifically. • The Hospital’s desire to control it’s own work flow and data and use. • To ensure best practices and workflow through the use EMC rules via the Quantros rules based engine feature.

36. Reasons for Vendor Rejection: • Implementation/Interface issues • Product was not easy to use • Product support/training options did not meet the needs of our staff • Poor value for the money • Conflict of Interest • Vendor references indicated frequent unscheduled downtimes • Product features did not meet our immediate or future needs

37. Questions

38. Resources • KLAS Report Infection Control: Improving Patient Care and Reimbursements • Released 06/08/2009 tp://www.klasresearch.com/store/reportdetail.aspx?productid=537 • http://www.cdc.gov/hai/recoveryact • The American Recovery and Reinvestment Act of 2009, Public Law 111-5 (ARRA) was signed into law on February 17, 2009. • https://www.cfda.gov/index?s=program&mode=form&tab=step1&id=ea9ba8ca3284e93605ab0865d2034c33 • Joint commission • Quantros web • Carefusion http://www.carefusion.com/products-and-services/products-services-categories/infection-prevention/medmined-benchmarking.aspx • Quantros IC Insight™ http://www.quantros.com./pdf/QTS-SS-ICInsight.pdf