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New Hanover Regional Medical Center

New Hanover Regional Medical Center. 2007 IS Business Plan Review October 2006 – September 2007. Governance. CEO. Information Systems Steering Committee. Technology Requests. Avery Cloud Ed Ollie Mary Ellen Bonczek Donna Bost Sam Spicer John Gizdic Keith Strawn.

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New Hanover Regional Medical Center

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  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 skillfuluse 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. 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 Acronym Index

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

  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 PC’s • 650 printers • 300+ servers • Gigabit ethernet (sufficient) • 13,530 typewritten pages per second • Clinical areas wireless (11 megabits) • Nortel phone network (5 PBX’s)

  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

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