Common Sense Strategies for Uncommon Times. Presented by: Tim Tindle, Executive Vice President & Chief Information Officer

Transcription

1 Common Sense Strategies for Uncommon Times Presented by: Tim Tindle, Executive Vice President & Chief Information Officer

2 What Will We Cover Today? Overview of Harris Health Our Transformational Journey Managing Leadership s expectations during a time of transformational change Shifted dollars from Running / Supporting the business to Growing or Transforming the business Meeting Ever Increasing Support Needs

3 HARRIS HEALTH SYSTEM OVERVIEW

4 Harris Health System Overview Harris Health is the safety net health system for Harris County, Texas. (Houston, TX) Population: 4,180,894 (2011) 3rd most populous in U.S million uninsured harrishealth.org 4

5 Caring for Harris County, Texas (Houston) Primary teaching hospitals and clinics Baylor College of Medicine UTHealth Our workforce 8,500 employees Physicians & Students $1.3 billion annual budget harrishealth.org 5

6 Harris Health Overview Three Hospitals 964 licensed beds Level 1 Trauma Center Level 3 Trauma Center 182,099 Total Emergency Room Visits 38,634 Total Inpatient Discharges 40+ Ambulatory Locations 1,950,472 Total Outpatient Visits harrishealth.org 6

7 The Patients We Serve (FY-15)* Payer Mix % By Source Charity and Self Pay 63.6% Medicaid / CHIP 20.7% Medicare 9.5% Commercial / Other 6.2% *Source: FY2014 Financial Report harrishealth.org 7

8 How We Are Funded (FY-15) Payer Source % Revenue Amount ($Millions) Property Tax 44.9% $574.3 Net Patient Services 28.6% $365.6 DSH / Uncompensated Care 18.4% $235.8 Other Revenue 8.2% $105.0 Total Revenue 100% $1,280.0 harrishealth.org 8

9 Harris Health System Our Transformational Journey harrishealth.org 9

10 Healthcare Industry Undergoing Transformation Electronic Health Records Meaningful Use Interoperability Analytics ACOs Pay for performance ICD-10 Population Health Disease Management harrishealth.org 10

11 Harris Health IT Governance Structure Board Technology Committee IT Executive Committee (C-Suite, EVPs, & Medical Schools) Division (Hospital / Ambulatory / Admin) Service Lines (Hospital / Ambulatory / Admin) Board ITEC Division Service Lines harrishealth.org 11

12 Guiding Principles for IT Strategic Plan Integration vs Best of Breed Buy vs Build: Software / Systems Solutions Must Conform to Infrastructure Standards Internal Cloud harrishealth.org 12

13 Guiding Principles for IT Strategic Plan All New Services Require Business Case Implementation Costs (HW, SW, Services) Ongoing Costs (Staff, HW / SW Maintenance) Return On Investment (5 Year) Hard Benefits with Assigned Accountability Increased Revenue Decreased Cost Quality Impact Compliance Governance Review / Approval harrishealth.org 13

14 IT Enterprise Platform Epic Enterprise Ambulatory, Inpatient EHR, Ancillary Revenue Cycle Live PeopleSoft ERP Financials, Supply Chain, HR Business Intelligence (Analytics) SAP Business Objects Epic Cogito harrishealth.org 14

15 Medical Records Before Primary Care Locations Same Day Clinic Locations Specialty Locations Hospitals harrishealth.org 15

16 EHR Vision Single electronic health record across continuum of care. Single source of truth Primary, Specialty, Acute, EC, Sub-Acute Available across our system Used by all! Facilitate & coordinate access to care Leverage analytics to managing the health of our community and for process improvement harrishealth.org 16

17 Harris Health EHR Implementation Our Journey Multi-phased, highly integrated approach Phase 4 Phase 1 Go-Live: Ambulatory EHR Full CPOE / Clinical Documentation harrishealth.org 17

18 Harris Health EHR Implementation Our Journey Multi-phased, highly integrated approach Phase 1 Phase 2 Go-Live: Ambulatory EHR Full CPOE / Clinical Documentation Go-Live: 2009 Enterprise Scheduling Registration ADT Revenue Cycle Bio Patient ID harrishealth.org 18

19 Harris Health EHR Implementation Our Journey Multi-phased, highly integrated approach Phase 3 Phase 1 Go-Live: Ambulatory EHR Full CPOE / Clinical Documentation Phase 2 Go-Live: 2009 Enterprise Scheduling Registration ADT Revenue Cycle Bio Patient ID Go-Live: 2010 Inpatient EHR Full CPOE / Clinical Documentation harrishealth.org 19

20 Harris Health EHR Implementation Our Journey Multi-phased, highly integrated approach Phase 3 Phase 4 Phase 2 Phase 1 Go-Live: 2009 Go-Live: 2010 Go-Live: Go-Live: Ambulatory EHR Full CPOE / Clinical Documentation Enterprise Scheduling Registration ADT Revenue Cycle Inpatient EHR Full CPOE / Clinical Documentation Analytics / EDW Clinical Operations Costs Quality Bio Patient ID harrishealth.org 20

21 Managing the Board s and Sr. Leadership s expectations during a time of transformational change that s driving dramatic increases in IT investment. MANAGING EXPECTATIONS harrishealth.org 21

22 Managing Expectations Huge increases in IT investments Combined Operating and capital budgets reaching between 5-6% of provider organization's budget Boards, CEOs & Sr. Leaders are Asking: What is a Reasonable IT Spend? harrishealth.org 22

23 Managing Expectations Benchmarking resources Vendor Benchmarking (EPIC, PeopleSoft..) Gartner Key Metrics Gartner Benchmarking Service IT Governance: Review and Educate CEO & Leadership (ITEC) Board Information Technology Committee harrishealth.org 23

24 What is a Reasonable? Harris Health Benchmarking Efforts Areas Benchmarked Budgets, Staffing and Process Maturity Benchmark comparison groups Peer based Workload based Industry Key Metrics harrishealth.org 24

25 harrishealth.org 25

26

27

28

29

30

31 Benchmarking Benefits Objective Transparent External experts Demonstrate good fiscal stewardship Provides a basis for decision making harrishealth.org 31

32 DID WE GET OUR MONEYS WORTH? harrishealth.org 32

33 Benefit Realization Benchmarking Hospitals & Health Networks Awards Health Care's Most Wired (2011, 2012, 2013, 2014, 2015) Innovation Award for Supply Chain HIMSS Analytics Stage 6 Hospitals (2011, 2012, 2013, 2014, 2015) Ambulatory (2012, 2013, 2014, 2015) (2nd in Nation) GHX Best 50 Healthcare Supply Chain Automation Named Emdeon s #1 Clean Claim Customer harrishealth.org 33

34 ROI Management & Reporting Epic: Projected Economic Benefit Clinical and Business Program Cost Estimate $72 Million Estimated Economic Benefit (5 Yr Est.) Increase Net Patient Revenue : $310 Million (+36%) Meaningful use: $19.0 Grant: $600k (ARRA Homeless EMR) Current 5 Year Estimated ROI $329.6 Million (FY-10 thru FY-15) harrishealth.org 34

35 Additional ROI Leveraging Epic, Harris Health continuously improved overall productivity and utilization Holding the increase in cost per adjusted patient day to only 3.1% over 5 years harrishealth.org 35

36 After massive capital investments Implementing IT Systems, support and maintenance costs are skyrocketing. SHIFTING IT SUPPORT DOLLARS TO GROW AND TRANSFORMING DOLLARS harrishealth.org 36

37 Support and Maintenance Cost Almost one third of the IT Budget is spent on Hardware and Software Maintenance The vast majority of salaries are spent supporting existing application functionality External Cloud solutions chew up operating dollars and typically cost more than an internal Cloud harrishealth.org 37

38 Standardization: Creating Your Own Cloud Integrated Enterprise Applications Strategy Epic Enterprise PeopleSoft Suite (HR, finance and supply chain) SAP Business Objects (Analytics) More time delivering enhanced functionality Vs. managing interoperability issues between large numbers of systems harrishealth.org 38

39 Lower Desktop Infrastructure Costs Desktop Standards SSDs extend life Use of Citrix minimizes performance issues Refresh in 7th year Utilization of Thin Clients (~25%) Very low cost and very long life Automated imaging and application provisioning Remote support / Advanced Help Desk harrishealth.org 39

40 Standardization: Lower Data Center Infrastructure Cost Standardization / Consolidation / Virtualization 90% Servers (~1000) Network Converged Platforms (Simplify) IBM Pure Flex HP Enterprise Licensee Agreements Cisco, Oracle, Automation harrishealth.org 40

41 Infrastructure Consolidation New IBM Tape Library (1 cabinet, 2 feet wide) Existing IBM Tape Library (14 feet long) harrishealth.org 41

42 Wintel Platform Legacy Wintel Environment (many individual commodity servers) New Wintel Environment (leveraging blade enclosures and virtualization) harrishealth.org 42

43 Unix Platform New AIX Environment IBM Pure/Flex Blade Enclosure Legacy AIX Environment (EPIC, ERP in multiple cabinets) GROWTH GROWTH GROWTH GROWTH GROWTH GROWTH GROWTH GROWTH harrishealth.org 43

44 Infrastructure Cost Reduction Old Data Center 6000 Sq. Ft. 64 Racks New Environment 10 Racks in Co-Location Space Savings Space, Power, Personnel SW / HW Cost SW / HW Maintenance Cost harrishealth.org 44

45 harrishealth.org 45

46 Meeting Ever Increasing Support Needs As the organization s reliance on Information Technology increases, support expectations change and are generally higher than before. IT SERVICE MANAGEMENT harrishealth.org 46

47 IT Service Management Establishing Value Defined Our Services What Information Systems assists are covered What services do we provide Service Level Agreements (SLAs) Turnaround time commitment by service PC break fix = 4 hours time to repair Simple Report = 5 business days Medium system enhancement = Governance assigned release cycle Ongoing Service Level Negotiation Changes in funding = Change In Service Level Measure and Report Performance Actual vs SLA Customer Satisfaction harrishealth.org 47

48 SLA Performance 12 Months Ending July 2014 harrishealth.org 48

49 Customer Surveys Received Performance 12 Months Ending July 2014 harrishealth.org 49

50 Overall Satisfaction Created: 15-Jul :38 PM harrishealth.org 50

51 Questions?