ME-PI Executive Dashboard Webinar Executive Dashboard Webinar 103 March 27, 2009
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1 ME-PI Executive Dashboard Webinar Executive Dashboard Webinar 103 March 27, 2009 Listen Hands-free. You may listen over your computer speakers or headphones. There is no dialing-in required! You may ask questions at any time using the Q&A interface.
2 Welcome to the Webinar! Welcome to the third of four ME-PI Executive Dashboard Webinars Future Webinars 104 Case Studies with Vendor Q & A June 12, 2009 Moderator: Cindy McKinney, IBM, FHIMSS Chair ME-PI Executive Dashboard Workgroup Focus: Identification of key operational needs within the area of executive dashboard, metrics, and data warehouses to develop white papers and education materials for open dissemination. HIMSS ME-PI Executive Dashboard Workgroup Workshop 2
3 What is ME-PI? Professionals with an interest in applying engineering principles to streamline business processes and practices in healthcare. We focus on educating and informing members of the latest topics, tools, and best practices for improving healthcare performance. HIMSS ME-PI Executive Dashboard Workgroup Workshop 3
4 HIMSS Management Engineering and Process Improvement Community Open to HIMSS Membership The ME-PI Community provides a unique opportunity for professionals to network on the focused topic of management engineering and process improvement within the healthcare information technology environment. Chair: Jim Langabeer Co-Chair: Kim Brant-Lucich Meets the 1 st Friday of the month, Noon-1pm EST, via WebEx for Networking and Education Contact: Juanita Threat at jthreat@himss.org HIMSS ME-PI Executive Dashboard Workgroup Workshop 4
5 Executive Dashboard Workgroup We identify key operational needs within the area of executive dashboard, metrics, and data warehouses to develop white papers and education materials for open dissemination. Chair: Cindy McKinney, MBA, FHIMSS HIMSS ME-PI Executive Dashboard Workgroup Workshop 5
6 Introduction of Speakers Karen Fairchild, President and CEO of Fairchild Consulting Inc, is an accomplished IT Technologist and Executive with over 20 years experience in strategic planning and development of healthcare technology solutions for providers and payers. Her EMR experience spans from her design of one of the industry s first EMRs in 1989 through today s interoperable Electronic Health Records and Health Information Exchanges. She also works with clients on Clinical Analytics in community health exchanges. Her areas of expertise include Strategic Technology Planning, Enterprise Architecture, Solutions Development and Execution, Operational Architecture, Business Intelligence and Vendor Evaluations. She is actively involved with the NY ehealth Collaborative (NYeC) EHR Collaborative work group and with HIMSS. HIMSS ME-PI Executive Dashboard Workgroup Workshop 6
7 Introduction of Speakers Henry Tenarvitz is the Chief Intellectual Property Officer of Versus Technology. Versus is well known for their innovative use of active RFID-IR for automating clinical operations over the past 15 years. A graduate of Michigan State University, Henry also has experience with manufacturing process automation systems in the automotive and aerospace industries. Mr. Tenarvitz now helps design patient flow automation systems for Emergency Departments and Outpatient Clinics throughout North America and Europe. Mr. Tenarvitz is a member of the HIMSS ME-PI, RFID SIG, UL 1069 Standards Technical Panel, and MS-HUG. HIMSS ME-PI Executive Dashboard Workgroup Workshop 7
8 Today s Objectives Understanding of what steps need to be taken in order to ensure the integrity of Executive Dashboard data Identifying aspects to consider in dashboard development Insight into the implementation process Identifying how feedback can be obtained on the value and utility of the Executive dashboard, once implemented HIMSS ME-PI Executive Dashboard Workgroup Workshop 8
9 Implementation Process An iterative lifecycle approach for Dashboard Development Life Cycle (DDLC) Initiate Governance, Resources, Strategies Design Business & Technical Solutions, Training & Testing Build/Construct Data Access, Tools, Training, Test Cases Test Training, Test System, Test Operations Conduct Pilot, Rollout Dashboard(s) Monitor, Evaluate Feedback, Next Iteration HIMSS ME-PI Executive Dashboard Workgroup Workshop 9
10 Project Initiation Set up governance to include decision making boards, change control, etc. Get project management, resources, infrastructures and strategies defined Assure all contracts are executed. Define roles and responsibilities for all project team members including any vendors, practice IT staff, clinicians, and other business participants. Schedule regular, timely progress reviews. Order, procure, stand-up infrastructure for test & production environments Establish Test Plan Strategy. Important to do this at the start of implementation. Establish rollout strategy including pilots, how much to roll out at a time HIMSS ME-PI Executive Dashboard Workgroup Workshop 10
11 Design Phase: Business Solution Design Business Solution: Identify the target audience (address executives, managers, clinicians likely multiple views needed) Potential key performance indicators Assure dashboard results are actionable (otherwise, why are you measuring them) Address workflow considerations and training needs Presentation should be intuitive and utilize data visualizations in a graphical presentation HIMSS ME-PI Executive Dashboard Workgroup Workshop 11
12 Design Phase: Technical Solution Design Technical Solution: Design Data Architecture Do you have data to support the KPIs you determined in the business design? Determine how often raw data needs to be collected, sampled or merged Design data integrity approach for aggregated data from different systems Design considerations for completeness and validity of the data so that it is statistically significant Consider algorithms that may need to be applied to transform data Design Dashboard Display Usability for targeted users Design standards Evaluate software/hardware for dashboard solution (clients & server) Design Operational Aspects SLAs, Policies, Procedures for Operations Backup/Recovery Strategies FRR01 :Intel Frame Relay Router +Internet : Ethernet Adaptor HOES01 :Ethernet Switched Hub DMZ Web Serv er :Dell PowerEdge 2650 «pc server» RAM = 2 x 1024 MB Processor = 2 x 2.8 GHZ Di sks = 4 x 80 GB Disk Controller = RAID 5 +DMZ : Ethernet Adaptor WebDataServer :Dell PowerEdge 6650 HOFW :WatchGuard «pc server» RAM = 1024 Mb P 30GH HIMSS ME-PI Executive Dashboard Workgroup Workshop 12
13 Design Phase: Testing Design Test Strategy May need to design test data to use for testing solution Considerations for data refreshes during testing this involves a lot of data that needs to be designed for Test cases for each view: personalized views for different users with KPIs most relevant to role Test cases for enterprise perspective HIMSS ME-PI Executive Dashboard Workgroup Workshop 13
14 Build Phase Develop mechanisms for getting the data from the sources (systems, paper, etc.) Set up selected ETL tools and other 3 rd party specialty tools (SAP/Crystal/BO, etc.) Build training materials Build operational schedules HIMSS ME-PI Executive Dashboard Workgroup Workshop 14
15 Test Phase Ensure all the tools work to get accurate results Ensure the updated workflow processes work with the new dashboard Ensure operational aspects work including operational procedures, backups/recoveries HIMSS ME-PI Executive Dashboard Workgroup Workshop 15
16 Rollout Phase Conduct training and begin production use Good practice is to start with a small pilot Rollout to larger groups after pilot has completed and you make any identified adjustments to solution, training, and/or operations procedures HIMSS ME-PI Executive Dashboard Workgroup Workshop 16
17 Monitor Phase Review and monitor the dashboard Check to see if the results are actionable Validate that the workflow continues to work with the dashboard Measure and trend data from dashboard evaluate impact on organization. Assess whether there other KPIs that need to be measured HIMSS ME-PI Executive Dashboard Workgroup Workshop 17
18 Outpatient Urology Clinic Patient Flow CASE STUDY Henry Tenarvitz HIMSS ME-PI Executive Dashboard Workgroup Workshop 18
19 Defining Objectives Urologists Needs: Treat More Patients Per Day Operate Effectively In An 8-5 Environment Patients Needs: Consistently Receive Safe, Effective Care Have Appointment Start And End On Time Have Good Experience Facility Needs: Operate Expansive New Clinic Update Manual Flags-Tags-Lights Operation HIMSS ME-PI Executive Dashboard Workgroup Workshop 19
20 Solution: Control Patient Flow Critical Path Define Milestone Indicators: Care Delivery Steps Common To All Patients For Each Patient Treated: Record Actual Milestone Data In Real-time Periodically Refresh, Deliver and Act on Indicators: Compile Each Milestones Data For All Patients Push Indicators Targeted by Stakeholder Desire Outcome: Defining Objectives Empower Stakeholder to Continually Improve Process High Quality, Safe Care Delivered More Quickly Patients Satisfied By Short, Safe And Effective Visit ROI Emerges As A Byproduct Of Process Improvement HIMSS ME-PI Executive Dashboard Workgroup Workshop 20
21 Design Obtain Desired Clinical Best Practice Review Regulatory Required Documentation Joint Commission LD3.15 Leadership Directive Requires: Detail of current Flow Plan To Improve Evidence Of Leadership And Clinical Responsibility Graphically Map Process Designed Data Architecture Designed Training Designed Multiple Stakeholder Views HIMSS ME-PI Executive Dashboard Workgroup Workshop 21
22 Outpatient Milestone Graphic HIMSS ME-PI Executive Dashboard Workgroup Workshop 22
23 Design Key Elements of Individual Milestone Design Activities Associated With Milestone Progress Timing, Associated activities (Tests, Consults) Notifications, Escalations and Messages Executed at Start, Timeout or Completion Examples: Start, Time-out: Notify All Stakeholders For This Milestone Completion: Record Data, Execute Next Alert Unit Manager HIMSS ME-PI Executive Dashboard Workgroup Workshop 23
24 Design Additional design considerations included: Critical path milestones to data source View(s) for each stakeholder Triggers that act upon milestone completion Refresh individual stakeholder views Automate mundane and repetitive chores Act on lagging milestones by: Automatically mitigating problem(s) if possible Notify if corrective action taken OR required Training Collateral Administrator Training In service training (including feedback processes) Activation Plan HIMSS ME-PI Executive Dashboard Workgroup Workshop 24
25 Design Critical path milestones to data source Tracking required: Patients, Staff optional Sources are: Staff member moves patients on screen manual Link to CIS system if movements are recorded Deploy RFID Auto-ID RTLS to locate automatically Passive RFID: Dependability? Active RFID: Latency, Accuracy? RTLS (Real Time Locating System)» Real-Time means less than 5 seconds» Must be accurate, dependable» May leverage nurse call infrastructure HIMSS ME-PI Executive Dashboard Workgroup Workshop 25
26 Build Hardware Environment Installed Test Environment Built Production Environment Built Software Installed and Configured Rules Engine Configured using Patient Flow Diagram from Design Phase Stakeholder Views Configured Test System Cases Developed Training Materials Developed HIMSS ME-PI Executive Dashboard Workgroup Workshop 26
27 Build Stakeholder views Urologist: My patients ready to see Urologist Support staff My patients and Next action Clinic operation staff Next Patient(s) and Facility resources Executive management Critical Path Dashboard Alerts Retrospective focused reports HIMSS ME-PI Executive Dashboard Workgroup Workshop 27
28 Urologist View: My patients ready to see HIMSS ME-PI Executive Dashboard Workgroup Workshop 28
29 Support: Operation Staff Next Patient(s) and Facility resources HIMSS ME-PI Executive Dashboard Workgroup Workshop 29
30 Executive View Critical Path Dashboard Alerts HIMSS ME-PI Executive Dashboard Workgroup Workshop 30
31 Executive Management Focused Retrospective Reports HIMSS ME-PI Executive Dashboard Workgroup Workshop 31
32 Test Activate / Train / Run Test System Test and refine activation plan Test and refine stakeholder training Walk visit type surrogate patients through Compare results to existing clinic performance Validate benefit delivery Is there more time for caregivers to give care? Are errors / omission reduced through automation? Does uniform care delivery increases patient safety? HIMSS ME-PI Executive Dashboard Workgroup Workshop 32
33 Test and Train Setup / Train / Run Test System (continued) Review Training Collateral Effectiveness Too Much? Too Little? Just right! Get Disaster Plans in Place Means to revert to previous process IF worst case system failure occurs Preserve pilot system as setup to use for: Prototyping refined or new dashboard features Pre-rollout testing of: Refined or new dashboard features Upgraded OS or adjacent IT systems HIMSS ME-PI Executive Dashboard Workgroup Workshop 33
34 Rollout Preparation Timing Optimum? All precursors rolled out first? Will majority of staff receive in-service? Time of minimized patient loading? Eases caregiver assimilation Ramping volume reveals weakness before failures Disaster Plan in Ready? Method to revert to previous process IF required Go / No-Go Criteria Established? Can I abort if needed HIMSS ME-PI Executive Dashboard Workgroup Workshop 34
35 Rollout Prep Meeting of Responsible Parties Review activation plan Will majority of staff receive in-service? Time of minimized patient loading? Eases caregiver assimilation Ramping volume reveals weakness before failures Disaster Plan in Place? Method to revert to previous process IF required HIMSS ME-PI Executive Dashboard Workgroup Workshop 35
36 Executive View Focused Retrospective Reports HIMSS ME-PI Executive Dashboard Workgroup Workshop 36
37 Executive View Focused Retrospective Reports HIMSS ME-PI Executive Dashboard Workgroup Workshop 37
38 Summary An iterative lifecycle approach for Dashboard Development Life Cycle (DDLC) Initiate Governance, Resources, Strategies Design Business & Technical Solutions, Training & Testing Build/Construct Data Access, Tools, Training, Test Cases Test Training, Test System, Test Operations Conduct Pilot, Rollout Dashboard(s) Monitor, Evaluate Feedback, Next Iteration HIMSS ME-PI Executive Dashboard Workgroup Workshop 38
39 Polling Evaluation Webinar 103 Questions & Answers Continuing Education Tracking Form will be ed to attendees which qualify for 1.2 HIMSS contact hours towards renewal of CPHIMS credential To join the HIMSS ME-PI Community contact Juanita Threat at
40 ME-PI Community Networking Breakfast HIMSS09 Chicago Open to members of the ME-PI Community Sunday - April 5, :30-8:30am McCormick Place S503AB
41 Executive Dashboard Webinar 104 June 12 Noon-1:30pm EST Presentation to include Executive Dashboards in Practice with a healthcare organization show-and-tell and vendor panel Q&A. Register:
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