Health Information Sciences Report to Medical Executive Committee September 2011

Transcription

1 University/MECH CPOE/eMAR Go-Live August 9 th Since conversion on August 9 through August 31, the University/MECH CPOE adoption rate has averaged out at 85.38%. All my teams in the Healthcare Information Sciences Division thank all medical and clinical staff for their constructive feedback and participation in emergency clearing houses as well as expedited actions by committees such as P&T to affect critical solutions and changes. The table below provides a statistical breakdown of issues and change requests. MUH Conversion Issues and Change Requests Issues Total Received 394 Total Closed 386 Total Open 8 Process/Training Related 246 Total Closed 244 Total Open 2 Other (e.g., Functionality, Break/Fix) 148 Total Closed 142 Total Open 6 Change Requests Total Received 157 Total Closed 77 Total Open 80 The Physician Analysts and Clinical Transformation Specialists continue to be actively engaged along with Unit Secretaries measuring Physician and Nurse Adoption and intervening to support and provide additional training when appropriate. Associates acknowledge and thank University Leadership and Medical Staff for their partnership in making this an exceptionally successful CPOE conversion. 1

2 Germantown CPOE Go Live October 25 Preparations for this conversion are in progress. Physician standard CPOE online training opens on September 5 th. Germantown CPOE online Physician Training will also include additional specialty modules for: Cardiology Hema/Oncology Pathology, Radiology NICU OB Peds Surgery Well Baby Nursery A letter has been sent to Germantown Physicians stating the training and adoption requirements for CPOE. Germantown CPOE Leadership and Super User Meetings have begun. Universal Protocol Information Technology has been provided a Radiology Imaging Equipment list for each of the major hospital OR s. The Desktop Support leadership staff is currently in the process of rounding with a designee for each OR to look at the specific hardware configuration for each area designated for potential site markings. Once the evaluation is complete IT will update hardware as appropriate with elevated rights to enable the successful viewing of images. As areas of concern are identified, these will be documented and reported as appropriate for specific resolution. Estimated completion date to have OR site marked hardware inventoried configured is September 30, Cause of Death One requirement for Meaningful Use is capturing the preliminary cause of death. This is only a preliminary cause of death and is in no way connected to the final diagnosis on the death certificate. This information will be entered by nursing staff during the discharge process. A maximum of 8 very broad categories will be provided in a drop down box. Six (6) of the 8 that have been suggested are: No respirations, no HR Cardiac /pulmonary failure/arrest Cong. Anomalies, prematurity Multi-organ failure, sepsis Cancer 2

3 Trauma If your Senior Leadership Committee has any comments regarding the above categories, please Meg McGill Resolution to PACS Downtime Issue We experienced a GE PACS downtime on August 15. In the incident review, GE reported this downtime as an isolated incident resulting from a database table scan. GE made some changes to the system that potentially caused a script to run errantly causing the database table scan. GE is monitoring the system to continue troubleshooting. As of September 8, we have not experienced a downtime since August 15. We are continuing to meet with GE frequently due to the downtime issues we have experienced this year. Ambulatory EHR and Health Information Exchange (HIE) The Ambulatory EHR Task Force is going through due diligence prior to awarding a contract to Epic. Reference site calls are in progress, including recent calls to Spectrum Health, University of Washington, University of Pittsburg, Franciscan Missionaries of Our Lady Health System, and NW Health System. MLH IS and Legal Departments along with a third party consultant, Impact Advisors, are working on cost of the applications, resources and hardware and contract details. Andy Fowler and team have received responses from the targeted HIE vendors. Response evaluation has begun. Dr Alastair MacGregor will take over the review of the HIE vendor responses. NHIQM (National Health Indicator Quality Measures) The project team has set an implementation date for NHIQM (Meaningful Use Quality Measures of Stroke, VTE and ED throughput) at North hospital for October 4 th. The team anticipates a roll-out to South by mid-november. Voice Recognition System The first phase will be for Radiologists only. Phase 2 will be Pathologists. We will be replacing their use of our Lanier Dictation System with a Voice Recognition System. In early August the two leading vendors demonstrated their systems at Germantown Hospital, Germantown Breast Center, Le Bonheur, North, and University. Surveys completed by attendees have been analyzed. Currently, reference calls are being scheduled, contracts from the two vendors are under review, and pricing is being obtained from each vendor. The 3

4 implementations will be in System Process Redesign Laboratory Information Systems Abbott istat point of care (POC) will be replacing Biosite Triage POC in the Adult EDs with the exception of Germantown. Neither Germantown nor Le Bonheur use cardiac POC in the ED. The change stems from ED physicians determining that a single Troponin cardiac marker is all they need in the ED. The current Biosite Triage contains Troponin, Myoglobin and CKMB, and the change will recognize a cost savings of about $250,000 annually across the system. North ED will go live August 30. South and University are scheduled to convert within the next days. Enhancement Request Management Requests for enhancements to onechart (Cerner) coming from hospital Clinical and Technology Advisory Groups, Clinical Service Groups, Pharmacy and Therapeutic Groups and other governance groups are now entered into a Healthcare Information Systems (HcIS) Share Point site which allows the requesting user and HcIS Associates to track the status of the enhancements. Share Point automatically s the requesting user when the request is initially submitted. The user has the option to be notified by when there has been a change in the status of the enhancement request. GE PACS Contract Methodist's GE PACS radiology support contract expires in August Information Systems leaders are negotiating a new contract with GE and consulting with radiology leaders to gather requirements. When the current contract ends our existing Radiologist PACS and Radiology Technologist workstations and short-term storage hardware will no longer be supported by GE due to the age of the equipment. In addition, the XP operating system on these devices will no longer be supported by Microsoft after Although the backend PACS hardware and PACS hardware support are funded through the IS corporate budget, PACS workstations and short-term storage are purchased via facility capital. We have informed each radiology director of the pending support issues and have strongly recommended replacing the aging hardware to reduce the risk of downtime. Due to the timeframe required to replace PACS hardware, Information Systems highly recommends budgeting for replacement in

5 ios Updates ipads The ipad connectivity pilot has been completed, and ipad users will soon be able to access My Apps. Information Systems Associates completed their training on September 1, and ipad connectivity documentation will be available on MethodistMD no later than September 16. The documentation will include instructions on connecting to the Guest network and configuring the Citrix client to connect to My Apps. Physician Analysts will also receive training to assist medical staff on how to configure their ipads to connect to onechart. Although ipads can currently connect to the wireless Guest network, to provide the best user experience, the code for the wireless network will be upgraded to a newer version. The newer code has been installed at University, and IS is working on a rollout strategy for the other facilities. iphones Information Technology is evaluating several different mobile management solutions for iphones and scheduling reference calls with other healthcare providers to obtain feedback on these products. The mobile management solution will allow new security policies to be enforced on all supported mobile devices that connect to the MLH system. These security policies will include at a minimum a screensaver pass code, screen timeouts, and specific operating system requirements (e.g., ios or higher) for anyone accessing the Methodist network with an iphone. Due to the disparity between iphone and Android operating systems and hardware, access to the Methodist Outlook system will be limited to iphone/ipad and Blackberry devices. Licensing for the mobile management solution will be paid by MLH. There will be no charge to medical staff. The mobile management solution will be selected and implemented by the end of September, piloted in October, and should be available (tentatively) in November. Physician Alignment SergeMD, our physician practice IT support partner, will complete all aligned physician office assignment by August 31. SergeMD will officially assume IT support for all aligned Physician Practices by August 31. All hardware within each physician office has been labeled with MLH asset labels that include the SergeMD call center contact information. Working with SergeMD, Information Technology is working on the technical infrastructure tasks related to on-boarding two new physician practices effective August 31: McClatchey 5

6 Medical Center in Olive Branch, MS, and Jordan Internal Medicine at 3473 Poplar. Both practices will leverage eclinical Works as their electronic medical record. Planned vs. Unplanned Downtime The following table depicts the Cerner Production system uptime and planned and unplanned downtime numbers from August 1, 2010 August 31, Note: This table does NOT include network downtimes that may have impacted access to onechart. Planned Downtime Un-planned Downtime Total Uptime Percent Cerner Uptime Percent August % % September % % October % 99.98% November % % December % % January % % February % 99.70% March % % April % % May % % June % 99.94% July % % August % % Total 1, % 99.97% Attached: Appendix 1 CPOE Inpatient and ED Adoption Rates 6

7 Appendix 1 CPOE Inpatient and ED Adoption Rates 7