Clinical Information System Implementation Project Prepared for Clinical Affairs Committee December...

Clinical Information System Clinical Information System Implementation ProjectImplementation Project

Prepared for Clinical Affairs Committee

December 4, 2002

December 4, 2002 Information Technology Department 2

Clinical Information System Outline

Objectives

Clinical Systems Overview

Critical Success Factors

CIS Implementation Plan

Project Committee Structure

Next Steps


Objectives

Implement a Clinical Information System that complements our leadership role in healthcare delivery

Meet or exceed all Leapfrog requirements

Improve effectiveness and quality of care delivery

Regularly quantify medical, financial, and patient satisfaction benefits

Deliver high quality care that achieves the best outcomes in the most cost-effective manner.

Develop and maintain a controlled medical vocabulary (CMV)

Implement a Computerized Physician Order Entry (CPOE) process

Ensure compliance with HIPAA information security and privacy mandates

Build and populate an online, real time computerized patient record (CPR)


Clinical Systems Overview

Enterprise Applications Scheduling,

Case Management

Users Clinical Reporting Management EIS Regulatory Agencies Performance Report Card

Users Clinical Reporting Management EIS Regulatory Agencies Performance Report Card

Location Specific and Distributed Transaction Systems

IINNTTEEGGRRAATTIIOONN

TTOOOOLLSS

UUSSEERRSS

Order Entry / Results

Pharmacy

Clinical Documentation

ADT/Registration

Radiology

STOR

SurgicalScheduling

ClinicalData

Repository

METADATA

DataWarehouse

Archived

Lightlysummarized

Highlysummarized

Archive

Archive

Clinical Decision Support




EMPI Interface Engine

EMPI Interface Engine


Computerized Patient Record (CPR)


Information Security Elements of CPRs

Availability - when and where needed

Authentication - a person or system is who they purport to be

Access Control - only authorized persons, for authorized uses

Confidentiality - no unauthorized information disclosure

Integrity - information content not alterable except under authorized circumstances

Attribution/non-repudiation - actions taken are reliably traceable


Critical Success Factors

Close ties between the organization’s strategic plan and the CPOE project

Continuous executive support

Getting the right people involved at the correct level

Focus on implementing people and process changes needed to support improved care, rather than on implementing a new computer system; technology is important but the organizational challenge is greater

Strong physician leadership and communication in all aspects of the project

Flexibility and willingness on the part of the vendor and Information Technology to tailor the system as needed to support the organization


CIS Implementation Plan


CIS Implementation Process

Eliminate Duplicate Patient Numbers (9/02 – 6/03) Cleanup of duplicate medical record numbers throughout UCSF. This process

includes the combining of all electronic patient records as well as all paper records.

Admitting Module (9/02 – 2/03) Implementation of IDX LastWord Admitting module. Transfer of inpatient

admission process from using IDXtend Outpatient Visit application to true inpatient admitting application. Includes use of barcoding technology for patient identification.

Pharmacy Module (9/02 – 5/03) Implementation of IDX LastWord Pharmacy module. Conversion of inpatient

pharmacy from current Mediware Pharmacy system to integrated IDX application to enable meeting Leapfrog requirements.

Emergency Department (9/02 – 5/03) Implementation of IDX LastWord Emergency Department module. This task will

provide ED with the ability to care for and track patients in an emergency medicine environment.



Order Entry / Results Reporting (9/02 – 7/04) Implementation of IDX Order Communication and Results Reporting module. This

process includes all orders for all ancillary departments and their corresponding results.

Physician (9/02 – 7/04) This process primarily involves physicians and focuses on the design, development,

testing and implementation of Computerized Physician Order Entry (CPOE) throughout UCSF.

Nursing (9/02 – 7/04) This process primarily involves nurses and focuses on the design, development,

testing and implementation of nursing orders and results reporting throughout UCSF.

Ancillary (9/02 – 7/04) This process primarily involves ancillary departments and focuses on the design,

development, testing and implementation of ancillary orders and results reporting throughout UCSF.



Leapfrog Compliant (7/04) At this milestone event in the CIS implementation, UCSF will be compliant with all

Leapfrog requirements.

Stor Conversion (4/03 – 7/04) Conversion of all patient data from the in-house developed STOR application to

LastWord's Computerized Patient Record.

Clinical Decision Support (1/04 – 11/05) Establishment of a Clinical Decision Support System to provide a clinical and

business data repository for research and analysis. Includes the implementation of a data warehouse to store and process all data.

Nursing Care Plans and Charting (7/04 – 6/05) Implementation of the IDX Nurse Care Plans and Charting module. This task will

provide Nursing with an automated tool for entering and utilizing acute care plans throughout the organization. This does not include critical care.



Critical Paths (6/05 – 5/06) Implementation of IDX Critical Paths module. This process addresses the

development of critical pathways for all medical and surgical patients.

Physician Critical Paths (6/05 – 5/06) This process primarily involves physicians and focuses on the design, development,

testing and implementation of physician critical paths throughout UCSF.

Nursing Critical Paths (6/05 – 5/06) This process primarily involves nurses and focuses on the design, development,

testing and implementation of nursing critical paths throughout UCSF.

Ancillary Critical Paths (6/05 – 5/06) This process primarily involves ancillary staff and focuses on the design,

development, testing and implementation of ancillary critical paths throughout UCSF.



CIS Foundation Implementation Complete (5/06) At this milestone event, the initial implementation of the Clinical Information

System is complete.


Project Committee Structure

C IS P hy s ic ia n S u b c o m m ittee

C IS N u rs in g Su b c o m m ittee

C IS D ep a rtm e n ta l Su b c o m m ittee

C IS Im ple m e n tatio n C om m ittee

In fo rm a tio n T e c h no lo g y S te e rin g C o m m ittee


Next Steps

Approve 5 year project funding . . . . . . . . . . . . . . . . . . . . . . . . . . . . IDX customer site visits for key stakeholders . . . . . . . . . . . . . . . . . . Begin UCSF-wide communications regarding CIS project . . . . . . . . Hire CIS Program Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Appoint physician leader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Finalize implementation plans with IDX . . . . . . . . . . . . . . . . . . . . . . Identify and schedule IDX staff resources . . . . . . . . . . . . . . . . . . . . . Identify and schedule other consulting resources . . . . . . . . . . . . . . . . Identify space and furnish CIS Program Office . . . . . . . . . . . . . . . . . Establish CIS Steering Committee and subcommittees . . . . . . . . . . . Perform Readiness and Risk Assessments . . . . . . . . . . . . . . . . . . . . . Develop job descriptions for CIS Project Team . . . . . . . . . . . . . . . . . Hire CIS Project Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Present CIS Implementation Plans to IT Steering Committee . . . . . .

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Clinical Information System Implementation Project Prepared for Clinical Affairs Committee December...

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