Clinical Information System Implementation Project

1
Clinical Information System Implementation Project

• Prepared for Clinical Affairs Committee
• December 4, 2002

2
Clinical Information System Outline

• Objectives
• Clinical Systems Overview
• Critical Success Factors
• CIS Implementation Plan
• Project Committee Structure
• Next Steps

3
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)

4
Clinical Systems Overview
Location Specific and Distributed Transaction
Systems

• Users
• Clinical Reporting
• Management EIS
• Regulatory Agencies
• Performance Report Card

• Enterprise Applications
• Scheduling,
• Case Management

Archive
INTEGRAT I ON TOOLS
Order Entry / Results
Data Warehouse
Pharmacy
USERS
METADATA
Clinical Documentation
ClinicalData Repository
Archive

• Archived
• Lightlysummarized
• Highlysummarized

ADT/Registration
Radiology
Clinical Decision Support
STOR
Surgical Scheduling
Clinical Decision Support
EMPI Interface Engine
5
Computerized Patient Record (CPR)
6
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

7
Critical Success Factors

• Close ties between the organizations 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

8
CIS Implementation Plan
9
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.

10
CIS Implementation Process

• 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.

11
CIS Implementation Process

• 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.

12
CIS Implementation Process

• 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.

13
CIS Implementation Process

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

14
Project Committee Structure
15
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 . . . . . .

Completed Started Not Started Completed Started St
arted Not Started Started Started Started Started
Completed Started Completed
16
Summary and Questions