download PPS - PowerPoint Show


Published on

Published in: Health & Medicine, Business
  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

download PPS - PowerPoint Show

  1. 1. Providing IT solutions to the healthcare industry. We manage healthcare with you. 111 E. Wacker Drive, Suite 1050 Chicago, IL 60601 p: 312.321.1638 f: 312.321.0128
  2. 2. Journey Through a Legacy System Landscape Mark A. Farrow Director, Information & Communication Technologies, HHS Account Director
  3. 3. Our family of hospitals <ul><li>Hamilton General Hospital </li></ul><ul><li>Henderson General Hospital </li></ul><ul><li>Chedoke Hospital </li></ul><ul><li>McMaster University Medical Centre </li></ul><ul><li>McMaster Children’s Hospital </li></ul><ul><li>Juravinski Regional Cancer Centre </li></ul>All brought together by a series of mergers
  4. 4. The region we serve South Central Ontario
  5. 5. HHS At-a-glance <ul><li>Number of Beds:  1,039 </li></ul><ul><li>ER visits:  107,587 </li></ul><ul><li>Admissions: 41,089 </li></ul><ul><li>Cancer Clinic </li></ul><ul><ul><li>Number of new patients per year: 7,000 </li></ul></ul><ul><ul><li>Active patients receiving care: 18,000 </li></ul></ul><ul><ul><li>Outpatient Visits per year: 180,000 </li></ul></ul>
  6. 6. Major Programs and Services <ul><li>Cardiac and Vascular Program </li></ul><ul><li>Neurosciences and Trauma Program </li></ul><ul><li>Digestive Diseases </li></ul><ul><li>High-risk Obstetrics and gynecology </li></ul><ul><li>Paediatrics </li></ul><ul><li>Acquired Brain Injury </li></ul><ul><li>Prosthetics and Orthotics </li></ul><ul><li>Children’s Exercise and Nutrition Program </li></ul><ul><li>Oncology (Cancer care) </li></ul><ul><li>Orthopedics </li></ul><ul><li>Rehabilitation </li></ul><ul><li>Palliative Care </li></ul><ul><li>Nuclear Medicine </li></ul><ul><li>Critical care </li></ul><ul><li>Infectious Diseases </li></ul><ul><li>Diagnostic Imaging </li></ul><ul><li>Emergency Medicine </li></ul><ul><li>General surgery </li></ul>
  7. 7. Post Merger Challenges <ul><li>Combination of non-integrated systems </li></ul><ul><li>Multiple best-of-breed </li></ul><ul><li>Ability to aggregate data difficult </li></ul><ul><li>Clinicians were faced with multiple accounts and feeder systems </li></ul><ul><li>Unable to provide standard training </li></ul>
  8. 8. External Assessment The interfaced “best-of-breed” IT environment at the former CMH sites is extremely complex, difficult to interface, lacks a common database and can no longer be adequately supported by staff and/or vendors; Causes include extensive in-house modifications, not keeping current with released versions of software, etc.
  9. 9. External Review Result “ Given the financial and clinical situation that the corporation finds itself in, it is important for HHS to move to a common clinical information system in the shortest possible timeframe , to alleviate some of the constraints and bottlenecks it faces in providing solid patient care.”
  10. 10. Conclusion <ul><li>Mandate the expansion of the MEDITECH (General site) clinical system to the remainder of the hospital within a 12-18 month time period. </li></ul>
  11. 11. Scope <ul><li>Integration of clinical applications to MEDITECH </li></ul><ul><ul><li>Admissions/registration </li></ul></ul><ul><ul><li>Medical records (MPI) </li></ul></ul><ul><ul><li>Scheduling </li></ul></ul><ul><ul><li>Order entry/result reporting </li></ul></ul><ul><ul><li>Pharmacy </li></ul></ul><ul><ul><li>Laboratory (regional) </li></ul></ul><ul><ul><li>Diagnostic imaging </li></ul></ul><ul><li>Previously we had moved Human Resources, Payroll and G/L to PeopleSoft </li></ul>
  12. 12. Goals <ul><li>Implement Enterprise–wide common core clinical systems </li></ul><ul><li>Reduce in-house developed or maintained applications and related support costs </li></ul><ul><li>Minimize interfaces </li></ul><ul><li>Implement in a window of opportunity that does not adversely impact on clinical program moves, capital construction projects or other initiatives </li></ul><ul><li>Implement the MEDITECH system as generically as possible </li></ul><ul><li>No extensive “re-engineering” of processes </li></ul>
  13. 13. Critical Success Factors <ul><li>Endorsement and ongoing support from VP’s and all management levels </li></ul><ul><li>Availability and commitment of staff time by directors and managers </li></ul><ul><li>Significant time commitment and involvement by all those involved in the project </li></ul><ul><li>Ability of staff to change and adopt new methods of information retrieval and/or procedures </li></ul><ul><li>Timely decisions by Sponsor and Senior Management </li></ul>
  14. 14. Benefits <ul><li>A single source core system for the clinicians </li></ul><ul><li>Training streamlined in the organization </li></ul><ul><li>Improved and consistent clinician data access </li></ul><ul><li>Common consistent Order Entry and Result Reporting </li></ul><ul><li>Common dictionaries for user consistency and maintenance </li></ul><ul><li>Better intermodule communication </li></ul><ul><li>Community wide appointment scheduling </li></ul><ul><li>Fewer interfaces to be designed and maintained </li></ul><ul><li>Fewer downtimes for the organization </li></ul>
  15. 15. Infrastructure Budget <ul><li>MEDITECH Licenses - $4.5M </li></ul><ul><li>PC’s/Printers – $1.0M </li></ul><ul><li>Servers - $1.2M </li></ul><ul><li>Misc. Equipment and Services (Lab, Rad, Rx) - $0.3M </li></ul><ul><li>No Back fill budget </li></ul>
  16. 16. Approach <ul><li>Server Acquisition and Installation </li></ul><ul><li>Merge General and Henderson MEDITECH Databases </li></ul><ul><li>Specific Terminal to PC replacements including printers </li></ul><ul><li>Upgrade to latest version of MEDITECH </li></ul><ul><li>Extend existing MEDITECH to McMaster & Chedoke </li></ul><ul><li>Implement MEDITECH’s Radiology Imaging & Therapeutic Services system </li></ul><ul><li>MEDITECH training </li></ul><ul><li>Integration / Interface Services </li></ul><ul><li>Legacy data conversion to follow </li></ul>
  17. 17. Timelines <ul><li>Feb 2001 - Servers Installed </li></ul><ul><li>April 2001 - Merge of General & Henderson </li></ul><ul><li>June 2001 - Sep 2001 - Installation of PC’s/Printers </li></ul><ul><li>Sep 2001 - Version 4.8 at General / Henderson </li></ul><ul><li>Nov 2001 - Build of 4.8 for MUMC /Chedoke </li></ul><ul><li>Jan 2002 - Apr 2002 - User Training at MUMC </li></ul><ul><li>Apr 2002 - Live with MEDITECH across HHS </li></ul><ul><li>Apr 2002 - Radiology / ITS </li></ul>
  18. 18. Major System Changes <ul><li>Allegra (Inpatient System) and ER replaced </li></ul><ul><li>MT Medical Records replaces CPI (Central Patient Index) </li></ul><ul><li>MT MIS (Medical Information System) will replace CDI (Central Doctor Index) </li></ul><ul><li>MT Billing/Accounts Receivable (B/AR) replaces MUMC and Chedoke Billing and Accounts Receivable Systems </li></ul><ul><li>MT Community Wide Scheduling replaces Clinic Scheduling System </li></ul>
  19. 19. Major System Changes <ul><li>MT Pharmacy replaces Cerner Pharmacy </li></ul><ul><li>MT ITS Radiology (ITS – Imaging Therapeutic Services System) replaces Cerner Radiology and transcription and MT $T Radiology at General and Henderson </li></ul><ul><li>MT Laboratory including Hematology/Chemistry, Microbiology, Transfusion Medicine & Pathology replaces Sunquest Lab </li></ul><ul><li>Additional devices (PC’s/Printers/Label printers) to be deployed – eg: OR, ICU, ADP, Home Transcription, Health Records, DI, MDU </li></ul><ul><li>Transition and decommissioning planning </li></ul>
  20. 20. Conversions / Data Access <ul><li>Sunquest Transfusion Medicine / Anatomical Pathology </li></ul><ul><li>Cerner Radiology Reports </li></ul><ul><li>Cerner Master Film Bag locators </li></ul><ul><li>Future Appointments </li></ul><ul><li>MPI (Master Patient Number) and patient demographics </li></ul><ul><li>Link from MEDITECH to EMR </li></ul>
  21. 21. Results <ul><li>One copy of Admissions, Medical Records, Laboratory, Radiology, Pharmacy, Billing, Order Entry, Patient Care Inquiry, Reporting </li></ul><ul><li>All visits to all sites maintained on a shared Master Patient Index (over 2 million patients) </li></ul><ul><li>Demographic Updates are shared among admitting facilities </li></ul>
  22. 22. Legacy Shutdown Project …Purpose & Goals <ul><li>Purpose </li></ul><ul><li>Streamline IT environment </li></ul><ul><li>Save $ on support and maintenance </li></ul><ul><li>Goals </li></ul><ul><li>Archive required data </li></ul><ul><li>Move historical data off of legacy systems </li></ul><ul><li>Decommission legacy apps and hardware </li></ul><ul><li>Completion </li></ul><ul><ul><li>Apps, Dec. 2002 </li></ul></ul><ul><ul><li>Hardware, Apr. 2003 </li></ul></ul>
  23. 23. Legacy Shutdown Project …Business Case <ul><li>System Cost </li></ul><ul><ul><li>$87,000 </li></ul></ul><ul><li>Savings…This Year </li></ul><ul><ul><li>$59,000 </li></ul></ul><ul><li>Savings…Future </li></ul><ul><ul><li>~$40,000/yr licensing for Sunquest and Cerner </li></ul></ul>
  24. 24. Legacy Shutdown Project …Strategy <ul><li>Work with clients to identify required data </li></ul><ul><li>Select reports with data, convert to text files </li></ul><ul><li>Move text files to archiving application </li></ul><ul><li>Provide ongoing view-only access </li></ul>
  25. 25. Legacy Data Outcome <ul><li>In shutting down the &quot;Legacy&quot; systems our clients still wanted/expected/demanded &quot;Online Access&quot; to the information in these systems to deliver patient care, meet legal requirements, and support for research with data search/extract ability </li></ul><ul><li>The support costs for the aging hardware, vendor maintenance costs, and the ICT operational staff to maintain these older technologies....were significant issues </li></ul><ul><li>Implemented an Online Web-based solution which enable the organization to shutdown the legacy hardware, operating systems, and applications </li></ul>
  26. 26. The Good, The Bad and the … <ul><li>Pro’s of moving to single HIS </li></ul><ul><ul><li>simplified support environment </li></ul></ul><ul><ul><li>cost savings re: staffing, contracts, etc. </li></ul></ul><ul><ul><li>data availability </li></ul></ul><ul><li>Con’s re: </li></ul><ul><ul><li>overcoming the political barriers - &quot;why did they pick MEDITECH?&quot; when we had a perfectly good system(s) </li></ul></ul><ul><ul><li>Former Civic Hospital already running MEDITECH - is that favoritism? </li></ul></ul><ul><ul><li>stress need for ‘buy in’ – how to get it? </li></ul></ul>
  27. 27. Successful outcome <ul><li>Received strong sponsorship </li></ul><ul><li>Able to implement consistent technology (printers, application, standard desktop) across 4 sites </li></ul><ul><ul><li>therefore, more efficient to purchase and support </li></ul></ul><ul><li>Totally integrated clinical system </li></ul><ul><ul><li>less overhead (staff to maintain) - interfaces etc. </li></ul></ul><ul><ul><li>less administration for staff (passwords) </li></ul></ul>
  28. 28. Successful outcome <ul><li>Used MEDITECH the way it should be and NOT tweaking it to work the same way the legacy application worked (system and processes) </li></ul><ul><li>Kept learning curve down as half of the hospital was already using MEDITECH </li></ul><ul><ul><li>rather than an entirely new system </li></ul></ul><ul><li>Benefit for staff who floated between sites - common platform </li></ul>
  29. 29. Issues <ul><li>Enforcing merger of processes and entities and then systemize the results </li></ul><ul><li>What we are still struggling with is the fact that departments at each facility continued to do their own thing rather than be expected to work together to establish common shared processes </li></ul><ul><li>Need support for the process changes not just the system changes </li></ul>
  30. 30. New Technology Add-ons <ul><li>FileNexxus </li></ul><ul><ul><li>Archiving former legacy best-of-breed data </li></ul></ul><ul><ul><li>Ability to search/report on data </li></ul></ul><ul><li>Sovera for HIM </li></ul><ul><ul><li>Document Imaging System for completed charts </li></ul></ul><ul><ul><li>Document completion </li></ul></ul><ul><li>Interbit Fax Services </li></ul><ul><ul><li>Report distribution system </li></ul></ul><ul><li>AccessPT Web View </li></ul><ul><ul><li>New user interface to integrate clinical data </li></ul></ul>
  31. 31. Clinical Web View <ul><li>AccessPt Inc. has been selected to help integrate multiple data sources and in real-time, consolidate and present the information via web based portal technologies. </li></ul>
  32. 32. A few features . . . <ul><li>Single Sign On </li></ul><ul><li>Single Patient Search </li></ul><ul><li>Intuitive Web Browser navigation </li></ul><ul><li>Consolidated information in real-time </li></ul><ul><li>Supports data and images </li></ul><ul><li>Multi-vendor integration </li></ul><ul><ul><li>allows consolidation of MEDITECH data sources but also other vendors sources such as GE PACS, HBOC Lab, AMS Sovera, OPIS, cardiology, fetal monitors and others </li></ul></ul><ul><li>Expandable, customizable </li></ul><ul><li>Simplified remote access </li></ul><ul><li>Support for various types of computers </li></ul><ul><ul><li>PC’s, PDA’s, tablets, Apple MacIntosh, Wireless </li></ul></ul><ul><li>Secure / Audit trails </li></ul>
  33. 33. Overview
  34. 34. Conclusion <ul><li>Integrated ‘legacy’ systems can provide a foundation to build your organization </li></ul><ul><li>Using new technologies strategically can advance your investment and acceptance </li></ul><ul><li>A focus on the processes with the systems will create a winning combination </li></ul>