Electronic Medical Records & HITECH Lyon, Popanz  Forester May 12, 2009 Where do you start? An answer, not the answer

What’s different about EMR? Hospitals have had electronic records for years: payroll, HR, inventory … What’s different? Part of the evolution toward system complexity that is happening in all industries, e.g., enterprise resource planning systems Increasing data exchange between systems within and outside the enterprise, e.g., payments processing systems Public access to real time data, e.g., home banking

Hospitals have had electronic records for years: payroll, HR, inventory …

What’s different?

Part of the evolution toward system complexity that is happening in all industries, e.g., enterprise resource planning systems

Increasing data exchange between systems within and outside the enterprise, e.g., payments processing systems

Public access to real time data, e.g., home banking

What’s different? Complexity More interfaces between systems inside and outside the enterprise Multiple use of some data elements The need for nationwide data and interface standardization Real time data acquisition and delivery Data integrity and error correction Security, security, …

More interfaces between systems inside and outside the enterprise

Multiple use of some data elements

The need for nationwide data and interface standardization

Real time data acquisition and delivery

Data integrity and error correction

Security, security, …

How do you manage complexity? Manage at a very high level to assure common direction, visibility and coordination Manage at a very low levels to control the quality of systems, interfaces and data Communicate between the two with a maximum of value and minimum of overhead

Manage at a very high level to assure common direction, visibility and coordination

Manage at a very low levels to control the quality of systems, interfaces and data

Communicate between the two with a maximum of value and minimum of overhead

What do you do at the top level? A “living strategy” to reflect the Evolving nature of the uses of information Improvements in tools to deliver information Clarification of regulations as they are developed Growth and changes in the institution Changes in the practice of medicine

A “living strategy” to reflect the

Evolving nature of the uses of information

Improvements in tools to deliver information

Clarification of regulations as they are developed

Growth and changes in the institution

Changes in the practice of medicine

What do you do at the system level? Projects to define and manage the development and enhancement at the level of applications and infrastructure

Projects to define and manage the development and enhancement at the level of applications and infrastructure

How do you manage the levels? A project management office to coordinate the evolution of the living strategy and the progress on projects A communication structure that provides information that is needed when and where it is needed

A project management office to coordinate the evolution of the living strategy and the progress on projects

A communication structure that provides information that is needed when and where it is needed

Where should you start? Process Start with a process that will focus your efforts You don’t need to do everything at square one You can’t do everything at square one Designate someone who has started large, vague and time driven projects before, e.g., HIPAA , Y2K , mergers Build a small team

Start with a process that will focus your efforts

You don’t need to do everything at square one

You can’t do everything at square one

Designate someone who has started large, vague and time driven projects before, e.g., HIPAA , Y2K , mergers

Build a small team

Where should you start? Team Create a team to focus and define: Scope for ERM at your facility External status: regulatory, standards, vendor solutions, sources of support … Internal status: records processes, systems, infrastructure, plans … “ Success” for your organization High level strategy for organization, planning and budgeting

Create a team to focus and define:

Scope for ERM at your facility

External status: regulatory, standards, vendor solutions, sources of support …

Internal status: records processes, systems, infrastructure, plans …

“ Success” for your organization

High level strategy for organization, planning and budgeting

Where should you start? Now Start with “now” What do you have? What is in process? What is planned? What do the regulations require and how will you stay current? Does all of this create new opportunities worth exploring?

Start with “now”

What do you have?

What is in process?

What is planned?

What do the regulations require and how will you stay current?

Does all of this create new opportunities worth exploring?

We work in the white space of organizations … including HIPAA, Y2K , mergers and the implementation of evolving regulations The white spaces of organizations occur on organization charts between internal departments, in contractual ambiguity and regulatory complexity. They are places where functional misunderstandings occur, communication falters, roles change, priorities conflict, rewards are unclear, risks are unknown, and managers sometimes see threats to their careers that outweigh the opportunities. We work in those white spaces to define problems so they can be solved, design solutions so they can be implemented, and structure implementation so it can be managed. Hal Amens [email_address]

We work in the

white space of

organizations …

including HIPAA, Y2K ,

mergers and the

implementation

of evolving regulations

The white spaces of organizations occur on organization charts between internal departments, in contractual ambiguity and regulatory complexity.

They are places where functional misunderstandings occur, communication falters, roles change, priorities conflict, rewards are unclear, risks are unknown, and managers sometimes see threats to their careers that outweigh the opportunities.

We work in those white spaces to define problems so they can be solved, design solutions so they can be implemented, and structure implementation so it can be managed.

Hal Amens

[email_address]