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  1. 1. Innovation Through Collaboration:Innovation Through Collaboration: Local, Regional, and StateLocal, Regional, and State HIT InitiativesHIT Initiatives Nancy L. Vorhees Chief Operating Officer Inland Northwest Health Services
  2. 2. Inland Northwest Health ServicesInland Northwest Health Services • INHS is a not-for-profit 501(c)3 corporation, owned by the hospitals in Spokane and serving residents of WA, ID, MT, OR and Canada. We facilitate clinical care by: • Improving clinical outcomes through information access and integrated clinical systems for physicians, hospitals, clinics and other health providers • Acting as the “trusted party” and secure custodian for the regional clinical data repository and a community-wide electronic medical record • Leveraging collaborative assets to control costs and provide high levels of expertise using shared resources • Utilizing advanced systems to increase patient safety
  3. 3. Northwest MedVan Northwest TeleHealth Northwest MedStar Spokane MedDirect Children’s Miracle Network Community Health Education And Resources Information Resource Management Providence Health Care Empire Health Services Regional Hospitals Information Resource Management St. Luke’s Rehabilitation Institute Regional Outreach and Hospital Management INHS ProgramsINHS Programs
  4. 4. Scope of SystemScope of System • 35 primarily independent hospitals (over 3500 beds) participating in the integrated information system with a single client identifier • More than 20 clinics receiving data electronically via HL7 messaging • More than 50 clinics and 400 physician offices able to view hospital, laboratory and imaging data • 68 hospitals, clinics and public health agencies connected to the INHS telehealth network
  5. 5. Foundation SystemsFoundation Systems • Integrated hospital information system • Integrated physician office EMR • Northwest TeleHealth
  6. 6. Local Initiatives
  7. 7. • Electronic Medical Record Server Farm: 38 clinics, 250 providers, 1250 users • Interfaced with hospital information systems, PACS, Reference Lab • Interfaced to practice management systems (demographics & scheduling) • 24 x 7 help desk/data center • Fully integrated day one Physician Office EMRPhysician Office EMR Source: INHS/IRM – Server Farm, Spokane Datacenter
  8. 8. Handheld Chart Mercury MD Clinical Usage Physicians Users = 300 Time Savings = 10 - 20 min. Complete Chart Lab results Pharmacy Orders Radiology Reports Nursing Notes Vitals & I/O Expert System Alerts Physician notes Mobile Chart with Decision SupportMobile Chart with Decision Support
  9. 9. Provides real time automated checkingProvides real time automated checking starting with the “Five Rights”…starting with the “Five Rights”…  Right patientRight patient  Right drugRight drug  Right doseRight dose  Right timeRight time  Right Route ofRight Route of AdministrationAdministration Clinical - BMV – Patient SafetyClinical - BMV – Patient Safety
  10. 10. 2.9 2.52.2 2.8 3 3.4 3 4 3.8 4.6 4.5 4.9 6.1 5.6 5.3 6.2 4.4 5.1 4.9 5.6 0 1 2 3 4 5 6 7 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 Q1 Q3 2001 2002 2003 2004 2005 Adult & Psych Reported Medication Error RateReported Medication Error Rate Peds & NICU
  11. 11. Regional Initiatives
  12. 12. Electronic Medical RecordElectronic Medical Record • A common Electronic Medical Record system operates in all participating hospitals and associated clinics, providing one standardized clinical data structure and presentation • Visit histories and transcription reports including e-Sign • Cumulative laboratory results and radiology exam profile/reports • Patient Demographics • Computerized Physician Order Entry • Each patient has a unique Master Patient Index (MPI) – one number, one regional record – currently over 2.6 million records in the system
  13. 13. Physician Access to EMRPhysician Access to EMR • A common hospital electronic medical record allows better physician access to necessary inpatient information • Physicians don’t have to learn different systems or use different access points when their patients are in different hospitals (anywhere in the region) • Physicians can access hospital records from their home or office – anywhere they have a secure web browser • Physicians can also access records wirelessly in hospitals using PDAs
  14. 14. INHS Telehealth SystemINHS Telehealth System • Nursing courses and education with universities and community colleges addressing Nursing Shortages • Rural hospital TelePharmacy program providing remote Pharmacist services • TeleER program assisting rural trauma doctors with ER cases remotely • Clinicians provide remote Clinical Consults and Education in Neurology, Wound Care, Psychiatric services, Diabetes and many other areas • Prison Based Health Services receive specialist care
  15. 15. TelepharmacyTelepharmacy • Currently ten rural hospitals are receiving pharmacy services from Sacred Heart in Spokane. More are being added this year. • Evaluation Measures: – Number of medication errors – Number of interventions – Type of interventions – Turn around time for orders – Hospital satisfaction
  16. 16. TeleERTeleER • TeleER links the Deaconess Emergency Room in Spokane with twelve rural hospitals. • Evaluation Measures: – Number of consults – Number of transfers – Health status – Impact of consult on status – Provider satisfaction
  17. 17. State Initiatives
  18. 18. State InitiativesState Initiatives • Washington Telehealth Consortium – Effort to link multiple telehealth networks – Also addressing barriers to telehealth utilization • Health Information Infrastructure Advisory Board – Identifying alternatives for state-wide health information exchange
  19. 19. Lessons LearnedLessons Learned • Develop a common mission of lowering regional health care costs • Recognize that clinical data and information technology should not be used as competitive tools • Where possible, adopt technical standardization • Be creative about sharing resources
  20. 20. Thank You Nancy Vorhees (509)232-8104