2 Topics Organization Overview EMR Implementation Journey at SKMC. EHR Implementation across SEHA and value propositionRealities of Healthcare
3 About SEHA Abu Dhabi Health Services Company (SEHA) Public Joint Stock Company owned by Govt. of Abu Dhabi.Focus to deliver world class medicine to residents of ADOwns and operates:12 Healthcare Facilities, 2,644 licensed beds62 AHCs/PHCs, 2 Blood Bank Centers and Diabetic Clinics.One of the largest employers in Middle East: 16,700 Staff
4 Sheikh Khalifa Medical City-SKMC Largest Hospital & Medical City in UAEFlagship Institution for Public Health SystemEncompasses several “Centers of Excellence”.Tertiary Care Teaching Hospital700 Beds ( 125 Behavioral Sciences)850K Patient visits, 7K Surgeries, 180K ED Visits14 Outpatient Specialty Clinics3,400 FTE (Over 50 Countries Represented)
5 SKMC AccreditationsApril 2011: The Surgical Pavilion, Medical Pavilion, 14 Outpatient Specialty Clinics and Abu Dhabi Blood Bank are all accredited by Joint Commission International (JCI)June 2009: SKMC is accredited as a Cycle III Chest Pain Center by the Society of Chest Pain Centers (SCPC). SKMC is the first hospital outside the USA to attain this accreditation for its cardiac and emergency servicesNovember 2012: Reaccreditation Level IVDecember 2010: SKMC Laboratory Medicine Department, Abu Dhabi Blood Bank and POC testing are accredited by the College of American Pathologists (CAP)December 2012: Reaccreditation
6 Snapshot History & Technology 2012200920102011200720082000EstablishedAcute care bed hospital &outpatient specialty clinicsSEHA(Abu Dhabi Health Services Company)Cleveland Clinic ManagementJCIA AccreditationDaily average approved beds: 775Infrastructure & EHR Implementation StartsEHR –Pharm, Lab, CPOE, Clinical Doc, Surgery, ED, RIS, PACSERP-Finance, HR , SCMUCEHR –Physician Doc.Critical Care, Device IntegrationJCIA Re-AccreditationCAP AccreditationEHR –AnesthesiaABNBMDIUnified Order EntryeRefferal
7 One Centralized Environment Achieve the eGovernment Vision – One Patient/One RecordEnables population health management across the system.Enables chronic disease management across the systemSystem wide reporting capabilitiesPersonal Health Record (National ID, communicate with physicians, schedule appointments and request refills at a countrywide level)Speed to ChangeEasier to implement government quality/regulatory initiatives across the systemSpeed to patient safety and Return On Investment (ROI)Easier to maintain/keep up to dateOverall CostLittle to no interoperability issuesReduced training costs, particularly for clinicians that practice at multiple facilitiesSignificantly lower Total Cost of Ownership
8 Health Care in the UAE Health Care Flow Hospitals Facilities After Health Care in the UAEHealth Care FlowHospitalsFacilitiesAfterBeforeSKMC HospitalNowBetweenMafraq HospitalUnderprocessOld WardsOrganizedAl Ain HospitalNew FacilitiesUnderprocessPaper; Paper Everywhere!!Diagnosis - No flow!!!Oasis Hospital, First In UAE
9 Technology - Strategic Themes Optimize Patient Flow and Satisfaction – Patient CentricEvidence Based Medicine/Order Sets/PathwaysIntegrated EMROptimize IT solutions & Provide operational dashboardsIntegration, BI, Data Warehouse, Reporting, Six SigmaEnhance IT governance and oversightCOBIT, PMP, ISO 20000Deliver world class IT service experience to staff:ITIL, ISO 20000, ISO 27001, PMP
10 IT Strategy Building Block Enterprise Master Patient Index - EMPIHealth Authority Oracle/AD/UCClinic – OutpatientHospital - Inpatient ADTEMRMallafiCore Clinical Inpatient & OutpatientAncillary Services: Laboratory – Pharmacy – Radiology – Surgery – EDEnterprise Business IntelligencePerformance Point/Anthem / CernerInterface EngineAncillary Services: PACS – CVIS – Critical Care – Blood Bank – Cardiology - CSSDBilling/Patient AcctingEnterprise Resource Planning ERPFinance – HR – Supply ChainInfrastructure
11 Buy-In and Deployment of EMR Leadership Support & Buy-in criticalPhysicians’ Engagement is a Must - ChampionsDo Not Automate Paper – Order Sets.Planned Measurements and Outcomes.Workflow & Process mapping (Before and After)Communication (Clinician Engagement, Early and often)Project Teams:ApplicationTechnologyClinical TransformationTraining
13 Application & Training Teams Application SpecialistsDesign, Build, ValidateIntegration & InterfaceImplementationSupportOver 50 Trainers & 12 Training RoomsOver 2900 clinical staff trained
14 Technology Team Service Desk & Desktop Support Back Office Systems Network and Telecommunication (UC)Wireless Deployment (Mobility).New Desktop Look & FeelIntranet Collaboration/WorkflowsEnhanced Security.
15 Malaffi Devices 250 Workstation On Wheels (WOW) 200+ wall-mounts carefully distributed across SKMC200+ Tablets - Utilized by physicians, Nurses, and Patient Experiece staff1000+ PCs and 900+ Printers/Scanners
16 Clinical Transformation & Communication Team Patient WorkflowReview & DesignProcess improvementEvidence-Based Order SetsDevice Road ShowComms Development and DistributionPatients, Staff and the Project TeamNewspaper Ads & Press ReleasesLong term view
17 Malaffi is the EMR composed of… Patient DemographicsInterfaces to Medical Equipment such as Laboratory Instrumentation and Bedside Medical Devices (e.g., Monitors, Ventilator's, etc.)Medication Ordering and Administration Details-eMARTest OrdersEmergency Department & Operating Theatre Tracking Boards and DocumentationTest ResultsHealth Reminders, Monitors, and Alerts* Not a comprehensive list of features/functions
18 Medication Process Improvement (Patient Safety) The “New and Improved” MethodThe “Old Fashioned” WayHand Written PrescriptionsPrinted Prescriptions
19 Malaffi Benefits & Business Imperatives Improve Patient Care - One Patient…One RecordPatient SafetyReduce Medical ErrorsCare DeliveryIncrease Physician Access to Clinical Information at the Point of CareEnables chronic disease management across the system (continuum of care)Increase Efficiencies/Cost EffectivenessTurnaround timeImprove Response Time to PatientsResource ConsumptionEliminate Redundant Test and Data Collection
20 PACS & CPACs PACS HIS Integrated and direct feed into EMR. Voice recognition: Radiologists report directly in EMR.Images stored electronically, viewed on any computer.System available 24 hours a day within health systemCPACSImages from ALL sites available, irrespective of the source.Inter-facility proxy reading.Inter-facility second opinion, on the fly.Acts as online back-up of local images on central archive.Eliminate need for duplicate exams
23 Record (EMR) Adoption Model US Electronic MedicalRecord (EMR) Adoption ModelIndustry standard Healthcare Information and Management Systems Society (HIMSS) Analytics Model for Electronic Medical Record (EMR) adoption
24 Asia Pacific EMR Adoption Model SEHA Facility Scores(as of Jan 2013)Mafraq – 5.32SKMC – 5.33Corniche –PilotMadinat Zayed – 6.008Tawam – 6.008Al-Ain – 6.008Al-Rahba – 6.008
25 Realities to Deal With Healthcare is becoming borderless. Patient experience will matter.Payment will be linked to value.Social care will blend with healthcare.Enterprises will need to focus on sustainability.
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