Presentation on theme: "CENTRICITY PERIOPERATIVE ANESTHESIA Oregon Health & Science University, Portland, Oregon Stephen T. Robinson, MD Associate Professor of Anesthesiology."— Presentation transcript:
CENTRICITY PERIOPERATIVE ANESTHESIA Oregon Health & Science University, Portland, Oregon Stephen T. Robinson, MD Associate Professor of Anesthesiology and Perioperative Medicine Vice Chair for Finance System General Electric Centricity Perioperative Anesthesia (CPA) Preop Installation: November 2006 replaced Department- developed preoperative system Intraop Installation : November 2007 replaced paper records EMR and AIM systems AIMS Service: Available throughout the hospital and any remote terminal; activity used in all ORs (except MRI rooms), L&D, preoperative clinic, some Out-of- OR sites AIMS Uses: Preoperative documentation, intraoperative documentation, postoperative notes, procedure notes AIMS Interfaces: ADT (EPIC); Scheduling (CPM); laboratory Effort involved in purchase, installation, and maintenance Primary Driver: Department Secondary Driver: Hospital and IT Goals: Convert internal preoperative record into commercial product and create electronic record for more accurate and searchable records Implementation timeline: 8 months for preoperative go-live; 20 months for intraoperative go-live FTE for implementation: Highly variable; at peaks Department 3-4, hospital and IT 2, vendor 2-3 FTE for maintenance: 2-4 with primary tasks assigned to 6 individuals and secondary tasks to others Under the hood Offsite servers Connection via Citrix servers Monitor data stream converted and forwarded by Capsule Technologies to MDIL to CPA Clinical data maintained in a cluster with one server and one on standby. SQL restore points every 15 minutes Tape backup once a day Report server updated daily User interface Lessons learned RFP Know why you want an AIMS Engage all elements of your hospital to develop Understand both your users‘ needs and what is realistic for an AIMS to achieve Site visits Look at like organizations Use a wide variety of team members: IT, nursing, etc. Vendor contract Define all hardware, software, and installation requirements and costs Set specific installation and performance requirements and include general functionality expectations Have consequences with teeth User training Don’t scrimp Training the trainers is as important as the training itself Professional billing A clean record provides the greatest benefit to support billing Billing modules offer incremental value if they work Benefits of AIMS Template for documentation of a legible record Ability to electronically monitor compliance Ability to drive care process Ability to look at processes and outcomes in a large database Detriments of AIMS Requires ongoing support Challenging when not working Limitations requiring workarounds Practice environment Academic practice 45 operating rooms at 5 sites plus L&D and Out-of-OR locations Perform 34,000 cases per year System used on 80% of cases Staff includes 65 faculty, 37 residents, 6 fellows, and 28 CRNAs Staffing includes medical direction of residents and CRNAs and some solo practice EMR vendor: EPIC used by all providers including nursing for perioperative documentation Use of EPIC by anesthesiologists: Order entry, chart review including PACs access, some clinical documentation Relationship between CPA and EPIC: ADT, cut-and-paste
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