0. How Content360 Solutions Helped Achieve HIMSS Stage 7
Jason Bickford
HIMS Applications Director

1. “We exist to make a difference in people’s lives through excellent patient care”
7 states / 23 Hospitals 
4,330+ Beds
35,000+ employees
9,000 employed physicians
55 bed simulation medical center

2. HIMSS Analytics Developed EMR Adoption Model in 2005.
Stage 7 represents an advanced patient record environment.
121 stage 7 US Hospitals.
Final evaluation of Stage 7 status is conducted via an on-site visit

3. HIMSS Analytics – Stage 7
NO PAPER CHARTS: The hospital no longer uses paper charts to deliver and manage patient care and has a mixture of discrete data, document images, and medical images within its EMR environment.
ANALYTICS: Data warehousing is being used to analyze patterns of clinical data to improve quality of care and patient safety and care delivery efficiency.
DATA SHARING: Clinical information can be readily shared via standardized electronic transactions (i.e. CCD) with all entities that are authorized to treat the patient, or a health information exchange (i.e., other non-associated hospitals, ambulatory clinics, sub-acute environments, employers, payers and patients in a data sharing environment).
DATA COTINUITY: The hospital demonstrates summary data continuity for all hospital services (e.g. inpatient, outpatient, ED, and with any owned or managed ambulatory clinics).

4. Why HIMSS believes Stage 7 Organizations are Successful
An enterprise that uses data to drive improved outcomes related to:
Process, Financial, Clinical, Quality & Safety
A paperless, or near paperless, organization 
All clinically relevant data is in the EMR
An enterprise fully committed to continuous process improvement through collaboration
Strong IT leadership and executive champions
Clinician/end-user champions
An organization that has embraced their technology supplier as a partner

5. Requirements for Stage 7 on paper documents
The Goal
Requirements for Stage 7 on paper documents
Clinically Relevant Documentation:  24 hours of creation of the document to be scanned into the EMR, for any medications, we expect those to be entered into the MAR before a patient is moved to the next unit of care.
Non-clinically relevant documentation: 72 hours after discharge is acceptable.

6. The Process
HIMSS Analytics surveyors conducted an on-site review of Banner’s EMR technologies at Banner Good Samaritan Medical Center located in Phoenix.
Suggested HIMSS Analytics Stage 7 Review Agenda:
Determine if coding staff requires paper for any paper/scanned documents that they must review.
Evaluate all documents being scanned to ensure they are being scanned in a timely fashion (critical information should be scanned ASAP, less critical information within 72 hours) and that no required electronic documentation is still on paper.
Evaluate dictation/transcription procedures for turn-around times relative to patient care impacts
Determine if floor space has been recovered from the removal of paper charts

7. The Test

8. The Solution: Content360 Document Imaging
Batch Capture: Complete capture within 24 hours
Frequent small batch scanning using Kofax
2005 Beginnings at Banner Estrella
Distributed point of service scanning for near real-time capture
: Phased model approach: PFS, LABS, & Clinical/CPOE
Hourly scanning and twice daily HIMS rounding
Single Document Capture: Real-time Capture
Direct scanning into Cerner applications
Real-time capture within the workflow: Horizon Labs, Drivers License, Insurance Cards, and ROI Authorization.

9. Content360 Reports Management at Banner
COLD feeds
Phillips EKG PDF
AGFA Echocardiogram PDF
ProVation Endoscopy PDF

10. Content360 Forms Management at Banner
Previous Forms Storage
Conent360 eForms

11. Content360 Forms Management at Banner
Forms Build
Forms Storage

12. Content360 Patient eSignature at Banner
PFS eSignature

13. Content360 Viewer at Banner
CPDI Transition
eForms printing
eSignature
Direct scan

14. Content360 solutions provide sophisticated document capture, storage
Content360 Benefits
Content360 solutions provide sophisticated document capture, storage
and retrieval — connecting users with relevant documentation within their daily
workflows.
Patient care and organizational performance are optimized by easy access to complete and usable electronic records.
Patients can sign electronic documents with a handwritten signature on a signature pad or tablet.
HIM staff can scan large volumes of paper in batches, flag and automatically route images for physician signature, and send coders home with remote access to images.
Physicians can electronically sign document images in the same application they sign transcribed documents and electronic orders.

15. HIMSS Stage 7 – Lessons Learned
Cultural Change
Strong leadership and communication
Training and ongoing support of both staff and leadership are essential
Perception and Diminish Individual Autonomy
Evidence based best practices
Work Flow Redesign
Rapid-cycle work redesign
Decision making includes participation of all stakeholders and functional area experts

16. Continued Partnership
Banner/Kofax/Cerner Content360 visioning session – March 2013
Cerner/Banner Health Strategic Roadmap Session – August 2013
How Banner defines innovation:
"Innovation at Banner is defined as the rapid identification and deployment of strategies leveraging Banner’s operating model and the science of care delivery to ensure an extraordinary patient experience, which is safe, efficient and effective."

17. QUESTIONS?

18. Visit the Enterprise Document Management pod within the Imaging Zone.