Trinity Health, Advancing Clinical Quality and Patient Safety with Health Information Technology Paul Conlon, PharmD, JD SVP, Clinical Quality and Patient Safety

We serve together in Trinity Health in the spirit of the Gospel, to heal body, mind and spirit, to improve the health of our communities and to steward the resources entrusted to us. Respect Social Justice Compassion Care of the Poor and Underserved Excellence Inspired by our Catholic faith tradition, Trinity Health will be distinguished by an unrelenting focus on clinical and service outcomes as we seek to create excellence in the care experience. Trinity Health will become the most trusted health partner for life. We support each other in serving our patients and communities We communicate openly, honestly, respectfully and directly We are fully present We are all accountable We trust and assume goodness in intentions We are continuous learners Mission Core Values Vision Guiding Behaviors Trinity Health

3  Fourth Largest Catholic Health System in the U.S.  44 Hospitals (32 Owned and 12 Managed) Across the Nation  Eleven of our 15 Michigan hospitals have electronic health records  8,074 Active Staff Physicians  44,500 Full-Time Equivalent Employees  Revenue of $6.3 Billion  $376 Million in Community Benefit Ministry

 Clinicians able to access records and place orders (drug, lab, etc.) any place and any time  Nurses spending more time at bedside rather than with paper records  Emergent medications administered 40 percent faster  Comparative effectiveness across 22 hospitals eliminates clinical variation with standardized order sets and drug formularies:  $1 million/yr of savings from Echinocandin drug class and Hematopoietic agents standards  31% reduction in patient falls with injury  45% reduction in pressure ulcers  29% reduction in severity-adjusted mortality  Computer-generated alerts (60,000 in 5 years) prompting physicians to change medication orders  Hardwired alert on diabetes medication (Avandia) sent to all hospitals within 10 days of FDA warning Smarter, Safer, More Cost-Effective Care - $300 million investment in EHR called Genesis - 25 hospitals – 11 in Michigan – are fully “live” with EHRs - One of nation’s largest single repositories of standardized data - Over 7 million interconnected patient records Nation’s first rural, integrated, EHR network  Medication verification conducted by a remote pharmacist, eliminating rural staffing expense  Transfer patients no longer wait for records to be copied & couriered by ambulance driver ID IA WVWV Key  Hospital with drug alert system  Fully “live” hospital with EHR, physician order entry, drug alert system, supply chain, and patient accounting/revenue management

Trinity Health Michigan Hospitals with an Electronic Health Record  St. Joseph Mercy Hospital – Ann Arbor  St. Joseph Mercy Hospital – Oakland  St. Joseph Mercy Hospital – Saline  St. Joseph Mercy Hospital – Livingston  St. Mary Hospital – Livonia  Mercy Hospital – Port Huron  St. Mary Hospital – Grand Rapids  Mercy Health Partners – Muskegon  Battle Creek Health System – Battle Creek  Mercy Hospital – Cadillac  Mercy Hospital - Grayling

Accomplishments to Date on the Clinical Platform  Over 7 million patients within the EMR  Clinical, financial and administrative data is contained in a single location  2 facilities have clinics managing inpatient & outpatient care in the same system  In 26 hospitals fully implemented… –Computerized Prescriber Order Entry (CPOE) with physician entry rates average 74% and as high as 84% of all orders –100% of the previous paper medical record is now electronic –More than 1,200 caregivers use the system simultaneously daily –300,000 chart openings per day. –Inpatient nursing care, pharmacy, and medication administration is documented directly by providers in the same electronic system. –Over 600,000 orders are placed, processed, and completed per day –Over 700 physicians place orders each day.

Current Performance and Recognition  Severity adjusted mortality rate at 71% of expected  HCAHPS “Would Recommend” score at the 76 th percentile  100% of core measure performance is greater than the national average –47% of hospital level core measures above the national top 10%  Trinity Health received the Thomson Reuters 100 Top Hospitals®: Health System Quality/Efficiency Benchmarks Top 10 System award  6 of our hospitals are recognized as Thomson Reuters 100 Top Hospitals  Trinity Health is the recipient of the 2004 National Health Care Quality Award

Is a Universal Medical Record Possible?  The goal of exchange of information between providers on behalf of patients is possible  It is likely not going to be a single data repository  It is likely going to be virtual record  Must have NATIONAL Interoperability Standards