1. Health Care Information Technology 2010 David S. Muntz August 25, 2010 ©

2. © 2010 Baylor Health Care System Agenda: Lets talk about Us – Baylor Health Care System US healthcare system Current state Future state Me Advice for those of us seeking opportunities within healthcare IT You You and Us 08/25/2010 22

3. © 2010 Baylor Health Care System 08/25/2010 3 Trick Question: Is this half-full or half-empty? Healthcare CIO Personality Test

4. Us – Baylor Health Care System 4

5. © 2010 Baylor Health Care System 5 Baylor Health Care System Founding Statement Is it not now time to build a great humanitarian hospital, one to which men of all creeds and those of none may come with equal confidence? Dr. George W. Truett, 1903 Co-founder of Texas Baptist Memorial Sanitarium, predecessor of Baylor Health Care System 08/25/2010

6. © 2010 Baylor Health Care System 6 Guided by Baylor Values Integrity Servanthood Quality Innovation Stewardship Baylor Health Care System Circle of Care 08/25/2010

7. © 2010 Baylor Health Care System 7 Baylor Health Care System – By The Numbers Faith-based, not-for-profit health care provider based in North Texas 26 owned, leased or affiliated hospitals 120,700+ admissions 20,000+ babies born 340,000+ emergency department visits 550,000+ outpatient registrations (excluding ED and home care) 3,423 licensed beds 20,000+ employees 3,000+ physicians on active staff Largest hospital has 1025 beds; smallest community hospital has 69 beds 08/25/2010

8. © 2010 Baylor Health Care System 8 Baylor Information Services (BIS) Innovation* Information 08/25/2010

9. © 2010 Baylor Health Care System 9 Top 20 Great Ideas - 2009 08/25/2010

10. © 2010 Baylor Health Care System 10 Health Care Innovator Finalist 2009 08/25/2010

11. US Healthcare System

12. © 2010 Baylor Health Care System Information Technology is Changing Rapidly Virtualization of servers, storage, and workstations Remote hosted versus in-house Zero tolerance for downtime Data network bandwidth needs Wireless and mobile data and voice Explosive demands for medical image storage Data security threats and prevention requirements 08/25/2010 12

13. © 2010 Baylor Health Care System The Healthcare Industry is Changing Rapidly ARRA Stimulus/HITECH Act Meaningful use Quality reporting Obtaining certified products HITECH Act HIPAA rule changes Health Care Reform Data needs for new payment models (i.e. ACOs, Medical Home) Ubiquitous access to records and quality data across the continuum 08/25/2010 13

14. © 2010 Baylor Health Care System Test: How does this relate to a healthcare CIO? 08/25/2010 14

15. © 2010 Baylor Health Care System Transformation Must Happen 08/25/2010 15

16. © 2010 Baylor Health Care System 16 Clinical Transformation: A Simple Definition People People Processes Processes Technology Technology People People Processes Processes Technology Technology Integrating clinical and non-clinical process improvements with enabling technologies Hardwiring STEEEP* *IOM Model: Safe, Timely, Effective, Efficient, Equitable, Patient-centered care. 08/25/2010

17. © 2010 Baylor Health Care System 17 Transforming Healthcare Delivery Installation is hard, and mainly technical Implementation is really hard, and mainly organizational Transition (lasting change) is incredibly hard, and purely human Transformation is a state of profound new personal and enterprise behavior Marc Overage, MD, Regenstrief Institute, Inc: A Healthcare Laboratory and a Community of Scholars 08/25/2010

18. © 2010 Baylor Health Care System Patient View of Hospital Workflow 08/25/2010 18 Patient Identification and Registration Patient Medical Services and Procedures Provided Patient Billing and Account Reconciliation Understanding Integration

19. © 2010 Baylor Health Care System 08/25/2010 19 Very Simplified Data Flow Map

20. © 2010 Baylor Health Care System 08/25/2010 20 Communications between programs is our biggest challenge.

21. © 2010 Baylor Health Care System 08/25/2010 21 Communications between programs is our biggest challenge.

22. © 2010 Baylor Health Care System 22 Lets talk about the future. 08/25/2010

23. © 2010 Baylor Health Care System 23 Predictions are dangerous, especially when you are talking about the future. - Yogi Berra 08/25/2010

24. © 2010 Baylor Health Care System 24 That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble, both to the patient and to the practitioner because its hue and character are foreign and opposed to all our habits and associations. That it will ever come into general use, notwithstanding its value, is extremely doubtful because its beneficial application requires much time and gives a good bit of trouble, both to the patient and to the practitioner because its hue and character are foreign and opposed to all our habits and associations. from The London Times in 1834 Commenting on... the stethoscope A computer for patient care? 08/25/2010

25. © 2010 Baylor Health Care System 25 Other Prognosticators Everything that can be invented has been invented. I think there is a world market for maybe 5 computers. Who the hell wants to hear actors talk? Charles Duell, Director of the Patent Office, 1899 Thomas Watson, IBM, 1942 H. M. Warner, Warner Bros., 1927 08/25/2010

26. © 2010 Baylor Health Care System Healthcare Today: There are so many participants. 08/25/2010 26 Delivery Systems Physicians Payers/ CMS Patients (Well & Ill) & Families BHCS Board Vendors & Suppliers Community Employees CDC, Depts Health Employers Pharmacies & PBMs Reference Information Producers

27. © 2010 Baylor Health Care System We must have electronic health records. 08/25/2010 27 Yesterday & Today Today & Tomorrow

28. © 2010 Baylor Health Care System 28 Why cant you do what my bank does? 08/25/2010

29. © 2010 Baylor Health Care System 29 08/25/2010

30. © 2010 Baylor Health Care System 30 Were building a Health Information Exchange (HIE) 08/25/2010

31. © 2010 Baylor Health Care System 31 Will my health information be safe at Baylor? 08/25/2010

32. © 2010 Baylor Health Care System 32 How do you balance security and access? Security Access Moredata …others 08/25/2010

33. © 2010 Baylor Health Care System 33 HITRUST announced today, March 17,2009, that it has recognized five organizations with the HITRUST Leadership Award. These organizations are honored for their exceptional dedication and contribution in the creation of the HITRUST Common Security Framework (CSF), and their exemplary leadership for the entire healthcare industry. The HITRUST Leadership Awards are presented to: Baylor Health Care System Express Scripts Inc. Humana Highmark Kaiser Permanente Is there a benchmark which measures the security of my information? March 2009 08/25/2010

34. Underway in FY 2010 FY 2011 and beyond Enterprise Data Management Infrastructure Patient Provider Integration & Portals New Areas, Research, Education, & Business Continuity Planning BCHS Information Services Timeline – Start Dates Enabling Technologies Electronic Health Record, Clinical Services, & Global Elements Administrative Systems Future State Hardwiring STEEEP Eclipsys, LIS, RIS Ambulatory EHR Patient Acuity & Staff Scheduling EHR for non-HTPN Physicians CLMM – BUMC, Plano CLMM – All Others BCP - All Scheduling Secure Messaging/Reminders e-Visits e-Prescribing Clinical Decision Support Disease Management Medical Home Bariatrics Diabetes Womens Services Neuroscience Oncology Cardiovascular Population Management Medical Informatics - Local - Regional - National Health Information Exchange Knowledge Bases Personalized Patient Schedule Personal Health Records Telemedicine Home Monitoring AP & GL Portals Enhancement Security Management Program EDM Governance Integration of USPI Integration of Eclipsys and GE Med Staff AR HR SCM CDM Biometrics SSO Identity Management Audit Framework Office Automation Videoconferencing Robotics Remote Access Encryption Interpreter Services Smart Cards Podcasts Device Management RFID Platform management & capacity planning Common Desktop Image Management Unified Messaging Switch Upgrades VOIP Uniform Dialing Plan Consolidation of 500+ Applications Physician Engagement Change Management CPM/Zynx Systemness Redefinition of Legal Medical Record Governance LEAN VMR Pain Management Centers Arlington Orthopedic Hepatology Clinic Cancer Center McKinney Business Continuity – AR/HR Simulation Education Research 08/25/2010 34

35. © 2010 Baylor Health Care System 35 The FUTURE: HIT is at the foundation. http://www.healthpolicyaudioconferences.com/hpaudio20090521/index.html 08/25/2010

36. Me 08/25/2010 36

37. © 2010 Baylor Health Care System Most frequently asked question 08/25/2010 37 Q: What path did I take to reach my position today? A: I followed my passion. Serendipity, mercy, and compassion.

38. You 08/25/2010 38

39. © 2010 Baylor Health Care System 39 Now Lets Talk About You Q: What suggestions do you have for those of us seeking opportunities within healthcare IT? 08/25/2010

40. © 2010 Baylor Health Care System 40 08/25/2010 40 Critical Success Factors? Degrees and Certifications AART AB BA BS CAN CCA CCNA CCNP CDP CIA CISSP CNE CPA CPHIMSS FACHE FCHIME MBA MCP MCSE MD MHA MHSA MSE MT(ASCP) PMP RHIA RN RT Equivalent experience

41. © 2010 Baylor Health Care System 41 08/25/2010 41 The Real Critical Success Factors Ability to communicate Orally In writing Deep understanding of business Customer empathy Collegiality / collaborative posture Humor Optimism Patience Technical skills

42. You and Us: How to create an employee/employer relationship. Disclaimer: Beware of subliminal messages! 08/25/2010 42

43. © 2010 Baylor Health Care System 43 08/25/2010 43 You and us: How can I apply for a job?

44. © 2010 Baylor Health Care System 44 08/25/2010 44 You and us: How can I apply for a job?

45. © 2010 Baylor Health Care System 45 08/25/2010 45 Advice Before You Get the Job Create a great resume Accurate Customized to the recipient Interesting For the interview Listen Be sincere Ask questions TAKE NOTES Ask for other leads Ask more questions TAKE NOTES After the interview Send a thank you Be persistent, patient, realistic Dont accept the first offer Make sure you want the job Pursue your passion

46. © 2010 Baylor Health Care System 46 08/25/2010 46 Advice After You Get The Job Listen Seek advice and counsel from coworkers at all levels Honor diversity Dont assume that if you deserve something, you will get it Persistence is more important than intelligence Dont let great get in the way of good Most important motivator is recognition Money is the least important motivator Be grateful Be respectful Be honest Acknowledge the contribution of others Greatest compliment you can give is Can I get your advice?

47. © 2010 Baylor Health Care System 47 "Computers are incredibly fast, accurate, and stupid; humans are incredibly slow, inaccurate and brilliant; together they are powerful beyond imagination." - attributed to Albert Einstein - 08/25/2010