1. A Live Implementation of Business (Care) Process Management Technology to Streamline Discharge Readiness Planning E-Health 2013 Cameron Keyes May 27, 2013

2. Conflict of Interest and Disclosure Cameron Keyes, MSc Has no real or apparent conflicts of interest to report © 2013 HIMSS

3. Key Take Away Points  Why there is a need for business process management in healthcare  What is TOH’s strategy for implementing “care” process management (CPM)  How we are rolling it out to streamline discharge readiness planning

4. The Hospital’s Vision – “ To provide each patient with the world-class care, exceptional service and compassion that we would want for our loved ones ” The Ottawa Hospital

5. Characteristics of Patient Care Processes today Lab Registration/ Scheduling Physician Nursing Unit OR Patient Medical Imaging OHP CCAC LTC Home New layer to orchestrate People, Processes, Data and Technology The Ottawa Hospital Way BPM CPM

6. CPM Journey LaunchAdoptTransform Maturity Conducting initial workshops Quick Win Pilots: Health Records, Wellness BPM Office Concurrent projects Development & Execution DRP, VTE, Wellness (ph 2), Health Records (ph 2) CPM Transformation Program Implementation Aug 2011Dec 2011 Adapted From: Dyer et al. 2012. Scaling BPM Adoption From Project to Program with IBM Business Process Manager. IBM. CPM Capabilities Jan 2012 - Present Key component of transformation strategy Expanded platform - Rules / Event Engine

7. Discharge Readiness Planning Process Inpatient Care Team Pain Points Lack of Clinician Accountability ‘Open Loop’ Communication Processes Delegated Actions Inability to keep track of who’s doing what

8. The Patient Care Team will become visible to everyone Care providers will have clearly identified tasks that they are accountable to report on Issues affecting discharge will be flagged at the beginning and the Medically Ready Date of the patient will be tracked and communicated throughout the patient’s stay The Main Goals of the Pilot

9. Application Layer Patient RegScheduling OR Mgmt EMR Communications … Enterprise Service Bus / Integration Engine Care Process Management Capabilities Web / Mobile User Interfaces HL7 MessagingDatabase ManagementRTLS BPMSRules/Event EngineBI ToolsCollaboration Messaging PCiPhoneiPadPortal Enterprise Process Architecture and Key Components RFID NursePhysician Health Professionals Whiteboard Notifications Entitlement

10. Process Driven Design

11. DRP: Mrs. Alice Blue’s Journey Notification to in-patient team Mrs. Blue is admitted to Service Setting Medically Ready Date Notification to other health professionals Mrs. Blue is discharged ED Consult Request Consult alert acceptance/ delegation Receiving acceptance Unstable Convalescent 48 h 24 h

12. Electronic Consult Requests

13. Physician estimates the Medically Ready for Discharge Date and requests Orders for Therapeutic Services

14.  A simple, easy to use visual interface that identifies the providers involved in patient’s care Circle of Care & Patient Roster  Patient Roster listing patient discharge status viewed by all team members

15. Key Leanings  Cultural Change  Careful selection of initial projects to demonstrate value and learn  New operating model  Embedding into existing infrastructure  Iterative approach  Measuring success

16. Thank you! Cameron Keyes Director, Healthcare Process Transformation The Ottawa Hospital (613) 737-8899 x 75910 cakeyes@toh.on.ca