1. 1 IS/Clinician Partnership Clinical Information Systems Steering Committee (CISSC) Update to COEC John D. Halamka MD Justine M. Carr MD

2. 2 CISSC Purpose Provide a multidisciplinary forum to communicate and coordinate projects among our various IS governance committees

3. CISSC Membership Chair of the Laboratory Information Systems Committee Chair of Radiology Information Systems Committee Chair of Critical Care Information Systems Committee Chair of Inpatient Information Systems Committee Chair of Ambulatory Information Systems Committee Chair of Health Information Management Committee Chair of Community Information Systems Committee Chair of Decision Support Information Systems Committee Chair of Revenue Cycle Information Systems Committee Medical Executive Committee Representative Operating Room Executive Committee Representative

4. 4 ICU 2008 ICU Documentation System (Vendor Metavision) –Live in NICU and Finard, ongoing rollout to other ICUs in 2008 –Clinical documentation and monitoring program that replaces Carevue –Benefits: Quality, Safety, Efficiency Multidisciplinary electronic documentation, enhanced by data from electronic monitoring. Standardized terminologies and problem list drive documentation. All notes by all caregivers will be completed electronically during ICU stay

5. 5 Perioperative (PIMS) 2008 Peri-anesthesia modules (Built in-house) –Pre-Op assessment in PAT clinic –Holding Area assessment –Pre-op Checklist RN and MD –Patient arrival (replaces old CCC function) –PACU log (replaces old CCC logs) Benefits: Quality, Safety, Efficiency, Compliance –RN documentation on line –Check list signed –H&P update real time –Identification of sleep apnea risk

6. 6 Inpatient H&P/Med Rec 2008 Inpatient H&P with med reconciliation pilot –June 2008 (Built in-house, P4P) Benefits: –Quality, Safety, Efficiency, Compliance –On-line documentation of H&P –Medication reconciliation interfaces with webOMR medication list –H&P interfaces with discharge summary now, and with progress notes when developed

7. 7 Oncology Management 2008 Oncology Management System (Built in-house) –Outpatient launched in 2007 –Inpatient launches in June 2008 –Patient dashboard with results Benefits: Quality, Safety, Efficiency –Chemotherapy ordering system that captures both inpatient and outpatient drug history and insures correct dosing.

8. 8 Emergency Department 2008 Medication Reconciliation –Vendor partnership with Fore runner –Live in 2008 History and physical and documentation –Vendor partnership with Fore runner –Under development

9. 9 Web OMR 2008 webOMR (Built in-house) Rolled out to all physician practices By July 31, 2008 all providers will use: –Medication List –Notes –Orders –Problem List –Results Benefits: Quality, Safety, Efficiency, Compliance –Medication reconciliation, –Decision support –Continuity of care across providers

10. 10 Ambulatory Projects E-prescribing (P4P) –Fully implemented with eligibility checking, formulary enforcement, routing to retail and mail order pharmacies, and community-wide medication history with drug/drug and drug/allergy checking. –Benefits: Quality, Safety, Efficiency Outpatient document scanning –Begun May 2008 –Dermatology notes (including drawings) scanned –Integrated with webOMR –FY09 evaluate addition of other applications

11. 11 Laboratory System 2009 Lab Information System (Vendor Soft Lab) –Goes live September 2009 (replaces CCC) –Benefits: Safety and Efficiency Eliminates need for relabeling samples Transfers to vendor the responsibility for ongoing alignment with FDA certification (Blood Bank) Eliminates need for customized interface with each new laboratory instrument Eventually will be able to show glucometer results

12. 12 Clinical Systems Plan

13. 13 Examples of CISSC Discussions How to coordinate QI Directors, PCAC and IS processes How to coordinate OREC, Critical Care, and anesthesia processes How to coordinate inpatient and outpatient oncology ordering and pharmacy systems How to communicate changes in lab and radiology systems to clinicians