1. UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project Sponsor: Dr. Michael Gropper, Acting Chair of Anesthesia Project Champions: Dr. Raman Khanna, Dr. Priyanka Agarwal, Min Zhu BCD Facilitator: Todd Elkin

2. 2 The ask:  Scope: Emerge Pilot  Integration (all one way outbound): ADT & ADT Coded, Orders/Results (Lab, Path), Results (Rad, Card), Doc Flowsheets, Pharm orders, Problems, Notes  Standing up 2 Virtual Machine Servers and associated connectivity  No request for data manipulation, device integration (both addressed by Emerge)  Size (IT/CS): Large; 2,551 Hours  IT/CS Total Cost (Vendor, Labor, …,): $354,825  IT Systems Engineering labor: 200 hours / $24,000  Hardware/software: Direct bill to project  IT Interfaces labor: 1,635 hours / $220,725  Epic (License fees and Implementation): $30,000  IT QA Team labor: 160 hours / $20,000  CS Reporting labor: 40 hours / $5,000  CS SMEs: Clin Doc, Orders, Pharmacy: 100 hours / $13,500  CDHI PM: 20%, 416 hours / $41,600  Maintenance: $3,500 (annual Epic vendor fees for net new interfaces) $TBD (add’l IT interface support will require CTG approval, post pilot)  Funding : Implementation is 100% Funded by the Gordon & Betty Moore Foundation Maintenance is TBD, post pilot.  Client & IT/CS negotiated timeline: Aug 2014 – Sep 2015

3. Overview: Project Goals 3 Project span 9 & 13 ICU – 32 beds Eliminate Preventable Harms CLABSI Delirium Ventilator–Associated Harms ICU Acquired Physical Impairment DVT / PE Loss of Respect & Dignity Misaligned goals of care Optimize Patient Outcomes and Experiences Reduce Healthcare Costs

4. Overview: Project Components 4 Culture Comprehensive Unit-based Safety Program (CUSP) Patient Family Advisory Council (PFAC) Technology Emerge Application Website

5. The Goal

6. Example: Ventilator Associated Harm 6

7. EHRSensors Patient & Family Members Care Team Members Emerge Ecosystem Open Source Platform

8. 8 Emerge Application – IT Integration

9. Key Outcomes 9 Disparate data integrated in a single visual metaphor Provider, Patient, & Family SatisfactionPatient Quality Outcomes

10. 10 The ask:  Scope: Emerge Pilot  Integration (all one way outbound): ADT & ADT Coded, Orders/Results (Lab, Path), Results (Rad, Card), Doc Flowsheets, Pharm orders, Problems, Notes  Standing up 2 Virtual Machine Servers and associated connectivity  No request for data manipulation, device integration (both addressed by Emerge)  Size (IT/CS): Large; 2,551 Hours  IT/CS Total Cost (Vendor, Labor, …,): $354,825  IT Systems Engineering labor: 200 hours / $24,000  Hardware/software: Direct bill to project  IT Interfaces labor: 1,635 hours / $220,725  Epic (License fees and Implementation): $30,000  IT QA Team labor: 160 hours / $20,000  CS Reporting labor: 40 hours / $5,000  CS SMEs: Clin Doc, Orders, Pharmacy: 100 hours / $13,500  CDHI PM: 20%, 416 hours / $41,600  Maintenance: $3,500 (annual Epic vendor fees for net new interfaces) $TBD (add’l IT interface support will require CTG approval, post pilot)  Funding : Implementation is 100% Funded by the Gordon & Betty Moore Foundation Maintenance is TBD, post pilot.  Client & IT/CS negotiated timeline: Aug 2014 – Sep 2015

11. Appendix 11

12. 12

13. Platform APIs Apps End Users Clinicians, Hospital Leadership, Staff, Patients and Families App Developers, Content Creators App 1 Platform App 2 App 3 App 4 App 5 EHR Systems Devices & Sensors Hospital Data UI Devices Data Sources Open Source Platform 13

14. Condition Specific Display

15. Example: VAHI 15

16. Context and Background Preventable harms in health care are the 3 rd leading cause of death in U.S.  1/5 ICU patients will endure a preventable harm  Patient / Family burden  Societal burden  Health care cost burden

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18. Grant Details 18

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20. Thank you! 20