Clinical Information System Implementation Project Prepared for

Clinical Information System Implementation Project Prepared for Clinical Affairs Committee December 4, 2002

Clinical Information System Outline Objectives Clinical Systems Overview Critical Success Factors CIS Implementation Plan Project Committee Structure Next Steps December 4, 2002 Information Technology Department 2

Objectives Implement a Clinical Information System that complements our leadership role in healthcare delivery Meet or exceed all Leapfrog requirements Improve effectiveness and quality of care delivery Regularly quantify medical, financial, and patient satisfaction benefits Deliver high quality care that achieves the best outcomes in the most costeffective manner. Develop and maintain a controlled medical vocabulary (CMV) Implement a Computerized Physician Order Entry (CPOE) process Ensure compliance with HIPAA information security and privacy mandates Build and populate an online, real time computerized patient record (CPR) December 4, 2002 Information Technology Department 3

Clinical Systems Overview Users Location Specific and Distributed Transaction Systems Enterprise Applications Scheduling, Case Management Order Entry / Results U S E R S Pharmacy Clinical Documentation ADT/Registration Radiology STOR Surgical Scheduling Clinical Decision Support December 4, 2002 I N T E G R A T I O N T O O L S Archive Clinical Reporting Management EIS Regulatory Agencies Performance Report Card Data Warehouse Clinical Data Repository Clinical Decision Support M E T A D A T A Archived Archive Lightly summarized Highly summarized EMPI Interface Engine Information Technology Department 4

Computerized Patient Record (CPR) December 4, 2002 Information Technology Department 5

Information Security Elements of CPRs Availability - when and where needed Authentication - a person or system is who they purport to be Access Control - only authorized persons, for authorized uses Confidentiality - no unauthorized information disclosure Integrity - information content not alterable except under authorized circumstances Attribution/non-repudiation - actions taken are reliably traceable December 4, 2002 Information Technology Department 6

Critical Success Factors Close ties between the organization’s strategic plan and the CPOE project Continuous executive support Getting the right people involved at the correct level Focus on implementing people and process changes needed to support improved care, rather than on implementing a new computer system; technology is important but the organizational challenge is greater Strong physician leadership and communication in all aspects of the project Flexibility and willingness on the part of the vendor and Information Technology to tailor the system as needed to support the organization December 4, 2002 Information Technology Department 7

CIS Implementation Plan December 4, 2002 Information Technology Department 8

CIS Implementation Process Eliminate Duplicate Patient Numbers (9/02 – 6/03) Cleanup of duplicate medical record numbers throughout UCSF. This process includes the combining of all electronic patient records as well as all paper records. Admitting Module (9/02 – 2/03) Implementation of IDX LastWord Admitting module. Transfer of inpatient admission process from using IDXtend Outpatient Visit application to true inpatient admitting application. Includes use of barcoding technology for patient identification. Pharmacy Module (9/02 – 5/03) Implementation of IDX LastWord Pharmacy module. Conversion of inpatient pharmacy from current Mediware Pharmacy system to integrated IDX application to enable meeting Leapfrog requirements. Emergency Department (9/02 – 5/03) Implementation of IDX LastWord Emergency Department module. This task will provide ED with the ability to care for and track patients in an emergency medicine environment. December 4, 2002 Information Technology Department 9

CIS Implementation Process Order Entry / Results Reporting (9/02 – 7/04) Implementation of IDX Order Communication and Results Reporting module. This process includes all orders for all ancillary departments and their corresponding results. Physician (9/02 – 7/04) This process primarily involves physicians and focuses on the design, development, testing and implementation of Computerized Physician Order Entry (CPOE) throughout UCSF. Nursing (9/02 – 7/04) This process primarily involves nurses and focuses on the design, development, testing and implementation of nursing orders and results reporting throughout UCSF. Ancillary (9/02 – 7/04) This process primarily involves ancillary departments and focuses on the design, development, testing and implementation of ancillary orders and results reporting throughout UCSF. December 4, 2002 Information Technology Department 10

CIS Implementation Process Leapfrog Compliant (7/04) At this milestone event in the CIS implementation, UCSF will be compliant with all Leapfrog requirements. Stor Conversion (4/03 – 7/04) Conversion of all patient data from the in-house developed STOR application to LastWord's Computerized Patient Record. Clinical Decision Support (1/04 – 11/05) Establishment of a Clinical Decision Support System to provide a clinical and business data repository for research and analysis. Includes the implementation of a data warehouse to store and process all data. Nursing Care Plans and Charting (7/04 – 6/05) Implementation of the IDX Nurse Care Plans and Charting module. This task will provide Nursing with an automated tool for entering and utilizing acute care plans throughout the organization. This does not include critical care. December 4, 2002 Information Technology Department 11

CIS Implementation Process Critical Paths (6/05 – 5/06) Implementation of IDX Critical Paths module. This process addresses the development of critical pathways for all medical and surgical patients. Physician Critical Paths (6/05 – 5/06) This process primarily involves physicians and focuses on the design, development, testing and implementation of physician critical paths throughout UCSF. Nursing Critical Paths (6/05 – 5/06) This process primarily involves nurses and focuses on the design, development, testing and implementation of nursing critical paths throughout UCSF. Ancillary Critical Paths (6/05 – 5/06) This process primarily involves ancillary staff and focuses on the design, development, testing and implementation of ancillary critical paths throughout UCSF. December 4, 2002 Information Technology Department 12

CIS Implementation Process CIS Foundation Implementation Complete (5/06) At this milestone event, the initial implementation of the Clinical Information System is complete. December 4, 2002 Information Technology Department 13

Project Committee Structure I n f o r m a t io n T e c h n o lo g y S te e r i n g C o m m i tt e e C I S I m p le m e n ta tio n C o m m itte e C IS P h y s ic ia n S u b c o m m itte e C IS N u rs in g S u b c o m m itte e C IS D e p a rtm e n ta l S u b c o m m itte e December 4, 2002 Information Technology Department 14

Next Steps Approve 5 year project funding . . . . . . . . . . . . . . . . . . . . . . . . . . .Completed . IDX customer site visits for key stakeholders . . . . . . . . . . . . . . . . . . Started Begin UCSF-wide communications regarding CIS project . . . . . . Not . . Started Hire CIS Program Director . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Completed . Appoint physician leader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Started Finalize implementation plans with IDX . . . . . . . . . . . . . . . . . . . . . . Started Identify and schedule IDX staff resources . . . . . . . . . . . . . . . . . . . Not . . Started Identify and schedule other consulting resources . . . . . . . . . . . . . . . . Started Identify space and furnish CIS Program Office . . . . . . . . . . . . . . . . . Started Establish CIS Steering Committee and subcommittees . . . . . . . . . . . Started Perform Readiness and Risk Assessments . . . . . . . . . . . . . . . . . . . . . Started Develop job descriptions for CIS Project Team . . . . . . . . . . . . . . . .Completed . Hire CIS Project Team . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Started Present CIS Implementation Plans to IT Steering Committee . . . . .Completed . December 4, 2002 Information Technology Department 15

Summary and Questions December 4, 2002 Information Technology Department 16