gillespie by suchenfz

VIEWS: 12 PAGES: 59

									       After the EHR:
Improving Quality and Safety
       Maryland HIMSS
        April 25, 2008
        William ‘Buddy’ Gillespie
               VP & CIO
             WellSpan Health
                York, PA
           Session Objective
• How to leverage existing EHR data by
  harvesting key clinical indicators to provide for:

   – Retrospective view of clinical performance
     measurements against established ―best-practice‖
     benchmarks
   – Feedback to quality improvement teams to trigger
     proactive adjustments to established programs
   – Real-time surveillance of clinical events
   – Intervention at point of care relative to infectious
     disease and ADE's
WellSpan Health –
  At A Glance

•   Geography
•   Facilities
•   Staff
•   Patient Care
       Drivers of Change
• Patient Safety & Quality of Care
•   Transparency Reporting
•   Regulatory & Legislative Mandates
•   Cost & Reimbursement
•   Patient Service & Satisfaction
•   Interoperability
•   Disaster Recovery
                                               2008 Survey
                                                                                     Sponsored by Cisco


  Top Business Issues Facing Healthcare
                                 (2008 vs. 2007 Results)                                 Figure 8


                   Improving Quality of Care
                                                                                   56%
                                                                                            69%
                         Medicare Cutbacks                               43%
                                                                               52%
             Patient (Customer) Satisfaction
                                                                       36%
                                                                                   55%
                         Demand for Capital                        34%
                                                                  31%
               Adoption of New Technology                          33%
                                                                     38%
Government Regulation or Compliance Issues
                                                                 30%
                                                           20%
            Creating New Revenue Sources
                                                                 28%
                                                N/A
     Increasing Need for Healthcare Services
                                                              26%
                                                                             45%

                                                      2007 Responses     2008 Responses
                                              2008 Survey
                                                                              Sponsored by Cisco


Current IT Priorities (Within Next 12 Months)
                                   (2008 vs. 2007 Results)                        Figure 6


           Inpatient Clinical Information Systems
                                                                      40%
                                                                            48%
   Reduce Medical Errors/Promote Patient Safety                      39%
                                                                              54%
                              Implement an EMR
                                                                     38%
                                                                            48%
    Connect Hospital with Remote Environments                    30%
                                                                   33%
     Business Continuity and Disaster Recovery                 27%
                                                                    35%
 Integrate Systems in a Multi-Vendor Environment
                                                               26%
                                                                   34%
                 Upgrade Network Infrastructure
                                                               26%
                                                              25%
         Implementing Ambulatory Care Systems
                                                             24%
                                                             23%

                                                    2007 Responses   2008 Responses
                                             2008 Survey
                                                                            Sponsored by Cisco


                    Projected IT Priorities
                            (Today vs. Next Two Years)                         Figure 7


          Inpatient Clinical Information Systems
                                                                      40%
                                                          23%
  Reduce Medical Errors/Promote Patient Safety                       39%
                                                         22%
                             Implement an EMR
                                                                     38%
                                                            26%
   Connect Hospital with Remote Environments                   30%
                                                          22%
    Business Continuity and Disaster Recovery                27%
                                                   14%
Integrate Systems in a Multi-Vendor Environment
                                                            26%
                                                   12%
                Upgrade Network Infrastructure
                                                            26%
                                                    15%
        Implementing Ambulatory Care Systems
                                                       24%
                                                     18%

                                                     In Two Years      Today
                                                     2008 Survey
                                                                                      Sponsored by Cisco


Most Important Applications (Next Two Years)
                                     (2008 vs. 2007 Results)                          Figure 10


                     Clinical Information Systems                                 45%
                                                                                  46%
 Computer Based Practitioner Order Entry (CPOE)                                 42%
                                                                                   47%
                Electronic Medical Record (EMR)
                                                                        31%
                                                                                    47%
     Enterprise-Wide Clinical Information Sharing                       30%
                                                                          35%
           Closed Loop Medication Management                            30%
                                                     N/A
                         Clinical Data Repository                       29%
                                                                              37%
                    Point-of-Care Data Collection
                                                                  21%
                                                                        29%
                                   Clinical Portal               21%
                                                     N/A

                                                           2007 Responses     2008 Responses
                                        2008 Survey
                                                                        Sponsored by Cisco


  Technology Adoption (Next Two Years)
                            (2008 vs. 2007 Results)                     Figure 16


                Identity Management                         45%
                                                                  54%
                   RFID Technology                         43%
                                                          42%
              Security Technologies                       42%
                                                             47%
        Data Warehouse/Data Mining                       40%
                                                              49%
Web-enabled Business Transactions                       38%
                                                      35%
                 Speech Recognition                   36%
                                                                55%
Automated Alerts/Paging to Clinicians                 35%
                                                             47%
                                VOIP                  35%
                                                             47%
               Bar Code Technology                    35%
                                                                            74%
                                             2007 Results    2008 Results
  WellSpan Solutions

• CareScience


• TheraDoc   TheraDoc®
                Incorporated June 28, 1999
        WellSpan Quality Management

                                                WellSpan Health
                                                                                                 Public
                                               Director of Quality                            Communication
                                                  Management




 WellSpan
                 Quality Data      Clinical Project                   Quality Management                Regulatory Compliance
Information
              Management Service   Management                        Education (“Dean of PI              (JCAHO, DOH, CMS)
  Services
                                                                           University”
        Quality Management
• Support WellSpan Health‘s staff in their
  efforts to achieve excellent patient care
  services by providing and promoting
  – expertise in the theory and techniques of quality
    management
  – a learning environment for process improvement,
    research, and excellence in individual patient care;
    mentor staff projects
  – individual case management services to selected
    patients
  – access to clinical data to understand process and
    measure outcomes
  – Changing behaviors and attitudes to enhance the
    quality of care
• Deploy WellSpan‘s QI Methodology
  – WellSpan Quality College
    • ―Deans‖ develop curriculum and identify faculty
    • Identify and develop Project Facilitators
• Begin to identify selected improvement projects
  – Ambulatory Group
  – Limited number of projects in Service Lines
• Implement data-mining tool (CareScience)
• Develop governance and leadership expertise
• Develop management expectations and expertise
  Clinical Effectiveness Teams
• Assist in the Measurement and Evaluation
  of Clinical Outcomes
• Nine CETs
• Focus: ICU, Stroke , Pneumonia,
  Congestive Heart Failure, etc.
• Publish Guidelines
• Key User of CareScience
 CareScience
Quality Manager
        Care Management Suite

   CareScience         Quick Reports
  Quality Manager      Standard Analysis
                       Advanced Analysis


                       Case finding, custom reports
Exploratory Analysis   Ambulatory data integration

     National          Comparative database of
   Comparatives        CareScience customers

 Standards of Care     JCAHO reporting (Atlas Today)

Clinical Terminology   Standardization
       Service         Hierarchy
       CareScience




We are Here
 Performance Measures Available in
   CareScience Quality Manager
• Structure – case types, volume, & assignments
• Process
   – Core Measures
   – Resource utilization (ICU, blood, etc.)
• Outcomes (raw and risk-adjusted)
   – Mortality
   – Morbidity
   – Complications
                                Standard Reports
   – LOS
   – Cost/charge
   – Readmissions (raw only)
        WellSpan’s Implementation Team
• Clinical Project Lead – SVP Care Management, Director QM
   • Oversight of project – report to executive sponsor
   • Key go-to person
• Information Services Resources – KM Architect
   • Technical Project Manager
   • Source-system experts
   • Interface Programmer
• Quality Department Representatives – Data Analyst
   • Data analysts
   • Improvement Coordinators, Team Facilitators, Outcome Managers,
      etc.
• Medical Records - Adhoc
   • Knowledgeable in your Coding Policies/ Practices
• Adhoc Steering Group – Project Team
   • Include key clinical representatives from IS, CareScience, nursing,
      pharmacy, safety, risk management, CETs,etc.
          Implementation Project Team
                           WellSpan
                            Steering
                           Committee



          CareScience                           WellSpan
           Client Mgr                           Sponsor



          CareScience                           WellSpan
          Project Mgr                          Project Mgr



            Data        Clinical        Technical        Clinical
Trainer    Manager      Auditor        Team Lead       Team Lead
           Interface     CTS            Interface        Data
            Analyst     Analyst          Analyst      Administrator

                                        Interface          Key
             DBA
                                       Programmer     Clinical User
                 CareScience Quality Manager
             Framework for Implementation Success

      Phase I                 Phase II               Phase III
    Preparation               Roll-out            Achieving Value

                       • Rollout Plan &
                                                • Secondary Training
  • Data & Source        Priority Grid
    System Review
  • Validation                                  • Quarterly Status with
                       • Test Cut & Data Demo
  • Core Hardware                                 Executive Team
    Set-up
                       • Clinical Terminology   • Client
  • Test Data Load
                         Roll-out                 Management Support
  • Historical Data
    Load
                       • Key User Skills
  • Data Integration                             Ongoing Education
                         Assessment
                                                 • Clinical Forum
                       • Primary & Key User      • Key User Forum
• Introductory Call      Training                • Quarterly Education
                                                   Sessions
                       • Clinical Case Study
• Kick-off Meeting     • Big Known Issues!

• Implementation       • Grand Rounds
  Design
                                    WellSpan –
                                  EHR Data Source
                                  Cerner
                                                             GE/IDX
Meds administered                                                       Exams performed
(by day of stay, from pharmacy                                          (by day of stay, from
system)                                                                 revenue detail)

        Eclipsys &               Pharmacy
        GE Flowcast                                        Radiology       Cerner

                                                                                          Tests
                                              PCS Data Manager
                                                  mds 7.x
Admission/Discharge/Transfer                   Remote Hosted

           ADT                                                           Laboratory


        Eclipsys                                          Eclipsys                 AllScripts
                                                                                   TouchWorks
                            UB-92
           Patient demographics     Resource (Charges)
           Dx and Px codes      (by day of stay, from revenue detail)   Ambulatory
     WellSpan EHR Data Source
•   Facility - Cerner             • Pharmacy Dispensing
•   Resource Master - Eclipsys      Administration – Cerner*
•   Staff Master - Eclipsys       • Pharmacy Order – Cerner*
•   Diagnosis - Cerner/Eclipsys   • Pharmacy Order
•   Encounter - Cerner/Eclipsys     Dispensing Map – Cerner*
•   Inpatient Event - Cerner      • Practitioner -
                                    Cerner/Eclipsys
•   Operating Room – Cerner*      • Procedure –
•   Payor – Cerner/Eclipsys         Cerner/Eclipsys
                                  • Resource –
                                    Cerner/Eclipsys
          *Phase II               • Test Result – Cerner*
                                  • Antibiotics – Cerner*
Eclipsys


                                            PCS Remote Host
                  Eclipsys                    Data Validation Report
 Cache      ETL     DW                          Report Selection

                                 Monthly
                  SQL2005
                  Staging        Internet
Cerner                                         PCS
                    DW           Xmit
                                              mds 7.X


                   Cerner
Oracle     SQL      DW
                                                 Internet

           MS Integration Services
Implementation Design Objectives

• Assess the existing organizational
  infrastructure of WellSpan Health for
  readiness to support care management
• Identify strengths and potential barriers that
  will affect implementation of the
  CareScience Quality Manager (QM)
• Identify opportunities to leverage staff
  resources through the use of QM
• Initiate a roll-out plan for QM
Clinical Case Study Objectives
• Demonstrate how CareScience
  Quality Manager (QM) can be used
  to accelerate clinical performance
  improvements
• Develop data mining skills of QM
  users
• Enhance ability of the CETs to use
  QM to identify care processes driving
  worse than expected outcomes
• Build knowledge and trust for QM
  capabilities and methodologies
  among physician, clinical, and
  administrative leaders
                                                                                          IDEAL IMPLEMENTATION TIMELINE

                                                                                                                                                                 Quarterly Client Executive Calls with Client Manager,                          1 Yr. Follow-up
                                                                                                                                                                                 Clinical Staff & Sales                                               Visit

                  Project Plan

                                                                                           Clinical Staff Participates
                                                                                                                                                                                                                                      Calls Transition to
                                                                                               in Call to Plan for                                     Bi Weekly Client Calls with Client Manager ***
                                                                                                                                                                                                                                           Monthly
                                                                                                  Case Study

              MDS Review


                                                                                                                                                                                                Weekly Case Study Prep w/Clinical Staff
                                                       On site
                                                        Data                                                                               Onsite
                                   On site                                                                                              Primary User
                 Plan                                 Demo &
                                  Analytics                                                                                               Training-
            Implementation                            Analytics
                Design             w/CMO                                           Key User                                                2 days                Case Study
                                                         ***
                                  &PI Dir.*                                          Skills                                                                         Topic
                                                                                  Assessment                                                                     Selected by
                                                                                                                                                                    Client                                                  Onsite
                                                                                                                                                                                                                          Secondary
                                                       Onsite
          Intro                                                                                                                                                                                                            Training
                                                     Rollout Plan                                        Final Data
          Intro
           Call                Onsite Kick Off                                                                                         GO LIVE
                                                      Review**                                          Submission
           Call                Implementation
                                   Design




   NCIF                                               Test Cut                                          Web Based                                      Key User
                                                                                                                                  Web Based
                                                                                                         Training                                    Training CS                                              Onsite Case
                                                                                                                                  Pre Training
                                                                                                       Analytics PU                                Office w/Opport.                                             Study
                                                                                                                                   Navigation
                                                                                                          & KU                                         Analysis




WEEKS 1   2       3      4    5    6    7        8   9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46
               Phase -I PREPARATION                                                                                  Phase -II ROLL OUT                                                                                  Phase -III ACHIEVE VALUE

                                                                                                                                       Legend
              Additional Activities                                                                                                                                                        Notes:
                     Quarterly web based analytics review                                                                                                                                 * Discuss Case Study Key User and Expectations
                     Monthly Client Mgr/Clinical Staff review of client activities                                                                                                        ** Initialize Prioritization Grid & Discuss Key User and
                     Grand Rounds                                                                                                                                                            Case Study Expectations
                     One year Assessment follow-up Status of Prioritization Grid                            Client         Clinical             Data          Client                      *** Data Demo with Test Cut data. Analytics with Admin/
                                                                                                           Management        Staff            Management                                       Physician Leaders and PI staff. QM access given to one user
                                                                                                                                                                                           Access to Free Benchmarking and National Comparatives
                                                                                                            MDS= Master Data Specifications
                                                                                                            KU = Key (Client) User
                                                                                                            PU = Primary (Client) User
                                                                                                                                                                                                                               Implementation Timeline- 5/31/05
     Two Parallel Implementation
               Tracks

STRATEGIC - Goal Setting, User
 Selection, Work Flow Analysis, Change
 Management Process, Training and
 Education

TACTICAL - Data Transfer, Validation
 and Processing
 Project Milestones Strategic Track

• Implementation Design – Clinical Staff
• Pre “Go Live” Training
   • Analytic Methodology
   • Navigation Training Primary Training
   • Coordinated by Client Manager

• Primary User Training
   • Coordinated by Client Manager
   • Conducted 1-2 weeks after ―Go Live‖

• Key User Training
   • Coordinated by Client Manager
   • Conducted 2-4 weeks after Primary Training
Project Milestones Strategic Track

• Ongoing Service and Support
   • Client Manager
   • Service Team (Service Center staff, data manager)
• Clinical Case Study – Clinical Staff
   • Scheduled 4-8 weeks after Key User Training

• Secondary Training
   • Coordinated by Client Manager
   • Scheduled 2 months after Case Study
  Project Milestones Tactical Track

• Master Data Specification (MDS)
   – Conference call – MDS Review
   – On-site meeting – Interface Planning
• Test data extraction (3 month cut)
   – Validation reviews
   – Data Audit
• Complete data extraction of 2 year Historical cut
  and “go live”
   – Validation reviews
   – Data Audit
     Key User Responsibilities
• Awareness of the organization’s
  strategic goals
   – How will CareScience Quality Manager (QM) be utilized
     within the system and/or facility?
   – How will QM fit into the overall organizational PI goals
     and objectives?
• Disperse information to Primary Users
   – Information from CareScience e-blasts
   – Communications from Client Manager and CareScience
     Consulting
• Support Primary Users in use of
  CareScience Quality Manager
   – For example, coordinate internal user group meetings to
     discuss what all users are doing. This can be a great
     forum for “practicing” data presentation and
     interpretation
• Train additional users (beyond those
  trained in the initial CareScience
  training)
   – System navigation
   – Report interpretation
   – CareScience Analytic Methodology
        Key User Responsibilities

• System Administration
   – Assign user ids and passwords (QM)
   – Monitor utilization through monthly User Usage
     reports sent by CareScience
   – Support the Query needs for the organization
• Support Clinical Terminology
  Mapping
   – Resources that are unable to be mapped or need
     clarification will be sent to the Key Users in an Excel
     spreadsheet. Key Users should follow up with the
     appropriate internal staff for clarification and return
     the spreadsheet to the Client Manager.
• Monitor quarterly or monthly data
  transfers
   – Ensure compliance to agreed upon update schedule
   – Review validation reports
   – Notification Primary Users of quarterly or monthly
     data update availability
Key Analyst Skill Requirements
– Experience with generating, analyzing and
  interpreting data
– Ability to explain data to others in an understandable
  manner
– Ability to partner with clinicians to understand data
  needs through hypothesis formulation
– Well-developed critical thinking skills
– Knowledge and understanding of organizational PI
  goals
– Ability to train others in system navigation
– Knowledge of relational databases
– Understanding of CareScience Master Data
  Specification
– Knowledge of internal data sources
– Knowledge of Exploratory Analysis tool
Key Clinical User Skill Requirements
 – Experience with generating, analyzing and
   interpreting data
 – Ability to explain data to others in an understandable
   manner
 – Ability to formulate hypothesis based on clinical
   knowledge
 – Well-developed critical thinking skills
 – Knowledge and understanding of organizational PI
   goals
 – Ability to train others in system navigation
 – Access to avenues for disseminating information
 – Ability to recognize strategic pitfalls
 – Ability to achieve consensus on clinical issues
 – Demonstrated change agent capabilities
 – Ability to facilitate team meetings
Outcome Profile Pneumonia —

To help the Medical Service line get started with data for the
Pneumonia patients they follow; i.e.

How many of the patients with pneumonia diagnosis, also had
a resource (charge) for a specific drug?
Outcome Profile -- WellSpan Health
CareScience

Discharge Dates: 07-01-2006 thru 06-30-2007

Facilities: Gettysburg Hospital, York Hospital, York Hospital Psych

Diagnoses: Include visits with any of the following Principal Diagnoses: Other bacterial pneumonia*
(482) OR Pneumococcal pneumonia (481) OR Pneumonia, organism unspecified (486) OR
Pneumonia: organism nec* (483) OR Viral pneumonia* (480)

Resources (CDM Mode): Include visits with any of the following Pharmacy Resources:
CEFTRIAXONE 1G INJ (2-14111210) OR CEFTRIAXONE 250 MG IV (1-80003367) OR
CEFTRIAXONE 250MG (1-80007769) OR CEFTRIAXONE 250MG IM (1-80009236) OR
CEFTRIAXONE 250MG INJ (1-80001433) OR CEFTRIAXONE 250MG INJ (2-80001433) OR
CEFTRIAXONE 250MG IV (1-80001432) OR CEFTRIAXONE 250MG IV (2-80009061) OR
CEFTRIAXONE 250MG IV (1-80003378) OR CEFTRIAXONE 250MG IV (1-80006998) OR
CEFTRIAXONE 250MG IV (2-80006998) OR CEFTRIAXONE 250MG IV (2-80003378) OR
CEFTRIAXONE 250MG UD (2-80009010) OR CEFTRIAXONE 250MG UD (2-80001434) OR
CEFTRIAXONE 250MG UD (1-80001434) OR CEFTRIAXONE 25MG IV (2-80009060)

Report By: Facility
Risk Calculation Mode: Standard Practice
Population Size: 248
York Hospital Length of Stay Comparison

  Total Cases                                185             Arithmetic Costs (dollars)

  Mean Patient Age (years)                   51.5            Arithmetic LOS (days)

  Mean Distance Traveled (miles)             29.3            Mean Comorbid Conditions



                                   Outcome
          Outcome                                   Actual        Expected                Deviation
                                    Cases

  Mortality

  Morbidity

  Complications                                                                                       *

  Geometric LOS

  Geometric Charges                                                                                   **

  Geometric Costs                                                                                     **
Gettysburg Hospital

  Total Cases                                63              Arithmetic Costs (dollars)

  Mean Patient Age (years)                   66.9            Arithmetic LOS (days)

  Mean Distance Traveled (miles)             19.0            Mean Comorbid Conditions



                                   Outcome
          Outcome                                   Actual        Expected                Deviation
                                    Cases

  Mortality

  Morbidity

  Complications

  Geometric LOS                                                                                       *

  Geometric Charges                                                                                   *

  Geometric Costs                                                                                     **
Length of Stay Comparison –
Length of Stay comparison for top 10 Principal diagnosis, and all other
diagnosis as a comparison group. This spreadsheet has tabs at the
bottom to allow comparison between Standard Practice and Select
Practice.

Standard Practice is a risk-adjusted mode based on a significant
number of acute facilities that submit data to CareScience.

Select Practice is also a risk-adjusted mode, but it allows us to
compare ourselves to a set of hospitals whose performance has been
determined by CareScience to be in a ―select‖ or superior group (i.e.
these hospitals perform in the top 15% on both quality and efficiency
measures).
Length of Stay Comparison --
WellSpan Health
CareScience

Discharge Dates: 01-01-2006 thru 12-31-2007
Facilities: York Hospital
Report By: Principal Diagnosis
Risk Calculation Mode: Standard Practice
Population Size: 60316

                                                                                    Arith   Arith         IC
                                 Tota   Outc
                                                                    Arith   Proce   metic   metic   ICU    U
                                   l    ome    Act   Expe   Devia
    Principal Diagnosis                                             metic    dure   Pre-    Post-   Cas    L
                                 Cas    Case   ual   cted    tion
                                                                    LOS     Cases    Op      Op      es   O
                                  es     s
                                                                                    LOS     LOS            S

COMPARISON GROUP

Single liveborn* (V30)

Oth chr ischemic hrt dis (414)

Heart failure* (428)

Acute myocardial infarct
(410)
Resp sys/oth chest symp*
(786)

Osteoarthrosis et al* (715)

Septicemia* (038)

Cardiac dysrhythmias* (427)
    CareScience Summary
•   Phase I Complete
•   Clinical Effectiveness Teams Trained
•   Data Load Complete March 1
•   24-Month Rolling Data
•   Monthly Upload – 120 Plus Data Elements
•   Canned Report Training Complete
•   Running 15 to 20 Canned Reports
•   Adapting to Reports & Data ‗Blending‘
•   AdHoc Report Training Next Week
•   Data Validation On-going
•   CET‘s to Identify Major Areas of Focus
•   Phase II to Begin in May
•   Phase II – Cerner Millennium Pathnet/SurgiNet at Gettysburg
                 What is TheraDoc?
            TheraDoc is a clinical informatics company that
            develops and implements electronic
            surveillance systems for injury detection and
            prevention to transform the quality, efficiency
            and safety of patient care through enhanced
            clinical decision making –in real-time.

            150 Hospitals in 27 States




TheraDoc®
Incorporated June 28, 1999
   Infection Control Services
                                                           WellSpan Health Director of
                                                                Infection Control




  WellSpan                  York County                                                           Adams County
 Information                  Facilities                                                            Facilities
   Services




WMG Offices &     Apple Hill Surgical      York Hospital       VNA                  Gettysburg      WellSpan        WMG Offices &
Ambulatory Care        Center                                                        Hospital    Endoscopy Center   Ambulatory Care
    Sites                                                                                                               Sites
      WellSpan          Expert System Platform®                                          Protected by US Patents 7,213,009; 7,230,529




                               Email/Pager                Handheld                                           Web Browser
         ADT
      Eclipsys
          Lab
       Cerner
                             Expert System Application




                                                                                         Infection Control Assistant®
         Micro




                                                                                           Clinical Alerts Assistant™
                              Electronic Real-time Surveillance




                                                                     Knowledge Modules
                                                                                                   ClinicalClinical
                                                                                                       ClinicalClinical
       Cerner




                                                                                             Antibiotic Assistant®
                                                                                                  Application
                                                                                                         Application
                                                                                                             Application
                                                                                                     Application
                              Standardized Patient Information




                                                                                                ADE Assistant®
       Pharmacy
       Cerner                 Case Finding with Smart Views
       Radiology              Patient Safety Vigilance (24x7)
      GE/IDX                  Knowledge Transparency
        Surgery
                              Clinical Workflow, Confirmation                                    Knowledge
                                                                                                        Knowledge
                                                                                                           Knowledge
                                                                                                     Knowledge
       Cerner                                                                                       Base Base
                                                                                                       Base Base
         Vitals               Comprehensive data access
       Cerner
     Patient Data
                                  Data Interoperability                        Knowledge Integration


TheraDoc®
Incorporated June 28, 1999
TheraDoc®
Incorporated June 28, 1999
                     Knowledge Modules
                 Infection Control Assistant® -
                   Infection/syndromic surveillance; Reporting, Real-
                   Time
                 Antibiotic Assistant® - Antimicrobial
                   Stewardship; Disease Management, Mobile,
                   Handheld, Patient Specific
                 ADE Assistant® - Medication Safety
                   Surveillance – Real Time
                 Clinical Alerts Assistant® - Global
                  trigger Adverse Event Surveillance
                  Rules-Based, Real-Time



TheraDoc®
Incorporated June 28, 1999
           Expert Systems Modules

                 Intervention Assistant® - Point-
                   of-care patient safety documentation

                 Rounds Assistant® - CDS
                   Workflow Gateway

                 EZ Alerts Assistant® - Clinician
                   Rules and Knowledge Editor




TheraDoc®
Incorporated June 28, 1999
              WellSpan
              EHR Data
Eclipsys

     Cerner
    Cerner
      Cerner
     GE/IDX
       Cerner
        Cerner




TheraDoc®
  Incorporated June 28, 1999
Why is TheraDoc Important to WellSpan?
       TheraDoc complies with ACT 52 and
   provides solutions for:

  • Recent Medicare Medical Error Ruling Reimbursement
    Exclusions
  • State Mandated HAI reporting
  • MDRO Prevention Initiatives – MRSA
  • Infection Control Interventions
  • Antimicrobial Stewardship
  • Adverse Drug Even Prevention
  • Critical Care Environments
  • Patient Safety & Quality of Care
  • Reduced Length of Stay
       PLAN

LIVE
      Value Added Benefits for
    Infection Control Department
• Produces an accurate patient flag report,
  save 60 min/day.
• Eliminates the daily sort of paper lab
  results, saving 15-30 min/day.
• Reduces the number of possible
  healthcare associated infections that
  require investigation.
• Save hours of MRSA surveillance time by
  implementing the MRSA surveillance
  report of all completed cultures.
        Value Added Benefits for
      Infection Control Department
• Produces specific ―criteria-based‖
  reports and work lists.
• Auto populates the census and
  formulates an infection rate. Graphing
  and trending capability.
• Creates a thorough electronic infection
  control report which was previously done
  manually. It captures and links
  microbiology, radiology, lab, bed trace,
  etc, and saves hours of time.
            WellSpan Implementation Resources


        Summary: (based on 4-6 month implementation)

                          (Approximate)
Title                         Total # hrs needed for entire install
 Executive Sponsor                                        20 hrs
 Project Manager                                          200 hrs
 Clinical Champion                                        40 hrs
 IS/Technical Staff                                       40 hrs
 Interface Engine Specialist                              40 hrs
 Interface Specialist /Tester                             40 hrs
            (per ancillary ADT, RX, LAB/MICRO, RAD)
        TheraDoc Summary
• Contract Signed in November, 2007
• Plan Submitted to DOH in January
• Project Kickoff Scheduled for July
• Cerner Millennium PathNet a Prerequisite
• Cerner SurgiNet Implementation at
  Gettysburg
• Real-time Data Feeds From Cerner
• Desired Go-live December 2008?
Closing
Remarks
  WellSpan Contacts
 Pam Goodling
 Infection Control
 TheraDoc Contact
 pgoodling@wellspan.org

 Lisa Stough
  Knowledge Architect
  CareScience Contact
  lstough@wellspan.org

								
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