Electronic Medial Record Update at Y

ELECTRONIC MEDICAL BUSINESS OPERATIONS SYSTEM (EMBOS) Progress & Productivity Update Dr. Otis Cosby, Dan Cannon, Jessi Metcalf, Melissa North, Steve Underwood April 19, 2007 EMBOS Project Team Occupational Health Services Dr. Otis Cosby* Debbie Hurst Dr. Russ Reynolds Stan Roberts Patsy Shelton Verilyn Smith Becky Sproles Sula Thomas Nancy Underwood Information Technology David Caldwell Dan Cannon* Jessi Metcalf* Matt Morrell Melissa North* Brian Ray Terry Richardson Steve Underwood* *present today Area of Expertise Medical Director BE Representative Psychologist & HRP Physician Assistant X-ray & MOHIS Expert, Records Human Reliability Program Scheduling Laboratory Business Operations, Nurses Applications Developer Applications Technical Lead Applications Developer Applications Developer Project Manager Database Technical Lead Applications Developer & MOHIS Technical Lead Technical Advisor 2 Why build EMBOS? • Compliance with state and federal regulations regarding storage and retrieval of vital medical records (e.g., 10CFR 851.210) • Requests for medical records continue to increase • Medical record volume continues to rise • X-rays (all hardcopy film) deteriorate with time • Medical records must be kept long-term • Costs to manage and store records continues to increase • Duplication of effort is significant • Current MOHIS system deployed 1994 • Technology refreshment necessary 3 EMBOS Goal Integration of tools, technology & security to streamline information capture and transfer to create a comprehensive electronic medical record (EMR) 4 EMBOS Integration EMBOS Voice Recognition Medical Digital X-ray External Inputs Outside Providers Consultants External Data Reporting Data Trend Analysis Individual / Group /Facility Electronic Patient Medical Record and Clinical Services (Main & Satellite Facilities) Psychological Services Electronic Lab Interfaces Y-12 Interoperability SAP, IH, IS, RADCON Pharmacy Functions Medical Business Operations Administrative Functions (Dept Level) Active Medical Records Scanning Workers Comp Management 5 EMBOS Software Development Goals • A Paperless Electronic Medical Record • Web-Based / Browser-Based Interface • Real-Time Data Capture and Retrieval • Eliminate Duplicated Data & Streamline Processes • Intuitive interfaces - Minimal Training Required • Multi-Tiered, Modular, Component-Based Software Architecture • Adherence to Standards (HL7, DICOM) • Direct Updating of Select Medical Data (e.g., medical History and medications) through the Patient On-line Medical Services (POMS) web site 6 Progress & Productivity 7 Progress & Productivity (cont.) 8 Progress & Productivity (cont.) 9 Progress & Productivity (cont.) 10 EMBOS Demonstration Dan Cannon & Jessi Metcalf 11 EMBOS Software Demonstration • Patient medical questionnaires • Patient registration process • Workflow through the medical facility – X-Ray Workstation • PACS sub-system overview • Integration with EMBOS using HL7 messaging – Medical Lab Workstation – Psychology Lab Workstation – Nurses Workstation – Providers Workstation • Scanning of paper records • Patient Electronic Medical Record • Medical reporting 12 EMBOS Demonstration 13 Questions and Answers 14 Thank you! 15 EMBOS Hardware/Software Environment • Web application – Browser-Based – no client software to install & maintain – Access from Remote Locations – Secure Access and Data Transmission – Microsoft © ASP.NET, C#, PL/SQL – Oracle 9i © RDBMS (portable to other compliant databases) • Moving to Oracle 10g with next release – Reports in PDF format – Operating system – Windows 2003 Server – Voice Recognition COTS – Badge Reader – Signature Pad – Scanning (Twain compliant) – Touch Screen – Digital Imaging • Picture Archiving and Communications System (PACS) • Digital Radiography (DR) 16 PACS Integration to DR & EMBOS Y12 Radiology Digital Imaging Sub-System Y12 Image Storage and WebBased Distribution SubSystem (FDA Cleared) Storage Rack LTO Tape Backup System HIS/RIS Gateway System HL7 Messaging EMBOS Y12 Film and CD - Based Image Distribution SubSystem Y12 Radiology Image Capture and Review Sub-System (Scanning and Diagnostic Workstations FDA Cleared) Paper Digitizer (FDA Cleared) Storage Array Kodak DirectView Web System EMBOS Workstation (w/o Web Viewer) Win 2K/XP Film / Paper Printer CD Recorder Sub-System Keyboard, Montitor Film Digitizer (TWAIN) (TWAIN) KVM switch Uninterruptible Power Supply CD Distribtion Workstation EMBOS Workstation (with Web Viewer) Win 2K/XP QC/Scanning Workstation QC/Diagnostic Workstation EMBOS Workstation DICOM DICOM DICOM DICOM DICOM DICOM DICOM Y12 / EMBOS Sub-Network Planned integration with Digital Radiography – FY08 17