January 17, 2011
Key Messages & Talking Points
These messages and talking points are intended to create additional awareness and a better
understanding of the Clinical Standardization project among key stakeholders including national
leaders and project teams, MBO leadership, clinicians and physicians.
As a system, we have embarked on OneCare, CHI’s multiyear program to advance patient care
through the power of information. OneCare will:
o Improve patient safety and clinical outcomes.
o Enhance the patient experience.
o Provide clinicians and staff with necessary tools and information.
o Eliminate duplication and waste.
o Better position us for the future.
Among other things, OneCare will create a shared, electronic, universal health record for each
CHI patient (Meditech 6.0 and Cerner).
Having one CHI hospital advanced electronic health record (EHR) will help to ensure clinical
standards are met and our EHRs are cost-efficient. One EHR also makes it easier to get
necessary information and tools into the hands of the bedside clinicians and staff faster.
Training can be replicated across hospitals, and we will be more nimble in our ability to adopt
new technology and evidence-based practices, while keeping current with regulatory
requirements. Improving patient safety and clinical outcomes, enhancing the patient experience,
eliminating duplication and waste, and better positioning caregivers for the future are additional
benefits. Overall, one EHR will help us more quickly achieve our goals for quality, satisfaction
The first step toward achieving one EHR is to adopt one standard for clinical content. This work
is called the Clinical Standardization project. Clinical subject matter experts from across the
system and from nearly all clinical areas are determining these clinical content and
documentation standards. Review of the clinical content by a critical mass of clinical users from
each MBO is vital to ensure that content is evidence-based and meets our documentation
needs as One CHI.
By the end of February 2011, MBO teams of clinical subject matter experts will have defined the
clinical content that will be used to build our advanced Meditech and Cerner EHRs.
The OneCare program includes implementing an advanced electronic health record (EHR) in all
Teams of clinical subject matter experts from across the system are defining the clinical
content that will be the One-CHI standard for our EHR (Meditech 6.0 and Cerner).
Having one standard for clinical content will:
1. Provide clinicians and staff with necessary tools and information,
2. Improve patient safety and clinical outcomes,
3. Enhance the patient experience,
4. Eliminate duplication and waste, and
5. Better position caregivers for the future.
It is important that every clinician reviews the clinical content for consistency with
evidence-based practices, making sure that our documentation needs are being
Ultimately, the new EHR will make it easier for us consistently provide care that is safe,
results in the best possible outcomes and meets our patient expectations.
About Clinical Standardization
Clinical Standardization will define the clinical content and documentation standards for
patient care in all CHI hospitals.
The clinical content will be used to build both the Meditech 6.0 and Cerner programs and
will include clinical documentation for:
o All nursing departments including emergency departments, obstetrics and
perioperative services (exclusions: NICU, Behavioral Health, Inpatient Rehab
o BCMA: bar-coded mediation administration and medication reconciliation
o Care Management
o Clinical Nutrition
o Order entry for nursing interventions and ancillary orders and clerk order entry
o Pastoral Care
o Physical and Occupational Therapy
o Physician documentation and CPOE in the emergency department
o Respiratory Therapy
o Social Services
The project does not include:
o Inpatient physician documentation and physician computerized order entry
(CPOE) – this will be a separate project
o Management of charges and supplies
o Pharmacy formularies
The design and build for Meditech 6.0 will start in January 2011. The design and build
for Cerner will start in April 2011. (St. Clare’s Cerner project will begin in February 2011.)
Benefits of Having One EHR
We want to make it easier for clinicians to provide care that is always safe and efficient,
results in the best possible outcomes and meets patient expectations.
Having one inpatient EHR will help us more quickly achieve our quality goals and better
steward our resources by:
o Improving patient safety and patient outcomes by decreasing variability in clinical
practice within MBOs and across the organization.
o Ensuring all hospitals have access to advanced clinical documentation and the
advantages of a comprehensive EHR.
o Allowing a more rapid implementation in all MBOs with easier replication of
education and training.
o Creating a standard foundation for collection, analysis and reporting of clinical
data with greater access including real-time data.
o Providing greater flexibility and timeliness in making changes and adopting new
clinical practices, regulatory requirements and system enhancements. We will no
longer need to do redesign multiple times for different programs and
o Achieving greater efficiency through economies of scale with enterprise-wide
standardization, which will optimize resource requirements for technical and
Clinical Standardization Design Teams
Clinical content decisions are being made by design teams composed of clinical subject
matter experts from across the organization and including nurses, advanced practice
nurses, ancillary professionals, physicians, pharmacists, nurse managers, clerks,
technicians, pastoral care staff, etc.
Phase I design teams have completed their work. Nearly 170 comments have been
received, and content and documentation standards have been submitted to the Nurse
Executive Council for final approval for:
o Ancillary Clinical Documentation
o Nursing Documentation
o Orders Standardization
o Perioperative Standardization
Phase II design teams will develop content from January 17 – February 18, 2011:
o Clinical Care Plans
o Emergency Department Nursing and Clinical Documentation
o Emergency Department Physician Documentation and Computerized Physician
Order Entry (CPOE)
o Perinatal Clinical Documentation
o Pharmacy, to include Medication Administration, BCMA and Medication
Developing the Clinical Content
Standardization of content, documentation and workflows will drive clinical quality and
resource efficiency, while still accommodating clinical judgment based on individual
patient needs. Our goal is to have 80 percent or more standardization of clinical content
with 20 percent flexibility to address specialty services.
We are not starting from scratch. We will design our EHR using content from:
o CHI-approved evidence-based practices and existing clinical documentation
o eClinical reference solutions
o Earlier BCMA standardization work
o Practice standards from professional organizations
o CHI core measures
o Regulatory agencies such as TJC, AHRQ, HIPPA, PQRI
o Zynx Health for select physician order development and Clinical Care Plans
o Analysis of current MBO Meditech and Cerner content
Reviewing the Clinical Content
As Clinical Standardization design teams approve clinical content, it is posted for review
in the form of “Clinical Content Briefs” so that any nurse or clinician, at any CHI facility,
can review and comment on it. Briefs are posted one the www.CHIOneCare.net website
(previously CHICIT.net). Check the Clinical Standardization page.
Review of clinical content by clinical users at each MBO or hospital is vital to ensuring
content is evidence-based and meets documentation needs as one CHI.
CHIOneCare.net is an external website designed expressly to make it easy for CHI
clinicians to access information about CHI’s OneCare program and to provide feedback.
Feedback on the clinical content can be provided in two ways:
o On the general comments sections at CHIOneCare.net.
o By emailing the design team lead/co-lead named on each Content Brief.
Feedback on content approved by design teams is due by February 28, 2011.
For More Information
Inside CHI – The OneCare channel under the Patient Care heading contains
communications tools, including the Clinical Standardization overview presentation, and
Clinical Standardization Update, published twice monthly. The Clinical Standardization
Update newsletter is available by email subscription.
CHIOneCare.net. This external website includes Clinical Content Briefs for each design
team, a comment section and FAQs about the clinical content.
For more information, please contact Ann Shepard, national director, Clinical Informatics, at 1-
800-944-6482 (x 1356).