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CHRISTUS Health, Biosense and NEDSS : An Administrator’s Perspective Hank Fanberg CHRISTUS Health May 28, 2008 PowerPoint PPT Presentation


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CHRISTUS Health, Biosense and NEDSS : An Administrator’s Perspective Hank Fanberg CHRISTUS Health May 28, 2008. AGENDA. CHRISTUS Health background CHRISTUS IT Infrastructure The Experience . I wonder what they meant by that?.

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CHRISTUS Health, Biosense and NEDSS : An Administrator’s Perspective Hank Fanberg CHRISTUS Health May 28, 2008

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  • CHRISTUS Health, Biosense and NEDSS :

  • An Administrator’s Perspective

  • Hank Fanberg

  • CHRISTUS Health

  • May 28, 2008


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AGENDA

  • CHRISTUS Health background

  • CHRISTUS IT Infrastructure

  • The Experience


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I wonder what they meant by that?

  • We just got word this morning that Downstream is having a problem with the format of one of our fields in the OBX4 segment of the Lab Results. We believe that what we are sending is correct (it is what CHRISTUS is sending us), but somebody is going to have to make a change in order for all Lab data to be stored and displayed correctly in the BioSense application.  


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Our Healing Ministry


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Our VisionWhat We Are Striving To do.

  • Strengthen current ministries and expand into new locations and services

  • Implement innovative approaches to caring for the whole person

  • Increase access to health care for the poor and underserved through advocacy and other initiatives

  • Make significant contributions to creating healthy communities

  • Create a work environment filled with hope, dignity and mutual respect


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Our Legacy

  • In 1866, Texas was faced with illness, disease and poverty of staggering proportions.

  • Galveston Bishop Claude M. Dubuis turned to his native France and issued a plea to Religious Sisters for assistance

  • Three Sisters answered the Bishop’s call, Mother Blandine, Sister Ange, and Sister Joseph


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On the Way to San Antonio 1869

  • The Sisters arrived in Galveston in October 1866 and founded the Congregation of the Sisters of Charity of the Incarnate Word.

  • In 1887 the Sisters opened the state’s first Catholic hospital in Galveston, Charity Hospital.

  • Mother Madeline, Sister Agnes and Sister Pierre traveled from Galveston to San Antonio in 1869

  • Within months, the Sisters established Santa Rosa Infirmary in San Antonio.


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Facts and Figures - Today

  • 40 hospitals and other health care ministries in more than 70 communities

  • Dozens of other health services in Texas, Louisiana, Arkansas, Utah, Oklahoma and Mexico

  • Approximately 27,000 employees

  • More than 8,000 staffed beds

Cont’d


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A Snapshot of our Demographics

  • Texas leads nation in uninsured; Louisiana is third (2005)

  • Majority are:

    - Working families with low and moderate incomes

    - Young adults age 19-34

    - Disproportionately Hispanic and African-American

    - Legal, US residents

  • Health care coverage is not available from employer or is unaffordable

Sources: Health Policy Institute; The Access Project


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CHRISTUS Direction

From

To

Focus on high cost,

ER-based charity care

to treat illnesses that

Could have been

prevented.

Comprehensive strategies

to address the symptoms

and underlying causes of

health problems.

Proprietary approaches

to planning and

implementation.

Community collaboratives

that mobilize and build upon existing community assets.


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Comprehensive Integrated Care

Enrollment

Medical Home

Admission

Wellness &

Prevention

Disease

Management

Prepare for treatment & discharge

Mental Health

Dental Health

Community

Collaboration

Care

Management

Diagnostic

Service

Medical or surgical treatment

Expanded

Insurance

Coverage

Pharmaceuticals

Access

Project & Information Management

Discharge to home and/or aftercare

Referrals

System

Durable

Medical

Goods


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Biosense: Two years in the Making

  • Major upgrade of core clinical information system

    • Convert all facilities to MEDITECH

    • Three year project

  • Had to wait for CHRISTUS human resources availability (team of about 12 people with a changing cast of characters)

    • Project Manager

    • Security SME

    • Architects

    • Interface engineer

    • Data manager

    • Network architect


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BioSense: Using Health Data for Early Event Detection and Situational Awareness

Wayne Myers, Project Director

Constella Group, LLC - Contractor to CDC

Emilie Kralicek

Clinical Specialist

June 15, 2006


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Why Participate?

  • Two reasons:

    • Texas and Louisiana

  • Situational Awareness is a good thing

  • We participated in a situational awareness project with the city of Houston following 9/11

  • But it’s a lot of work

  • Requires a lot of resources

  • Concerns about privacy and confidentiality


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Health Care Landscape

  • The Healthcare Continuum or Landscape is comprised of various patient demographics, located in multiple settings and includes a population with different economic realties. Across this continuum, we have multiple care channels that provide a comprehensive and robust inventory of services.

Patients

Care Channels

Focus

Age Group

Settings

Socio-economicStatus

Access

Location

Provider/

Payer

Service

Geographical

Area

Infants

Rural

High

In Person

Home

Traditional Providers

Alliances

Local

Adolescent

Suburban

Medium

Telephonic

Rehabilitative

Public/Private Insurers

Partnerships

Regional

Adult Men

Urban

Low

Electronic

Hospital

Acute

National

Alternate Providers

Adult Women

Proxy

Emergency Department

Retail

Midlevel Provider

Regional

Poverty

Municipal

Senior Men

Long Term Care

Non-Acute

Health Infomediary

Federal

Senior Women

Clinical

Home Health

International

Laboratory

State

Community

Wellness


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Some Key Technologies Needed by Health Systems in General (which we don’t have)

  • Enterprise Master Person Index (EMPI)

  • Accurately identify the patient

  • Deliver comprehensive view of patient

  • Streamline patient registration across facilities

  • Enterprise Interface Engine

  • Exchanges data via

  • HL7 messaging

  • Standardized communications

  • Lower long term costs

  • Enables cross coordination and interoperability

  • Clinical Data Repository

  • Consolidates data from a variety of clinical sources to present a unified view of a single patient

  • Improve the quality of patient care

  • Reduces the cost of health care

  • Service Oriented Architecture (SOA)

  • Allows for effective and affordable business-level interoperability

  • No application rip and Replace requirements

  • Enabler of business change (Plug and Play)

  • Leverage the Web


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HIE Infrastructure


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The CHRISTUS Health Enterprise Goal

Standardization

Integration

Integration

Standardization

Acceptable

Satisfactory

Excellence

Customer-centric innovative and integrated approaches to care delivery

Alignment

IT

Governance

Strategic Goals

Optimization

Governance

Business

Alignment

End State Goal: A complete picture of the patient across time and services


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Governance Model

  • Differing IT Systems & Applications

  • Multiple views of the same patient

  • Fragmented Data

  • Higher IT Costs

  • Higher Acute care costs

  • Strained and reduced resources

  • Geographical disparity of care

  • Disparate, uncoordinated enterprise systems

  • Functional silos

  • Cross functional inefficiencies

  • Disconnected business decisions

  • Central Leadership

    • SLT

    • IMOC

  • Regional Oversight

    • Regional CEO

    • Regional IM Executive

  • Trans Regional Requirements Planning

    • Long Term Care

    • Home Health

    • Community Health

  • Local Execution

    • Acute facility

    • Long Term Care

    • Home Health

    • Community Health

    • Retail

    • Non-CHRISTUS local entities

Implications


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Customers and

Consumers

Patients

Providers

Insurers

Alliances

Partnerships

CHRISTUS Health Model (Today)

Regional

Execution

Santa Rosa Health Care

Spohn Health System

Ark-La-Tex

Central Louisiana

Northern

Louisiana

Southwestern

Louisiana

Southeast

Texas

Gulf Coast

Acute Care

Non-Acute Care

Environments

Long Term Care

International

USFHP

Clinical

Services

Home Care

Physicians

GL

General Ledger

PP

Payroll and Personnel

QM / RM

Quality / Risk Management

BAR

Billing / Accounts Receivable

AP

Accounts Payable

Business

Functions

MM

Materials Mgmt

GL|AP|AR|PP|MM|BAR|MM|QM

GL|AP|AR|PP|MM|BAR|MM|QM

Standards /Interfaces

HL7

ASTM

DRG

ITS

TCP/IP

HTML

DSM

X12

XML

EDI

Common IT Governance

ITIL

Processes

Problem Management

Release

Management

Incident Management

Change Management

Configuration Management

Capacity

Management

Availability

Management

Service

Continuity

Service Desk

Service Level

HDW & SFTW

Shared IT Infrastructure


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Existing

New

BioSense Technical Approach

Data Source Systems

CDC BioSense

Applications

Vocab

PHINMS

Mapping

Receiver

BioSense

Data Warehouse

Interface

Engine

BioSense

PHINMS

Or Tools

Integrator

Sender

Internet

(SSL)

Transport

Queue

Other

BioSense

BioSense

Web

Applications

Local

Public

Health

Data Feeds

Viewer

Linker

Database


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Difference

  • CHRISTUS needs a unified view of the patient (a lot of information about one person)

  • Biosense and NEDSS need a little bit of information about everyone


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Patient Portal

Referral

Kiosk

Ambulatory

CHRISTUS Health Enterprise View – TomorrowIt’s not about me, It’s about us

Customer Channels

Acute Care

Standardized Products across Services and Regions

  • Uniform face to the customer

  • Standardized language

  • Tools point of need, when, where

  • needed

Integrated Products and Services

Services

CHRISTUS Digital Nervous System

Clinical Data

Repository

Personal Health

Record

Retail

International

Services

Value Added Services

Value Added Services

Services

  • Analytics

  • Clinical

  • Business

  • Patient

  • Single View

  • Quality Care

Enterprise Master Person Index

SOA Architecture

Optimized Products, Services and Processes

Aligned Strategic Goals, Strategies and IT Services

Services

Non-Acute Care

Customer Channels

Medical Travel

Referral

Kiosk

Ambulatory

Retail

Patient Portal


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Good document is critical

  • BioSense Team meeting: Progress since our last meeting.

  • Closed Items:

  • MOU sent to CHRISTUS Health

  • Hardware configuration approved by CHRISTUS Health Solution Architects

  • SNOMED Codes received.

  • Requirements further refined.

  • Met with Peter V to confirm a number of key technical assumptions

  • Technical design featured by CDC in presentation at AMIA

  • Approval given by CHRISTUS Health to collapse NEDSS-ELR project into the overall CHRISTUS Health BioSense project.

  • Key outstanding items on for the CHRISTUS Health

  • Hardware installation

  • Validating test scripts and working with CHRISTUS Health to verify that they are part of integration testing

  • Coding in the BioSense Integrator

  • Confirmation of SNOMED codes required by the state

  • Delivery and confirmation of business requirements to TDSHS

  • SOW in final stages of development/review/approval process

  • Risk: Upgrade activation date set for CHRISTUS Health MediTech upgrade (BioSense dependency on this date) The upgrade is date driven, and is set for 2/14/08. 11/16: CHRISTUS Health project members confirm that the project is on schedule.


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We had challenges

  • A lot had to do with our MEDITECH conversion

  • But we persevered

  • And just became certified


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QUESTIONS

QUESTIONS


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