Unified Communications Strategy Development

Unified Communications Strategy Development Steering Committee April 13, 2010

Discussion Outline • Opening Comments • Report Out: Current State Assessment • Findings • Comments/Questions • Next Steps: • Retreat Preparation/Pre-Work • Retreat – Future State Design

Unified Communications Strategy DevelopmentOpening Comments Steering Committee April 13, 2010

Unified Communications Strategy DevelopmentProblem Statement • Problem Statement: • Lacking Overall Vision/Strategy/Governance for Enterprise Unified Communications • Current communication processes are confusing, ineffective and inefficient • Fragmented, duplicated, confusing and inconsistent messages • Data integrity issues, slow response time, a negative and/or non response. • Breeds lack of trust and/or lack of urgency between the caregivers. • Potential Causes: • Multiple & disparate communication channels • Too many devices/channels • Unclear roles &/or misunderstood communication approaches • Lack of training • Unclear send of message • Unconfirmed receipt of message • Lack of clarity in message sent • No standard definitions (e.g. urgency, response needed by, etc.)

Unified Communications Strategy DevelopmentHigh Level Approach • Document Current State Communications Approaches • Document “Voice of the Customer” – 1:1, Observation, Department Meetings, Surveys • Review current communication channels within the UK HealthCare enterprise following the Patient’s Journey from Entry to Discharge • Physicians/Nurses/Ancillaries/Other Caregivers/Service Providers • Patients/Families • Inventory All Communication Channels/Devices/Methods • Market Survey/Site Visits/Best Practices in Unified Communications • Develop Future State Vision, Strategy, Governance for Enterprise Communications Approaches • Develop a “Desired Unified Communication Future State” • Implement a “Hospital of the Future” Environment • Validate Future State (Industry Experts/Vendors) • Select & Prioritize Solutions to Implement • Pilot Selected Solutions • Develop Multi-Year Implementation Plan • Rollout Successfully Piloted Solutions • Develop & Implement Support Model • Measure Effectiveness of Implemented Solutions & Support Model

Unified Communication Strategy Framework Current State Assessment • Interviews • Shadowing • Rounding • Inventory • Research • Webinars • Vendor Info. • White Papers Best Practice Review Future State Design • VOC • Visioning • Identify Gaps • Potential • Solutions • Target Env. Select Opportunities • Link to • UKHC Pties • Prioritize • Quick Wins • Hi Level • Sequence Portfolio Management & Roadmap • Plan/Scope • People/Skills • Budgets • Sequence • Dependencies • Pre & Post • Measures Value Delivery • Results • Benefits • Internal Best • Practices • New Ideas • CSA Report • Problems • Requirements • Inventory • Pitfalls • Limitations • Comm. • Protocols • Stdization • Workflows • Expectations • Roles • Technology • Target • Environment • Vision • Align with • UKHC Pties • Link to Key • Process • Indicators • ST/LT Pties • Quick Wins • Roadmap • Plan/Scope • Resources • Budgets • Validation • Measurement • Accountability

Unified Communications Strategy DevelopmentReport Out: CurrentState Assessment Steering Committee April 13, 2010

Unified Communication Strategy Current State Assessment Summary Steering Committee Meeting April 13, 2010 Michelle McCleerey, PhD, MA, MEd, MBA, RNDirector, Patient Safety Business UnitHill-Rom IT Solutions

Current State Communication Evaluation • Purpose • Identify current communication processes, practices and the technologies within identified functional groups • Gaps and obstacles to communication/information flow • Common patient pathways and touchpoints • Methodology(March 2010) • Communication Technology Survey • Manager interview • Technology available within each functional area • Respective roles utilizing specific technologies • Integration capabilities of available technologies • Communication Process Assessment • Stakeholder interviews • Observation of work/communication/patient flow • Collection of hard-copy communication materials

Inpatient Chandler Campus Inpatient Care Units Medical Intensive Care Burn Trauma Intensive Care Cardiac-Thoracic Intensive Care Surgical Intensive Care Neuro Intensive Care Pediatric Intensive Care Neonatal Intensive Care Pediatrics Acute Care 6th Floor Progressive Care & Telemetry Markey Cancer Center Portals of Entry Emergency Department Perioperative Services Maternity Pharmacy Nursing House Officer Physicians Inpatient-Outpatient Diagnostic/ Treatment Services Central lab Radiology Endoscopy Cath Lab Gill Imaging Outpatient Services Women’s Center Endocrine Clinic Center for Ambulatory Surgery Outpatient Pharmacy Good Samaritan Hospital Emergency Department Perioperative Services Critical Care Unit Medical-Surgical Unit Endoscopy Lab Radiology Staffing/HOA Functional Areas Assessed

Overall Communication Assessment Findings • Multiple Disparate Technologies • Lack of technology standardization across departments/units • Lack of consistent technology integration/interoperability • Redundant, Manual Workflow Processes • Lack of automated workflow • Manual processes used to support/compensate for limitations of automated workflow • Inconsistent Communication Processes • Variation in practices and processes across functional areas • Unused Technology/Technology Features • Restricted use of available technology due to impaired functionality, inaccurate information, lack of accessibility, undue complexity • Incomplete User Adoption • Limited integration into workflow and care delivery model due to user non-compliance, lack of training, and lack of standardized protocol for use

Available Asynchronous Technology* Percent of Use Across Functional Groups • Fragmented purchase and deployment of technologies • Variation of implementation • Inconsistent utilization • Differing degrees of isolated success * Excluding EMR and other clinical documentation applications

Limitations of Communication Applications • BEEP system • Inaccurate/insufficient information • EMR • Need for hard copy records/collateral • Navigation challenges • Restricted integration/interoperability with other HIT • Lack of trust as a mode of communication • Patient flow • Lack of transport/EVS process visibility and promptness • Dependency upon procedural/OR manual update

Current Communication Pitfalls • Patient-Family Communication Obstacles • Reduced opportunity for face-to-face interaction with physicians • Varying nurse call applications/functionality/processes • Limited medical device communication • Variable patient/family hospitality • Way finding challenges • Staff-to-Staff Communication Barriers • Multiple modes of communication without standardized processes • Over-reliance on synchronous modes of communication • Phone calls • Overhead paging • Lack of visibility/unification of functional group care plans • Identification of care team • Care schedule and objectives

Unified Communication Solution Requirements • Standardized technology and processes • Optimal integration of people-process-technology • Implemented asynchronous communication technologies and processes to mediate obstacles of synchronous communication • Convey urgency, context, completeness of message • Confirmation of reception, comprehension, and commitment to act • Immediately accessible, accurate physician identification and contact information • SCM as the single source of truth • All patient information entered/managed/accessed • Trusted means of communication • User-friendly screen formats to facilitate hand-offs and data collection • Ease of navigation/documentation • Accessible patient information across the continuum of care • Facilitation of patient flow • Automatic updated patient movement • Unit/department visibility

Unified Communication Solution Requirements • Timely, sufficient patient/family information • Increased exchange of information • Increased visibility/improved expectations of patient access • Sufficient physical environment navigational support • Adequate privacy protection • Nurse call application • Standardized • Locating technology • Direct communication • Escalation paths • Direct, immediate automatic notification of critical information • Critical values • Doctor’s orders • Device alerts • Automatic relevant patient information at the point of care • Shared sites with adequate, efficient access

Successful Processes Enterprise-wide implementation and management Design Implementation Support model Standardization Product Process Workflow Training Accountability Well-established governance model Sample of New Technology Automated reporting Self-service kiosks In-room, interactive patient applications Improved network infrastructure Distributed antenna systems IP-DECT In-room clinician dashboards Electronic patient room signage Automatic bedside device management In-room interactive touch screen displays Smart phones Innovative integration of existing technologies Innovative Best Practices

Current State Assessment Discussion/Reactions/ Feedback Anything Missing?

Unified Communications Strategy DevelopmentPlanning RetreatFuture State Design Steering Committee April 13, 2010

Unified Communications Strategy DevelopmentUpcoming Schedule – Future State Design • Current State Findings 4/13/10 • Distribute Pre-Work for Planning Retreat 4/16/10 • Future State Design (FSD) – Planning Retreat 4/27/10 • Draft 1 of FSD to Steering Committee/ITG Wk of 5/3/10 • External Review of FSD Wk of 5/10/10 • Finalize FSD & Road Map 5/27/10 • FSD & Road Map to Steering Committee/ITG Wk of 5/31/10 • Steering Committee – 6/1/10 • IT Governance - 6/3/10

Allison, Penne Armstrong, Mark Bernard, Philip Blechner, Michael D Clark, Murray Conigliaro, Joseph Curtright, Jonathan W DePriest MD, Paul Dunn, Judi Unified Communication Strategy Future State Design Retreat – Invited Participants • Gabbard, Byron L • Gilbert, Peter N • Griffith, Darrell A • Hensley, Sara B • Herrington, Amy E • Holland-Morris, Lissa • Jaros, Sandra • Kirschling, Jane • Mitchell, Rachel W • Phillips, John W • Prevost, Suzanne S • Smith, Ann • Srinath, Jamie R • Stanton, Ryan A • Steltenkamp MD, Carol • Swartz, Colleen H • Weaver, Diana • Retreat Planning Team: • Baker, Steve; Harrington, John (Hill Rom); McCleerey, Michelle (Hill Rom); Montgomery, John; Tarnowski, Tim; Wildman, Tim (Hill Rom); Wimberg, Donna A

Future State Design • Planning Retreat: • Hillary J. Boone Center • April 27, 2010 • 8:00 a.m. – 5:00 p.m. • Pre-Work • Distribute Pre-reading Materials (4/16/10) • Read Pre-reading Materials • Prepare Pre-retreat Assignments • Prioritization

Retreat Pre-Work • Prioritization of Identified Problems • Cost: 1 (expensive) – 5 (low cost) • Involves the purchase of costly applications/device or extensive IT development/implementation • Time: 1 (long term) – 5 (short term) • Involves a large project scope requiring months of implementation • Business Case: 1 (soft dollars) – 5 (hard dollars) • Involves a relationship to desired outcomes that are difficult to directly connect to hard dollar savings • Value: 1 (specific effect) – 5 (enterprise effect) • Involves an effect that is specific to an individual functional area • UK Mission/Strategy: 1 (not aligned) – 5 (well aligned) • Involves a project that is not in alignment with the UK defined mission/strategy and current initiatives

Overview of Retreat Agenda • Presentation of Assessment Findings • Review of Solution Requirements • Group Visioning Exercise • Cross-functional groups • Assigned problem area • Group Presentations • Presentation of Current/Available Technology • Purchased technology • Stabilization/upgrade of current technology • Technology available for purchase • Groups Review of Solutions • Refinement/reprioritization of problems/solutions

Unified Communication Strategy Framework Current State Assessment • Interviews • Shadowing • Rounding • Inventory • Research • Webinars • Vendor Info. • White Papers Best Practice Review Future State Design • VOC • Visioning • Identify Gaps • Potential • Solutions • Target Env. Select Opportunities • Link to • UKHC Pties • Prioritize • Quick Wins • Hi Level • Sequence Portfolio Management & Roadmap • Plan/Scope • People/Skills • Budgets • Sequence • Dependencies • Pre & Post • Measures Value Delivery • Results • Benefits • Internal Best • Practices • New Ideas • CSA Report • Problems • Requirements • Inventory • Pitfalls • Limitations • Comm. • Protocols • Stdization • Workflows • Expectations • Roles • Technology • Target • Environment • Vision • Align with • UKHC Pties • Link to Key • Process • Indicators • ST/LT Pties • Quick Wins • Roadmap • Plan/Scope • Resources • Budgets • Validation • Measurement • Accountability

Unified Communications Strategy DevelopmentNext Steps Portfolio Management & Roadmap Steering Committee April 13, 2010

Unified Communication Strategy – Sample Roadmap (Priority/Funding TBD) Sub-Area Status Area 7/10 – 6/11 7/11 – 6/12 7/12 – 6/13 7/13 – 6/14 7/14 – 6/15 App. Workflow Redesign Optimize Usability Orders Upgrade Obsolete System #1 Upgrade Plan Go-Live • Upgrade Obsolete System #2 Decide Plan Implement Optimize Other Software Various Implement – Various Products Optimize Plan Rollout Opt. Pilot List All Devices - #1 Various Integration Rollout Opt. Pilot List All Devices - #N Various Plan Implement Opt. List All Applications - #1 Various List All Applications - #N Various Plan Implement Opt. Rollout Opt. Pilot Technology #1 Various New Solutions Rollout Opt. Pilot Technology #2 Various Plan Implement Opt. Technology #3 Various Technology #4 Various Plan Implement Opt.

Unified Communications Strategy DevelopmentQuestions/Comments? Steering Committee Sub-Committee April 13, 2010

Unified Communications Strategy Development