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Healthcare Executive Forum. Dr. Steve Hester Chief Medical Information Officer Joseph DeVenuto Chief Information Officer. Who Is Norton Healthcare?. Integrated Delivery Network of Five Not-for-Profit Facilities

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Healthcare executive forum

Healthcare Executive Forum

Dr. Steve HesterChief Medical Information Officer

Joseph DeVenuto Chief Information Officer

Who is norton healthcare
Who Is Norton Healthcare?

Integrated Delivery Network of Five Not-for-Profit Facilities

1.2 Million yearly patient encounters

35 Employed Physician Practices

5 Immediate Care Centers

10,000 Employees

2,000 Physician Medical Staff

2,000 Licensed Beds

60,000 Admissions/year

Norton healthcare a vision for technology
Norton HealthcareA vision for technology

  • Improve patient safety and quality

    • Measure and communicate quality, safe, efficient patient care and supporting services

  • Utilize technology to facilitate patient centered care

    • Provide a comprehensive continuity of care which is patient centered through clinical systems and appropriate integration

    • Provide tools to patients, physicians and staff to achieve safe and efficient patient care through a systematic transformation of the clinical care process

  • Provide tools and support for managing compliance and regulatory standards

Portals provide infrastructure for improved business processes and quality outcomes
Portals Provide Infrastructure For Improved Business Processes And Quality Outcomes


Provide the standard of care through a systematic transformation of the clinical care process to improve Quality

Outcome based results

(best practices)

Improved Decision Support

Process Excellence

Portal Management


Information Access




Information Presentation


Portals support integration and cross organization collaboration

Physician Portal Processes And Quality Outcomes

Marketing Portal

Nursing Portal

Support Services Portal



Mgt Portal


Patient Portal


HR Portal

Portals Support Integration And Cross Organization Collaboration

  • Single entry point for personalized information

  • Access from multiple systems integrated and tailored by role

Compliance Information

Electronic Forms

Policies and Procedures





Lab System

Collaboration and integration pulling the puzzle together
Collaboration And Integration Processes And Quality OutcomesPulling the puzzle together

TransparentQuality Reporting


Patient, Physician & Employee Portal





& Mobility

Ease of Use

Improved Interoperability



Policy and Procedures

Order Set Standardization

HR Portal

Norton healthcare clinical quality
Norton Healthcare Processes And Quality OutcomesClinical quality

  • Norton Healthcare Quality Initiative

    • Quality drives strategy

    • Public Reporting

      • Strong Senior Leadership

  • Physician and Staff Collaboration for Clinical Quality Improvement

    • Create an environment focused on improving business, workflow and clinical process

    • Portals provide foundation for improving clinical quality

  • Go Green Initiative

    • Collaborative effort across the organization

  • Long Range Clinical Quality Plan

    • Approach Quality like Long Range Financial Plan

    • Quality is a measurable entity

Key success measures
Key Success Measures Processes And Quality Outcomes

Providers Must

  • Track and Measure Results

  • Analyze their results, to find their strong and weak points

  • Compare their results with those of other hospitals…

  • Welcome publicity not only for their successes, but for their errors…

Providers Must

Track and Measure Results

Analyze their results, to find their strong and weak points

Compare their results with those of other hospitals…

Welcome publicity not only for their successes, but for their errors…

“Such opinions will not be eccentric a few years hence.”

Dr. Ernest A. Codman, 1917

Quote from: The Role of Clinical Data and Risk Adjustment in Public Reporting of Hospital Performance. Massachusetts Health Data Consortium, December 10, 2003. RS Johannes, MS, MD, Vice President for Medical Affairs, Data & Clinical Information – Cardinal Health.

Norton healthcare quality report
Norton Healthcare Quality Report Processes And Quality Outcomes

  • 244 Quality Measures on the Internet available for public evaluation

    • Plan for Ambulatory Metrics in first quarter of 2006

  • Side-by-side, hospital-specific numbers

  • Highlight red or green based on 99% confidence limits around the U.S. average

  • We say “worse” and “better”

  • Popup boxes give indicator definitions and any hospital-specific response

  • We show state average when available

Long range quality plan
Long Range Quality Plan Processes And Quality Outcomes


Process ImprovementMethodology Implementation


Improve Collaboration for QualityImprovementsGo-Green Planning Finalized 12/05


Go-Green Planning Finalized 12/05

Mobility for Point of Care

Clinical Decision SupportQuality Bundle Implementation 7/06CPOE 7/07

Patient satisfaction report
Patient Satisfaction Report Processes And Quality Outcomes

Financial stewardship report
Financial Stewardship Report Processes And Quality Outcomes

Physician portals for quality improvement
Physician Portals For Quality Improvement Processes And Quality Outcomes

  • Central access for provider specific information

    • Reference materials

    • Group specific quality information

  • Central location for quality indicator collaboration

Norton healthcare collaboration and portals initiatives
Norton Healthcare Collaboration And Portals Initiatives Processes And Quality Outcomes

PHASE I – Administrative portals

  • Employee Portal (EmployeeLINK)

  • Organizational Policies and Procedures management

  • Ongoing Education and CME (Learning Management System)

  • Guest Services

  • Clinical Quality Collaboration

  • Create Easy to Use Collaboration Tools

    • Hurricane Katrina Collaboration Site and Patient Tracking

  • Mobile Solutions for physician documentation and access

PHASE II –Clinical portals and Mobility Solutions

  • Clinical portals – integration with Electronic Medical Record

  • Physician Peer Review

  • Patient Portal with Disease Management Focus (GuestLINK)

    • Wireless infrastructure for patient satisfaction and education

  • Increased mobility for information retrieval and workflow integration at time of delivery

  • DOCLINK – Norton Healthcare’s version of Virtual Physician Office

Employee portal
Employee Portal Processes And Quality Outcomes

Employee Portal

  • Employee Portal (EmployeeLINK)

  • Problem

    • Limited and disjointed access to personalized employee and benefits information

  • Solution description

    • Integration to People Soft HR system

    • HR Forms access – future online forms completion

    • IHDN System Communication Tool

    • Integration with existing applications

      • Offer employees online Over the Counter Medication Discount program

  • Benefits/ROI

    • Online Open Enrollment

      • $100,000 savings each year

    • Online Benefits Management and Pay Stub

      • $50,000 savings each year

Policies and procedures portals
Policies And Procedures Portals Processes And Quality Outcomes

  • Problem

    • Document management needed for policies and procedures

  • Solution description

    • Portal to provide a central location and standardized process for storing and revising documents to ensure regulatory compliance and ease of workflow

  • Benefits/ROI

    • Central Universal Location

    • Version Control

    • Central Updates

    • Risk Management Control

    • Improved Patient Safety

    • Standardization

Policy & Procedure

Learning management portal
Learning Management Portal Processes And Quality Outcomes

  • Problem

    • Training documents, courses and internal documents spread out across organization

  • Solution description

    • Single point of access to training documents, courses and internal documents for employee training personalized to user

      • Integration with People Soft

      • CME and CEU Opportunities

        • Norton Healthcare is the largest provider of CME in the state of Kentucky

        • Real Time access and testing for Web Based Training

  • Benefits/ROI

    • $3 Million savings for recent Hospital EMR Go-Live

    • At home training opportunities for employees

Learning Management Portal

Other administrative portals
Other Administrative Portals Processes And Quality Outcomes

  • Problem

    • Need flexible and easy to use tools to create collaboration and portals as needed

  • Solution description

    • Leverage portals to provide easy to use collaboration tools

  • Benefits/ROI

    • Example - Hurricane Katrina Site

      • Central Location for Information

      • 10 minute setup time

      • Extremely flexible

      • Excellent use of technology to augment workflow

Clinical portals and mobility benefits
Clinical Portals And Mobility Processes And Quality OutcomesBenefits

  • Instant, Real Time Information Access

    • Enables caregivers to access patient information where they need it most—at the point of care

  • Improved Patient Safety

    • Electronic capture of patient data reduces errors that inevitably occur with paper-based forms

  • Streamlined Compliance and Enhanced Security

    • Reduced reliance on paper, increased control over information, and digital signature capabilities can improve both regulatory compliance and overallinformation security

Clinical Portals and Mobility

Clinical portals and mobility current initiatives
Clinical Portals And Mobility Processes And Quality OutcomesCurrent initiatives

  • Outpatient Oncology unit with Tablet PC clinical documentation

    • Problem

      • Need to access and document clinical results at the bedside and other locations

    • Solution Description

      • Display digital images on the Tablet PC to consult with patients and families

      • Collect patient documentation at the bedside

    • Benefits

      • Improved patient care and satisfaction

Clinical Portals and Mobility

Mobility and wireless current initiatives
Mobility and Wireless Processes And Quality OutcomesCurrent initiatives

  • Nurse and Respiratory Therapy with access to clinical information system and EmployeeLINK

    • Problem

      • Nurse and respiratory highly mobile

    • Solutions description

      • Therapists and nurses access clinical and employee information

    • Benefits

      • Improved patient care and satisfaction, nurse satisfaction

  • Patient access to Patient Portal via wireless network

    • Problem

      • Patients and families want overall access to the Internet as well as disease reference information in the hospital

    • Solution Description

      • Patient education, disease management, personal email available for patients in the hospital

    • Benefits

      • Patient Satisfaction

Clinical Portals and Mobility

Clinical portals mobility and wireless solutions phase ii initiatives
Clinical Portals, Mobility and Wireless Processes And Quality OutcomesSolutions - Phase II Initiatives

  • Neonatal Intensive Care Unit online documentation utilizing Tablet PC

  • Hospital based Cardiologists with access to Cath and Echo films for viewing via wireless tablet

  • ED online documentation via wireless tablet

  • Physician utilization of tablet devices for patient care management

    • EMR Utilization of Tablet PCs


and Wireless

Why microsoft
Why Microsoft? Processes And Quality Outcomes

  • Familiar and easy to use

  • Adaptive

  • Supports multiple platforms, devices,and mobility

  • Low cost of ownership

  • Works with existing technology investments

  • Interoperable by design

Norton healthcare summary

Process excellence Processes And Quality Outcomes

Improved Decision Making

Data integrity and integration

Return on investment

Improving workflow and collaboration

Access at point of care through mobility solutions

Collaborative team behaviors

Norton Healthcare Summary

  • Technology enabling a collaborative relationship between care givers and administrative employees

  • How Portals and Technology Supports Norton Healthcare Quality Initiatives



Based results




Norton healthcare takeaways
Norton Healthcare Takeaways Processes And Quality Outcomes

  • Pilot Groups – Start Small and Grow

  • Strong Strategic Partners

  • Adequate Support Structure for growth

  • Legal involvement with wireless technology

  • Changes in Workflow Management

  • Multiple opportunities for return oninvestment with collaborative technologies