NSW State-wide Intensive Care Clinical Information System (ICCIS) Program Briefing

1. NSW State-wide Intensive Care Clinical Information System (ICCIS)Program Briefing welcome NSW Ministry of Health | Critical Care Taskforce |

2. ICCIS Background • ICCIS positive impact on quality of care, mortality, length of stay, efficiency, patient safety and staff satisfaction/turnover • ICCIS business case approved by Gateway/Treasury 2006/07 the scheduled for 2014/15 • Specifically recommended by the Garling Review (2008/9) • In 2009 Critical Care Taskforce obtained formal confirmation from the former Minister that ICCIS would be funded in 2011/12 as a component of the broader eMR strategy (Phase 2) • 5 to 6 year delay led to issues regarding scope due to critical care service growth • Consultation and development: • Intensive Care Taskforce CIS Advisory Group • Unit reps briefed on CIS project and study tours • Key milestone 26 November 2010 Statewide Intensive Care Services Planning Day • Vendor demonstrations • Leverage Queensland, ACT, Canada (Alberta) and local SAH, MPH ICU CIS Project • Gartner Institute / Dr Michael Shabot (US) • Existing NSW ICU CIS sites Blacktown, CHW, Orange, RPA, St George • Lessons learnt from NSW Health IT projects • Potential options state base build or commercial “off-shelf” product • Openly consider all viable products

3. Procurement & IPS NSW Configuration Implementation Hand over ICCIS Scope, Deliverables and Timeframe • NSW statewide configuration (standardised platform) • Scope: 45 ICU/HDUs incl. 2 PICUs – total 697 beds • Proposed roll-out stages: • First: Existing ICU CIS sites, Level 6/5 (including ICU unit redevelopments) • Second: Remaining Level 5, 4 and 3 (HDU) • Third Neonatal ICU 6 (subject to eMR Phase 3 funding - configuration included in requirements documents) • Local CIS support: CIS Manager/Project Positions (single site and networked) • Capital budget of $43.1 m • Recurrent budget for 10 years is under development

4. ICU CIS • Electronic recording and documentation (electronic flow chart) • Access to multiple data and information sources simultaneously • A coordinated interface for bedside devices • Configure data for clinical review/management and evaluation • Medication management • Clinical decision support • Monitoring and reporting (AORTIC, ACHS) • Quality improvement • Clinical research

5. Facility ICCIS Manager Facility ICCIS Manager Facility ICCIS Manager Facility ICCIS Manager Facility ICCIS Manager Facility ICCIS Manager Facility ICCIS Manager Facility ICCIS Manager Governance, Structure, Roles and Responsibilities ICCIS NSW Configuration and Implementation Procure Only Business as Usual Steering Committee Evaluation Panel Evaluation Advisory Group Critical Care Task Force Implementation Management Group Reference Groups# Critical Care Task Force ICU Nurse Mgrs Group Infrastructure Board Application Advisory Group CEC ICCMU Pharmacy & EMM^ ICCIS Project Facility Implementation Facility Implementation Facility Implementation Facility Implementation Facility Implementation Facility Steering Committee Facility Steering Committee Facility Steering Committee Facility Steering Committee Facility Steering Committee* Facility Implementation Manage. Group Facility Implementation Manage. Group Facility Implementation Manage. Group Facility Implementation Manage. Group Facility Implementation Manage. Group Facility Project Facility Project Facility Project Facility Project Facility Project Legend Governance Role Participant Role * Facility steering committees will include cardiologists as required # ICCIS will consult CCT on clinical decisions, CEC on patient safety decisions, ICCMU/ANZICS on quality and clinical registry reporting, ICU Nurse Managers’ Group on nursing decisions, and Pharmacy / EMM on medication management ^ Pharmacy consulting may be via the pharmacy reform program. Consulting with the medication management program will commence once HSS establishes the program Reporting Direction

6. Facility Implementation Facility Implementation Facility Implementation Facility Implementation Facility Implementation Governance, Structure, Roles and Responsibilities Internal Program Structure Program Director Program Mgr Stakeholders & Change Implementation Program Manager ICCIS Resource Manager (10%) Program Support Officer* ICCIS Solution Architect Training SME pool with experience in medicine, nursing, allied health, pharmacy, adult ICU, adult HDU, pediatric, neonatal Contract Mgr (15%) Finance Manager (50%) ICCIS Tech & Infrastructure Change Option# Master Scheduler# (33%) Benefits Team (10%) Testing^ Implementation Contributions will vary over the program life cycle. Percentages are across the whole program, which is forecast for 3 years SME SME SME Data Conversion Transition to BAU SME Bedside Devices Interfaces System Integration & Interfaces Business Analysis Benefits Measurement * Also responsible for some services to vendors such as provisioning ^ Also responsible for non-functional deliverables such as support service level testing # Initially, the PM S&C will manage implementation. As the program scales, a PM focusing on facility implementations will be necessary as will a Master Scheduler

7. Program Success • ICCIS Program will not be run as ‘giant project, but ‘portfolio of projects’ • Rotating memberships through Implementation Management Group to provide tacit knowledge and mentorship • Clinical ownership and engagement: • Steering Committee is largely clinical • Extensive clinical involvement in IMG • Evaluation Panel almost exclusively clinical • Leveraging ICCMU, ICU/HDU Nursing Managers Group, CEC and CCT where possible • Planning for evaluation of clinical and business outcomes before, during and after implementation via UNSW Centre for Health Systems and Safety Research (Professor Johanna Westbrook’s team) • Ensure process for sharing real experiences of the good, the bad, the ugly – in real time

8. Implementation Applied lessons • Emphasis on change management including dedicated resources for on-going training • Undertaking a proof of concept for lead sites with evaluation and enhancement before statewide roll out • Providing adequate resources for the configuration and maintenance of the ICCIS solution • Dedicated support for change management • Ensuring significant clinician input and leadership • Sharing of work around solutions and version control

9. Implementation Two phases: • Phase 1: Statewide ICCIS content and configuration • Phase 2: Deployment • Establish local ICCIS Implementation Steering Group • Lead implementation hospital identified in each LHD/network to go live, evaluate then staged roll out • Early recruitment and mentoring of local ICCIS managers • Standardised statewide platform for the ICCIS • Local interface refinements can be made following the agreed guidelines • User training • Integration testing and user acceptance testing

10. Change and Risk Management Risks: • Statewide Implementation Planning Study • Impact on data centres is under investigation • The phased implementation approach will: • Assist to mitigate the potential risks around the infrastructure • Manage the change to work practices • Test the potential impacts and assumptions for refinement before broader implementation • Manage the resourcing requirements that the project of this size will impose • Risk identification, mitigation and disaster recovery plans will be developed and updated prior to, and throughout the life of the project • ICCIS requires high reliability and “up-time” • Business continuity and disaster recovery strategies will be developed and implemented prior to going live • Active reporting process through out the project to ensure due diligence and early escalation

11. Evaluation Method Publish on eTender Vendor Briefing Delegate Authority for Tender Approve RFT     Engage Evaluation Panel  Tenders Close 7 February 2012 Stage 1: Compliance Screening Stage 2: Initial Review  Develop Requirements  Stage 4: Vendor Presentations Stage 3: Evaluate Compliant Tenders Stage 3: Short Listing Develop Evaluation Methodology  Stage 4: Reference Checks Stage 4: Best and Final Offer Stage 5: Evaluation Report Stage 6: Negotiations Stage 6: Develop Orders for IPS Implementation Planning Study Develop Orders

12. Site Surveys Site Surveys • Draws on standard biennial Intensive Care Coordination and Monitoring Unit (ICCMU) surveys • In addition to biomedical devices, will gather data on ICU current state infrastructure • Consider hardware options/ergo metrics • Currently providing informal early engagement with LHD CIOs and IT staffs; developing survey instrument; engaging a contractor to provide assistance • All ICUs / HDUs in scope for investment • Provide information for the Implementation Planning Study, and hence shorten how long the successful vendor will need to execute the IPS • Change management opportunity to present ICCIS to local ICU, IT, Hospital Executive staff • Taking place over the next 8 weeks

13. Reference Information/Communications • Communications Plan • Monthly ICCIS Newsletter • ICCMU website http://intensivecare.hsnet.nsw.gov.au/ • Critical Care Taskforce • Infrastructure Board • Senior Executive Advisory Board • Local site steering and implementation groups