Unified Communications Strategy Development

1. Unified Communications Strategy Development Steering Committee May 18, 2010

2. Discussion Outline • Meeting Start Up Activities • Summary of Retreat • Future State Design • Future State Design Architecture Tool & Examples • Beds • Smart Pumps • Governance Discussion • Next Steps

3. Unified Communications Strategy DevelopmentSummary of Retreat Steering Committee May 18, 2010

4. Unified Communications:Retreat Participants • Sponsors: Colleen Swartz, Tim Tarnowski • I.T.: Steve Baker, John Montgomery, Cecilia Page, Donna Wimberg • Hill Rom: Michelle McCleerey, John Harrington, Plus Three Hill Rom Facilitators • Retreat Activities: • Current State Assessment Findings • Group Visioning • High Level Review of Current/Available Technology • Refinement/Reprioritization

5. Unified Communications:Retreat Priorities – Voice of the Customer

6. Patient at the Center Communication Flow – Devices & Equipment Top Priorities: • Touch the Patient • Device Integration • EMR Optimization • Discharge Process Cardiac Monitor Telemetry Vitals Fix & Portable • Blood Pressure • Temp • Pulse Ox • Etc Inpatient Care Ventilator Smart Pump Patient Room TV Nurse Call Patient Smart Analyzer • Glucose • Creatinine • Reactive Protein • Coagulation • Etc Device Info Patient Phone FrontlineWorker Support Ops Administration Specialty Monitor • Fetal • EEG • Etc. Smart Bed Outpatient Care Patient Armband

7. 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. • Link to • UKHC Pties • Prioritize • Quick Wins • Hi Level • Sequence Select Opportunities Portfolio Management & Roadmap • Plan/Scope • People/Skills • Budgets • Sequence • Dependencies • Pre & Post • Measures • Results • Benefits • Internal Best • Practices • New Ideas Value Delivery • 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

8. Unified Communications Strategy DevelopmentFuture State Design Steering Committee May 18, 2010

9. Unified Communications - Mission • Create an enterprise-wide standardized communication solution that will allow efficient and effective information flow from the patient to the care team, within the care team, and back to the patient with inherent flexibility that is able to account for needed cultural and/or departmental changes

10. Unified Communications - Objective • Identify and incorporate properly designed asynchronous communication technology that will not replace face-to-face interaction, rather will mediate the interruptions that are not urgent, so communication can become more efficient and less time consuming and directed toward the improvement of care. Such technology will actually divert face-to-face communication to more opportune times.

11. Future State Design • This patient-centered model accounts for the following: • Active and passive communication to and from medical devices • Direct patient care and communication through interactions with various care providers (or Roles, such as nurse, physician, transporter, etc.) in the hospital • Active two-way communication to and from patients via communication devices including, but not limited to nurse call, information, entertainment systems, telephones, etc. • All of the coordination and subsequent communication between the various care providers (roles) and the repositories and rules engines (Applications) with respect to patient information

12. Future State Requirements • Standardize Application Repositories • Communication Engine • EMR • Patient Flow • Standardize: • Communication Devices • Nurse Call • Delivery of Critical Messages • Provide Medical Device Integration • Establish: • Patient & Family Communication • Unified Care Plan

13. Unified Communications Strategy DevelopmentFuture State DesignArchitecture Tool & Examples Steering Committee May 18, 2010

14. Patient at the Center Future State Design Architecture Tool

15. Unified Communications Strategy DevelopmentFuture State DesignArchitecture Tool & ExamplesBEDS Steering Committee May 18, 2010

16. Patient at the Center Future State Design Communication Flow – Beds Smart Bed Bed Placement and Association

17. Patient at the Center Future State Design Communication Flow – Beds Arrow # One - Data Elements • Bed Scale Installed • Bed Exit Alarm Installed • Powered Air Surface Installed • Bed Location • Service Required • High-Low Motor Lockout • CPR Mode Engaged • Brakes Set • Bed in Low Position • Head End Rail Up/Down • Foot End Rail Up/Down • Right Head End Side Rail Up/Down • Left Head End Side Rail Up/Down • Right Foot End Side Rail Up/Down • Left Head End Side Rail Up/Down • Bed Exit Alarm On • Nurse Call Button Activated • Head of Bed Angle Value • Head of Bed Angle Alarming • Patient Weight • Bed Exit Alarm Status (Stages) • Head Motor Lockout • Foot Motor Lockout

18. Patient at the Center Future State Design Communication Flow – Beds Smart Bed Arrow # Two Program Elements • Activate/Deactivate Alarm (s) • Set Bed Angle Value • Zero Scale • Activate/Deactivate Motor Lockout (s)

19. Patient at the Center Future State Design Communication Flow – Beds Smart Bed Arrow # Three Alert Elements • Location • Status • Priority • Urgency

20. Patient at the Center Future State Design Communication Flow – Beds Smart Bed Arrow # Four Human Interaction Elements • Easy Navigation • Intuitive • Multiple Methods • Vibrate/Silent • Audible 1 • Audible 2 • Audible 3

21. Patient at the Center Future State Design Communication Flow – Beds Smart Bed Arrow # Five • Confirm Communication

22. Patient at the Center Future State Design Communication Flow – Beds Smart Bed Arrow # Six • Confirm Communication

23. Patient at the Center Future State Design Communication Flow – Beds Smart Bed Arrow # Seven Real Time Two Way Communication • Advise actions • Comfort patient • Intervention • Protocol support

24. Unified Communications Strategy DevelopmentFuture State DesignArchitecture Tool & ExamplesSMART PUMPS Steering Committee May 18, 2010

25. Patient at the Center Future State Design Communication Flow – Smart Pumps Smart Pump Placement and Association

26. Patient at the Center Future State Design Communication Flow – Smart Pumps Arrow # One - Data Elements • Pump Key Stroke Capture • Infusion Data • Alert Data • Bar Code Scan Data

27. Patient at the Center Future State Design Communication Flow – Smart Pumps Arrow # Two – Program Elements • Drug Library (Soft – Hard Limits) • Treatment Order • 3-way scan • Drug Label • Patient ID • Clinician ID • Software Updates • Drug Library Updates

28. Patient at the Center Future State Design Communication Flow – Smart Pumps Arrow # Three Treatment Conformation & Activation • Role validates pre programming • Role activates infusion

29. Patient at the Center Future State Design Communication Flow – Smart Pumps Arrow # Four Alert Elements • Location • Status • Priority • Urgency

30. Patient at the Center Future State Design Communication Flow – Smart Pumps Arrow # Five Human Interaction Elements • Easy Navigation • Intuitive • Multiple Methods • Vibrate/Silent • Audible 1 • Audible 2 • Audible 3

31. Patient at the Center Future State Design Communication Flow – Smart Pumps Arrow # Six • Confirm Communication

32. Patient at the Center Future State Design Communication Flow – Smart Pumps Arrow # Seven • Confirm Communication

33. Unified Communications Strategy DevelopmentGovernance Discussion Steering Committee May 18, 2010

34. Patient at the Center Communication Flow – Devices & Equipment Top Priorities: • Touch the Patient • Device Integration • EMR Optimization • Discharge Process Cardiac Monitor Telemetry Vitals Fix & Portable • Blood Pressure • Temp • Pulse Ox • Etc Inpatient Care Ventilator Smart Pump Patient Room TV Nurse Call Patient Smart Analyzer • Glucose • Creatinine • Reactive Protein • Coagulation • Etc Device Info Patient Phone FrontlineWorker Support Ops Administration Specialty Monitor • Fetal • EEG • Etc. Smart Bed Outpatient Care Patient Armband

35. Unified Communications Strategy DevelopmentGovernance Discussion • Unified Communication Governance Requirements: • Over-arching Strategy for Communication Technologies • “Keeper” of the Patient at the Center Model • Enterprise Wide Scope & Standards • Oversee/Guide Enterprise Wide Unified Communication Projects • Walk Through Design of New Communication Technologies Before Deployment (e.g. Architecture Tool) • Monitor Impact on Work Flow • Review Education Process • Ensure Support Model(s)/Ownership Appropriate • Accountability/Monitor Effectiveness • Manage Strategic Communications Vendors

36. Unified Communications Strategy DevelopmentGovernance Discussion • In Progress: • Beds • Smart Pumps • Nurse Call • Emergin • Ultrasound • Pyxis • Cell Phones • Others…..

37. Unified Communications Strategy DevelopmentGovernance Discussion • Strategic Communications Vendors: • Hill Rom • Stryker • Philips • USA Mobility • Capsule • Eclipsys • Microsoft • Etc…..

38. Unified Communications Strategy DevelopmentGovernance Discussion • Governance Model Options: • Continue As Is • Leverage Existing Teams • Create New Team

39. Unified Communications Strategy DevelopmentNext Steps Steering Committee May 18, 2010

40. Unified Communications Strategy DevelopmentNext Steps • External Review of FSD Wk of 5/10/10 • Finalize FSD & Road Map Including Governance 5/27/10 • FSD & Road Map to Steering Committee/ITG Wk of 5/31/10 • IT Governance - 6/3/10 • Initiate Unified Communications Governance • Develop Implementation Plans June 2010

41. Roadmap The FSD solution is a multi-phase, multi-project, multi-year effort beginning with the stabilization and establishment of the foundation for a Unified Communications platform

42. 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. Rollout Opt. Pilot Technology #1 Various Other Themes TBD Rollout Opt. Pilot Technology #2 Various Plan Implement Opt. Technology #3 Various Technology #4 Various Plan Implement Opt.

43. Unified Communications Strategy DevelopmentQuestions/Comments? Steering Committee Sub-Committee May 18, 2010