Pella Regional Health Center

1. Pella Regional Health Center Health Information System Selection

2. Organizational Overview Licensed for 47 acute care beds 109-bed long-term care unit (24-bed dementia unit) Emergency and urgent care departments Occupational health clinic Five family health clinics (Pella, Bussey, Sully, Monroe and Knoxville) Specialty clinics Hospital-based dialysis unit

3. Organizational Overview Surgical Services Rehabilitative services Hospice Home Health 100-bed residential care facility Independent living campus

4. A New Vision To establish a fully integrated enterprise-wide information system encompassing clinical and financial applications which are tied to a patient-centric database enabling data to flow to authorized customers through internal and external networks.

5. Potential Derailment Negotiated with a single vendor Unable to reach an affordable price Ongoing concern with respect to the perceived level of risk

6. Revived the search process!

7. Back to Basics Which vendor and products? How much should be spent? The nursing process in IS?

8. Existing Vendors/Applications

9. Existing Vendors/Applications

10. Diagnosis Ineffective Communication related to multiple silos of data

11. Silos of Data Redundant processes Less than optimal patient safety Labor intensive data analysis and reporting

12. Diagnosis Management of Therapeutic Regimen, Challenging: Community

13. Multiple Systems (Including a Paper-based Medical Record) Patient-specific data not readily accessible Shadow charts created within departments Labor intensive for IS staff Maximum value NOT derived from individual systems

14. Dispel the Myths We will find the perfect system If you build it - they will come! Implementing a new HIS will automatically solve organizational inefficiencies Mass consensus and enthusiasm for a vendor will be the key indicator for the right choice

15. Overall Approach(Source: Dr. Leo Black, Mayo Clinic Jacksonville) There are choices to be made: Choice #1 Start with the �big picture� and later develop individual programs OR Start with individual programs and later try to link them

16. Choice #1 Start with the �big picture� and later develop (enhance) individual programs. Data center design and build Migrate current functionality to new HIS Enterprise-wide order entry with focus toward point-of-care medical necessity checking Enterprise-wide EMR for resulting

17. Overall Approach(Source: Dr. Leo Black, Mayo Clinic Jacksonville) Choice #2 Go predominantly with one vendor OR Go with best of breed

18. Choice #2 Go predominately with one vendor. Minimize interfaces Similar �look and feel� across the enterprise Ultimately achieve maximum utilization of functionality Sound Easy?

19. Which Vendor? Consultant Request for information and request for proposal Current state was evaluated Written report submitted Functional specifications provided by consultant and sent to relevant departments

20. Lessons Learned Interview several consulting firms and evaluate their methods for facilitating your selection process: Pose questions that uncover a �one size fits all� approach Identify potential conflicts of interest Request references of similar organizations � conduct conference calls to solicit their experience and satisfaction

21. Lessons Learned Define deliverables and establish realistic expectations Maintain leadership � a consultant will never know your organization as well as you, nor will they lead you to the perfect system!

22. Best of Breed Sirens

23. Identify Health Information System (HIS) Vendors Retrieved the 2003 HIMSS Conference Exhibitor List Quick scan of websites to identify health information system vendors Categorized vendors

24. HIS Vendor Offerings Created a table to identify the clinical components of each vendor�s HIS Eight vendors provided: registration, scheduling, clinical data repository, order management, clinical documentation, laboratory, medical imaging, pharmacy and health information management

25. Potential Vendors Cerner CPSI Dairyland Epic Keane McKesson MediTech Siemens

26. Overall Approach(Source: Dr. Leo Black, Mayo Clinic Jacksonville) Choice #3 View this as an isolated project/function OR View this as part of an overall institutional strategy

27. Information Technology Portfolio

28. Information Technology Portfolio

29. Information Technology Portfolio

30. Information Technology Portfolio

31. Information Technology Portfolio

32. Overall Approach(Source: Dr. Leo Black, Mayo Clinic Jacksonville) Choice #4 Is a positive financial return very important in the near term? OR Is financial return of lower importance than other goals?

33. Estimating Return on Investment (ROI) Financial return was deemed important and necessary, but a long-term view was utilized. Literature review completed Vendor estimates reviewed Potential line items identified, linked with literature citations and issues for consideration

34. Line Items within ROI % Gain in patient volumes within out-patient clinics % Gain in surgical net revenue Reduction in file clerk positions in HIM Reduction in labor costs associated with charge entry Avoidance of inappropriate/redundant orders Reduced denials

35. Line Items within ROI Increase in-patient charge capture Increase out-patient charge capture Reduction in paper forms and supplies Reduction in labor costs associated with data collection/analysis Reduction in labor costs related to pharmacy billing Decreased nursing overtime