Epic Enterprise Implementation Kick-off Meeting September 19, 2012

Today’s Agenda Welcome and Opening Remarks Meet Epic Organization and Charter Application Project Teams Timelines Program Scope Key Performance Indicators What to Expect in the Short Term Adjourn

Robert Warren, MD, PhD, MPH Chief Medical Information Officer NOT REALLY

Health Care in Transition Engagement Competition Regulation Reimbursement “Care Delivery Factories” OLD MEDICINE “Home Sweet Medical Homes” NEW MEDICINE Patient as Disease Patient as Partner Disconnected care; limited access Facilitated access to care Real-time connection with patients and community physicians and services “Isolated” experts; care variance Evidence-based care Real-time clinical decision support Unrelated Clinical Research Integrated Research Driving Best Care $$ for service “No Margin, No Mission” $$ for outcomes “No Outcome, No Income” PriceWaterhouseCoopers (adapted)

MUSC Health Strategic Plan Patient-engaged, evidence-based best care Responsive to community needs and regulatory requirements Efficiently provided and reported Informing health care education and research Integrated electronic patient record expanding our outpatient success: Epic Enterprise: July 1, 2014

A New Record … a cultural shift from adoption to ownership

TOGETHER

A Few Words from our Sponsor(s) Etta Pisano, MD VP Medical Affairs & Dean, COM W. Stuart Smith VP Clinical Operations & Executive Director, Medical Center Stephen Valerio CEO MUSC Physicians & Associate Dean for Finance, COM Frank Clark, PhD VP Information Technology & CIO

And Now……. A Word from our Partners

Meet our Representatives Jim Pfleger, Implementation Manager Ryan Marshall, Implementation Coordinator

Who is ? Founded in 1979 Located in Verona, Wisconsin Private & employee owned 275 “customers” 70 academic medical centers 6200 employees Almost all employees engaged in R&D or customer support Named # 1 overall software vendor for 2011 by KLAS > 40% of the U.S. population is cared for using Epic software.

Timelines August – September 2012 October – November 2012 Phases 0 & 1: Discovery and Planning October – November 2012 Phase 2: Workflow validation December 2012 – August 2013 Phase 3: System Build and Preparation September 2013 – June 2014 Phase 4: Testing and Training July 2014 – August 2014 Phase 5: Go-Live / Support

Revenue Cycle Inpatient Ambulatory EMR eCareNet Committee Executive VP Group EHR Development & Operations Council Enterprise Executive Sponsor Dr. Bob Warren Epic Program Administrator Melissa Forinash PMO, Dan Furlong Communications Periop Steering & ED IT Steering Committee Revenue Cycle Steering Committee Inpatient Steering Committee Analytics Development & Operations Council C. Carr S. Russell S. Harvey K.Weaver Gail Scarboro-Hrtiz R. Freeman K. Davis S. Miller J. Kratz C. Liddy Revenue Cycle J.Dell M.Balassone Inpatient Clinicals D.Northrup Ambulatory EMR T.Walsh Training & Support N. Whichard Enterprise Reporting & Analytics M. Daniels Infrastructure & Technical Support K.Nendorf Emergency, OR, & Anesthesia B.Seyfried OCIO/IT Leads Admins & Clinical Leads Legend Advisory & Steering Groups

Application Project Teams Approximately 150 people assigned full or part time ~ 40 additional people hired within OCIO to staff project teams 33 people currently certified in one or more Epic modules >80 people currently in training / certification process

The “Charter” Overall Governing Document for Epic Enterprise Program Defines overall scope & timelines Defines activities at various phases Establishes Key Performance Indicators for program success Approved by eCareNet Committee 8/13 Sign-off by Executive Leadership

Program Scope Enterprise-Wide Patient Access & Revenue Cycle Inpatient clinical systems Enterprise-wide Analytics & Research Continued enhancement of Ambulatory clinical systems

Enhancement of Ambulatory EHR and integration with Enterprise   2012 2013 2014 Aug Sep Oct Nov Dec Jan - Mar Apr - Jun Jul - Sep Oct - Dec Ongoing Optimization Meaningful Use Stage 1 x EpicCare Link (referring MDs) ~1/15/13 Version Upgrade to 2012 6/1/13 Kaleidoscope Ophthalmology ~6/15/2013 6/15/13 ICD10 Phoenix Transplant 6/1/13 6/1/13 6/15/13

Patient Access & Revenue Cycle Welcome Cadence Prelude Identity Resolute HIM BedTime Patient Kiosk Scheduling Enterprise Registration and ADT Enterprise MPI Professional & Hospital Billing ROI Deficiency Tracking Bed Management

Inpatient Clinicals EpicCare Clinical Documentation & Stork EpicCare Physician Order Entry Willow Radiant Beacon ASAP OpTime & Anesthesia ClinDoc and L&D CPOE Inpatient Pharmacy Radiology Oncology Emergency OR & Anesthesia

Analytics and Research Administration over all reporting platforms: “Workbench” reporting at the application level “MyEpic/Radar” Dashboard “Clarity” analytic reporting Other 3rd party platforms Reporting Analysts – write Crystal Reports (Clarity) and collaborate with SME’s for all reporting needs Manage Enterprise Information Request process (formerly Hospital Data Request) Coordination with the Research community regarding resources for research build and reporting

Other Modules Licensed (currently not in scope) Cupid Cardiology Info System Willow Ambulatory Retail Pharmacy Beaker Laboratory Cogito data warehouse Enterprise Data Warehouse Tapestry Claims Management

Existing departmental systems not expected to be replaced Diagnostic Image Archives PACS in Radiology, Cardiology, OB, GI, etc. Document scanning (McKesson HPF) Niche specialty systems EKG, Sleep Lab, Fetal Monitoring, Ped Card, Vascular Lab, Meducare, RescueNet, PaceArt, Radiology systems such as PenRad, PeerVue, TeraRecon, etc. HR, General Accounting, General Financials

KPI’s – Ten for Overall Program Examples KPI’s – Ten for Overall Program Determined by eCareNet Committee Examples Implementation by 7/1/14 Average weekly cash posted for hospital and professional billing Utilization of Epic by external stakeholders (MyChart, EpicCare Link) Percent of new patients seen within 1 to 5 days of initial contact Successful attestation Stage 2 Meaningful Use

KPI’s – Application Specific Each team will identify KPI’s specific to their application as a measure of success by September 30 Examples: Days in AR for hospital / professional billing % of regulatory requirements reportable through Epic OR – prophylactic antibiotic medication compliance Admission medication reconciliation compliance

Measuring Success MUSC Health leadership support and active participation “Ownership” by the project teams and operations Interdisciplinary Teamwork and Workflow Engagement and empowerment of physician and nurse super users as well as departmental “SME’s” Timeline Management Set go-live dates and stick to them Control scope closely Stick closely to Epic’s ‘Model System’ Expect post-live adjustments

What’s Next? Kick-off and Site Visits Validation Sessions This Week Validation Sessions October 16-18 November 6-8 November 27-29 Reengineering Sessions December 18-20 January 8-10

What can you do? Help us make sure we have the right people at the table Help make decisions in a timely manner Revisiting decisions will cost us time and $$$$$ If you have a concern, voice it – don’t assume we already know Be Cheerleaders!! Check our hearing!! Help us stay focused on the big wins

Growing Pains Change, Change, Change Super-user and “SME” time commitment Training: 10-15 + hours of physician and nurse training/competency testing Standardizing workflows where possible Electronic and paper workflows Backup / downtime procedures

Realizing the Benefits Volumes of discrete data for reporting Easy access to patient data in a single database Interdisciplinary Record Better charts lead to Better care Better reimbursement Increased patient satisfaction Improved quality of care

Questions???