Getting Ready for Stage 2 DVHIMSS Spring Education Event June 14, 2012 Karen Ohl Main Line Health System

Main Line Health Main Line Health System Four Acute Care Facilities Standalone Rehab Hospital Drug and Alcohol Treatment Center Five Free Standing Outpatient Facilities Department Structure Centralized Information Services Department serving all facilities reporting to CIO

Main Line Health: Key Statistics 10,280Employees1,933Medical Staff Members 1,168Licensed Beds12,536Cardiovascular Discharges 65,824Admissions803,459Outpatient Visits 7,456Births148,188Emergency Visits 15,510Inpatient Surgeries19,339Outpatient Surgeries

Main Line Health: Applications Environment Primary Vendors: Siemens - HIS, Radiology, Pharmacy, MAK, Patient Accounting, OPENLink Interface Engine. Soarian for Results, Clinical Documentation, Workflow, Order Entry and CPOE, EHR, Critical Care Cerner – One facility uses Cerner clinical suite for CPOE, documentation, and ancillary systems. In process of converting to Soarian NextGen – Practice Management and EHR McKesson - Enterprise Radiology & Cardiology PACS, Medication dispensing (robot-rx), Cardiology Information System (CIS) PeopleSoft HR, GL, Materials and AP Health Information Exchange (HIE) - MobileMD Variety of other vendors for departmental and specialized functions. Over 130 applications in inventory

Agenda  Identifying Best Practices for implementing meaningful use initiative  Program Management Strategy  Staffing and Communication  Tracking and Reporting  Final recommendations

Attested for Meaningful Use Stage 1 in February 2012

Overall Best Practice Recommendation in implementing Meaningful Use Do not approach as only an IT project Establishing an ARRA executive steering committee. Assigning operational and IT owners to every objective. Focus on Long Term Goals (how to get to Stage 3) Don’t work in silos, establish multidisciplinary project teams Maintain open and constant communication Adopt internal tracking and trending tools Make MU part of department agendas Establish system to improve compliance Monitor metrics and celebrate success Adapted from HIMSS webinar by McKesson on Beyond Meaningful Use Data Driven Clinical Improvement: retrieved January 19, 2012

Best Practice Recommendations Program Management Structure  Do not approach as only an IT project  Assigning operational and IT owners to every objective.  Focus on Long Term Goals

Program Management Structure: Stage 1 Developed Meaningful Use Program Strategy  Had a master project, “ARRA Initiative”, in our MS SharePoint Project Management system.  Tracking issues as well as progress of each objective was done at the ARRA program level.  Each objective was assigned a Operational Business Owner as well as an IT owner.  Initial gap analysis for each objective was done completed with these owners

 Established PROJECTS within the PROGRAM  Some individual objectives in stage 1 were managed as projects within the Program  CPOE  Problem List  Medication Reconciliation  Quality Measures Program Management Structure: Stage 1

 Maintain clear communication path between PROJECTS and PROGRAM to ensure that work related to objectives:  Align MU objectives with MLH goals and strategic initiatives.  Continue involvement of objective owners  Quality Measures evaluation Program Management Structure: Planning for Stage 2

Program Management Structure: Planning for Stage 2 Projects in progress or proposed for Stage 2  ePrescribe- Medication Reconciliation  Patient Portal  Health Information Exchange  Business Intelligence  Workflows  Care Plans

Best Practice Recommendations Staffing and Communication Plans Establishing an ARRA executive steering committee. Assigning operational and IT owners to every objective. Don’t work in Silos, establish multidisciplinary project teams  Maintain open and constant communication  Make MU part of department agendas

Staffing Plan / Communication for Stage 1 Project Management Office

Staffing and Communication Planning for Stage 2  Expand the IT MU workgroup to be a “Multidisciplinary MU workgroup team”  Define of MU objective and deliverables.  Review all final objective documentation and signoffs for completion.  Conduct project quality review to ensure objectives are on target and work is following program guidelines.

Methods of Program Communication  Reported progress using a “MU report card” to executive steering groups  Used our MS Project Management SharePoint workspace to store and share all documentation and information  Provided updates at various department meetings.

Methods of Program Communication Planning for Stage 2  Stage 2 increase communication at department meetings  Present MU objectives as they relate to strategic plan and other initiatives taking place in the organization.

Best Practice Recommendations Tracking and Reporting Methods Adopt internal tracking and trending tools  Establish system to improve compliance

Tracking and Reporting in Stage 1  Tracked key milestones for each objective  Technically available  Objective being used in Production Environment  Objective Met Threshold  Signoff Function Live Hosp 1 Hosp 2 Hosp 3 Hosp 4 Reports Adoption

Tracking and Reporting Planning for Stage 2  Plan to follow similar model as established in Stage 1.  Possibly use Business Intelligence software to generate the dashboard of objective thresholds.

Final Objective Summary Reporting Stage 1 and Plan for Stage 2  Summary per objective to capture key information about how we met the objective  Description of what was done  Links to any training materials or policy/procedures that may have been created or updated  Signoff from owners  Copies of final reports  Screen prints of any new fields  Reference materials

Best Practice Recommendations Monitor Metrics and Celebrate success!

Celebrate your Success   Recognize that implementing Stage 1 was a result of the great efforts of many different individuals, project teams, workgroups and leadership committees working together.   Take time to acknowledge this achievement and build your team relationships. These teams will be working together for a long time.

Stage 2 Candy Gram Survival Kit  Rubber band to remind you to be flexible  Paper Clip to hold things together especially when they seem to be getting out of control  Gum to keep your stick to it attitude. It is worth a MINT!  Starburst to give you an extra burst of energy  Bandaid when the schedule gets rough.  Smarties to give you the “smarts” to interpret the rules  Candle to remind you there is light at the end of the tunnel  (just not until 2015)  Spoon for when you have to stir things up  Hot Chocolate to remind you to relax  Snickers to remind you to laugh  100,000 bar $because you are worth a lot to the team  M&Ms for a memorable and “meaningful” Stage 2 implementation!

Final thoughts on recommendations we will follow again for Stage 2  Know the regulations  Utilize CMS and ONC websites  Work with your vendors  Network- MU user group  View each objective with not only “Technology in mind but People and Process”  Educate and Communicate  Help “connect the dots” how does MU objectives benefit and support other initiatives being worked on in the hospitals

Thank You ! Karen Ohl - Project Manager Main Line Health Questions & Discussion …