Rural Wisconsin Health Cooperative Information Technology Network (Achieving eHealth in Rural Hospitals) eHealth Summit (6/12/08) Prepared by Louis Wenzlow.

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Presentation transcript:

Rural Wisconsin Health Cooperative Information Technology Network (Achieving eHealth in Rural Hospitals) eHealth Summit (6/12/08) Prepared by Louis Wenzlow RWHC ITN CIO

ITN Initiative in a Nutshell …to implement a collaborative electronic health record (EHR) environment (initially consisting of a hospital information system and a physician practice EMR system) that will be shared by multiple hospitals from a common datacenter and supported by a pooled staff.

Chronology of Events 2005 AHRQ THQIT Planning Grant 2006 Vendor Selection (goal setting, vendor evaluations, RFIs, RFPs, onsite visits) 2007 Legal Work (consortium—RWHC ITN— articles of incorporation, bylaws, tax exempt status, etc.) 2007 Business Planning (to clearly demonstrate the collaborative business case to participants) 2007 Contract Negotiations 2008 Datacenter Development 2008 Staff Development 2008 Pre-implementation Work

Four Founding Hospitals Boscobel Area Health Care Memorial Hospital of Lafayette County St Joseph’s Community Health Services Tomah Memorial Hospital

Guiding Principles Contain HIS/EHR Costs (Financial) –HIS negotiated discounts –Server/Datacenter sharing –Grants –Participants positioned for future collaborative benefits Shared Dictation, PACS, Ancillary systems Shared Radiologist, after-hours Pharmacist… Shared IT, Transcription, Claims, Collections…

Guiding Principles Improve HIS/EHR Effectiveness (Quality) –Shared HIS support staffing (high level of specialized expertise distributed between facilities) –Redundancy Datacenter/Server Connectivity –Data exchange Between participants With referral centers (as standards mature) –Participants positioned to collaboratively work on P4P, quality reporting, interoperability…

Legal Structure 501(e) –Qualify for tax exempt loans, tax exempt profits and not-for-profit grants Governed by Members –Participant Board (the decision-making body through which collaborative financial and legal decisions are made) –End-user Advisory Committees (the body through which collaborative operational decisions are made) –Shared Management and Staff Facilitates

Vendors Selected Healthcare Management Systems (HMS) –Community Hospital Information System Vendor –One of Initial Four CCHIT Certified Inpatient Vendors Medinotes –Small Physician Practice EMR Vendor –CCHIT Certified at 2007 Standards

Shared EHR Modules & Functions Facility Management Medical Records Inpatient Clinicals 1. Data Repository 1. HIM Core Module 1. Inpatient charting 2. Master Patient Index2. Chart & Film Tracking2. Multidisciplinary 3. Database reporting3. Chart deficiency tracking3. e-MAR 4. Registration/ADT 4. Release of Info. Tracking4. Barcoding 5. Billing 5. Coding & abstracting5. Patient Education 6. General Ledger 6. Bulk scanning option6. Physician portal 7. Accounts Payable7. Dictation 7. PDA support 8. Fixed Assets 8. Electronic signature8. CPOE 9. Materials ManagementDepartmental Systems9. Decision support 10. Payroll/HR 1. Pharmacy 10. Patient portal 11. Time & Attendance2. Lab Other Modules 12. Executive Support3. Radiology 1. Long term care 13. Budgeting 4. Other ancillaries 2. Home health 14. Enterprise Scheduling5. ER 3. QI 15. Order Entry 6. OR 4. Physician EMR 16. Integration tools 7. ICU 5. Physician PM

CAHHIT Helps Fund Startup Phase of Shared Staffing Model

Technical Configuration Redundant Server Model –2 servers; 2 datacenter locations; continuous replication –High availability (planned downtime limited to annual New Release installations) –Disaster recovery in minutes rather than days or hours Redundant Connectivity to Datacenters

Ongoing Activities Application Implementation Activities Participant Facility PCs and Printers Datacenter and Server Installation Work Telecommunications Infrastructure Sharepoint/PhaseWare: Communications Policy and Procedure Development Version 2 of Density of HIT Adoption Report (insert link)

Looking Forward Phase 1 Go Live: July 1st Phase 2 Go Live: October through 2009 Data Sharing Between ITN Facilities: 2009 Engage ITN Facility Tertiary Partners to Collaboratively Explore Data Exchange Use Cases: 2009 Participate In/Align With eHealth Initiative