1. Respiratory Therapy Department Data Considerations October 21, 2009 Best Ever Hospital Best City, IL MMI – 405: HIT Integration, Interoperability, and Standards Suzi Birz, Nicki Cliffer, Lincoln Farnum, Debbie Michaelson

2. Best Ever Hospital Best City, IL Agenda October 21, 20092 Background Business Case Stakeholders Workflow Next Steps

3. Best Ever Hospital Best City, IL Background October 21, 20093 Best Ever Hospital Best City, IL

4. Best Ever Hospital Best City, IL Best Ever Hospital Mission To meet the healthcare needs of our community by providing all services in a cost-effective and competent manner with compassion, integrity and efficiency while preserving dignity, enhancing quality, and being very mindful of patient satisfaction throughout the continuum of care. Vision Best Ever Hospital will strive to be a leading acute care center providing cost-effective, patient-focused, quality healthcare utilizing new services and technology. October 21, 20094

5. Best Ever Hospital Best City, IL Respiratory Care Services The mission of Respiratory Care Services is: to provide the highest quality respiratory patient care in a timely, effective, safe and efficient manner; to promote internally and with other areas of responsibility continuous quality improvement activities to improve the performance of the Respiratory Care Service as well as the overall performance of the organization; and to provide support for clinical research activities. This requires that Respiratory Care Services assess needs, formulate action plans, instruct/inform as required, implement plans, evaluate actions taken for effectiveness and revise the action plan as needed October 21, 20095

6. Best Ever Hospital Best City, IL Business Case October 21, 20096

7. Best Ever Hospital Best City, IL Business Issue Respiratory Care Services implemented a Respiratory Care Management Information System Best Ever Hospital has deployed an integrated electronic medical record that does not have a Respiratory Care module Modules for other ancillary services have been deployed including pharmacy, laboratory, and imaging. October 21, 20097

8. Best Ever Hospital Best City, IL Current State – Future State Disconnected RT Department Duplication of Documentation Documentation Silos Fragmented Medical Record Lost Charges Manual transmission of new orders Difficult to manage resources Delays in starting new services Integrated RT Department Online, Accessible Documentation Available to all providers Integrated Medical Record Automatic Charge Capture Automatic transmission of new orders Improved resource management Fewer delays in starting new services Improved patient care Improved employee satisfaction October 21, 20098

9. Best Ever Hospital Best City, IL Goals and Objectives October 21, 20099 Costs Reduction in labor costs tangible Reduction in cost of goods tangible Increased net revenue tangible Improved cash flow through reduction in accounts receivable tangible ARRA and reimbursement tangible Quality Improved outcomes tangible Improved provider-patient relationships intangible Improved patient satisfaction intangible Improved recruitment and retention intangible

10. Best Ever Hospital Best City, IL Justification Financial $ Cost reduction $ Revenue increase Regulatory ARRA TJC Organizational Strategy Stakeholder satisfaction Achieve mission and vision October 21, 200910

11. Best Ever Hospital Best City, IL Stakeholders October 21, 200911

12. Best Ever Hospital Best City, IL Key Stakeholders October 21, 200912 Keep SatisfiedManage Closely  Director, Revenue Cycle Management  Chief Information Officer  Chief Nursing Officer  Director, Respiratory Care Services  Directors, Intensive Care Services  Chief, Pulmonary Medicine  Chief, Emergency Medicine  Director, Health Information Management  Chief Compliance Officer  Director, Pharmacy MonitorKeep Informed  RCMIS Vendor Representative  IT Project Management Office  Director, Admissions Services  Respiratory Therapy Patients  Staff INTEREST POWERPOWER

13. Best Ever Hospital Best City, IL Stakeholder Roles October 21, 200913 STAKEHOLDER ChampCustomerPartnerDataSystem RCSDirector, Respiratory Care Services ICUDirectors, Intensive Care Services ER Director, Emergency Department Chief, Emergency Medicine PMChief, Pulmonary Medicine CNOChief Nursing Officer CIOChief Information Officer RCMDirector, Revenue Cycle Management ADTDirector, Admission Services HIM Director, Health Information Management CCOChief Compliance Officer RXDirector, Pharmacy PTSRespiratory Therapy Patients VENRCMIS Vendor Representative PMOIT Project Management Office

14. Best Ever Hospital Best City, IL Direct and Indirect Impacts October 21, 200914 RCSICUERPMCNOCIORCMADTHIMCCORXPTS Admissions ddDdDiDDiddD Orders DDDDDiDiiDDD RT Demand DddDIIIIidId Assignments DddDDiiiiddd Work Status DddDDIDiiDDD PT Routing dDDdDIiDiIdD Charting DDDDDiddDDDI Results DDDDDiddDIDD Billing ddddiIDDIiDD Productivity DddDDIDiDiDi D = direct, high impact I = indirect, high impact d = direct, low impact i = indirect, low impact

15. Best Ever Hospital Best City, IL Workflows October 21, 200915

16. Best Ever Hospital Best City, IL Order Respiratory Care Services October 21, 200916

17. Best Ever Hospital Best City, IL Document Service and Charge October 21, 200917

18. Best Ever Hospital Best City, IL Next Steps October 21, 200918

19. Best Ever Hospital Best City, IL Define the Information Architecture Examine and document the standards Determine and document the information system requirements Bring the findings back to this group on November 4, 2009 October 21, 200919

20. Best Ever Hospital Best City, IL References 1.University of Connecticut Health Center. Respiratory Therapy Department. Retrieved October, 2009, from http://nursing.uchc.edu/unit_manuals/respiratory/index.html. http://nursing.uchc.edu/unit_manuals/respiratory/index.html 2.Johns Hopkins Medicine. Respiratory Care Services at Johns Hopkins. Retrieved October, 2009, from http://www.hopkinsmedicine.org/respcare. http://www.hopkinsmedicine.org/respcare 3.Medical College of Georgia. Respiratory Therapy. Retrieved October, 2009 from http://www.mcg.edu/sah/respther/index.html.http://www.mcg.edu/sah/respther/index.html 4.Quality Health Care in America. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academy of Sciences; 2001:39-40,100. 5.Aspden P, Wolcott JA, Bootman JL et al., eds. Preventing medication errors. Washington,DC: National Academies Press; 2007:4. 6.Safe practices for better healthcare: a consensus report. Washington, DC: National Quality Forum; 2003. 7.Joint Commission on the Accreditation of Healthcare Organizations. Proposed revisions to Standards MM.4.10 and MM.8.10. Retrieved October, 2009, from www.jointcommission.org.www.jointcommission.org 8.Williams, B. 1990. How to do an ROI (return on investment). Healthc Inform 7(2):30-2. 9.Ford, Richard M. Respiratory Care Management Information Systems. RESPIRATORY CARE. (2004); 49(4): 367-377. 10.Pullen, EE. Computers help provide better care. RESPIRATORY THERAPY. (1980); 10(4): 25-27. 11.Nelson, Steven B. Conference Summary: Computers in Respiratory Care. RESPIRATORY CARE. (2004) 49(5): 531-536. 12.Mussa, CC. Respiratory care informatics and the practice of respiratory care. RESPIRATORY CARE. (2008); 53(4): 488-499. October 21, 200920