1. UCSF Medical Center CTG – March 6, 2014 Project: MD Link – First Access/ Patient Creation BCD Project Manager: NA UCSF Medical Center

2. 2 The presenters: The ask: Stephen Wilson, Brian Cosgrove Policy Decision: final CTG approval to move forward with “First Access and Patient Creation” functionality activation in MD Link  Scope:  First Access - allows a user to initiate and obtain managed access to a patient record to which they do not currently have access to  Pt. Creation - allows a user to create a patient in APeX when a patient is not found thru First Access  Timeline: Activation following CTG approval – April 14, 2014  Cost / Savings: $16,835 / year savings (current / projected volume)  Funding: Current operating budget

3. 3 Summary Strategic Drivers  Provide real time access to patient information for Referring and Community Primary Care Providers  Immediate and automated communication of key results, outpatient visit summary, hospital admission & discharge notifications  Secure patient messaging with UCSF providers  Ability to place e-Referrals, Radiology and Lab Orders to UCSF Planned future e-Consult option (in pilot phase) Impacted Application Resources (Victoria Bender, Jonathan Meyers, SheRee Garcia) Tar get Completion Date: April 14, 2014 EpicCare LinkAccessHIM

4. 4 Feb 6, 2014 CTG - Follow Up Item Alter First Access Patient Search to provide open access to UCSF database  Validate: allow probable matches to display when searching for patient, remove more restrictive search parameters Users can then view limited information from each record and select the appropriate one First Access / Patient Creation Search  What happens if there are two patients with the same F/L name, MI & DOB? 1)First Access request: If more than one record matches the search criteria, no search results are returned. 2)Patient Creation request: Duplicate checking, prior to new patient record creation, would prompt user with potential matches. Additional duplicate checking occurs post record creation, which place record on Medical Records Duplicate report for review. Additional Policy Decision: SSN capture is a hard stop during patient creation  When an external provider is creating a patient and the SSN is not known, train users to enter 888-88-8888 – which is the current internal process (ED, SSN not given or known)

5. Costs / Savings: 5 Replace Manual Linkage by APeX Analyst  Non–monetary End user satisfaction  Monetary Average 43 linkage request / week = ~3.6 hrs. of analyst time per week (Savings) $14,000/year Savings Incrementally increasing as number of groups using MD Link increases Replace Manual Patient Creation  Non–monetary Eliminate Impediment to end-user adoption of eReferral, orders and eConsult capabilities  Monetary (unknown) Early target of 15 new patients per month – if manual that would equate to 3.75 hrs. of analyst time per month $3,400/year Savings Incrementally increasing as number of groups using MD Link increases Duplicate checking / merge  Potentials duplicates fall on to the existing Duplicate Report for review Assume ¼ need review @ 10mins / duplicate 0.6hrs / month or $565 savings / year

6. 6 Next Steps: Pending CTG final approval  Update MD Link application with build changes  Communication (Internal) Access, HIM/MR PAC and Referred to Depts. Ancillaries  Communicate change to MD Link Community user base Email Verbal / In person - MD Link Representatives and Physician Liaisons