1. Georgia Rural Health Information Technology Conference Healthcare Information Systems Requirements to Achieve Meaningful Use Certification December 10, 2009 ebrown@gwinnettmedicalcenter.org Wallace Ed Brown, Senior VP/CIO Gwinnett Medical Center

2. Gwinnett IT Journey Board Priority Quality and Patient Safety Strategic IT Plan Board Approval Vendor Selection and Negotiation Governance Physician Involvement Project Management

3. HITECH System Requirements Electronic Medical Record (EMR) Quality Reporting Connectivity Security/Confidentiality Enhancements Infrastructure

4. HITECH System Requirements Electronic Medical Record –Clinical Data Repository –Clinical Documentation –Computer Provider Order Entry (CPOE) –ePrescribing –Bar-coded Medication Administration –Medical Device Interoperability –Medical Imaging

5. HITECH System Requirements Quality Reporting –Data Warehouse (Clinical & Financial) –Reporting Module Connectivity –Physicians and Hospitals Exchange Clinical Data –Health Information Exchange (HIE) –Problem: Standard Patient Identifier Security/Confidentiality Enhancements –Paperless Legal Medical Record –Provide Electronic Medical Record to Patient –Selectively Secure Access Per Patient Request

6. Infrastructure –Hardware Redundancy and Reliability Network Server Data Storage Computer Center –Support IT Super Users –Interfaces Registration, ADT, Orders, Results Engine Specialists “Care Critical” Trumps “Mission Critical” HITECH System Requirements

7. Considerations Recognize the significance of this major clinical transformation; may be the most complex project ever undertaken. Secure trusted consulting. Educate the Board. Shift funding priorities over the next few years. Organize Governance driven by doctors and nurses. Recognize the need for professional project management.

8. Considerations Develop comprehensive RFP specifications and make responses part of contract. Negotiate with at least two viable vendors. Negotiate “Limitation of Liability.” Recognize shortage of healthcare IT professionals for both vendors and providers. Be wary of vendors without healthcare track record. Allow 24-36 months to complete from contract signing.

9. Considerations Consider pooling of resources or hooking up with larger medical center. Viable vendors are going to be overwhelmed with work. Realize that percentage of expense budget for IT will rise.