1. Somerset Medical Center Inet and BMDI Design and Implementation Dennis Dacquel, RN

2. 2 Somerset Medical Center Non-Profit Community Minor Teaching Hospital 355 Licensed bed 261 maintained / 240 average census Annual Statistics – 40,000+ Emergency visits – 30,000+ Inpatient Visits – 250,000+ Outpatient procedures – 1420 FTEs (1800 people) – 540 Independent Staff Doctors Average LOS = 4.9 – 5.1 days

3. 3 Somerset Medical Center Strategies Top 100 Community Teaching Hospitals Leapfrog Certification e-Health

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5. 5 Clinical Systems Vision: Nursing Process Automation & Redesign Standards of Care Documentation Charge automation Order Processing & Results Charting Care Delivery Task Management Medication Management GOAL: MORE TIME FOR PATIENT CARE

6. 6 M1 M2 M3 M4 M5 M6 M7 M8 M9 M10 M11 M12………………………………… M24 Ancillary Departments: Lab, Rx, Radiology, OR Hospital-wide Integration at Somerset Scheduling, EMPI, Registration Clinical Data Repository Chart Tracking & Deficiency Orders, Documentation Phase I: Replace the Core CPOE M.A.R. Patient Safety Initiatives Order Sets/Pathways Patient Care / Physician Workflow Redesign ICU Integration Phase II: Add the Intelligence E-Sign

7. 7 Critical Care Pavilion ICU(8 beds) CCU(12 beds) IMCU(8 beds) 85 Critical Care RNs 1 Intensivist, 1 PA, 1 NP

8. 8 Timeline Summary

9. 9 Project Organization

10. 10 Inet Project Team SMC IS staff Critical Care Clinician Specialist Critical Care Manager Critical Care Director Critical Care Staff Cerner Inet/Documentation Resource Cerner BMDI resource

11. Design and Build

12. 12 Design Sessions Multiple ‘wish-list’ meetings Ensuring wish-list items are JCAHO compliant. Form design BMDI data acquisition requirements

13. 13 Inet Build Inet OCDs Upload Event Codes Upload Event Sets Create DTAs Turn on the Flowsheets

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25. 25 Technical Design Local Model - ‘fat client’ PC with direct multiple serial connections to bedside devices for every bed - reference database needs to be copied to every PC - troubleshooting - maintenance - hardware

26. 26 Technical Design Centralized Gateway Model - ‘thin’ clients - 1 BMDI gateway to capture data for all bedside devices via TCPIP network - 1 Cerner reference database

27. 27 Hardware needs Purchase ASAP!!!! BMDI gateway Cerner BMDI server Cables/terminal servers/network access etc.

28. 28 BMDI Vendor Selection Cerner only responsible for inbound data Client responsibility to acquire gateway solution: - HP/Philips - GE - Siemens/Legacy Integrators

29. 29 Siemens/Legacy Centralized Solution Auto device ID & detection Port independence - any device / any port. Network based - efficient and fast. Flexibility - 4 ports at the bedside Scalability - deploy in 1 care unit, multiple units, or the entire hospital

30. 30 Critical Care Bedside Devices 29 bedside monitors - GE Marquette Unity network 14 ventilators(floating) - Siemens Servo 300 3 IABPs(floating) - Datascope system 97

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37. Questions?