EMR, EHR & Service Excellence Journey

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17 Νοε 2013 (πριν από 3 χρόνια και 8 μήνες)

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EMR, EHR & Service Excellence Journey


Healthcare ICT

Ahmad Yahya

Chief Information Officer (A)

Sheikh Khalifa Medical City

Topics


Organization Overview


EMR Implementation Journey at SKMC.


EHR Implementation across SEHA and value
proposition


Realities of Healthcare

About SEHA


Abu Dhabi Health Services Company (SEHA)


Public Joint Stock Company owned by Govt. of Abu Dhabi.


Focus to deliver
world class medicine to
residents
of
AD


Owns and operates:


12 Healthcare Facilities, 2,644 licensed beds


62 AHCs/PHCs, 2 Blood Bank Centers and Diabetic
Clinics.


One of the largest employers in Middle East: 16,700 Staff


Sheikh Khalifa Medical
City
-
SKMC


Largest Hospital & Medical City in UAE


Flagship Institution for Public Health System


Encompasses several “Centers of Excellence”.


Tertiary Care Teaching Hospital


700 Beds ( 125 Behavioral Sciences)


850K Patient visits, 7K Surgeries, 180K ED Visits


14 Outpatient Specialty Clinics


3,400 FTE (Over 50 Countries Represented)

SKMC Accreditations



April 2011
:
The Surgical Pavilion, Medical Pavilion, 14
Outpatient Specialty Clinics and Abu Dhabi Blood Bank are
all accredited by Joint Commission International (JCI)




June
2009
: SKMC is accredited as a Cycle III Chest
Pain Center by the Society of Chest Pain Centers (SCPC).
SKMC is the

first hospital outside the USA to attain this
accreditation

for its cardiac and emergency
services



November
2012
: Reaccreditation Level IV



December 2010
: SKMC Laboratory Medicine
Department,
Abu Dhabi Blood Bank and POC testing are
accredited by the College of American Pathologists (CAP
)



December
2012:
Reaccreditation

5

Snapshot
History & Technology


Established


Acute
care
bed hospital
&

outpatient
specialty
clinics

SEHA

(Abu Dhabi
Health
Services
Company)


Cleveland
Clinic
Management


EHR



Pharm,
Lab,
CPOE,
Clinical
Doc, Surgery,
ED, RIS, PACS

ERP
-
Finance,
HR , SCM

UC


2010

2011

2008

2007

2000


JCIA
Accreditation


Daily average
approved beds:
775


Infrastructure &
EHR
Implementation
Starts

2009


EHR


Physician Doc.

Critical Care,
Device
Integration


JCIA Re
-
Accreditation

CAP
Accreditation

2012


EHR



Anesthesia

ABN

BMDI

Unified Order
Entry

eRefferal

One Centralized Environment

Achieve the
e
Government

Vision


One Patient/One Record


Enables population health management across the system.


Enables chronic disease management across the system


System wide reporting capabilities


Personal Health Record (
N
ational ID, communicate with physicians, schedule
appointments and request refills at a countrywide level)

Speed to Change


Easier to implement government quality/regulatory initiatives across the system


Speed to patient safety and Return On Investment (ROI)


Easier to maintain/keep up to date

Overall Cost


Little to no interoperability issues


Reduced training costs, particularly for clinicians that practice at multiple facilities


Significantly lower Total Cost of Ownership


Health Care in the UAE

Before

SKMC Hospital

Mafraq Hospital

Al Ain Hospital

Now

Under

process

Between 1960
-

1980

Oasis Hospital, First In UAE

Old Wards

Paper; Paper Everywhere!!


Diagnosis
-

No flow!!!

Organized

Facilities

Health

Care

Flow






















Under

process

After

Hospitals

New Facilities

Technology
-

Strategic Themes


Optimize
Patient Flow and
Satisfaction


Patient Centric


Evidence Based Medicine/Order Sets/Pathways


Integrated EMR


Optimize
IT
solutions &
P
rovide operational dashboards


Integration, BI, Data Warehouse, Reporting, Six Sigma


Enhance
IT governance and
oversight


COBIT, PMP, ISO 20000


Deliver
world class IT service experience to
staff:


ITIL, ISO 20000, ISO 27001, PMP


IT Strategy Building Block

Ancillary Services:
Laboratory


Pharmacy


Radiology


Surgery


ED

Enterprise Master Patient Index
-

EMPI


Hospital
-

Inpatient


ADT


Clinic


Outpatient

Core Clinical Inpatient & Outpatient

Billing/Patient
Accting

Enterprise Resource Planning ERP

Finance


HR


Supply Chain

Enterprise Business Intelligence

Performance Point/Anthem / Cerner

Health Authority
Oracle/AD/UC

Infrastructure

Ancillary Services
: PACS


CVIS


Critical Care


Blood
Bank


Cardiology
-

CSSD

EMR

Mallafi

Buy
-
In and Deployment of EMR


Leadership Support & Buy
-
in critical


Physicians’ Engagement is a Must
-

Champions


Do Not Automate Paper


Order Sets.


Planned Measurements and Outcomes.


Workflow &
Process mapping (Before and After)


Communication (Clinician Engagement, Early
and
often)


Project
Teams:


Application


Technology


Clinical Transformation


Training

Oracle (ERP)

HR

Finance

Malaffi

(Cerner)
-

EHR

Medical
Rec.

Scheduling

Registration

Radiology

Retail Pharm

Pharmacy

Lab

CPOE

Material Mgt

GL & AP

Billing

Meditech

Material Mgt

Pharmacy

Lab

Order Entry

Great Plains

GL & AP

HR (limited)

Payroll

Billing

Surgery

Emergency

Nursing Doc

Physician Doc

Phase 2a


Dec. 2009

Phase 1


July 2008

Oct. 09

Implementation Strategy

Phase 2b

Nov 2010

2011

Critical Care

CVIS

Registration

Application & Training Teams


Application Specialists


Design, Build, Validate


Integration & Interface


Implementation


Support


Over 50 Trainers & 12 Training
Rooms


Over 2900 clinical staff trained



Technology Team


Service Desk & Desktop Support


Back Office Systems


Network and Telecommunication (UC)


Wireless Deployment (Mobility).


New Desktop Look & Feel


Intranet Collaboration/Workflows


Enhanced Security.



Malaffi

Devices


250 Workstation



On Wheels (WOW)



200+ Tablets
-

Utilized by
physicians, Nurses, and
Patient
Experiece

staff


200+ wall
-
mounts
carefully distributed
across SKMC


1000+ PCs and 900+
Printers/Scanners

Clinical Transformation &
Communication Team


Patient Workflow


Review & Design


Process improvement


Evidence
-
Based Order Sets


Device Road Show


Comms Development and Distribution


Patients, Staff and the Project
Team


Newspaper Ads & Press
Releases


Long term view


Malaffi is the EMR composed
of…

*

Not a comprehensive list of features/functions

Patient Demographics

Test Orders

Interfaces to Medical Equipment such as Laboratory Instrumentation and
Bedside Medical Devices
(e.g., Monitors, Ventilator's, etc.)

Emergency Department & Operating
Theatre Tracking Boards and
Documentation

Medication Ordering and Administration
Details
-
eMAR

Test Results

Health Reminders, Monitors, and Alerts

Medication Process Improvement

(Patient Safety)

The “Old Fashioned” Way

The “New and Improved” Method

Hand Written Prescriptions

Printed Prescriptions

Malaffi Benefits & Business
Imperatives


Improve Patient
Care
-

One Patient…One
Record


Patient Safety

Reduce Medical
Errors


Care Delivery

Increase Physician Access to Clinical Information at the Point of
Care

Enables
chronic disease management across the system (continuum of
care)



Increase Efficiencies/Cost Effectiveness


Turnaround time

Improve Response Time to Patients


Resource Consumption

Eliminate Redundant Test and Data Collection


PACS & CPACs

PACS


HIS Integrated and direct feed
into
EMR.


Voice
recognition: Radiologists report directly in EMR.


Images
stored
electronically,
viewed on any
computer.


System
available 24 hours a
day within health system

CPACS


Images
from ALL sites available, irrespective of the source.


Inter
-
facility proxy reading.


Inter
-
facility second opinion, on the fly.


Acts
as online back
-
up of local images on central archive.


Eliminate need for duplicate exams









Current
: Centralization of Images

e
health

One Patient…One Record

EMR, EHR & Service Excellence Journey


Healthcare ICT

Ahmad Yahya

Chief Information Officer (A)

Sheikh Khalifa Medical City

US Electronic Medical

Record (EMR) Adoption Model

Industry
standard
Healthcare
Information and
Management Systems
Society
(HIMSS
)
Analytics Model for
Electronic Medical
Record (EMR)
adoption

Asia Pacific EMR Adoption Model

SEHA Facility Scores

(as of
Jan 2013)


Mafraq


5.32

SKMC


5.33

Corniche



6.
-
008


Pilot

Madinat

Zayed


6.008

Tawam



6.008

Al
-
Ain



6.008

Al
-
Rahba



6.008

Realities to Deal With


Healthcare is
becoming borderless.


Patient experience
will matter.


Payment will be linked
to value.


Social care will blend
with healthcare.


Enterprises will need
to focus
on
sustainability.




Thank You!