Wednesday, September 16, 2009

The Draft FY10 IS Clinical Systems Plan

Every year, BIDMC IS leadership gathers input from all our governance committees to produce an IS operating plan. The Clinical Systems area is the most challenging since we need to balance limited resources with ever increasing demand. Here is the draft FY10 IS Clinical Systems Plan based on the priorities of all our stakeholders. You'll notice an emphasis on projects which support meaningful use criteria for 2011 and 2013, accelerate national standards implementation, and provide increased interoperability.

* Implement pharmacy, charging and other revisions to support Pharmacy 340B requirements.
* Complete implementation of CPOE for NICU
* Complete implementation of CPOE for ED
* Implement outpatient pharmacy for oncology/chemotherapy
* Enhance inpatient applications as prioritized by the Inpatient Clinical Applications Committee
* Expand project and application support for in-house developed systems

Ambulatory (webOMR is our self-built EHR)
* Complete referral tracking to “close the loop” for outpatient referrals
* Continue to develop and expand the roll out of test results tracking
* Expand the roll out of pharmacy-initiated renewals
* Enhance problem lists to improve user interface and support SNOMED-CT
* Support implementation of PatientSite Personal Health Record patient-provider encounter summary sharing (Open Notes)
* Pilot expanded healthcare information exchange technologies in Cancer Center to push outpatient notes to referring MDs
* Pilot online surgical booking orders
* Enhance webOMR as prioritized by webOMR Users Group
Clinical Documentation
* Develop a strategy, plan and timeline, in conjunction with Clinical Leadership, to implement meaningful use standards for 2011 and future years.
* Begin planning for acute care documentation, standardized problem list and eMAR
* Complete medication reconciliation modules
* Complete enhancements supporting multidisciplinary collaboration in discharge applications
* Continue expansion of NEHEN notification and communication systems

Operating Room
* Implement intra-operative documentation in PIMS (Perioperative Information Management System)
* Implement “sign out” and related safety enhancements in PIMS
* Enhance PIMS as prioritized by OREC (O.R. Executive Committee)

Health Information Management/Scanning
* Integrate scanned notes and reports in webOMR as prioritized by the webOMR Users Group
* Integrate faxed documents in PIMS to support Preadmission Testing and OR in managing documents faxed from external sites

* Expand roll out of web-based report signing (currently in pilot)
* Develop a strategy for displaying preliminary reports (with Radiology)
* Implement multi-year roadmap to enhance our in-house developed RIS and optimize RIS-based workflow
* Continue project management and technical support for projects / enhancements as prioritized by department governance including:
* Installation of new Radiology modalities
* Image sharing with Children's hospital
* Needham Hospital PIX (Patient Identity Cross Reference system)
* Front-end Voice Recognition
* RIS/PACS integrator
* Nuclear Medicine enhancements / upgrades

Laboratory Information System
* Continue implementation of the Soft Laboratory system including:
interface development and testing
integrated test planning and execution
* Continued management of the application environment including software upgrades and implementation of a new server environment

Critical Care/Anesthesia
* Perform major upgrade to MetaVision (MV ICU) version 5.46
* Evaluate and implement MV ICU enhancements as prioritized by ICU governance
* Continue to support MV ICU Application Administrator activities until the role is fully transitioned to the department of Critical Care
* Develop a plan and budget for implementation of an enhanced Anesthesia
* Information Management system
* Support existing systems including Patient Safety Reporting System, OB-TraceVue, Transplant and Trauma Registry.

* Participate in planning, analysis, budget, and timeline development for:
Cath Lab Reporting
Vascular Reporting
* Continue implementing/supporting CVI Registries
* Support Apollo, MACLab/CardioLab and Echo

Enterprise Image Management
* Advance enterprise PACS efforts in conjunction with the IS infrastructure teams, including:
Provide consultative and project and technical management to Radiology, OB, GI, CVI and other medical center PACS projects as prioritized by the Enterprise PACS committee
Continue to explore strategy for Enterprise Archive management
* Complete CardioPACS Migration Including:
GemNet Upgrade
Echo DVD Migration
CVI Cath / Echo Web Images
Complete Radiology PACS Disaster Recovery
Support G-Care/G-Med

Radiation Oncology
* Continue project management and technical support for projects / enhancements as prioritized by department governance including:
* Completion of Mosaic Phase II (Digital Images)
* Implementation of Radiation-Oncology HIS/ADT Interface
* Upgrade Philips Pinnacle Treatment Planning System Workstations
* Upgrade Elekta CMS/Focal Treatment Planning System
* Support existing systems including: Impac, Cyberknife and associated treatment planning systems.

Infection Control Surveillance
* Develop plan and approach for implementation of infection control surveillance software

Ambulatory/Community EHR
* Continue to support efforts to implement the eClinicalWorks EHR to non-owned BIDPO clinicians
* Analysis and planning for BID Lab Results interface to BIDPO eClinicalWorks
* Migrate existing Logician practices to eCW as appropriate
* Analysis and planning for BID Radiology Results interface to the Fenway CHC
* Design and implement an online archive system for all Logician retired systems and practices.
* Support community systems

Decision Support
* Implement Performance Manager reports and dashboards as needed to support organizational needs.
* Implement clinical data marts as needed to enable quality measurement, pay for performance goals, and other decision support needs.
* Enhance the Community Provider Index to better support Health Information Exchange via NEHEN gateways.
* Implement enhancements to the Patient Activity Profile to support enhanced reviews required by JCAHO.
* Enhance SOAR (Accounts Receivable workflow) to support denial tracking and appeals workflow
* Explore the introduction of new Business Intelligence tools as funding permits
* Support Cactus and NEHEN Express users

Web Applications
* Continue to enhance the Adverse Events Manager as prioritized by Healthcare Quality.
* Continue the migration of account provisioning and metadirectory services to SQL Server and ASP.NET.
* Develop services to support document scanning, metadata capture, and document display.
* Continue to support implementation of a new BIDMC intranet portal
* Create web services as needed for integration of BIDMC applications and for interactivity with external collaborators
* Support PatientSite for clinicians and the end-user community

We're also updating our 5 year plan to reflect new ARRA priorities and new compliance requirements. I'll publish that soon.

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