Data Center Hosting: Build, Upgrade or Partner Tuesday, February 21, a.m. 12 p.m.

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1 Data Center Hosting: Build, Upgrade or Partner Tuesday, February 21, a.m. 12 p.m. DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2 Speakers Tanya Freeman Chief Information Officer, Central Maine Healthcare and Chief Operating Officer, Huntzinger Management Group Denis Tanguay Technical Director, Central Maine Healthcare and Client Executive, CareTech Solutions 2012 HIMSS 2

3 Conflict of Interest Disclosure Tanya Freeman, MS Denis Tanguay Have no real or apparent conflicts of interest to report HIMSS 3

4 Learning Objectives Describe the business case at Central Maine Healthcare (CMHC) Identify the options and criteria necessary to evaluate data center hosting options (build, upgrade, or partner) Discuss the data center hosting options, including parameters to consider 2012 HIMSS 4

5 Central Maine Healthcare Based in Lewiston, Maine 1 of only 3 trauma centers in Maine 57+ medical and surgical specialties Serves approximately 400,000 people Parent organization for: Central Maine Medical Center (250 bed) Bridgton Hospital (25 bed CAH) Rumford Hospital (25 bed CAH) CMMG (325 employed physicians) College of Nursing 2012 HIMSS 5

6 Key Statistics 10,585discharges 41,579 patient days $530M annual revenue $510M net patient revenue 2012 HIMSS 6

7 Applications Inpatient Ambulatory Financial & administrative 189 applications 433 local servers 170 remote servers 5,000+ users Technical Profile 45 geographical sites supported Disaster recovery requirements 2012 HIMSS 7

8 History Summer 2002 Executed contract inpatient/ancillary applications and physician practices/ambulatory Fall 2003 Decided to fully outsource IT (applications, data center, help desk, infrastructure, telecomm, disaster recovery) July 2005 CMHC goes live with inpatient EMR 2012 HIMSS 8

9 October Bridgeton Hospital goes live with inpatient EMR October Rumford Hospital goes live with inpatient EMR January Managed services agreement with Parkview Medical Center September 2008 History Full IT outsourcing contract reaches five-year term 2012 HIMSS 9

10 History Current outsourcing arrangement coming to term Five-year contract expiring in fall Re-evaluate IT delivery options based upon business challenges Management outsourcing group brought in to evaluate IT needs and recommend go-forward plan 2012 HIMSS 10

11 HIMSS EMR Adoption Model SM Stage Cumulative Capabilities 2010 Q Q3 STAGE 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP 1.0% 1.1% STAGE 6 Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS 2.8% 4.4% STAGE 5 Closed loop medication administration 3.7% 7.1% CMHC s Current Level STAGE 4 CPOE, Clinical Decision Support (clinical protocols) 10.3% 13.2% STAGE 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 49.7% 46.1% STAGE 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 15.4% 12.6% STAGE 1 Ancillaries - Lab, Rad, Pharmacy - All Installed 6.7% 5.9% STAGE 0 All Three Ancillaries Not Installed 10.5% 9.6% Data from HIMSS Analytics Database 2011 N = 5,310 N = 5, HIMSS 11

12 What were the Business Challenges? Aggressive timeline to acquire physician practices Desire to implement EHRs within all physician practices Sustaining CPOE compliance to greater than 80% Focus on improved patient safety issues Limited access to capital Increasing operating margins Increasing Medicaid and Medicare visits 2012 HIMSS 12

13 What were the IT Challenges? Need for high availability systems Increased ambulatory support requirements Disparate critical systems required major upgrades Increased data and information time/availability requirements Growing number of system users Aging network infrastructure 2012 HIMSS 13

14 What was the Evaluation Process? RFP distributed to several outsourcing suppliers for full outsourcing Data center hosting decision options: Build New location, brick and mortar Upgrade Partner Move and upgrade data center within existing hospital facility Flexible delivery model leveraging cost components and technical expertise 2012 HIMSS 14

15 What was the Evaluation Process? Based upon business objectives decided to: Bring IT leadership in-house (CIO) Bring application support in-house (analysts) Outsource the following: Help desk/service desk Network management/remote monitoring Disaster recovery Data center hosting 2012 HIMSS 15

16 Considerations Build Upgrade Partner Capital Expense Yes Yes Minimal Operating Expense Neutral Neutral Increased Industry Expertise and Awareness Data Center Hosting Considerations Lower Lower High Facility High High Lower High Availability Increased Slightly Increased System Stability Lower Lower High Affordable Scalability Limited Limited Flex Up/Down Technical Resources Neutral Neutral Increased Access Control High High Medium 2012 HIMSS 16

17 Decision: Partner with IT Services Outsourcer Healthcare focus and proven performance history Experience with similar hospitals (understands community-based hospital culture) 100% referenceable Partner Flexible and scalable to accommodate CMHC evolving environment and changing healthcare landscape Predictable and transparent cost structure utilizing shared expertise delivery model Ability to provide system stability (experience hosting EMR and Citrix environments) 2012 HIMSS 17

18 Migrated 50 servers from vendor data center to Troy, MI Completed all software upgrades simultaneously Implemented high availability within 4 months rather than 6 Data Center Relocation Launched hospital help desk 2012 HIMSS 18

19 Minimal downtime clinicians back on-line within 24 hours 300% immediate response time improvement 100% immediate purge time improvement Command center rapidly addressed issues Clinical help desk available Secured environment System stability Business Accomplishments 2012 HIMSS 19

20 Three Years Later Giving C-Suite Peace of Mind Focus on healthcare issues, not IT ARRA compliance for Meaningful Use Total cost of ownership with predictable cost structure Highly available system with reliable data supporting clinicians Geographic transparency Access to state-of-the-art technology SSAE 16 SOC 1 TYPE 2 compliant data center Dependable, repeatable processes keeping data safe and secure Proactive monitoring of IT systems maintaining availability Disaster recovery procedure in place 2012 HIMSS 20

21 Lessons Learned Increase planning time Increase execution time Represent the extended enterprise Hospital business unit IT provider Application vendors Engage all interested parties from day one Clearly state and understand objectives and goals Establish strategy and communicate strongly Encourage collaboration both internally and externally 2012 HIMSS 21

22 Q & A Tanya Freeman Chief Information Officer, Central Maine Healthcare and Chief Operating Officer, Huntzinger Management Group Denis Tanguay Technical Director, Central Maine Healthcare and Client Executive, CareTech Solutions 2012 HIMSS 22

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