Suite vs. Best of Breed with a Focus on Change management. Theme 2 Nordic ehealth Exchange

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Annis Clarke
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1 Suite vs. Best of Breed with a Focus on Change management Theme 2 Nordic ehealth Exchange

2 Welcome to Theme 2 Suite vs. Best of Breed with a Focus on Change management Claus Duedal Petersen Odense University Hospital Region Southern Denmark - Moderators - Simon Kaiser Accenture Denmark - Our speakers - Mikael Johansson Strategist, Center for ehealth in Sweden Niels Reichstein Larsen Head of IT Department, Capital Region Denmark Dr. Bjerne Skjødt Worm Vice President, the Young Doctor Association, Denmark Nard Scheurs Project Leader, IKT Norway Eskola Pasi MD, Univeristy of Oulu, Finland Jon Hilmar Fridriksson MD and Excutive VP, Landspitali University Hospital Iceland 2

Kaiser Accenture Denmark - Our speakers - Mikael Johansson Strategist, Center for ehealth in Sweden Niels Reichstein Larsen Head of IT Department,

4 What is it we are trying to achive? Health Information Exchange (HIE) Primary care CPOE / Order Communication, Alerts & Sets Critical Care: ICU, Operating Room, Emergency Care Social care Ambulatory / Outpatient / Home-based Care Closed Loop Medication Patient -centric Clinical Documentation (All health professionals) Acute / Inpatient Clinical Decision Support & Analytics Evidence-based Patient Safety Efficiency 4

ICU, Operating Room, Emergency Care Social care Ambulatory / Outpatient / Home-based Care Closed Loop

5 One of the oldest debates in ICT is whether to adopt a single vendor application suite or deploy best-of-breed packages What is best for your Hospital? Best in Suite VS Best in Breed Always deploy the application that fit into the overall software platform architecture that had been chosen Always deploy clearly the best application for the individual task the application that is Best of Breed the PAS, ERP, EMR, PACS, LIMS etc. 5

Best in Suite VS Best in Breed Always deploy the application that fit into the overall software platform

6 Why do a best in suite? In the case of best-in-suite, the assumption is that the suite approach can handle both current and future needs, because those needs are relatively static or the chosen suite is sufficient and adaptable to future expectations. Best in Suite 6

approach can handle both current and future needs, because those

7 Why do a best in breed? In the case of best-in-breed, the assumption is that current needs cannot be handled by a large transformation to a one-solution-fits-all approach or that future uncertainty demands a hedge against vendor lock-in. Best in Breed 7

8 In the end, neither best-in-suite nor best-in-breed should dominate the discussion Fit to Vision Vendor s size, stability, financial strength, leadership, research and development, and product lifecycle Support for Model of Care across all Provider venues and scope Commitment to local market Functionality Risk Technology Cost Uniquely important functions, which will support integrated workflows: All venues of care from Acute to Ambulatory Care Sites (primary/secondary) Patient Access, Enterprise-wide Scheduling and Revenue Cycle Computerized Provider Order Entry (CPOE), Closed Loop Medication, HIMSS EMR Adoption Levels/ Gartner maturity levels etc. Timely Implementation, Content Development and Data Conversion Financial and Operational Challenges Vendor Delivery and Maintenance Performance Delivery and support for language, localization, measurement systems, etc. Compatibility, stability, security, scalability Current Hardware, operating system, networking, database mgmt. and Business Intelligence (BI) Architecture and other standards, bandwidth impact, and integration with existing applications Total Cost of Ownership (TCO), contract structure, capital mitigation, financing and sourcing total solution, incl. Software, Hardware, Resources and Services One time and recurring: Implementation, Application, New Releases and Upgrades 8

workflows: All venues of care from Acute to Ambulatory Care Sites (primary/secondary) Patient Access, Enterprise-wide Scheduling and Revenue Cycle Computerized Provider Order Entry (CPOE), Closed

9 And we know its not simple? BUSINESS e-health PATIENT FINANCIALS HEALTH INFORMATION MANAGEMENT ACCESS MANAGEMENT AMBULATORY CLINICALS ANCILLARIES HOSPITAL CLINICALS Material Equipment Tracking General Ledger Accounts Payable Budgeting Fixed Asset Human Resources Payroll Staff Scheduling Time & Attendance Reporting Cost Accounting Corporate E - mail Corporate Intranet Public Internet Website Personal Health Record Tele - Radiology Tele - Pathology Second Opinion Tele - Consultation E - Prescribing E - Monitoring Physician Referrals Consumer Portal Interfaced National Initiatives Charge Entry Physician Billing Inpatient Billing Claims Remittance Collections Contract Core EPR Ancillary / e-health Admin. / ERP Chart Dictation Transcription Release of Information Coding Abstracting Document Imaging Patient Mgmt./Billing EMPI Patient Scheduling Pre - Registration Registration ADT Bed Control Eligibility Verification Referral Authorization - Workflow Patient Tracking Patient Summary Encounter Documentation Orders Entry Results Reporting Prescription Allergy Tracking Immunization Tracking Health Maintenance Clinical Messaging Patient Education Phone Notes Digital Images E & M Coding Automated Charging Laboratory Blood Bank Pathology Radiology PACS Pharmacy (hospital) Pharmacy (retail) Dietary Clinical Supply Interfaced National Initiatives Clinical Data Repository Provider Documentation Nursing Documentation CPOE / Order Medication Administration Clinical Results Reporting Emergency Department Surgery Anesthesia Cardiology Critical Care Neonatalogy NICU Oncology Rehab Medicine Device Interfaces Nurse Call Communication Patient Amenities Interfaced?.... to.... Integrated? 9

Budgeting Fixed Asset Human Resources Payroll Staff Scheduling Time & Attendance Reporting Cost Accounting Corporate E - mail Corporate Intranet Public Internet Website Personal Health Record Tele -

12 Questions to our speakers?? What would you considered important when selecting Health ICT service or solutions? Vendor s size, stability, financial strength, leadership, research and development, and product lifecycle Support for Model of Care across all Provider venues and scope Commitment to local market 12

14 Questions to our speakers?? What would you considered important when selecting Health ICT service in terms of the functionalities needed? Uniquely important functions, which will support integrated workflows: All venues of care from Acute to Ambulatory Care Sites (primary/secondary)? Patient Access, Enterprise-wide Scheduling and Revenue Cycle? Computerized Provider Order Entry (CPOE), 14

16 Questions to our speakers?? What would you considered important when selecting Health ICT service in terms of risks Risk related to running large implementation program? Content Development and Data Conversion risks? Financial and Operational Challenges and risks? Vendor Delivery and Maintenance Performance risks? Delivery and support for language, localization, measurement systems risks? Integration and interfaces risks? Risk related to contract management? 16

large implementation program? Content Development and Data Conversion risks?

18 Questions to our speakers?? What would you considered important when selecting Health ICT service in terms of the technology? Compatibility, stability, security, scalability Current hardware, operating system, networking, database mgmt. and Business Intelligence (BI) Architecture and other standards, Bandwidth impact, and integration with existing applications 18

19 The application og infrastructure landscape Users IT Service Product- og Service management, Arkitecture Integration, Security og support Clinical application Administrative application Cross hospital application/registre External vendors Datacenter: Servere og Storage Other hospitals Network (WAN & LAN) 19

application Administrative application Cross hospital application/registre

21 Questions to our speakers?? What would you considered important when selecting Health ICT service in terms of cost? Total Cost of Ownership (TCO), Contract structure, Capital mitigation and financing Sourcing total solution, incl. Software, Hardware, Resources and Services One time and recurring: Implementation, Application, New Releases and Upgrades 21

23 Questions to our speakers?? What would you considered important when selecting Health ICT service in terms making sure it works when the vendor is out the door? Staffing internally and externally Involvement of the clinician Securing ownership Navigating the change Provide strong leadership Enable the organization to the change 23

24 FTEs A Health Transformation requires people (exemple) EMR Implementation Resource Model IT PMO User Months 24

25 Think about individuals they make the different in making change stick Forces of Change Blockers Snipers Followers Cheerleaders Visionaries X X???????!! Power of opposition depends on intrusion (provocation) Behaves like followers until triggered by glitch Underlying resistance to change until benefits proven Relationshiporiented and motivated by anticipated benefits Driven by vision: intrinsic motivation 25

26 Thank you 26

Addressing the State of the Electronic Health Record (EHR)

Addressing the State of the Electronic Health Record (EHR) Agenda Definitions Attributes Differences Adoption Model Current State Challenges Implementation considerations What is it? EMR CMR EHR EPR PHR