Profile. The Challenge. Implementation Overview

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Baldric Evans
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1 HIMSSS Analytics Stage 7 Case Stud dy MultiCare Health System

2 Prfile MultiCare is a nt-fr-prfit healthcare rganizatin with mre than 10,000 emplyees and a cmprehensive netwrk f services thrughut suthwest Washingtn. We are a 1,130 bed tertiary care rganizatin with 2,350 credentialed prviders, 608 f whm are emplyed. There are 42,426 admissins per year and 512,000 annual utpatient visits. Tday, MultiCare is made up f five hspitals cnsisting f 4 adult and 1 pediatric trauma center. These include Allenmre Hspital, Auburn Medical Center, Gd Samaritan Hspital, Mary Bridge Children's Hspital and Tacma General Hspital, numerus utpatient specialty centers, primary and urgent care clinics, as well as a variety f ther services and cmmunity utreach prgrams. The lcatins included in the HIMSS Analytics EMR Adptin Mdel sm Stage 7 award are Allenmre and Tacma General Hspitals and 107 ambulatry clinics. The HIMSS Analytics EMR Adptin Mdel sm Stage 7 award was received n January 9, The Challenge Our strategy invlved the implementatin f an enterprise-wide electrnic health recrd t create ne patient, ne recrd a seamless experience fr patients n matter where at MultiCare they received care. Our gal f transfrming the way care is delivered at MultiCare led the executive team t cnclude that an investment in leading edge technlgy was the key t ffering the best care fr ur patients, t ensure patient safety, and t imprve the efficiency f ur care teams. T reach ur gal, MultiCare decided t build ur electrnic health recrd using an integrated platfrm instead f selecting varius systems that were the best f breed. An integrated platfrm wuld reduce the technical challenges and need fr interfaces cmmn with nn-integrated systems and ur data wuld be held in a single repsitry. Anther key decisin was t take ur cncept f ne patient, ne recrd and expand this t include ur cmmunity. We decided t ffer ur cmmunity prviders access t the electrnic health recrd by creating an Applicatin Service Prvider (ASP) netwrk called CareCnnect giving reginal prviders secure access t patient data utside the MultiCare delivery system. Implementatin Overview A multidisciplinary team f healthcare peratins and infrmatin technlgy staff spent 1996 reviewing ambulatry practice management systems with the gal t standardize t a single platfrm. In 1996 after much discussin regarding ur strategic directin, Epic s ambulatry electrnic health recrd (EHR) and practice management applicatins were selected. The ambulatry clinics went live in February 1998 with the practice management applicatins. The EHR was implemented at ur first lcatin in August The rll ut acrss ur ambulatry lcatins cntinued thrugh In 2004, the enterprise suite fr inpatient and acute care was selected and a frmal kick-ff was held in September In 2007, 3 hspitals went live with admissin, discharge, transfer, billing, revenue applicatins, clerk rder entry and an electrnic medicatin administratin recrd. In 2008, clinical dcumentatin fr all staff was implemented alng with Cmputerized Physician Order Entry (CPOE).

Tday, MultiCare is made up f five hspitals cnsisting f 4 adult and 1 pediatric trauma center.

3 Several mdules have been implemented since that time t include Radiant, Hme Health, Hspice, OpTime and Anesthesia. Bedside Barcde Medicatin Administratin was implemented in all areas acrss the acute care arena with the exceptin f Interventinal Radilgy and Gastrintestinal Lab. Our current apprach t implementatin is big bang, with all functinality ging live at ne time. This apprach has been used successfully in ur last tw hspital implementatins and in all f ur clinics. In additin, there is extensive device integratin acrss the system t include mnitrs, ventilatrs and Pint f Care Testing equipment. MultiCare currently has a single platfrm f Epic acrss 120+ sites f care. The actual g-live has been less difficult than I anticipated, and there has been great supprt as we change habits that we ve cultivated ver years (and smetimes decades). Ultimately I think this will be a great step allwing easier access t charts acrss facilities. - Dr. Kelly McGinnis Resulting Value / ROI MultiCare has recgnized significant benefit in many areas, t include: Access Accuracy Efficiency Knw the patient s stry and ensure that the infrmatin fllws the patient Physicians can nw access immediate, accurate patient infrmatin frm anywhere at any time Patients can access their infrmatin via MyChart pwered by MultiCare Imprved cmmunicatins between clinicians 27 percent increase in dcumentatin f the plan f care by at least tw disciplines 30 percent increase in rder legibility Electrnic health recrd shws the same medicatins, patient histry, allergies, etc. at any lcatin where the patient is seen Medicatin recnciliatin is standardized thrughut the rganizatin and built int clinical wrkflws 75 percent decrease in callbacks t in-huse pharmacies 30 percent reductin in transcriptin vlumes Average 30 percent decrease frm dispsitin time t patient admitted time in the Adult EDs Operating Rm scheduling turn-arund-time under 2 minutes Mean labratry rder turnarund time reduced by 30 percent Median imaging rder turnarund time reduced by an average f 50 percent Financial Perfrmance $12M in net benefit as a result f imprved Patient Respnsibility cllectins $5M reductin in claims with pen denials $1,029,808 in avidable write-ffs $585,000 in staff reductins in Patient Financial Services $20M in imprved cash cllectins

Our current apprach t implementatin is big bang, with all functinality ging live at ne time. This apprach has been used successfully in ur last tw hspital implementatins and in all f ur clinics.

4 Lessns Learned Executive Spnsrship and Ownership The implementatin f MultiCare Cnnect must be wned, champined, and actively supprted by rganizatinal and clinical leadership. System implementatins are ften seen as IT prjects, but withut the engagement f the clinical end-users and their leaders, success cannt be realized. Organizatinal Pririty and Cmmitment As with any large rganizatin, multiple initiatives and pririties will cmpete fr the number ne spt. The success f an implementatin f this magnitude requires cnsistent cmmunicatin t the rganizatin abut the electrnic health recrd and the benefits it brings bth t the patient and emplyee ppulatins. MultiCare prvided cnsistent messaging frm the tp dwn s that emplyees bth understd and were excited abut MultiCare Cnnect. Leaders were cmmitted t meeting milestnes and clearing bstacles. Even staff members in supprt departments wh never utilize the system prvided rallying encuragement during the implementatin. During the first week f the 2008 g-live, several f thse departments hsted cheering statins whse sle purpse was t encurage the clinical staff and give them quick breaks frm their wrk. Bths featuring Las Vegas-style events, cking demnstratins and the pprtunity t limb fr a latte let thse wh were deep in the midst f their g-live learning curve get a well-deserved mental break and see hw the rest f the rganizatin was behind them. Investing in Peple MultiCare knws that a multimillin dllar technlgy investment withut an investment in peple is just a very expensive technlgy venture. Thrugh seminars, brwn bag sessins, educatin and cmmunicatin the prject team made peple the heart f the implementatin. Care fr the patient is always at the frefrnt, and emplyees understand that their feedback is welcme and incrprated. System-Wide Culture Change Mving frm a paper recrd, r even a stand-alne electrnic health recrd, t a system-wide recrd requires the ability t be flexible and pen t change. Leaders frm MultiCare s Organizatinal Effectiveness Department hsted change management seminars t educate staff members n simple things like attitude and envirnmental changes they culd make t help ease the transitin. The prject team als presented rad shw demnstratins n the clinical flrs, at department meetings, in dctrs ffices, and in the cafeterias, s that all future users culd get an early lk at the system and be prepared t adpt ur new electrnic health recrd. Have Fun Many members f the prject team have wrked n this initiative fr years (the riginal implementatin f the electrnic health recrd began in ur ambulatry clinics in 1998). Within the prjects, we try t remember that encuragement, recgnitin, and time fr levity are key aspects f keeping thse team members engaged.

Organizatinal Pririty and Cmmitment As with any large rganizatin, multiple initiatives and pririties will cmpete fr the number ne spt.

5 MultiCare has been cmmitted t advancing ur EHR fr mre than 15 years. We believe cnnecting all ur prviders and patients in a seamless and sustainable way supprts safer and mre cnvenient care fr ur patients. This certificatin acknwledges the hard wrk and dedicatin f all f ur staff members wh cntributed t this effrt. We are well psitined fr partnering with patients, prviders and ther health systems fr healing and a healthy future." Flrence Chang Chief Operating Officer MultiCare Health System

ur patients. This certificatin acknwledges the hard wrk and dedicatin f all f ur staff members wh cntributed t this effrt.

Overview of the CMS Modification to Meaningful Use 2015 through 2017

Overview of the CMS Modification to Meaningful Use 2015 through 2017 Overview f the CMS Mdificatin t Meaningful Use 2015 thrugh 2017 On April 10, 2015, the Centers fr Medicare & Medicaid Services (CMS) issued a new prpsed rule fr the Medicare and Medicaid EHR Incentive