UCSF Medical Center. CTG Dec. 7, 2013

Transcription

1 UCSF Medical Center UCSF Medical Center CTG Dec. 7, 2013 Projects: Merge (EyeRoute Replacement) and Kaleidoscope Department: Ophthalmology Department Project Sponsor: Dr. Stephen McLeod Primary Business Contact: Dr. M. Reza Vagefi BCD Project Manager: Susan Churchill

2 The Presenters Dr. M. Reza Vagefi, EMR Lead, Ophthalmology Dr. Stephen McLeod, Chair of Ophthalmology The ask: At the end of this presentation, the Committee is requested to prioritize these projects: Scope: Merge Healthcare for EyeRoute Replacement Merge Interfaces to APeX Epic s Kaleidoscope Module to OPHTH Size (IT/CS): Large ( Hours) Costs: $583,310+ $17,271/year (ed for vendor license/support renewal costs) Funded by: CS/IT Contingency: $178,490 Clinical Systems: $235,200 Clinical Systems: $85,500 (Epic Good Install Credit) Interfaces and Project Management: $84,120 (IT and CS No Charge) Preferred Timeline: Apr Oct 2014; Preferred Go-live: Aug/Oct

3 Background: Project Drivers EyeRoute Acquired by Topcon and soon to be sunsetted Topcon s Synergy not suitable for OPHTH needs Not APeX integrated Software is five years old Requires separate log on Older legacy devices not network compatible Multiple modality DBs isolated with multiple entries for same patient Image import function does not work DB searches suffer due to data entry errors Potential for numerous patient care issues Lacks ability for user customization Cannot import videos Lack of test availability often delays interpretation and billing Merge Superior platform; Contemporary image management system Supports data collections from more than 40 Ophthalmic testing devices Automatic image import from networked devices Will be integrated into APeX during implementation Video files can be imported and stored More user configurable and user friendly PACS, APeX, HL7 (interface message protocol) and DICOM (preserves image quality) complaint With HL7 interface/automation, no more data entry errors Easy image review & prior study comparisons Integrates with digital fundus and slit lamp cameras 27 devices can now be connected vs 15 with EyeRoute 3

4 Project Drivers - Kaleidoscope APeX Ambulatory for OPHTH Major issues with current workflows: Inability to integrate wide variety of tests, images into patient record Epic s OPHTH Kaleidoscope Module Along with other ophthalmology-specific functionalities, device integration will be greatly improved with Kaleidoscope Compliance and billing issues Certain measures are required to streamline Ophthalmic testing acquisition, storage, routing, interpretation and billing. Numeric device integrator that will import metrics from devices directly into Epic (e.g. Auto-refractor) Test interpretation specific functionality, e.g. Events column designate patient location in clinic Tech worksheet allows techs to see when and what tests were ordered, which need to be performed, and ability to arrive patient without a separate test visit appointment Study review area allows MD to interpret test using Smartforms Reading work list provides dedicated area unique to each provider where test requiring interpretation can be found and completed Segregation of profee and tech charges Need specific Oph-centric code for addressing non-standard billing for routine testing in the dept. Further customizations specific to each division of ophthalmology that allows improvement in progress note, procedure note and exam documentation 4

5 Project Scope - Proctor Francis I. Proctor Foundation for Ophthalmology Research is an internationally renowned, clinical and research unit at UCSF Proctor Medical Group uses EyeRoute/APeX; will also use Merge and Kaleidoscope Four Proctor devices will be included during Merge and Kaleidoscope implementations Proctor has their own Apex Build with a few SmartSets Proctor can use Kaleidoscope sub-specialty feature to mimic current sub-specialties SmartSets 5

6 Locations, Staff Involved Clinic divisions of ophthalmology (15 Clinics) 1. Comprehensive 2. Cornea 3. Glaucoma 4. Retina 5. Oculoplastics 6. Pediatrics 7. Neuro-ophthalmology 8. Oncology All Clinics using EyeRoute affected: Beckman Vision Center 2nd & 7th floor, ACC and ASC Admin - 35 Ophthalmologist 30 Clinical - 18 Clinical roles COA (Certified Ophthalmic Assistant) CRA (Certified Retinal Angiographer) OCT-C (Optical Coherence Tomographer-Certified) Surgical Technician Non-certified personnel Physicians: Comprehensive, Cornea, Glaucoma, Plastics, Retina, Pediatrics, Uveitis, Oncology, Neuroophthalmology Proctor 95 Kirkham St. Faculty 7 Optometrists - 3 Fellows 3 clinical, 1 research Staff - 3 6

7 Funding/Cost Summary Funded by: CS/IT Contingency: $178,490 Clinical Systems: $235,200 Clinical Systems: $85,500 (Epic Good Install Credit) Interfaces and Project Management: $84,120 (IT and CS No Charge) Timeline: Apr Oct 2014; Go-live: Aug/Oct 2014 Merge Hardware/Software, Pro Fees & Labor Costs: Total Merge Vendor $107,581 IT Hardware/Software (Servers) $ 70,909 Total Merge Project Costs $178,490 ADT Interface Labor $ 13,650 Project Management: $ 70,470 CS/IT Labor Costs: $ 84,120 Kaleidoscope Costs: APeX Build, Training - back-fill $205,200 Epic Vendor $115,500 Total Kaleidoscope Project Costs $320,700 Assumptions: 1) Ophthalmology resources and decision makers required to do the analysis, testing and issue resolution are committed to working with the IT/CS teams on this project during the timeline indicated. 2) A PMO PM will be made available to manage both projects (.5 FTE each project for 6 months). 3) Should significant alteration of HL7 messages be required of interface team, labor costs will be adjusted. Same if less effort than estimated. 4) Should significant APeX build changes be required of the APeX teams, labor costs will be adjusted. Same if less effort than estimated. 5) The High Definition Recording Project and APeX Interfaces was pre-approved, although vendor may change. Interface work is pending scheduling. Total Cost of Projects $583,310 first year Plus, annual license/support renewal fees (all vendors) $ 17,271 end of first year forward, paid by CS 7

8 Recap Request the Committee prioritize these projects: Scope: Merge Healthcare for EyeRoute Replacement Merge Interfaces to APeX Epic s Kaleidoscope Module to OPHTH Size (IT/CS): Large ( Hours) Costs: $583,310+ $17,271/year (ed for vendor license/support renewal costs) Funded by: CS/IT Contingency: $178,490 Clinical Systems: $235,200 Clinical Systems: $85,500 (Epic Good Install Credit) Interfaces and Project Management: $84,120 (IT and CS No Charge) Project Timeline: Apr Oct 2014 Go-live: Aug / Oct

9 Appendix 1. Merge Diagram 2. Interfaces Diagram 3. Kaleidoscope Certification Path 4. EyeRoute Diagram 9

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14 Merge and Kaleidoscope Servers Merge Epic (Kaleidoscope) Interfaces Clinical Systems Total Funding Source Merge Implementation $ 178,490 Servers, Storage $ 70,909 IT/CS contingency License $ 67,381 IT/CS contingency Implementation cost $ 40,200 IT/CS contingency Project Management Interfaces ADT Implementation cost $ 13,650 $ 13,650 IT no charge Project Management $ 70,470 $ 70,470 PMO no charge Kaleidoscope Implementation $ 320,700 License Implementation cost $ 85,500 Good Install Credit Epic Staff Travel $ 30,000 workflow design Training.5 FTE for Training $ 50,400 Apex Instructional $ 2,400 3 APeX Trainers Go $ 34,200 Development 2 Apex AMB Certfied $ 4,800 Development $ 113,400 Capital Total $ 583,310 Epic good install credit contribution ($85,500) IT/CS contingency ($178,490) Annual Operating Costs - 2nd year forward $ 17,271 Kaleidoscope License / Suuport $ 6,768 MERGE License / Suuport Renewal $ 10,503 14