Angela Nutt Resurrecting BusinessObjects For Meaningful Use and Integrated Electronic Health Record Reporting Session # 2732

Transcription

1 Angela Nutt Resurrecting BusinessObjects For Meaningful Use and Integrated Electronic Health Record Reporting Session # 2732

2 Oregon Health & Science University is a nationally prominent research university and Oregon s only public academic health center. It educates health professionals and scientists and provides leading-edge patient care, community service, and biomedical research.

3 Healing Facts Total patient visits: 987,098 Total patients : 267,475 Staffed beds: 528 Teaching Facts Students in degree programs: 2,861 Interns, residents, postgrads: 1,118 Continuing education students: 41,000+ Faculty: 2,608 Research Facts $ 1B goal reached for cancer research Operating Facts Employees: 14,616

4 Resurrecting? Reinvesting in BusinessObjects in order to gain additional tools to improve patient care outcomes.

5 Agenda Overview Meaningful Use? Phase 1: Reinvesting Phase 2: Migration Phase 3: Actionable BI Lessons Learned

6 Overview In 2013 healthcare organizations were required to implement Stage 2 of a regulatory requirement referred to as "Meaningful Use" Custom reporting solution required changes to meet requirement Electronic Health Record vendor, Epic, had recently updated their solution This put OHSU at a crossroads to make a decision: continue with custom, or adopt the vendor model

7 Reporting Content Available Vendor (Epic) 800+ Crystal Reports Many enabled for Epic-Crystal Integration Interactive with the Epic Hyperspace application Standard reports for Meaningful Use Stage Universes on the Epic Clarity database New Epic Cogito data warehouse and universes

8 Advantages of Adoption Reduce the cost of BI development Leverage industry standard best practices Less effort to interpret regulatory logic Integration between BusinessObjects and Epic Access, execute and display reports and dashboards directly in Epic Hyperspace.

9 The Integrated BI Landscape Hyperspace Epic Chronicles (Cache) Epic Application Reporting Tools Pre-generated External BI Cognos Web Epic ODS ETL Process Epic-Crystal Integration Interactive OHSUDW (Oracle) Epic Clarity (Oracle) Epic Cogito Data Warehouse (SQL Server) Epic Billing Cubes BusinessObjects Crystal Reports Web Intelligence

10 Meaningful Use? Meaningful Use is a set of objectives and measures which eligible professionals and eligible hospitals must meet to qualify for EHR incentives and avoid reimbursement penalties from Medicare or Medicaid. Created by the HITECH Act which is part of ARRA HITECH Act - Health Information Technology for Economic and Clinical Health Act ARRA - American Recovery and Reinvestment Act

11 Meaningful Use?

12 Meaningful Use Stages

13 Phase 1: Reinvesting Decision Point Upgrading and Upsizing the Infrastructure Pilot Project Meaningful Use Stage 2 Quick Wins Distribution Requirements

14 Stage 2 Stage 1 Meaningful Use Stage 2 Vendor Solution Poor performance Lack of support for specialties Immature reports Legacy Crystal environment Custom Solution Development of all business logic Design and creation of warehouse structures and ETL Development of reports Enterprise BI solution, Cognos Improved performance Standard reports Management processes in the EHR Legacy Crystal environment Development of all business logic Design and creation of warehouse structures and ETL Development of reports Enterprise BI solution, Cognos *Green indicates solution chosen for each stage

15 Upgrading and Upsizing: Infrastructure

16 Quick Wins Vendor Supplied Reports Eligible Provider Summary Meaningful Use Executive Dashboard Eligible Hospital Summary

17 Rollup Reports Pediatrics Academic Department Pediatrics Specialty Clinics Practice Pediatrics Neurology Academic Division

18 Distribution: Publications Publications Reports distributed at multiple levels Attestation report to providers Rollup reports to Chiefs, Chairs and Practice Managers Reports distributed via with supporting links Included documents with measure explanations Burst to a file share to use with attestation submission

19 Phase 2: Migration Crystal had been around a long time. Content and Security Analysis System Management Policy Soft Launch User Migration Solving Legacy Entanglements

20 Crystal had been around a long time.

21 Legacy Crystal Environment 100's of Folders, Many Named Similarly Thousands of Reports Created Over a 10+ Year Period Medical Group Custom Authentication Pathology Using Crystal as ETL Crystal System Legacy Obstetrics System Using Crystal Viewer Launched from a VB6 Application Research Department Intranet Page Using Open Document Links with Parameters 3 rd Party Credentialing Application with Direct Integration

22 Content Analysis Many reports and folders named similarly

23 Security Analysis

24 Formulating Solutions Collected audit information User logins Actual report use Used APOS to scan the security hierarchy Cross referenced use and security Identified new folder structure Determined new security setup

25 System Management License Management Design Standards Systems Management Content Management Development Life Cycle Security Framework

26 License Management All users now must be allocated a license from IT in order to access the system, benefits include: Eliminate excess spending Ability to negotiate the best licensing options Ensure license compliance Upgrades synchronized with the server environment Eliminate version incompatibilities

27 Content Management Relevant, Accurate and Timely Content (reports and dashboards, for example) are relevant, accurate and timely, and meet the needs of their respective business area Content Areas Reports and folder structures that are related to specific business area, business function or application Content Manager Each content area defined as a single business unit or a group of common functions/activities should have a Content Manager and/or Subject Matter Expert

28 Security Framework Organize (Folder Structure) Common Content Secure Content and Functionality (BI Tool Groups) BOBJ Content Subject Area - Consumer BOBJ Content Subject Area - User BOBJ Content Subject Area - Secured User BOBJ Content Subject Area - Super User Authorize Access (AD Groups provisioned via CARS) BI Role Z - Consumer BI Role Z - User Department Content BOBJ Department\Role - Consumer BOBJ Department\Role - User BOBJ Department\Role Secured User BOBJ Department\Role - SME BI Department A - Consumer BI Department A - User BI Department A - Secured User BI Department A - SME

29 System Development Life Cycle

30 Design Standards and Policies Implemented design standards for Crystal, Webi and Universe development Standards adhere to OHSU branding guide Organization best practices

31 Soft Launch Migrating Users Met with each department Reviewed content Discussed new process and procedures Purchased additional licenses Identified content management resources Scheduled migration Soft Launch Migrated each department individually over six weeks One on one training and assistance for SMEs

32 Solving Legacy Entanglements Custom Authentication Issues Modified BusinessObjects web tier Provider Billing - sensitive financial data Required row-level security Solution Created a business view to support dynamic parameters

33 Solving Legacy Entanglements Credentialing Application Issues Mission critical functionality Used to credential providers Periodic volume would overwhelm the system Solution Purchased additional licensing Segregated the environments

34 Solving Legacy Entanglements Legacy Obstetrics Application - STORC Issues Reports executed via VB6 application Use confirmed by audit data Legal retention period 20 years after last visit Solution Burst reports to pdf to be incorporated with imaging system

35 New Managed Environment

36 Phase 3: On-Demand Actionable BI Integrating BI with the EHR Rolling out additional content Training User Adoption

37 Actionable BI - Video

38 User Adoption Continuing to rollout additional content Universes for clinical subject areas Additional Crystal Reports Training WebIntelligence Analysis for OLAP Data mart context specific training

39 Lessons Learned Standard reports need adjustments for organization specific requirements Contact users early to discuss transition planning Identify legacy issues early and have multiple contingency plans Engage other IT teams early to resolve legacy issues Find use cases up front for embedded BI

40 Questions?

41 STAY INFORMED Follow the ASUGNews team: Tom Chris Craig

42 SESSION CODE 2732