Role of Innovation at Sharp August 15, 2011 Bill Spooner Senior Vice President and CIO
REFLECTION "Some men see things as they are and say Why?. I dream things that never were and say Why not.? " - Robert Kennedy
Agenda Sharp Background Perspective on Innovation Examples of IT role in Innovations Other Areas we are Exploring Conclusions
Sharp HealthCare Largest health care system in San Diego 7 hospitals, 2000+- beds 4 Acute Care and 3 Specialty 2 Affiliated Medical Groups Health Plan 5 Urgent Care Centers 2 Skilled Nursing Facilities Home Health and Hospice Largest private employer in San Diego 15,000 Employees 2,600 Affiliated Physicians 2,000 Volunteers $2+ Billion Operating revenue
Brief Organization History Early 1950 s: Key hospitals opened Mid-1980 s: Mergers forming Integrated Network 1980 s: Embraced managed care model 1985-1995: Tight reimbursement Mid-1990 s: Financial distress 1995-1997: Columbia/HCA option explored 1997: Emerged independent and stronger 1997-2000: Just say No campaign 2001-2011: Sharp Experience 2007: Baldrige Award
John Glaser on Innovation Practical innovation the kind of innovation that genuinely improves patient care or workflow and can be implemented by an organization today is based on four cornerstones: The Right Culture Organizational fabric, directed at business or clinical value The Right Questions Vision, strategy, process, technology The Right Processes Portfolio, idea input, evaluation, pilots, impact assessment The Right Tools in support of innovation Technology has no inherent ability to cause innovation. Its innovation value is determined by the context of its potential use. HHN Feb. 2008
The Right Culture Sharp Translation Creativity encouraged Healthy risk appetite, tolerance for failure Strongly motivated leaders, seldom fail The Right Questions Strategy alignment? Business or clinical value? Quality, Service, Finance Replicable across organization? The Right Processes Open door policy Lean Sigma Strategic Planning Committee, IT Executive Committee The Right Tools Early adopter / creative adapter of commercial products
History of Innovations
History of IT Innovations 1970s - Lab system 1985 - Clinical documentation alpha site (Clinicomp) 1993 - Hospital Patient Accounting alpha site (IDX) 1995 - EDI enrollment, claims and encounters 1998 - Sharp.com Internet baby" 1999 - First of eleven Most Wired awards 2000 - Hospital EMR and PACS (Fuji) begins 2003 - OnBase live with managed care claims 2004 - Medical Group EMR begins (Allscripts) 2006 - New Hospital EMR strategy (Cerner) 2007 - EMR for Sharp s IPA begins (Allscripts) 2010 - mysharp patient portal 2011 - HIE for Sharp providers (dbmotion)
Innovation Example Collaborative Care Evolution
Collaborative Care Evolution 1980: Pacificare partnership 1985: Delivery Network integration Late 1980 s: Capitation, Contract management 1991: Master Patient Index Mid-1990 s: Data warehouse analytics Mid-1990 s: EDI 1999 - CFO: We have to have an EMR! 2000+-: Clinical analytics, preventive health 2003: Claims scanning 2004: Town Hall with David Brailer, MD 2005+-: Online alerts eg Diabetes 2011: Pioneer ACO application
October 2004 San Diego Town Hall
Value Proposition Steady market share gains Profit improvement Pay-for-performance dollars High quality and patient satisfaction scores Press Gainey Pacific Business Group Malcolm Baldrige National Quality Award Strong employee satisfaction scores Low turnover San Diego leader on the Web IT recognized in Baldrige Award
Health Reform: Full Continuum of Care IT Strategy Identify, develop, and implement IT solutions to support effective care management from both an operational and patient-care focus. Wellness Illness Prevention and Wellness Disease Management Outpatient Acute Post Acute Home Care Hospice/ Palliative Care Evidence-Based Care Operational Excellence Master Patient Index (MPI) Financial & Practice Mgt Sharp s Information Technology Hospital EMR Medical Group EHR Data Warehouse MEDai Health Information Exchange mysharp External Care Coordination Providers Patients Quality Reporting Government Quality Programs Pay for Performance Meaningful Use
mysharp Portal CCHIT Certification Underway xxxxxxxxxxxxxxxxxxxxxx xxxxxxxxxxxx xxxxxxxxxxxx
Health Information Exchange
Innovation Example Clinical Analytics
Sharp Data Warehouse Supports Real-time P4P Performance Management
P4P Reports
Compliance Non-Compliance
Drill Down Report on Non-Compliance
Diabetes Action Sheet
Percent of Patients HbA1c Greater than 9 Sharp Rees-Stealy 12% 10% 8% Start DM-9 6% 20% Improvement 4% 2% 0% Sep- 06 Oct- 06 Nov- 06 Dec- 06 Jan- 07 Feb- 07 Mar- 07 Apr- 07 May- 07 Jun- 07 Jul- 07 Aug- 07 Sep- 07 Oct- 07 Nov- 07 Dec- 07 Jan- 08
HCC/Quality Button Touchworks
Innovation Example Admitting Workflow
Paperless Admitting 2007+-
Palm Vein Scanning Improving Patient Identification at Registration Hospitals and SRS medical group Reduces unintentional duplicates and overlaps Protects patients from medical fraud and identity theft Non-intrusive and highly accurate Currently 40,000+ patients are enrolled Implemented 2010
Innovation Example Out of Network Repatriation
Out of Network Repatriation Bringing Sharp patients into Sharp hospitals Coordinating quality care Decreasing OON hospital expenses Saved about $8 million in 2010 Workflow automation Notification of OON patients, logging, tracking Bed availability Physicians and case managers Patient transfer
OONWA (Out of Network Web Application) Integrated IT Toolset Web Application 2 way paging Reporting
Innovation Example Clinician Convenience Patient Safety
Way2Care Allows users to login/logout quickly with their employee badge. Complements single sign-on, context management Positive user response. Implemented 2010
Virtual Integration
Innovation Example On Watch Real Time Event Trigger
Event Triggers Specific events that prompt investigation Reversal agents Critical lab values Sequential events/ trends Linked events such as meds and lab values Derived from research literature, clinical expertise Designed to identify events where harm has the potential to occur
House-Wide View
Unit Level Dashboard
Patient Detail View
Online Patient Chart
Areas we are exploring
Patient-centered Workflow Information and resources located at local level EMR, Device, Environmental, Communication, etc Cerner & non-cerner systems Various Forms and Formats Early Stages Elements to support a contextually aware experience EMR Medical Devices Medical ImagingConsumer Devices Communications Entertainment Environment Internet Maternity Surgery Fetal Monitor Physician Office IV Pump iaware Patient Perspectives Gadget Library Facility Perspectives Photo Rx Station Auto Chem Hemodynamic Ultrasound Activity Pathology DigitalSensors PACs Camera Bed Heart Rate C-PACs ECG Healthe Scale BP Glucometer Messaging Discovere Vocera Cell Phone RFID Proximity MyStation Gaming Sat Radio Movies Security Monitoring Video Conf Plumbing Lighting IQHEALTH Thermostat Education Research Reference EMR Medical Devices Medical Imaging Consumer Devices Communications Entertainment Environment Internet Maternity Surgery Physician Office Bed Fetal Monitor Rx Station IV Pump Auto Chem Hemodynamic Ultrasound Photo PACs C-PACs ECG Pathology Digital Camera Scale BP Glucometer Heart Rate Activity Sensors Vocera Unified Messaging Cell Phone RFID Presence \ Location MyStation Movies Gaming Sat Radio Video Conf Security Monitoring Lighting Thermostat Plumbing Proximity Education Research Reference
Early Stages Unified Communications Apps and Communications Merge on Wireless Devices Cellular WiFi Tablet WiFi Mobile Station To Deliver Schedule & Patient Info Clinical Results Approvals & Orders Portals & Dashboards
Enterprise Logistics via Positioning Technology Patients =ƒ(patient Progression, Fixed Assets) Product Evaluation EPS Visibility Capacity Management Patient Acuity Care Level Index Staff Assignment Case Management 3D Queuing: Predict and Position Staff & Mobile Assets =ƒ(patients, Fixed Assets) Staff Scheduling Labor Analytics Asset & Materials Management ibus Fixed Assets
Conclusions Practical Innovation is key to our success It must have a purpose! Clinical and/or business drivers Six Pillars at Sharp Anyone can be the innovator (There are no bad ideas!) We need it more than ever!
Thank you! Questions?