EMR, EHR & Service Excellence Journey

Healthcare ICT

Ahmad YahyaChief Information Officer (A)Sheikh Khalifa Medical City

Topics

Organization Overview EMR Implementation Journey at SKMC. EHR Implementation across SEHA and value

proposition Realities of Healthcare

About SEHA

Abu Dhabi Health Services Company (SEHA) Public Joint Stock Company owned by Govt. of Abu Dhabi. Focus to deliver world class medicine to residents of AD Owns and operates:

– 12 Healthcare Facilities, 2,644 licensed beds– 62 AHCs/PHCs, 2 Blood Bank Centers and Diabetic

Clinics. One of the largest employers in Middle East: 16,700 Staff

Sheikh Khalifa Medical City-SKMC

Largest Hospital & Medical City in UAE Flagship Institution for Public Health System Encompasses several “Centers of Excellence”. Tertiary Care Teaching Hospital 700 Beds ( 125 Behavioral Sciences) 850K Patient visits, 7K Surgeries, 180K ED Visits 14 Outpatient Specialty Clinics 3,400 FTE (Over 50 Countries Represented)

SKMC Accreditations

April 2011: The Surgical Pavilion, Medical Pavilion, 14 Outpatient Specialty Clinics and Abu Dhabi Blood Bank are all accredited by Joint Commission International (JCI)

June 2009: SKMC is accredited as a Cycle III Chest Pain Center by the Society of Chest Pain Centers (SCPC). SKMC is the first hospital outside the USA to attain this accreditation for its cardiac and emergency services November 2012: Reaccreditation Level IV

December 2010: SKMC Laboratory Medicine Department, Abu Dhabi Blood Bank and POC testing are accredited by the College of American Pathologists (CAP) December 2012: Reaccreditation

5

Snapshot History & Technology

Established

Acute care bed hospital

& outpatient specialty

clinics

SEHA (Abu Dhabi

Health Services

Company)

Cleveland Clinic

Management

EHR –

Pharm, Lab, CPOE, Clinical Doc, Surgery, ED, RIS, PACSERP-Finance,

HR , SCMUC

2000

JCIA Accreditation

Daily average approved beds:

775

Infrastructure & EHR

Implementation Starts

EHR –

Physician Doc.

Critical Care, Device

Integration

JCIA Re-Accreditation

CAP Accreditation

EHR –

AnesthesiaABNBMDI

Unified Order Entry

eRefferal

One Centralized Environment

Achieve the eGovernment Vision – One Patient/One Record Enables population health management across the system. Enables chronic disease management across the system System wide reporting capabilities Personal Health Record (National ID, communicate with physicians, schedule

appointments and request refills at a countrywide level)

Speed to Change Easier to implement government quality/regulatory initiatives across the system Speed to patient safety and Return On Investment (ROI) Easier to maintain/keep up to date

Overall Cost Little to no interoperability issues Reduced training costs, particularly for clinicians that practice at multiple facilities Significantly lower Total Cost of Ownership

Health Care in the UAEBefore

SKMC Hospital

Mafraq Hospital

Al Ain Hospital

Now

Under process

Between 1960 - 1980

Oasis Hospital, First In UAE

Old Wards

Paper; Paper Everywhere!! Diagnosis - No flow!!!

Organized

FacilitiesHealth Care Flow

                      

              

Under process

AfterHospitals

New Facilities

Technology - Strategic Themes

Optimize Patient Flow and Satisfaction – Patient Centric– Evidence Based Medicine/Order Sets/Pathways– Integrated EMR

Optimize IT solutions & Provide operational dashboards– Integration, BI, Data Warehouse, Reporting, Six Sigma

Enhance IT governance and oversight– COBIT, PMP, ISO 20000

Deliver world class IT service experience to staff:– ITIL, ISO 20000, ISO 27001, PMP

IT Strategy Building Block

Interface Engine

Ancillary Services: Laboratory – Pharmacy – Radiology – Surgery – ED

Enterprise Master Patient Index - EMPI

Hospital - Inpatient ADT Clinic – Outpatient

Core Clinical Inpatient & Outpatient

Billing/Patient Accting

Enterprise Resource Planning ERPFinance – HR – Supply Chain

En

terp

rise

Bu

sin

ess

Inte

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ence

P

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rman

ce P

oin

t/A

nth

em /

Cer

ner

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Au

tho

rity

O

racl

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Infrastructure

Ancillary Services: PACS – CVIS – Critical Care – Blood Bank – Cardiology - CSSD

EM

RM

alla

fi

Buy-In and Deployment of EMR

Leadership Support & Buy-in critical Physicians’ Engagement is a Must - Champions Do Not Automate Paper – Order Sets. Planned Measurements and Outcomes. Workflow & Process mapping (Before and After) Communication (Clinician Engagement, Early and often) Project Teams:

– Application– Technology– Clinical Transformation– Training

Oracle (ERP)

HR

Finance

Malaffi (Cerner) - EHR

Medical Rec.

Scheduling

Registration

Radiology

Retail Pharm

Pharmacy

Lab

CPOE

Material Mgt

GL & AP

Billing

Meditech

Material Mgt

Pharmacy

Lab

Order Entry

Great Plains

GL & AP

HR (limited)

Payroll

Billing

Surgery

Emergency

Nursing Doc

Physician Doc

Phas

e 2a

– D

ec. 2

009

Phas

e 1

– Ju

ly 2

008

Oct. 09

Implementation Strategy

Phas

e 2b

Nov

201

0

2011

Critical Care

CVIS

Registration

Application & Training Teams

Application Specialists – Design, Build, Validate– Integration & Interface– Implementation – Support

Over 50 Trainers & 12 Training Rooms Over 2900 clinical staff trained

Technology Team

Service Desk & Desktop Support Back Office Systems Network and Telecommunication (UC) Wireless Deployment (Mobility). New Desktop Look & Feel Intranet Collaboration/Workflows Enhanced Security.

Malaffi Devices

250 Workstation

On Wheels (WOW)

200+ Tablets - Utilized by physicians, Nurses, and Patient Experiece staff

200+ wall-mounts carefully distributed across SKMC

1000+ PCs and 900+ Printers/Scanners

Clinical Transformation & Communication Team

Patient Workflow – Review & Design– Process improvement

Evidence-Based Order Sets Device Road Show Comms Development and Distribution

– Patients, Staff and the Project Team– Newspaper Ads & Press Releases

Long term view

Malaffi is the EMR composed of…

* Not a comprehensive list of features/functions

Patient Demographics

Test Orders

Interfaces to Medical Equipment such as Laboratory Instrumentation and Bedside Medical Devices (e.g., Monitors, Ventilator's, etc.)

Emergency Department & Operating Theatre Tracking Boards and Documentation

Medication Ordering and Administration Details-eMAR

Test Results

Health Reminders, Monitors, and Alerts

Medication Process Improvement(Patient Safety)

The “Old Fashioned” Way

The “New and Improved” Method

Hand Written Prescriptions

Printed Prescriptions

Malaffi Benefits & Business Imperatives

Improve Patient Care - One Patient…One Record Patient Safety

Reduce Medical Errors

Care DeliveryIncrease Physician Access to Clinical Information at the Point of CareEnables chronic disease management across the system (continuum of care)

Increase Efficiencies/Cost Effectiveness Turnaround time

Improve Response Time to Patients

Resource ConsumptionEliminate Redundant Test and Data Collection

PACS & CPACs

PACS HIS Integrated and direct feed into EMR. Voice recognition: Radiologists report directly in EMR. Images stored electronically, viewed on any computer. System available 24 hours a day within health system

CPACS Images from ALL sites available, irrespective of the source. Inter-facility proxy reading. Inter-facility second opinion, on the fly. Acts as online back-up of local images on central archive. Eliminate need for duplicate exams

Current: Centralization of Images

ehealth

One Patient…One Record

EMR, EHR & Service Excellence Journey

Healthcare ICT

Ahmad YahyaChief Information Officer (A)Sheikh Khalifa Medical City

US Electronic Medical Record (EMR) Adoption Model

Industry standard Healthcare Information and Management Systems Society (HIMSS) Analytics Model for Electronic Medical Record (EMR) adoption

Asia Pacific EMR Adoption Model

SEHA Facility Scores (as of Jan 2013)

Mafraq – 5.32SKMC – 5.33Corniche – 6.-008

PilotMadinat Zayed – 6.008Tawam – 6.008Al-Ain – 6.008Al-Rahba – 6.008

Realities to Deal With

Healthcare is becoming borderless.

Patient experience will matter.

Payment will be linked to value.

Social care will blend with healthcare.

Enterprises will need to focus on sustainability.

Thank You!