uk healthcare it strategic plan

Information Technology

Strategic Plan

An enterprisewide initiative to solidify the future

2012

ApplicationsStaci AllenWalter ArnettTerrielyn AshleySteve BainerJohn BastonLisa BeardBarry BlakelyKoula BroaddusRob CanalesLana ColeNatalie CollettTeena CollinsChuck CombesMarilyn ConeGary Coutts

UK HealthCare Information Technology will partner more closely with our medical and business functions in the years ahead. We will dedicate ourselves to building upon our strong momentum and living our vision.

Sharon CraftKaren DotySatyander DudeePatricia DunnElizabeth FanninPeggy FosterJay FurtulaDianne GarrisonBrandon GreenStephen HaggardJeannie HassebrookPamela JacobsStephen KeckBrent KreinJamie KumarDebbie KyleCarl MaggardDonna ManningDonna MillerDoris MillerBlake MillsTommie MinnickAlan Moore Pamela MoseleyIrina MoskalevDaniel NeillPhyllis PatchPritesh PatelJamie PatrickSteve Patton

Linda PetroczyJill RamboGreg RedmonShamika RichardsonLeigh SawyerKimberly ScottDavid ShearerSusan SpringerJessy ThomasSharon ToddBrig WakelandAmy WebbNancy WhitakerMike WilsonRoss WinderHongbing Zhu

Architecture & StrategySteve BakerMichelle GerdingBenjamin NichollsVincent Willoughby

InformaticsLynda BennettJenny ChenDaniel CotterBill DavisCecilia PageLauren RileyDiana SageAric SchadlerTrish SeaboltMichelle SimpkinsCarol Steltenkamp, MDCarla TeasdaleMatt TurnerLaura Williams

Portfolio ManagementJoy BarnesMichelle CassinJohn Del BelloTami DunniganGinger FraserRamona GarnerRegina Heiser

Ron HornPaula HudsonBrian KinneySharon MacLaughlinJohn MontgomeryTiffany MorganMahendran NaiduLisa PopeMichael RushingWally ShropshireKarla SouthworthMark SpearsAmy Walker

SecurityAaron AllenMike Booth

Bill CotterDoug FeeAmy JusticeDoug KeebortzBranden MillerConnie MitchellDon RichardsonStan SettleEric Shock

TechnologyWilliam AdamsMary AllenEddie BakerJan BatesChris BohlGerald BottomFred BroachJustin BrockJeffrey BrockmanRobert BrownKarl BurgessTimothy BynumBruce ByromBeverly CarpenterCynthia CasteelWilliam ClarkCory ColemanJay CollettJohn CoxSteve Crawford

Patricia CroweMarcus DaleyJennifer DarlingJeff DavisDohn DeatherageMichael DillardGregory DunniganTracie EdmondsEarnie EdwardsMark EimerSteven EndicottChristopher FinneyJohn FischerRoss FlanneryRitch FlorekKevin Frick

Michelle GreenAnthony GriffithLaShonda HaddixWilliam HaganChris HallMichael HamptonDerrick HansenScott HaynesJennifer HerrinChadwick HolbrookChris HowesJames HubbardEdward IsaacsMichele IsaacsDallas JelfTerrance JohnsonWilliam JonesKelly KingAshley KiserShane KiserJohn KolaczJohn LaffinPeter LandfieldStephen LeedyJeff LynnRudolf MachilekMarcia MastersonChris McIntyreEric McWhorterPatricia Miller

Kenneth MorganDaniel MorrisJim MorrisArmen MuhovicZachary NashBrian NiemeyerLinda NoffsingerWilliam OverstreetDeepali PaiGregory ParsonsJames PaughSteve PetersJames PlowmanMichael PoseyJohn PoskinTahelia Powe

David PowersGary PreeceCorey PrestonRodrigo PrudencioSusan ReinstedlerToquoto RichardsonJoseph RolfesAmanda RouseyCraig SilveyMichael SmallBelinda SmithDiana SouheaverLeslie SpringerRosa SnowThomas StakelinGlenn SteketeeDavid SwartzMelissa TaylorStefan TaylorGuy TerpeningGrant ThomasWesley ThomasRobert TowerySarah TreenRico WalkerChristopher WattsLinda WelchJerry WilliamsChristopher WilsonDana York

INTRODUCTION

2 Executive Vice President for Health Affairs

3 Information Technology

4 Executive Summary

SERVICE STRATEGIES AND INITIATIVES

6 Ambulatory Services

7 Behavioral Health

8 Cardiology

9 Chief Medical Information Officer

10 Clinical Network

11 Clinical Performance

12 College of Medicine

13 Compliance

14 Critical Care

15 Development

16 Emergency Department

17 External Affairs

18 Facilities

19 Finance Hospital

20 Finance Planning

21 Good Samaritan Hospital

22 Graduate Medical Education

23 Internal Medicine

24 Kentucky Children’s Hospital

25 Kentucky Medical Services Foundation

26 Laboratory

27 Legal Counsel

28 Marketing

29 Markey Cancer Center

30 Neuroscience

31 Nursing

32 Obstetrics

33 Perioperative Services

34 Pharmacy

35 Radiation Medicine

36 Radiology

37 Revenue Cycle

37 Strategic Planning

39 Supply Chain

40 Surgery

41 Trauma

42 INFORMATION TECHNOLOGY COMMITTEES

43 KEY ATTRIBUTES OF A WORLD-CLASS IT ORGANIZATION

44 OUR PASSPORT TO IMPROVEMENT

What’s Inside

UK HealthCare 1

Introduction

Michael Karpf, MD

UK HealthCare, the clinical enterprise of the University of Kentucky, is committed to supporting the university’s vision to become a Top 20 public research university. Our drive to excel at quality, safety, efficiency and service, as well as UK HealthCare’s growing reputation for clinical and research excellence, are becoming increasingly dependent on high-quality data, information and knowledge.

UK HealthCare physician faculty and dedicated staff lead the advanced specialty care in the region and recognize the critical role information technology (IT) plays in achieving our medical and business strategies. Additionally, IT will be a fundamental organizer in relationship development and making improvements to care delivery.

Our dedicated teams of clinicians, operations, finance and IT specialists are in pursuit of a single patient record to be distributed across our health care enterprise. Eventually, this record will be shared with providers across the Commonwealth and beyond to ensure they have current information while caring for members of our community. This single record will contain valuable data which can be used as a strategic asset to improve UK HealthCare. Over the last decade, we have made significant investments and have laid the foundation for our ever-increasing data and information needs in this era of health care reform.

This document further expands upon IT strategies summarized in UK HealthCare’s updated strategic plan – Advancing to meet the health care needs of Kentucky and beyond: 2011 – 2015.

Michael Karpf, MD Executive Vice President for Health Affairs UK HealthCare, University of Kentucky

The Commonwealth can count on us to meet health care needs – today and tomorrow

IT will be a fundamentalorganizer in relationship development and making improvements to care delivery.”Michael Karpf, MD

“

2 UK HealthCare

Tim Tarnowski

Congratulations to our multidisciplinary teams on their significant accomplishments.”Sergio Melgar &

Tim Tarnowski

Gaining an edge in an evolving environment

As UK HealthCare has become increasingly reliant on data and information, we have made significant progress toward a lofty vision to build a world-class IT function to transform UK HealthCare.

In 2009, our IT Governance team developed some major goals, including implementation of technology for our new hospital pavilion; integration of a recently acquired community hospital; and achieving “meaningful use,” as defined in the American Recovery and Reinvestment Act, and determining a solution for our ambulatory electronic medical record.

To begin, we restructured the IT leadership team. After recruiting nationally, we have established a strong team excited about the challenges ahead. This new leadership team worked to recruit and build a team with an updated, more contemporary IT skill set. We are currently finalizing the selection of our remaining team members. Succession planning, development planning and mentoring programs are being established to ensure our team members are positioned for successful careers here at UK HealthCare.

Parallel with this transformation, we made significant progress on our goals.. All phases of the new pavilion at UK Albert B. Chandler Hospital opened on time, and IT systems and services were executed very well. The UK Good Samaritan Hospital activation was equally successful – more than 50 systems were activated on a single day without incident or disruption. We have successfully completed our attestation period for inpatient meaningful use – stage one. Additionally, to pursue meaningful use for our ambulatory clinics, a solution for our ambulatory electronic medical record is currently being implemented. Congratulations to the dedicated teams of clinicians, operations, finance and IT who worked together on these significant accomplishments.

Part of our transformation included creation of an “Improvement Journey,” which puts the patient at the center of our work. Page 44 shows the passport each team member has received to provide clarity in these efforts.

Finally, we set out to create strong strategic alignment with our medical and business functions. To that end, we created this plan after interviewing our medical and business leaders. This document is a summary of medical and business strategies we gathered during this process and identifies potential items to align with IT solutions. Our IT Governance team will use this input in the coming years to continue guiding IT as well as establish upcoming priorities and funding for our solutions and services.

As we work closely with our medical and business functions in the years ahead, we will build upon our strong momentum and live our vision. We are excited about the challenges we face and committed to keeping the patient at the center of our ambitions.

Sergio Melgar Chief Financial Officer UK HealthCare, University of Kentucky

“

Tim Tarnowski Chief Information Officer UK HealthCare, University of Kentucky

Sergio Melgar

UK HealthCare 3

Investments in information technology (IT) will enable UK HealthCare to improve patient care, enhance communication with providers, adhere to regulations and operate profitably. The overarching goal is to have a single patient record that can be shared across the health care enterprise to improve the quality of care we provide to our patients. Information technology will be a fundamental organizer in relationship development and making improvements to care delivery. Therefore, UK HealthCare has invested heavily in information technology.

AccomplishmentsThe main area of investment in IT has included the automation of the inpatient medical record. Currently, UK HealthCare’s electronic health record (EHR) includes computerized physician order entry (CPOE), electronic medication administration and online nursing documentation. Additionally, information systems have been implemented in the majority of UK HealthCare’s clinical areas, such as surgery, the emergency department, laboratories, radiology imaging and pharmacy.

Additionally, major IT investments have been made to support UK HealthCare’s growth and system integration strategies. Several multiyear IT projects were completed to provide state-of-the-art information systems in both the new pavilion at UK Albert B. Chandler Hospital and at UK Good Samaritan Hospital. This will ensure that information on patient care provided in these settings will be accessible to all health care providers within UK HealthCare. The electronic integration of patient care data and information is an ongoing strategy being pursued by UK HealthCare.

The entire health care industry is making major investments in health care IT. The American Reinvestment and Recovery Act included a component that has provided significant emphasis on improving health care IT capabilities. We will continue to leverage IT as a means to improve UK HealthCare.

Future strategies• Upcoming IT efforts in the inpatient

setting will include the expansion of electronic physician documentation, the optimization of currently installed systems and improved analytics capabilities. These actions will continue to enhance our abilities to better serve patients in the inpatient settings, as well as position us for further system development.

• Continued investments in health care IT for the ambulatory settings are also being pursued. Implementing an electronic medical record in the ambulatory clinics

Executive summary

4 UK HealthCare

is a key component to our strategies. These investments will ensure accurate and complete patient information from all of our care settings is available to providers at any time and from any place.

• Following the success of the physician portal, UK HealthCare will pursue development of a secure patient portal. The ability to look up medications, test results, schedules and patient education will be part of this functionality.

• UK HealthCare will continue to pursue future meaningful use components, including participation in the Kentucky Health Information Exchange (KHIE).

• Major implementations in our registration, admission, scheduling and billing information systems are also being considered in the overall IT investment plan. Updating the automation in these and other administrative functions is part of our overall strategy to continually improve our operational effectiveness and efficiency.

• IT will play a critical role in the organization’s plans to develop closer working relationships and collaborations with community hospitals and providers. In order to operate as a more structured system, IT must be leveraged to provide information about the patient to all of the patient’s caregivers no matter where a provider is located within the system.

EMR JOURNEY TO DATE

2008 & earlierInpatient EMR/CPOESurgery Info SystemLabRadiologyRegistrationSchedulingBillingFinancial Decision SupportAcute & Critical Care Clinical DocumentationPACSHIMS/Medical RecordsCardiologyeMAR

2009-2010Document Image ScanningPatient Access CenterEMR in EDInpatient PharmacyBed ManagementPhysician DocumentationGood Samaritan Hospital IntegrationNew Patient Care Facility - EDLab Specimen CollectionAnalyticsOutpatient PharmacyRisk ManagementCentral TelemetryRx WriterPhysician Portal

2011-2012New Patient Care Facility - Inpatient/ICUAmbulatory EMR SelectionGeorgetown Clinic EMRHealth Information ExchangeNew Patient Care Facility - ORNew Patient Care Facility - Data Center EncryptionInpatient EMR Meaningful Use UpgradeMeaningful Use Eligible Hospital Stage 1 AttestationFacility Boards

The complexity of developing an electronic medical record is illustrated. UK HealthCare has already implemented a majority of the components and is now actively pursuing the most complex components such as the patient health record, health information exchange and data warehouse.

UK HealthCare 5

Ambulatory Services

Ambulatory Services Strategy

1. Transition of care (creating an integrated patient experience)

2. Space optimization

3. Access

4. Ambulatory services standardization

Input provided by: Jonathan Curtright Marc Randall, MD

InitiativesWhat Ambulatory Services is Doing

1. Transition of care (creating an integrated patient experience) • Inpatient & outpatient integration • Outreach & on-campus integration • Community-based practices integration • Physician referral communication

2. Space optimization • Right-sizing clinics • Physical building growth • Consolidation of services around patient needs

3. Access • Patient access center - “schegistration” • Outreach • Subspecialty growth

4. Ambulatory services standardization • Management structure reorganization • Creating model clinics

How IT Can Help

1. Transition of care (creating an integrated patient experience) • Single-patient health record • Remote clinic access • Referring physician access

2. Space optimization • Clinic and building growth • Standardization of clinic systems

3. Access • Practice management system • Patient access

4. Ambulatory services standardization • Role-based system access • Standardized model clinics

IT Strategy

“Always On” Computing

Data as a strategic asset

Electronic health record

Integration and interoperability

of electronic systems

Support growth and outreach

Unified communications

Usability of installed systems

World-class IT service delivery

6 UK HealthCare

Behavioral Health

Behavioral Health Strategy

1. Clinical documentation

2. Patient units

3. Best practices Input provided by: Darlene Spalding

InitiativesWhat Behavioral Health is Doing

1. Clinical documentation • Electronic health record

integration • Integrate behavioral health clinical

practice guidelines with Sunrise Clinical Manager

2. Patient units • Segregation of units

- Emergency room - Adult - Adolescence

• Methamphetamine Mom program

3. Best practices • Follow behavioral health best

practices

How IT Can Help

1. Clinical documentation •Electronic health record • Behavioral health clinical practice

guidelines integration with Sunrise Clinical Manager

2. Patient units • Segregation of units • Methamphetamine Mom program

3. Best practices • Behavioral health best practices

IT Strategy










UK HealthCare 7

Cardiology

Cardiology Strategy1. Electrophysiology and

Catheterization Lab

2. Imaging

3. Outreach

4. Inpatient services

5. Clinic

6. Cardiac rehabilitation

7. Cardiovascular research

8. Education

9. Administration

Input provided by: Justin Campbell Rick McClure, MD Susan Smyth, MD, PhD Vincent Sorrell, MD

InitiativesWhat Cardiology Is Doing

1. Electrophysiology and Catheterization Lab • Provide program description

2. Imaging • Computerized axial tomography • Magnetic resonance imaging • Echocardiogram • Holter and event monitors • Vascular • Nuclear

3. Outreach • Imaging • Clinics • Electronic medical record

4. Inpatient services • Medical records • Core measures

5. Clinic • Electronic medical record • Integration of Medtronic Paceart®

system for device clinic

6. Cardiac rehabilitation • Integration of ScottCare’s cardiovascular solutions with the electronic medical record and Sunrise Clinical Manager

7. Cardiovascular research • Clinical database integration

8. Education • Fellows • Teaching database

9. Administration • Scheduling faculty

How IT Can Help

1. Electrophysiology & Catheterization Lab • Program optimization

2. Imaging • Standardization of imaging protocols

3. Outreach • Imaging • Clinics • Electronic medical record

4. Inpatient Services • Inpatient portal services

5. Clinic • Electronic medical record and cardiac data integration

6. Cardiac rehabilitation • Electronic medical record

7. Cardiovascular research • Clinical database integration

8. Education • Physician and staff portals • Teaching database

9. Administration • Scheduling systems

IT Strategy










8 UK HealthCare

Chief MedicalInformation Officer

Chief Medical Information Officer Strategy

1. Optimization of clinical systems

2. Centralized data warehouse

3. Outreach and growth

4. IT recognition

Input provided by: Carol Steltenkamp, MD

InitiativesWhat Chief Medical Information Officer is Doing

1. Optimization of clinical systems • Stabilize clinical systems • Research and implement the “right” systems • EHR optimization

2. Centralized data warehouse • Clinical and financial data into centralized data warehouse - Represented as a strategic asset - Reliable, accurate, authentic always available - Managed for local and outreach growth • Reinforce flow of data to information to knowledge • Informatics growth - Provide reliable, accurate information - Publish quality information

3. Outreach and growth • Health record integration with: - National Health Information Network - Kentucky Health Information Exchange - Physician and patient portals • Collaborate with health care colleges - Create support model for research, education synergies - Develop education, training environment - Engage, train and retain nursing staff • Coordination of care through optimized use of technology

4. IT recognition • Market IT value addition to UK HealthCare • Recognition of IT success, accomplishments, milestones

How IT Can Help

1. Optimization of clinical systems • Optimization and improvement of clinical systems

2. Centralized data warehouse • Clinical and financial data into centralized data warehouse • Support of informatics growth

3. Outreach and growth • Integration of health record with various levels of health information exchanges • Research and education support model with health care colleges • Develop education and training environment with reliable and accurate information • Coordination of care

4. IT recognition • Facilitate communication of IT value addition to UK HealthCare

IT Strategy










UK HealthCare 9

Clinical Network

Clinical Network Strategy Affiliate network1. Outreach clinics network

2. Community division network

3. Network access and reporting

Input provided by: Joe Claypool Karen Riggs

InitiativesWhat Clinical Network is Doing

1. Affiliate network • Outlying community clinics and

hospitals: - Specialty services - UK medical oversight presence

2. Outreach Clinics Network • UK physicians providing specialty services at remote sites • Outreach connectivity

3. Community division network • UK physicians providing specialty

services in own community • Research: - Translational trials - Clinical trials

4. Network access and reporting • Physician referral tracking • Centralized inpatient and

outpatient data warehouse • Kentucky Hospital Association

data sharing and reporting • Clinical data sharing physician

access portal • Patient access portal • Guideline, policy, procedure

incorporation • Telehealth

How IT Can Help

1. Affiliate network • Specialty services

2. Outreach clinics network • Specialty services • Outreach connectivity

3. Community Division network • Specialty services • Research

4. Network access and reporting • Referral tracking system • Data warehouse • Kentucky Hospital Association

data sharing and reporting • Access portals • Telehealth • Mobile applications

IT Strategy










10 UK HealthCare

Clinical Performance

Clinical Performance Strategy

1. High-quality care, patient safety & service

2. Providing the most efficient care

3. Standardized care

4. Continuum of care focus

Input provided by: Paul DePriest, MD Carol Steltenkamp, MD

InitiativesWhat Clinical Performance is Doing

1. High-quality care, patient safety & service • Evaluation of quality & patient safety • Use of “swarms” • Mortality reviews • Power of collaboration –

benchmarking and best practices • Core measure performance • Infection control • Rapid response teams • Nurse-sensitive indicators

2. Providing the most efficient care • Establishing standard work and

adoption of “lean” techniques • Competitive length of stay • Managing capacity • Adoption of culture for rapid-cycle

changes

3. Standardized care • Using informatic principles and

advanced analytics to improve: - Operational effectiveness - Quality, safety, patient outcomes - Research and publication - Adoption of culture for rapid- cycle changes • Emphasis on evidence-based

practice

4. Continuum of care focus • Boundary focus across

platforms of care • Population health

How IT Can Help

1. High-quality care, patient safety & service • Improving process through

technology innovations • Hardwire documentation,

reporting for core measures, nurse-sensitive indicators, hospital-acquired conditions and patient safety indicators • Automation of processes for

infection control • Predictive analytics mortality

prediction and patient deterioration algorithms

2. Providing the most efficient care • “Usability” of electronic

documentation • Electronic systems for patient

flow and capacity management

3. Standardized care • Data warehousing & data

stewardship • Analytics • Real-time data availability at

the point of care

4. Continuum of care focus • Integration of disparate systems • Creation of fully functioning

electronic health record

IT Strategy










UK HealthCare 11

College of Medicine

College of Medicine Strategy

1. Continuing education central function

2. Enterprise research storage

Input provided by: Fred de Beer, MD

InitiativesWhat College of Medicine is Doing

1. Continuing education central function • Increase number of students

attending UK medical school • Use distance learning synergies

and educational media transmissions with the university

• Collaboration with College of Pharmacy on enterprise distance learning program

2. Enterprise research storage • Provide appropriate storage

mechanism for research

How IT Can help

1. Continuing education central function • Facilitate discussions with UK IT

and College of Pharmacy to identify best approach moving forward

• Establish distance learning and educational media transmissions to increase number of students

2. Enterprise research storage • Establish UK HealthCare storage

solution for College of Medicine research

IT Strategy










12 UK HealthCare

Compliance

Compliance Strategy

1. Privacy & security

2. Research

3. Billing

4. Conflict of interest

Input provided by: Andrew Hill Brett Short

InitiativesWhat Compliance is Doing

1. Privacy & security • Mandatory reporting • Media releases • Encryption • Comply-Line (confidential ethics and compliance reporting option) • ComplyTrack Suite (enterprise risk management software) • Single source data warehouse • Compliance data storage growth and optimization • Social media growth - Compliance - Documentation (TigerText secure mobile messaging platform)

2. Research • Study manager optimization

3. Billing • Hospital billing • Professional billing • Optimization - Eliminate waste - Enforce accountability - Pattern of practice for fraud

4. Conflict of interest • Code of conduct optimization • Gifts and benefits management optimization • Conflict management optimization

How IT Can Help

1. Privacy & security • Audit reports • Encryption • Compliance • Data growth • Social media

2. Research • Study manager software

3. Billing • Accountability • Efficiency • Fraud • Billing optimization

4. Conflict of interest • Tracking software • Conflict of interest optimization

IT Strategy










UK HealthCare 13

Critical Care

Critical Care Strategy

1. High-quality care & patient safety

2. Providing most efficient care

3. Data-based decision-making

4. Improve outcomes

Input provided by: Pam Branson Kathleen Kopser Scott Morehead, MD

InitiativesWhat Critical Care is Doing

1. High-quality care & patient safety • Evaluation of quality, patient safety in the intensive care unit • Mortality predictability • System standardization across the enterprise – one intensive care unit

2. Providing most efficient care • Improving process of care by establishing standard work and adoption of “lean” techniques • Integration of all devices with new monitors for all intensive care unit beds • Competitive length of stay • Managing capacity • Procedural support for ultrasound order, documentation and central line accreditation

3. Data-based decision-making • Using informatics principles and advanced analytics to improve • Emphasis on evidence-based practice

4. Improve outcomes • Intensive care unit protocol development to improve outcomes • Inclusion matrix of service lines • Benchmarking against industry standards

How IT Can Help

1. High-quality care & patient safety • Improving process through technology innovations • Predictive analytics with mortality prediction and patient deterioration algorithms • Electronic medical record standardization across disciplines and facilities

2. Providing most efficient care • Usability of electronic documentation • Electronic systems for patient flow and capacity management • Device integration of new monitors

3. Data-based decision-making • Analytic support for real-time decision-making • Real-time data availability at the point of care • Integration of evidence into the electronic medical record decision support

4. Improve outcomes • Dashboard development to assist with protocol support • Benchmarking using University HealthSystem Consortium and other industry standards

IT Strategy










14 UK HealthCare

Development

Development Strategy

1. Enterprise & College of Medicine fundraising activities

2. Fundraising audiences & approaches

Input provided by: Vickie Myers Brad Smetanko

InitiativesWhat Development is Doing

1. Enterprise & College of Medicine fundraising activities • Pavilion A and Arts in Healthcare hosted events • Kentucky Children’s Hospital - Facilities - Programs • Research and education programs - Markey Cancer Center - Sanders-Brown Center on Aging - Other centers, departments • Development consolidation and collaboration - Deans - UK central development office - UK HealthCare

2. Fundraising audiences & approaches • Grateful patients - Secure major gifts • Medical alumni - Annual phone-a-thon - Secure major planned and leadership gifts • Employees, faculty & retirees - Secure major planned and leadership gifts • Community - Secure major and planned gifts - Conduct targeted appeals and community fundraisers for focus areas • Corporations and foundations - Secure gifts and grants to support focus areas

How IT Can Help

1. Enterprise & College of Medicine fundraising activities • Pavilion A and Arts in HealthCare • Kentucky Children’s Hospital • Research and education programs • Consolidation of corporate development • Development systems and analytics • State-of-the-art fundraising software • Benchmarking initiatives • Gift processing database

2. Fundraising audiences & approaches • Fundraising approaches

IT Strategy










UK HealthCare 15

Emergency Department

Emergency Department Strategy

1. High-quality care & patient safety

2. Providing most efficient care

3. Data-based decision-making

4. Improved outcomes

5. Community integration Input provided by: Penne Allison

InitiativesWhat Emergency Department is Doing

1. High-quality care & patient safety • Evaluation of quality, patient safety in the ED • System standardization across the enterprise (One ED)

2. Providing most efficient care • Improving efficiency, throughput to allow for growth and expansion of services • Competitive door–to–doctor time • Managing capacity turnaround time (TAT) • Reduction of boarders and appropriate placement of patients • Discharge order to discharge instructions

3. Data-based decision-making • Using informatics principles and advanced analytics to improve care • Emphasis on evidence–based practice

4. Improved outcomes • Continue to improve patient satisfaction and HCAHPS scores • Benchmarking against industry standards

5. Community integration • Integration to emergency management system • Interoperability of outlying systems

How IT Can Help

1. High-quality care & patient safety • Electronic medical record standardization across disciplines and facilities • “Always On” strategies to provide uptime of electronic medical records and enhance patient safety • Support innovation of technology in advancing patient care

2. Providing most efficient care • Usability of electronic documentation • Electronic systems for patient flow, capacity management • Data reporting for process improvement • Innovations to promote efficiency

3. Data-based decision-making • Analytic support for real-time decision-making • Real–time data availability and identification for efficiency • Allocation of dedicated resources in business intelligence

4. Improved outcomes • Benchmarking using University HealthSystem Consortium (UHC) and other industry standards • Core measure data for compliance & improvements

5. Community integration • Integration of disparate systems for interoperability

IT Strategy










16 UK HealthCare

External Affairs

External Affairs Strategy

1. Central Web function

2. Access Center

3. Contracts, vendor relationships

4. Health care reform

5. Portfolio Management Office optimization

6. Employee linkages

7. Affiliations

Input provided by: Mark Birdwhistell Rob Edwards

InitiativesWhat Affairs External is Doing

1. Central Web function • Web strategy • Patient access portals

2. Access Center • Physician access portal • Centralized registry solution • Process consolidation, collaboration • Regional extension center

3. Contracts, vendor relationships • Contract optimization

4. Health care reform • Strategic alignment - Partner with health plans and affiliates • Payor and provider integration of different performance and outcome models • Accountable care organization and health maintenance organization integration • Consumerism: Improve outcomes and reduce costs

5. Portfolio Management Office optimization • Program director for Executive VP for Health Affairs

6. Employee linkages • Support UK-HMO growth • Change participant behaviors - UK-HMO - Community partners

7. Affiliations • Norton community physicians • Community physicians

How IT Can Help

1. Central Web function • Web strategy collaboration • Patient portals system delivery

2. Access Center • Physician access portal • Centralized registry • Process consolidation and collaboration • Regional extension center

3. Contracts, vendor relationships • Contract optimization • Vendor relationship software

4. Health care reform • Payor and provider integration • Accountable care organization and health maintenance organization integration • Birdwhistell pyramid

5. Portfolio Management Office optimization • Portfolio management Office support for EVPHA

6. Employee linkages • UK-HMO

7. Affiliations • Physician support

IT Strategy










UK HealthCare 17

Facilities

Facilities Strategy

1. UK Good Samaritan Hospital

2. UK Albert B. Chandler Hospital (pavilions A, HA, H, G, CC)

3. Ambulatory Services Input provided by: Murray Clark

InitiativesWhat Facilities is Doing

1. UK Good Samaritan Hospital • Evaluating the facility and

developing a tactical facility plan to maintain operations within the facility for an extended period of time

• Upgrading infrastructure • Upgrading clinical, ancillary

and support spaces • Repurpose clinical areas • Specific emphasis is being placed on: - Operating room suites - Emergency Department - Endoscopy

2. UK Albert B. Chandler Hospital (pavilions A, HA, H, G, CC) • Carry out the master facility plan for Chandler Hospital over a

multiyear period - “Fit up” of additional patient care and support units in Pavilion A - Repurpose HA floors for Kentucky Children’s Hospital - Move Markey inpatient units to Pavilion A - Repurpose Markey inpatient units for outpatient care - Repurpose or decommission vacated areas of Pavilion H • Maintain facilities to insure quality

patient care and functionality

3. Ambulatory Services • Implement Ambulatory Services tactical facilities plan over one to five years, enhancing services by addressing: - Clinic realignments, relocations and expansions - Ambulatory care support functions - Faculty and staff support space - Patient and family amenities and support space

How IT Can Help

1. UK Good Samaritan Hospital • Infrastructure, application

and software validation or replacement

2. UK Albert B. Chandler Hospital (pavilions A, HA, H, G, CC) • Infrastructure, application and software validation or replacement

3. Ambulatory Services • Infrastructure, application and software validation or replacement

IT Strategy










18 UK HealthCare

Finance Hospital

Finance Hospital Strategy

1. Hospital accounting

2. Long-term capital forecasting

3. Capital portfolio management

Input provided by: Byron Gabbard Jay Sial

InitiativesWhat Finance Hospital is Doing

1. Hospital accounting • System optimization • Documentation management

program

2. Long-term capital forecasting • System platform upgrade

3. Capital portfolio management • Capital allocation optimization • Capital request website

optimization

How IT Can Help

1. Hospital accounting • System optimization • Documentation management

program

2. Long-term capital forecasting • System platform upgrade

3. Capital portfolio management • Capital allocation optimization • Capital request website

optimization

IT Strategy










UK HealthCare 19

Financial Planning

Financial Planning Strategy

1. Maintain leading-edge financial systems

2. Better utilize campus applications Input provided by: Teresa Centers

InitiativesWhat Financial Planning is Doing

1. Maintain leading edge financial systems • Replace Relative Value Unit (RVU) • Update program manager • Replace decision support vendor • Replace Enterprise Budgeting Application (EBA)

2. Better utilize campus applications • Systems Applications & Products (SAP) optimization with UK HealthCare • Kronos optimization

How IT Can Help

1. Maintain leading-edge financial systems • Improved performance and reliability • Disaster recovery (DR) • Program manager • SharePoint services • Decision support system

optimization and/or replacement • Enterprise budgeting application (EBA) system optimization and/or

replacement

2. Better utilize campus applications • Budgeting software replacement • Systems Applications & Products

(SAP) integration • Kronos optimization

IT Strategy










20 UK HealthCare

Good Samaritan Hospital

Good Samaritan Strategy

1. Community hospital system growth

2. Enterprise service optimization

3. Infrastructure optimization and expansion Input provided by: Ann Smith Darlene Spalding

InitiativesWhat Good Samaritan is Doing

1. Community hospital system growth • Collaboration with community

physicians • Maximize utilization and drive

appropriate acuity cases to Good Samaritan

• Promote and develop Good Samaritan as a high-quality secondary level of care at a contained cost

• Promote and develop elective surgeries that require an appropriate inpatient stay

• Incorporate the culture of change acceptance at Good Samaritan within the enterprise

2. Enterprise service optimization • Integration and standardization of

best practice across the enterprise • Collaboration and consolidation

of best practices as appropriate in the community hospital environment

• Optimization of specialty services with an appropriate level of

care, such as Behavioral Health and Orthopaedics

• Centralized magnetic resonance imaging at Good Samaritan • Centralized laboratory with critical

testing in the hospital space • Growth and integration of post-

acute care with Select Medical Long Term Acute Care and other providers

3. Infrastructure optimization and expansion • Renovation and utilization of Good

Samaritan space. Examples include:

- Departmental moves - Workflow improvements - 7th floor - Cafeteria - Emergency department - Nursing stations - Physical plant • Develop an enterprise medication

distribution center • Develop a retail pharmacy

How IT Can Help

1. Community hospital system growth • Promoting and developing Good

Samaritan high-quality secondary level of care

2. Enterprise service optimization • Move and development of

UK HealthCare enterprise services • Centralized MRI at Good Samaritan • Centralized laboratory for

the enterprise with potential telepathology capabilities

3. Infrastructure optimization and expansion • Renovation and utilization of

Good Samaritan space • Develop an enterprise

medication distribution center • Develop a retail pharmacy

IT Strategy










UK HealthCare 21

Graduate Medical Education

Graduate Medical Education Strategy

1. Informatics as a core competency in medical education

2. Innovations in medical education

3. Supporting a culture of safety

4. Improved communication strategies Input provided by: Susan McDowell, MD

InitiativesWhat Graduate Medical Education is Doing

1. Informatics as a core competency in medical education • Develop tools to promote utilization of innovations in medical education • Accreditation is based on full deployment and utilzation of an electronic medical record

2. Innovations in medical education • Support of new strategies to

address changes in resident staffing

• Create new scheduling opportunities for credentialing - Tracking of clinical procedures

3. Supporting a culture of safety • Increase utilization and

development of simulation as a methodology to teach team- based care

• Emphasis on interdisciplinary evidence-based care

• Focus on reduction of errors and performance improvement methodologies

• Quality improvement is a part of accreditation standards

4. Improved communication strategies • Address “on call” system with

house staff database • Full utilization of the hand-over tool for hand off’s in care

How IT Can Help

1. Informatics as a core competency in medical education • Promote strategies for third- &

fourth-year medical students to utilize the electronic medical record in clinical settings

• Incorporate the education and utilization of the electronic medical record as a part of ambulatory projectONE

2. Innovations in medical education • Usability of electronic documentation • Evaluate “on call“ house staff

database • Evaluate optimization of credentialing

and perioperative solutions for procedural logs

3. Supporting a culture of safety • Incorporate the simulation lab as

a part of projectONE • Engage residents in the clinical

decision support committee and work to integrate decision support into care processes

• Support procedures to integrate evidence into practice

4. Improved communication strategies • Evaluate and/or replace BEEP

system for communication • Include the physician role in the

front-line worker strategic efforts

IT Strategy










22 UK HealthCare

Internal Medicine

Internal Medicine Strategy

1. Integrated research database

2. Portable electronic health record

3. Residency training & education

4. Outreach integration

5. Affiliations

6. Faculty compensation Input provided by: David Moliterno, MD

InitiativesWhat Internal Medicine is Doing

1. Integrated research database • Accurate research database • Outsourcing current database load

2. Portable electronic health record • Integration of portable devices • Portable voice recognition • Integration of telemedicine • Unknown impact of accountable care organization, medical home, managed care organization

3. Residency training & education • Optimization of residency training & education

4. Outreach integration • Optimization of physician resources in remote locations • Open access for one-stop physician scheduling • Refer to our own physicians rather than our competitors

5. Affiliations • Outlying community clinics & hospitals - Specialty services

6. Faculty compensation • Compensation platform • Real-time results driven by metrics, benchmarks & comparative data

How IT Can Help

1. Integrated research database • Accurate and real-time research database

2. Portable electronic health record • Integration of portable devices and voice recognition • Integration of telemedicine • Prepare for accountable care

organization, medical home, managed care organization

3. Residency training & education • Residency training & education with optimized access • Contemporary educational

approaches

4. Outreach integration • Physician resource optimization in outreach location • Open access scheduling

5. Affiliations • Specialty services at outlyi ng community clinics & hospitals

6. Faculty compensation • Optimized compensation platform model • Metrics & data mining

IT Strategy










UK HealthCare 23

Kentucky Children’s Hospital

Kentucky Children’s Hospital Strategy

1. Program expansion

2. Patient quality & safety

3. Patient & family satisfaction Input provided by: Gwen Moreland Suzanne Springate Carmel Wallace, MD

InitiativesWhat Kentucky Children’s Hospital is Doing

1. Program expansion • Open centralized sedation suite

in Pavilion H second floor • Increase primary care physicians • Faculty office space on fourth floor

after UK Transplant Center move • Neonatal Intensive Care Unit

in Pavilion H first floor critical care space

• Observation outpatient unit in the clinical decision unit ground floor space

2. Patient quality & safety • Evidence-based protocols &

process improvements being developed

• Decrease transfer times from the ED to Pediatric ICU

• Efficient handover & communication

• Electronic prescribing

3. Patient & family satisfaction • Increase face-to-face time • Optimize throughput

How IT Can Help

1. Program expansion • Infrastructure & applications

software updates & replacements • Electronic medical record access • New location

2. Patient quality & safety • Rapid cycle changes • Infrastructure analysis for

electronic medical record transformation

• Reports and Sunrise Clinical Manager updates

• Electronic medical record handover tools

• Nurse call system • Nurse-to-nurse & patient-to-nurse

communications

3. Patient & family satisfaction • Wireless devices that support more

face-to-face time • Facilitating efficient throughput

IT Strategy










24 UK HealthCare

Kentucky Medical Services Foundation

Kentucky Medical Services Foundation Strategy

1. Enterprise centralized billing

2. Health care & insurance reform

3. Quality initiatives & growth

Input provided by: Darrell Griffith

InitiativesWhat Kentucky Medical Services Foundation is Doing

1. Enterprise centralized billing • Replace Signature billing system • Implement an optimum

centralized billing system across the enterprise

2. Health care & insurance reform • Provider-based clinics • Payer contracts • Bundling payments • Accountable care organization • American Recovery &

Reinvestment Act • ICD-10 • Health Insurance Portability &

Accountability Act-5010 • Ambulatory EHR • Medicaid managed care

3. Quality initiatives & growth • Chart abstracting • Propensity to pay optimization • Pricing estimator optimization • Enterprise denial management • Provider coding & documentation • Handheld charge capture • Resource skill set optimization • Succession planning for key

management • Remote property & facility

management for the enterprise

How IT Can Help

1. Enterprise centralized billing • Signature billing system

replacement • Enterprise centralized billing

system

2. Health care & insurance reform • Provider-based clinics • Payor contracts • Bundling payments • Accountable care organization • American Recovery &

Reinvestment Act • ICD-10 implementation • Health Insurance Portability &

Accountability Act-5010 • Ambulatory EHR • Medicaid managed care

3. Quality initiatives & growth • Chart abstracting • Propensity-to-pay optimization • Pricing estimator optimization • Enterprise denial management • Provider coding & documentation • Handheld charge capture • Resource skill set optimization

IT Strategy










UK HealthCare 25

Laboratory

Laboratory Strategy

1. Workflow optimization

2. Exchange of patient information

3. Diagnostic testing quality improvements using state-of-the-art technologies

Input provided by: Helen Banks Melanie Browning Barbara Bush Martha Davenport Milford Jarrells Neysa Kiser John May Sandy Mills Daoping Zhang

InitiativesWhat Laboratory is Doing

1. Workflow optimization • Surgical pathology relocation • Enterprise laboratory integration • Pathology optimization • Kentucky Clinic space renovation • Roche automation solution • Blood bank order set rebuild • Real-time results log • Quest diagnostics transition • Automated metaphase finder • Blood transfusion guidelines

2. Exchange of patient information • Logical observation identifiers

names & codes to University HealthSystem Consortium

• Northeast Kentucky Regional Health Information Organization

• Web page redesign • Electronic health record

implementation • CoPath report format • Laboratory information system

molecular human leukocyte antigen solution

3. Diagnostic testing quality improvements using state-of-the-art technologies • Sunquest, collection manager

upgrade • Autoimmune fast track

implementation • Enterprise hematology solution • Fully utilize genotyping solution • Liquid chromatography mass

spectrometry • Transplant Center collaboration • Fluorescence in situ hybridization

How IT Can Help

1. Workflow optimization • Relocation and space renovation • Enterprise laboratory integration • Pathology systems optimization • Blood bank systems optimized

2. Exchange of patient information • Health information exchange • Web page redesign • Electronic health record

implementation • Laboratory information system

molecular human leukocyte antigen solution

3. Diagnostic testing quality improvements using state-of-the-art technologies • Laboratory system upgrades & optimization • Blood bank optimization • Histology upgrade and

integration • Enterprise hematology solution • Point of care glucometer

integration

• Point-of-care glucometer replacement

• Mass spectrometry implementation

• Serology transitions to Abbott Laboratories

• Chromosome microarray testing

IT Strategy










development

26 UK HealthCare

Legal Counsel

Legal Counsel Strategy

1. Contracts & agreements

2. Policies & procedures

3. Licenses/Permits/Certificates

4. Legal consultation

5. Malpractice insurance

6. Litigation

7. eDiscovery

Input provided by: Ruth Booher

InitiativesWhat Legal Counsel is Doing

1. Contracts & agreements • Contract reviews • Third-party & affiliation

agreements • Buildings & practices acquisitions

2. Policies & procedures • Custodian – Home for policies & procedures

3. Licenses/Permits/Certificates

4. Legal consultation • Human resources & personnel

issues • Ad hoc consultation

5. Malpractice insurance • Orchestration

6. Litigation

7. eDiscovery

How IT Can Help

1. Contracts & agreements • Contract & agreement support

2. Policies & procedures • Website development &

management with policy cross- reference

3. Licenses/Permits/Certificates • Document management

4. Legal consultation • Document management

5. Malpractice insurance • Document management with

policy cross-reference

6. Litigation • Litigation support

7. eDiscovery • Discovery & search tools • Forensics • Document management

IT Strategy










UK HealthCare 27

Marketing

Marketing Strategy

1. Grow word-of-mouth commentary

2. Attract higher acuity patients

3. Increase familiarity with UK HealthCare Objectives • Grow selected volume • Build stronger relationships • Enhance organizational image Input provided by: Wanda Adkins Jason Britt Bill Gombeski Karen Riggs Jan Taylor Tanya Wray

InitiativesWhat Marketing is Doing

1. Grow word-of-mouth commentary • Support better patient experience • Grow employee pride • Support patient access • Improve marketing quality • Expand marketing-induced word-

of-mouth

2. Attract higher acuity patients • Build physician-referred business • Grow higher acuity patients • Explore destination medicine

marketing • Support hospital partner

marketing

3. Increase familiarity with UK HealthCare • Promote UK HealthCare and

launch brand campaign • Promote and support patient care

outreach • Expand community and public

health-based initiative • Increase campus employee

preference • Build relationships with insured

patients

How IT Can Help

1. Grow word-of-mouth commentary • Infrastructure for patient feedback

data collection and reporting • Analytics for collected data • New intranet platform to

communicate with employees • Improve online provider directory • Wayfinding • Print-on-demand hardware

2. Attract higher acuity patients • Content management system tools

and platform • Referral directory • Digital content management tools

and infrastructure for internal and external users

3. Increase familiarity with UK HealthCare • Database and analytics to support

return-on-investment effectiveness of marketing initiatives

• Consolidate Web presence to establish one UK HealthCare community engagement destination

• Explore use of mobile applications • Expand use of social media • Referring physician portal

IT Strategy










28 UK HealthCare

Markey Cancer Center

Markey Cancer Center Strategy

1. Program completion

2. Improvements

3. Program expansion Input provided by: Sue Durachta David Gosky

InitiativesWhat Markey Cancer Center is Doing

1. Program completion • Active Comprehensive Breast

Care Center (CBCC) equipment and information technology installations

2. Improvements • Oncology-specific electronic

medical record • Outpatient pharmacy in Whitney-

Hendrickson building

3. Program expansion • Move of Ear, Nose, Throat-Head &

Neck cancer program to multidisciplinary hospital-based clinic

• Move multiple staff & program into Whitney-Hendrickson third floor space

What IT Can Do

1. Program completion • Comprehensive Breast Care

Center (CBCC) equipment and information technology installations

2. Improvements • Oncology-specific electronic

medical records • Outpatient pharmacy in Whitney-

Hendrickson building

3. Program expansion • Ear, Nose, Throat-Head &

Neck cancer program move to multidisciplinary hospital-based clinic

• Staff & program move into Whitney-Hendrickson third floor space

IT Strategy










UK HealthCare 29

Neuroscience

Neurosciences Strategy

1. Quality & safety

2. Efficiency

3. Service excellence

4. Growth & development

Input provided by: Joe Berger, MD Julie Blackburn Michael Dobbs, MD Dean Hanlon Gary King Phil Tibbs, MD

InitiativesWhat Neurosciences is Doing

1. Quality & safety • Integration of service line results

for image management into a centralized enterprise archival solution

• Active participation in the state registry for services

• Increase currency of data submission

• Stroke affiliate network • Comprehensive stroke center certification

2. Efficiency • Electronic medical record • Redesigning clinic work flow

3. Service excellence • Improved patient experience

throughout the continuum of care

4. Growth & development • Deep brain stimulation • Neurosurgical services utilizating

hybrid operating room • Elective cerebral vascular • Movement disorders • Spine • Growth of hospital clinical practice • Brain telemetry • Hypothermia

electroencephalogram telemetry • Remote monitoring • Seizure recognition software • Creation of neuroscience critical

care service

How IT Can Help

1. Quality & safety • Develop an enterprise image

management strategy • Analyze and identify requirements

to enhance telemedicine for outreach activities

• Data management for program development

2. Efficiency • Integration of EMRs • Electromyography/Nerve

conduction velocity (EMG/NCV) integrated reporting with archiving

• Standardization of record locations • Transfer of external electronic

images and reports to replace compact disk downloads

3. Service excellence • Respond to patient feedback on

access opportunities to data through survey analysis

• Interface between inpatient and outpatient information to facilitate follow up appointments and information exchange with providers

4. Growth & development • Evaluate EMR health information

exchange requirements to partner in program development

• Integrate the EMR into service areas such as interventional radiology and gamma knife for consistency of documentation and care hand-offs

• Increase access in Pavilion H with focus on 7 West and 7 South

IT Strategy










30 UK HealthCare

Nursing

Nursing Strategy

1. Quality & safety


3. Operational excellence Input provided by: Colleen Swartz, DNP

InitiativesWhat Nursing is Doing

1. Quality & safety • Align nurse sensitive indicators

to meet National Database of Nursing Quality Indicator targets

• Interdisciplinary integration of professional practice model

• Mature & improve collegial relationships with physician partners & leaders

• Hardwire nursing accountability for meeting core measures

2. Service excellence •Improve patient and family

experience • Improve staff experience • Increase BSN to 80 percent of

nursing staff by 2020

3. Operational excellence • Optimal utilization of staffing

resources • Create and optimize user interface

design of Sunrise Clinical Manager • Identify delays in patient care

that impact length of stay and the discharge process

• Mutualistic relationship with College of Nursing

How IT Can Help

1. Quality & safety • Hardwiring nurse sensitive

indicators in Sunrise Clinical Manager through mutually agreed upon designs based on evidence

• Hardwiring nursing role in core measure compliance

• Standardization of the patient profile across the enterprise

• The Joint Commission plan of care framework for compliance

• Development of population health outcomes by service line

• Integration of evidence through core performance group updates

• Timely & accurate key clinical data

• Mobile device implementation

2. Service excellence • Patient engagement in the plan of

care design • Unified communication tactics

3. Operational excellence • Completion of the EMR across

departments • Complete disparate forms • Usability of the EMR and

knowledge-based charting • Implementation of Acuity system • Data management for meeting

operational decisions

IT Strategy










UK HealthCare 31

Obstetrics

Obstetrics Strategy

1. Quality & safety

2. Program expansion

3. Patient satisfaction

4. ONE paperless patient record Input provided by: Wendy Hansen, MD Gwen Moreland John O’Brien, MD Anita Taylor

InitiativesWhat Obstetrics is Doing

1. Quality & safety • Integration of image management

into a centralized enterprise archival solution

• Increase in obstetric thrombin- antithrombin (TAT) and throughput

• Coordinated data management for the Obstetrics service line

• Development of a provider dashboard

• Better tools for patient hand-offs between providers

2. Program expansion • Development of women’s

care outpatient services in cardiovascular, obesity & diabetes

• Expand Good Samaritan obstetrics space

• Fetal care center program development

• Partner with health department • Continued development of

resident clinic at Good Samaritan & Polk-Dalton for international patients

• Evaluate alternative provider roles such as utilization of nurse practitioner and midwife

• Increase consultation efficiency & consults in outlying areas

3. Patient satisfaction • Satisfaction surveys • Optimize throughput • Increase patient satisfaction

through enhanced amenities such as beltless monitoring system & wireless PC access

4. ONE paperless patient record • Optimize handover • Physician documentation • Outpatient-to-inpatient integration

How IT Can Help

1. Quality & safety • The need and requirements to

enhance telemedicine • Integration of obstetric images

into the enterprise image archival strategy

• Data management strategy for Women’s Health & Obstetrics service line

2. Program expansion • New clinic • New care center • EMR & health information

exchange integration to partner with the health department

3. Patient satisfaction • Driving quality and satisfaction

initiatives with Obstetrics • Facilitating efficient throughput

4. ONE paperless patient record • Handover tools optimization • Clinician-to-clinician & clinician-

to-patient communication • Electronic medical record &

documentation • Interoperability & efficiencies • Outpatient-to-inpatient integration

IT Strategy










32 UK HealthCare

Perioperative Services

Perioperative Services Strategy

1. Operational excellence

2. Data management Input provided by: Julie Deverges Rebecca Napier Donna Norton

InitiativesWhat Perioperative Services is Doing

1. Operational excellence • Establish a systematic approach

for the standardization in the perioperative suite

• Current: • Increase volume through the

department • Enhance patient safety through

safe patient hand off’s in transitions of care

• Optimal equipment management in the perioperative setting

• Stabilization of systems of care post-construction

2. Data management • Support the patient flow metrics

for intraoperative patient management improvements

How IT Can Help

1. Operational excellence • Standardize deployment of

software solutions in the perioperative environment consistent with optimal workflows

• Establish a standard workflow and software solution for transitions in care

• Evaluate deployment of equipment tracking in the perioperative setting

• Complete a post-project assessment for improvements in care from new Pavilion A information technology changes

2. Data management • Establish a dashboard for quality

& safety data to service line leadership for performance improvement activities

• Data management for operational decisions

Chandler SCM PICIS Paper Pre-‐OP X Holding X Intra-‐OP X PACU X GSH SCM PICIS Paper Pre-‐OP X Holding X Intra-‐OP X PACU X CAS SCM PICIS Paper Pre-‐OP X Holding X Intra-‐OP X PACU X

IT Strategy










UK HealthCare 33

Pharmacy

Pharmacy Strategy

1. Pharmacy program stabilization

2. Pharmacy program expansion

3. Patient quality & safety Input provided by: Gary Johnson, PharmD

InitiativesWhat Pharmacy is Doing

1. Pharmacy program stabilization • Replace end-of-life equipment • Acquire new pharmacy resource

to assist with internally supporting pharmacy applications

• Auto Pharmacy SRX integration • Replace current ambulatory Rx

point-of-service system

2. Pharmacy program expansion • Expand Kentucky Clinic outpatient

pharmacy services • Build patient assistance program • Establish provider-based clinics • Establish specialty pharmacy (340b) • Establish pharmacy benefits

manager • Open two new retail pharmacies • Upgrade auto pharmacy for new

carousel Rx central distribution center

• Upgrade PYXIS medication stations

• Upgrade and integrate Interactive Voice Response (IVR) and Interactive Web Response (IWR) with RX3000 pharmacy management system

3. Patient quality & safety • Reduce medication errors through

use of IT • Implement bar-code medication

labeling

How IT Can Help

1. Pharmacy program stabilization •Replace carousel • Develop Information Technology

Infrastructure Library RACI documentation

• Auto Pharmacy SRX integration • Ambulatory Rx point-of-service

system • Assemble business case proposal

for information technology governance review and approval

2. Pharmacy program expansion • Outpatient pharmacy software

for Kentucky Clinic • Patient assistance program • Provider-based clinics • Specialty pharmacy (340b) • Pharmacy benefits manager • Two new retail pharmacies • PYXIS medication stations • Interactive Voice Response (IVR)

and Interactive Web Response (IWR) pharmacy management system

3. Patient quality & safety • Bar-code medication

administration

IT Strategy










34 UK HealthCare

Radiation Medicine

Radiation Medicine Strategy

1. Radiation Medicine improvements

2. Radiation Medicine expansion

3. Electronic management system Input provided by: Sue Durachta David Gosky

InitiativesWhat Radiation Medicine is Doing

1. Radiation Medicine improvements • Linear accelerator replacements • Brachytherapy suite move to old

Gamma Knife® suite - Addition of new brachytherapy

equipment

2. Radiation Medicine expansion • Addition of a linear accelerator for

inpatient treatments in Pavilion A

3. Electronic management system • MOSAIQ upgrade

How IT Can Help

1. Radiation Medicine improvements • Accelerator replacements • Brachytherapy suite move and

optimization

2. Radiation Medicine expansion • Accelerator addition

3. Electronic management system • MOSAIQ upgrade and optimization • ICD-10 integration • EHR integration • Optimization of image transfer

IT Strategy










UK HealthCare 35

Radiology

Radiology Strategy

1. Teleradiology

2. Imaging

3. Transcription Input provided by: Gary Conrad Liz Oates, MD Denise Quandt

InitiativesWhat Radiology is Doing

1. Teleradiology • Optimize teleradiology program

2. Imaging • Develop an enterprise image

management strategy • Optimize 3D & other imaging

activities • Picture Archiving &

Communication System (PACS)

3. Transcription • Optimize Transcription program

How IT Can Help

1. Teleradiology • System implementations

2. Imaging • Enterprise image management

strategy • Imaging systems optimization • Picture Archiving &

Communication System (PACS) replacement & optimization

3. Transcription • Transcription strategy • Data management

IT Strategy










36 UK HealthCare

Revenue Cycle

Revenue Cycle Strategy

1. Health care payments, reform & regulatory compliance

2. Quality initiatives & compliance

3. Account receivables management Input provided by: Frank Blair Ed Erway Rhonda Killingsworth Craig Rogers Carrie Rudzik Pam Ryan Diane Ward Elaine Younce

InitiativesWhat Revenue Cycle is Doing

1. Health care payments, reform & regulatory compliance • ICD-10 • Provider-based clinics • Payor contracting • Governmental payor cost reporting • Bundling payments • Accountable care organization • Quality reporting systems • Electronic facsimile solution • American Recovery & Reinvestment

Act • Health information management

2. Quality initiatives & compliance • Master patient index optimization • Consolidation of complete record • Handheld dictation devices • Compliance tracking optimization • Quality module software • Electronic health record • Chart abstracting & scanning • Electronic physician query • Physician clinical documentation • Computer-assisted coding

3. Account receivables management • Integrate Central Kentucky

Management Services functions • Enterprise accounts receivable

solution • Patient access portal • Propensity-to-pay optimization • Pricing estimator optimization • Improve charge master compliance • Reduce initial claim rejection • Eliminate paper charge process • Enterprise denial management • Third-party financing

How IT Can Help

1. Health care payments, reform & regulatory compliance • ICD-10 implemation • Provider-based clinics • Payor modeling • Governmental payor cost report • Accountable Care Organization • Quality reporting systems • Electronic facsimile • American Recovery &

Reinvestment Act metric solutions • Health information management

2. Quality initiatives & compliance • Master patient index maintenance • Electronic record optimization • Handheld dictation device • Compliance tracking • Quality module software • Physician clinical documentation • Computer-assisted coding • Chart scanning and abstraction for

AEHR

3. Account receivables management • Central Kentucky Management

Services system • Enterprise accounts receivable • Patient access portal • Charge master optimization • Propensity-to-pay optimization • Pricing estimator optimization • Eliminate paper charging • Enterprise denial management

IT Strategy










UK HealthCare 37

Strategic Planning

Strategic Planning Strategy

1. Decision support

2. Growth & outreach Input provided by: Melody Flowers Jim Zembrodt

InitiativesWhat Strategic Planning is Doing

1. Decision support • Reliable and high-quality data • Advanced electronic tools for

decision support • External reporting for

UK HealthCare data • Assessment and acquisition of a

new decision support system

2. Growth & outreach • Partnerships with external

providers and facilities - Remote clinical management of patients

- Telemedicine clinical application - Telemedicine enhanced

communication - Continuing education - Physician portal

• Enabling internal providers in remote outreach locations

How IT Can Help

1. Decision support • Decision-support application delivery • Data stewardship and retention

of reliable data

2. Growth & outreach • Physician portal • Telemedicine • Remote application delivery

at outreach sites

IT Strategy










38 UK HealthCare

Supply Chain

Supply Chain Strategy

1. Warehouse automation

2. Pick list automation

3. PYXIS

4. Decision support system

5. Standardization Input provided by: Lorra Miracle

InitiativesWhat Supply Chain is Doing

1. Warehouse automation • Systems, Applications and

Products (SAP) bar-coding solution

• Inventory management • Return rate reduction

2. Pick list automation • Standardization

3. PYXIS • Hospital implementation

4. Decision-support system • University HealthSystem

Consortium (UHC) tool

5. Standardization • Case-specific physician

preferences • Ekahau wireless real-time

location system (RTLS)

How IT Can Help

1. Warehouse automation • Systems, Applications and Products

(SAP) bar-coding solution • Inventory management system

2. Pick list automation • Carousel implementations • Automation optimization

3. PYXIS • Hospital implementation

4. Decision-support system • Tools • Database

5. Standardization • Ekahau optimization

IT Strategy










UK HealthCare 39

Surgery

Surgery Strategy

1. Optimize enterprise footprint

2. Outreach

3. Hospital-based practice

4. Leverage robotics in surgical services

5. Automate & integrate surgery patient flow Input provided by: Darren Johnson, MD Raleigh Jones, MD Rebecca Napier Jay Zwischenberger, MD

InitiativesWhat Surgery is Doing

1. Optimize enterprise footprint • Center for Advanced Surgery • Pavilion A • Pavilion H • Good Samaritan Hospital • Clinics • Outreach • Hybrid operating rooms

2. Outreach • System integration and

optimization • EHR • Services growth • Mobile device integration

3. Hospital-based practice • Services integration

4. Leverage robotics in surgical services • Replace end-of-life robotics

equipment • Optimize robotics

5. Automate & integrate surgery patient flow • Clinical systems integration &

optimization - Access - Flow - EHR - Documentation - Eliminate expensive labor

How IT Can Help

1. Optimize enterprise footprint • Expansion & optimization of

footprint

2. Outreach • System integration and

optimization • EHR • Services growth • Mobile device integration

3. Hospital-based practice • Streamline registration and

scheduling • Services integration

4. Leverage robotics in surgical services • Integrate robotics with EHR • Robotics replacement and

upgrades

5. Automate & integrate surgery patient flow • Integration of vital sign data across

the continuum of care • Clinical system integration and

optimization • Document fragmented current-

state system configuration • Facilitate decision process for

Surgery leadership to decide which systems to use across the Surgery continuum

• Design a solution & implement the selected integrated design

IT Strategy










40 UK HealthCare

Trauma

Trauma Strategy

1. Quality & safety


3. Operational excellence Input provided by: Andrew Bernard, MD Julie Blackburn Phillip Chang, MD

InitiativesWhat Trauma is Doing

1. Quality & safety • Utilization of the trauma registry

to benchmark care (National Trauma Quality Improvement Program)

• Develop a methodology to automate the data collection processes

• Update the handover tool for providers

• Upload of outside films • Optimize electronic trauma history

& physical document

2. Service excellence • Improve staff experience • Optimize interoperability of

emergency management systems & UK HealthCare systems

3. Operational excellence • Address the levels of alert by

creating two levels; one for the trauma surgeon and one for the ED resident providing visualization into the patient for the trauma team

• Trend data for errors and analyze for performance improvement opportunities across the system

How IT Can Help

1. Quality & safety • Service line dashboard for trauma

services • Integration of data collection to

registry to enhance efficiency • Optimization of physician &

provider handover tool • Upload and archive of outside films • Optimization of electronic trauma

history & physical document

2. Service excellence • Optimize interoperability of

emergency management systems & UK HealthCare systems

3. Operational excellence • Quality & safety dashboard to

service line leadership for performance improvement activities

• Data management for meeting operational decisions

IT Strategy










UK HealthCare 41

IT Governance UK HealthCare’s IT Governance team guides information technology strategy, direction, priorities, funding and resource plans. A process was established for IT Governance to rate all requests against UK HealthCare’s signature metrics. The members of the IT Governance Team are:

• Sandra Chambers

• Phillip Chang, MD

• Murray Clark

• Jonathan Curtright

• Ed Erway

• Darrell Griffith

• Sandra Jaros

• Jane Kirschling, PhD

• Sergio Melgar, co-chair

• Elizabeth Oates, MD, co-chair

• Keith Shelton

• Brett Short

• Ann Smith

• Carol Steltenkamp, MD

• Colleen Swartz, DNP

• Tim Tarnowski

The following governance subcommittees have been established, or are in the process of being established, to assist with specific themes and challenges:

• Project request prioritization

• Data warehouse

• Infrastructure and security

• Service request prioritization

IT Committees

42 UK HealthCare

Key Attributes of a World-Class IT OrganizationIT’s vision is to “Build a World-Class IT Function to Transform Health Care.” We adopted an industry best practices framework with the following components:

We have assigned cohorts of multidisciplinary Information Technology teams to develop the definitions for each attribute as they relate to UK HealthCare. The cohorts will also determine the components for each attribute and work to make the related approaches and processes a part of the way we work. This approach will enable us to link our approaches to industry best practice while tailoring the specific needs to our environment.

Used by permission; Corporate Executive Board, Key Attributes of the World-Class Information Technology Organization.

IT Governance

ApplicationsDelivery

BusinessEnablement

InfrastructureDelivery

Security & BCPlanning

PerformanceMeasurement

TalentManagement

VendorManagement

Strategy& Planning

EnterpriseArchitecture

Business CaseDiscipline

PortfolioManagement

ValueDemonstration

RiskManagement

Security, Policies& Standards

ProjectManagement& Execution

MaintenanceCost

Containment

AvailabilityManagement

Life Cycle CostEfficiency

TechnologyInnovation

ProcessDigitization

Data & Knowledge

Management

IT EnabledCollaboration

RequirementsDefinition

ApplicationDesign

CostTransparency

DR & BCPlanning

IT Staff Development

PerformanceDevelopment

Leadership Development

VendorPerformance

Oversight

VendorSegmentation

PerformanceReporting

UK HealthCare 43

UK HEALTHCARE MISSIONUK HealthCare is committed to the pillars of academic health care – research, education and clinical care. Dedicated to the health of the people of Kentucky, we will provide the most advanced patient care and serve as an information resource. We will strengthen local health care and improve the delivery system of the Commonwealth by partnering with community hospitals and physicians. We will support the university’s education and research needs by offering cutting edge clinical services on par with the nation’s best providers.

VALUESSense of UrgencyTeamworkAccountabilityInnovationRespect

Our Improvement Journey

Signature Metrics

Quality / Safety

ServiceExcellence

Efficiency

Impact

In 2012 we developed and trialed a “Passport for Our Improvement Journey” to reflect our mission of

improving the University of Kentucky and UK HealthCare. Based on this trial period, the IT leadership team decided to deploy this passport more broadly within IT. Each IT leadership team member signed this passport to reflect our commitment to our improvement journey. We have distributed this passport to each UK HealthCare IT team member.

QUALITY/SAFETY

EFFICIENCY

SERVICE EXCELLENCE

IMPACT

MY PASSPORT FOR OUR

IMPROVEMENT JOURNEY

UK HEALTHCARE INFORMATION TECHNOLOGY MISSIONImprove UK & UK HealthCare

VISIONBuild a World-Class IT Function to Transform Health Care

VALUESRespectAccountabilityIntegrityServant LeadershipExcellence

IT Strategic Plan

Budget

IT Governance Milestones

Enterprise Goals

World-Class Attributes

FY 2013 IT Executive Council Goals

44 UK HealthCare

In 2009, the following information technology strategies were introduced to the IT Governance Team:

These IT strategies were created to guide our thought processes and to tie IT investments to value delivery. Initial definitions have been developed for each of these strategies, which are currently being updated based on what we learned over the last several years. Once these are updated, they will be incorporated in future documentation.

AcknowledgementsSpecial thanks to the interview participants as well as the following UK HealthCare Information Technology Strategic Planning Teams:

Core Team:Steve Baker Rob CanalesDoris Miller Jim MorrisMatt Turner Vince Willoughby

Interview Teams:Eddie BakerJoy BarnesJan BatesLisa BeardLynda BennettMike BoothRobert BrownMichelle CassinNatalie CollettChuck Combes

IT Strategies

Sharon CraftJeff DavisDoug FeeMichelle GerdingChris HallRon HornChris HowesPaula HudsonBrian KinneyMark Little

Sharon MacLaughlinJohn MontgomeryMahendran NaiduBen NichollsLinda NoffsingerCecilia PagePhyllis PatchLinda PetroczyLisa PopeLauren Riley

Mike RushingDiana SageAric SchadlerWally ShropshireKarla SouthworthCarla TeasdaleMatt Turner

IT Strategy










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