Present: T. Basler, F. Clark, K. Davis, B. Ellis, T. Higerd, S. Mixon, M. Schaffner, M.Schmidt, D. Soper, M. Snook, J. Waller, P. Wamsley, J. Welton
Absent: P. Cawley, L. Montgomery,
Guests: Kurt Nendorf, Dave Northrup, Mark Daniels, John Dell, Joe Gough, Ben Rogers, Amanda Pritchett
Dr. Frank Clark opened the meeting at 0730. Minutes were approved as written. Please forward any corrections / changes to Melissa.
Organizational Changes
Dr. Clark announced two organizational changes within the Office of the CIO. Mark Daniels has been promoted to the position of Director, Enterprise IT Architecture and he will be responsible for assessing large scale integration across the MUSC enterprise. Melissa Forinash will be assuming the responsibility for continuing the roll-out of the eCareNet suite of applications, including Clinical Documentation, ED tracking board, AdminRx, and CPOE.
Security Update - Kurt Nendorf
Mr. Nendorf gave overview of the Information Security paradigm - Prevention, Detection, Incident Response, and Enforcement. We've done more under prevention than anything else, such as: border routers and firewalls, intrusion prevention, laptop encryption, SPAM filters, installation of a guest network, Anti-virus, malware, identity management, data storage erase process, data center access control. Future prevention strategies include email encryption, network registration, single sign-on (currently in beta testing with ART DDC), multi-factor authentication, patch management, penetration assessment, and a comprehensive awareness and training program.
Dr. Schmidt inquired how rogue devices and people are prohibited from violating our security policy. Dr. Clark emphasized the importance of enforcement and accountability - that money and tools alone could not totally solve security challenges.
For the Detection component, we currently are doing the following: Alerts, network taps, snort detection, network monitoring, airwaves diagnostics wireless monitoring and video surveillance. We need to implement centralized logs for faster detection.
A great deal of time is spent in Incident response, including notification, network taps, video recording, splunk to search logs, isolating the threat and recommending / taking corrective action. We need to implement better and additional forensic tools to preserve the data for e-discovery and to meet HIPAA requirements.
For Security Enforcement, we currently have an Information Security and Compliance Committee, which is co-chaired by Reece Smith and Richard Gadsden.
Update on Core Clinicals Rollout - Mark Daniels:
Clinical Documentation (ClinDoc) and Medication Administration (AdminRx) along with the critical care eCareNet Viewer has been rolled out to ART ICUs and the Adult med surg units. ICUs include physiologic monitoring integration. All results are flowing into the Clinical Data Repository (CDR) and are available in the eCareNet Viewer.
Computerized Provider Order Entry (CPOE) has been rolled out to five units in ART, including 100 beds and four service lines. CPOE will be rolled out to the remaining critical care units in ART by end July, and ART should be fully activated on core clinical information systems by then.
The new cCareNet Viewer was specifically enhanced and custom developed to mimic MUSC's critical care flowsheets. There is a full data transfer from the McKesson modules into the Viewer as a single convenient place for clinicians to view patient data. Completing the Viewer can be considered as the first phase of developing the "patient centric" model of clinical information system support.
There is good progress being made on the Enterprise Data Warehouse (EDW) as well. Initial data is being staged from the clinical data repository, but will encompass financial data in the long term. A reporting tool has been installed and there was first productive use last week. The EDW, designed for research purposes rather than operational, is currently not being actively updated, but will be in the future. Dr. Davis asked if quality data will be obtained through the EDW and Mr. Daniels replied that he is talking with Chris Rees regarding that possibility.
McKesson software will be upgraded to the new version 10.1 over the next couple of months. The upgrade process will officially kick off in August and be finalized on November 17. This version is required before the new revenue management system (Keane replacement) can be installed.
Future plans for the remainder of the calendar year include rolling out ClinDoc and AdminRx in IOP, implementing CPOE in adult units in Main Hospital, and starting ClinDoc design for Pediatrics.
There are some new projects that will be done within the Emergis / Oacis framework over the next year including a Discharge Summary module, Medication Reconciliation and inpatient physician notes. Medication reconciliation will require interfaces with Practice Partner. Dr. Waller commented that the Discharge Summary module has a lot of functionality and is a top priority as it will all be a key part of "meaningful use".
There are a number of high priority interface requests / integration projects with the eCareNet viewer: Ambulatory / Practice Partner, vascular lab, Perioperative / Anesthesia, Ophthalmology, scheduling for therapies, neurophysiology, and dialysis to name a few.
Dr. Schaffner suggested this same presentation be made at the next MEC meeting. Dr. Waller commended the team for the level of collaboration between MDs, critical care staff, and the vendor in order to best meet their needs. Dr. Schaffner added that we are a leading institution nationwide for rollout of core clinical information systems within critical care.
Practice Partner Update - Dave Northrup / Dr. Kim Davis
We are currently "paperless" for approximately 500+ attendings, residents, and fellows. Psych is only 30% installed. Some specialties require more specialized systems. Currently on Practice Partner (PP) we have 3800 users, 4500 "fat" clients installed on PCs, and have a peak concurrent use by about 1800 users. There are electronically-signed notes which are interfaced to the eCareNet viewer. Notes must be signed within 28 days after visit.
A pilot is in place right now at UIM and East Cooper OB for ePrescription. This checks against insurance and makes recommendation for best selections, and enables immediate counseling with pt.
The IT support staff for PP has increased, but still may need more. Sites similar in size and scope to ours have almost three times as many support personnel.
There are 37 ongoing enhancement or improvement projects for PP. Some of the top priorities include:
Dr. Soper commented that it is remarkable how much progress has been made despite all these issues. Dr. Clark added that while we probably wouldn't choose this product if we were starting de novo, but it will be with us for several more years regardless of whatever decision we make. Dr. Davis concurred that no product will ever be perfect for every specialty clinic.
Projected Activities FY10 - Dave Northrup
Mr. Northrup provided a brief overview of projected activities for FY10.
Dr. Davis asked about encrypted email. Kurt Nendorf responded that we are still working on this and doing some testing. Dr. Soper added that this is an important feature for clinicians, with handling hundreds of thousands of phone calls, it would be so much easier and better for notification of appointments, email consults, etc.
Revenue Cycle Replacement System:
The Keane system is currently 22 years old and will soon be replaced. The "Keane replacement project" will address a number of operational functions, some that we currently have and some that will be new to the institution.
The project starts in October 2009 and will be an 18 month project. There will be an MPI cleanup of over 50,000 duplicates before the project starts. There are roughly 35 ADT interfaces as well as a bi-directional interface with IDX which will need to be addressed. There will not be a conversion of existing accounts in Keane and the old accounts will be allowed to run out. The important driver is that there cannot be any impact to the cash position. A governance committee has been established and a search is on for a strategic consultant to
assist with the project. There have already been some pre-project activities and operational reviews and assessments in preparation for project kickoff.
CIIC Update - Dr. Schaffner
Dr. Schaffner reported that all of her updates had primarily been covered during the meeting, but asked Dr. Waller to provide an update on the PICIS project. Great progress has been made on this project in the Perioperative / Anesthesia areas. Scheduling, OR Nursing Documentation have been live for some time. The EMR documentation module is now in place at ART. Additional interfaces may be necessary and an upgrade is scheduled soon.
FAIC - Patrick Wamsley
Mr. Wamsley reported that FAIC had met three times. CHP presented a request for an asset management system, but they have been asked to go back and do more homework. Success Factors was another initiative which took off with a lot of support. Mr. Ellis thanked John Dell again for his efforts in negotiating the contract, including the university and UMA. Six months of work has been completed in three and so far 300 people have been trained. This system will help to cascade pillar goals down to all employees based on financial, quality, and service parameters. The third presentation was on PCI compliance and funds have been included in the capital budget to address those concerns.
Mr. Wamsley also reported that we are transitioning to a single vendor for cell phones and evaluating taxable aspect as IRS has called upon congress to make cell phones a non-taxable fringe benefit.
Other:
Dr. Schaffner asked if we can have presenters come back in the future and address ROI aspects of their implemented technologies. Council members agreed this was a good idea.
Next Meeting Date / Time:
There was no further business and the meeting adjourned at 0900. The next meeting will be held on Wednesday, November 11 in CSB Room 601.