Present: M. Balassone, F. Clark, K. Davis, T. Higerd, S. Mixon, M.Schmidt, D. Shaw, M. Snook, D. Soper, J. Waller, P. Wamsley,
Absent: T. Basler, P. Cawley, B. Ellis, L. Montgomery, M. Schaffner, J. Welton
Guests: Richard Gadsden, Roger Poston, Mark Daniels, John Dell, Dave Moses, Melissa Smith, Amanda Pritchett, Joe Gough, Ben Rogers, Kurt Nendorf
Dr. Frank Clark opened the meeting at 0730. Minutes were approved as written. Please forward any corrections / changes to Melissa.
Update on Core Clinical Information Systems and Rollout - Mark Daniels:
Mark presented a "stoplight" chart demonstrating what products were live in what locations and what percentage complete if not entirely installed. Plans for the ER 10.1 upgrade for McKesson applications were reviewed. The kickoff is November 18 with go live plans in mid-March. Most of the time spent working on this upgrade will be in testing.
A chart demonstrating the evolution of the clinical data repository (CDR) and current state was also reviewed. Three new modules are in process: 1) a discharge summary module which will be interactive through the entire course of stay, 2) medication and allergy reconciliation, which will reconcile inpatient pharmacy with CPOE and ambulatory EMR, and 3) physician documentation, which is a new initiative and joint partnership with Telus for physicians to use the CDR to enter progress notes and data.
An update on the Enterprise Data Warehouse (EDW) was also given. We are currently moving through an extraction, transaction, and loading (ETL) process in order to create a clinical, financial, and administrative data warehouse which will support the MUSC enterprise.
The Carolina eHealth Alliance was established through a Duke endowment grant, in which emergency department data will be shared electronically between the several entities (MUSC, Roper, East Cooper, Trident). There are six distinct inpatient facilities and 12 emergency department settings. Data will be held temporarily in a transient repository, such that it is accessible as needed but not permanently available.
PCI Compliance - Patrick Wamsley
Patrick introduced Melissa Smith, Dave Moses, and Richard Gadsden, all of whom have been working on PCI compliance issues for some time and should be considered our local experts. PCI stands for "Payment Card Industry" and is a set of credit / payment card standards set by private industry with which we must comply. Risks are great and fines could be as high as $250K or $10,000 per instance. Additionally, if there is a breach, credit companies will come back and sue for additional costs incurred. As an educational institution, we are under the most stringent compliance requirements at stage 5. Richard Gadsden researched best practices and recommendations from the FAIC mimic what is commonly being practiced within our industry. Recommendations from the FAIC are to keep everything on the network but take steps to secure the network. This will require a combination of capital funding and operational allocations based on numbers of transactions. Estimates for hardware and software alone (no human resources) are $925,000. Some of these purchases can also be leveraged to accommodate additional HIPAA and HITECH security requirements. Estimates are that it will take at least two years to get to a state of reasonable compliance. Kurt Nendorf added that the infrastructure group would like to escalate the improvements and there is a lot of work to do. This was approved by the council and will be placed on the next agenda for President's Council. Dr. Higerd also suggested that we take this opportunity to look at our whole identity management process and how two factor authentication may benefit not only PCI standards but identity management as well.
FAIC - Patrick Wamsley
Patrick reported that there is a large demonstration scheduled on November 19-20 for asset management. Asset management software has now branched out into broader aspects of workflow, work-orders, inventory, and property control. In assessing what kinds of products are currently being used on campus, seven different versions of software were identified. Ideally, it would be good to standardize on one. After demonstrations, the FAIC will come back with recommendations on next steps.
Academics & Research Update - Dr. Darlene Shaw
Other Clinical Updates - Melissa Forinash
CPOE went "live" in Main Hospital yesterday on 8E and 8W. Fifteen patients are currently on the system. No further go-lives are scheduled until after the first of the year, which will enable time to do an overhaul of nursing instruction and protocol orders and evaluate the modify order feature in CPOE.
Telemedicine - Dr. Soper:
Dr. Clark asked Dr. Poston to review several improvements that have been made to the infrastructure to prepare for distance learning and telemedicine. Network bandwidth has been increased to 10Gb across campus and new gateways were installed to access the networks. We upgraded the ability to use Internet 2 for unsecured access and have 200Mb on the commodity internet, with an additional 100Mb planned. The total campus is wireless with over 900 access points and we can move secured information across the wireless network. The Palmetto State Providers Network (PSPN) currently has 80 sites to healthcare institutions in the state and is trying to add an additional 380 sites and MD offices. This shared network is connected to the SC light rail. There are three 10Gb channels between here and USC. We are optimized for telemedicine (TM) and can do distance learning over it, and working to have three platforms completely available for telemedicine.
Dr. Soper asked that the topic of TM be discussed today. TM is ideal for the consultant who needs to interview a patient but doesn't need to examine, and can use images at a remote location to render a diagnosis and medical plan. We are already doing this with Florence for high risk pregnancies. Potentially these sites could be in every physician office in the state but we don't have an organizational framework to support it sufficiently. We need to develop some type of centralized TM czar or process to ensure that this is being centrally coordinated. Dr. Clark inquired about barriers such as reimbursement and asked if there was a business model in place. Neurosciences is currently using TM for stroke assessment. Dr. Davis added that there seem to be huge opportunities for specialty care. Dr. Schmidt asked if the commodity internet will be sufficient for outlying areas. Dr. Soper added that the image that the patient sees needs to be outstanding. Dr. Higerd suggested that Dr. Egan's hypertension network also be evaluated, and asked if this function could also be expanded to research. The SC light rail was specifically designed for research collaboration.
All were in agreement that this issue is worth discussing further with seemingly endless opportunities.
Next Meeting Date / Time:
There was no further business and the meeting adjourned at 0845. The next meeting will be held on Wednesday, March 10, 2010 in CSB Room 601.