May 17 2017 Avera Healths HIMSS Analytics Stage

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May 17, 2017 Avera Health’s HIMSS Analytics Stage 7 Journey: Lessons Learned Susan Feilmeier,

May 17, 2017 Avera Health’s HIMSS Analytics Stage 7 Journey: Lessons Learned Susan Feilmeier, Pharm. D IT Clinical Services Officer Avera Sacred Heart IT Regional Information Officer

Journey to HIMSS Stage 7 Award EMRAM (EMR Adoption Model) “A strategic roadmap for

Journey to HIMSS Stage 7 Award EMRAM (EMR Adoption Model) “A strategic roadmap for effective EMR adoption and maturity” www. himssanalytics. org

Journey to HIMSS Stage 7 Award HIMSS EMRAM

Journey to HIMSS Stage 7 Award HIMSS EMRAM

HIMSS Analytics Stages STAGE 2016 Q 3 2016 Q 4 N: 5449 N: 5478

HIMSS Analytics Stages STAGE 2016 Q 3 2016 Q 4 N: 5449 N: 5478 7 4. 6% 4. 8% 6 30. 5% 5 34. 5% 34. 9% 4 10. 1% 10. 2% 3 14. 1% 13. 9% 2 2. 2% 2. 3% 1 1. 7% 1. 4% 0 2. 4% 1. 9% www. himssanalytics. org

HIMSS Annual Scoring Tool Complete HIMSS Annual Study Scoring

HIMSS Annual Scoring Tool Complete HIMSS Annual Study Scoring

HIMSS Stage 6 – Telephone Interview Survey

HIMSS Stage 6 – Telephone Interview Survey

Journey to HIMSS Stage 7 Award HIMSS EMRAM

Journey to HIMSS Stage 7 Award HIMSS EMRAM

Journey to HIMSS Stage 7 Award – Original Timeline

Journey to HIMSS Stage 7 Award – Original Timeline

Lessons Learned Use your EMR Vendor Go and See Mock it Up Timeline Realism

Lessons Learned Use your EMR Vendor Go and See Mock it Up Timeline Realism

Journey to HIMSS Stage 7 Award - Tools Lesson #1: Use your EMR Vendor

Journey to HIMSS Stage 7 Award - Tools Lesson #1: Use your EMR Vendor VENDOR Baseline Assessment

Journey to HIMSS Stage 7 Award - Tools HIMSS Stage 7 Reviewer Guide

Journey to HIMSS Stage 7 Award - Tools HIMSS Stage 7 Reviewer Guide

Journey to HIMSS Stage 7 Award - Tools Criteria Scoring Document

Journey to HIMSS Stage 7 Award - Tools Criteria Scoring Document

Journey to HIMSS Stage 7 Award

Journey to HIMSS Stage 7 Award

Journey to HIMSS Stage 7 Award Lesson #2: Go and See Visit your own

Journey to HIMSS Stage 7 Award Lesson #2: Go and See Visit your own Departments and Observe Visit Other Health Systems HIMSS Stage 7 Surveys

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness OR/PACU Medication Code Blue Medication 24 -7 -365 Clinical Relevant Document Scanning Breast Milk Scanning TAR

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness OR/PACU Medication >90% for 4 consecutive months 24 -7 -365 Clinical Code Blue Medication Relevant Document Scanning Providers & Midlevels TAR Breast Milk Scanning

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness OR/PACU Medication >95% for 4 consecutive months 24 -7 -365 Clinical Code Blue Medication Relevant Document Scanning Breast Milk Scanning Patient and Medication Scan TAR

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness OR/PACU Medication 24 -7 -365 Clinical ORCode and PACU Medications Entered Blue Relevant Breast Milk Medication Document Scanning into the EMR prior to patient Scanning transfer out of PACU TAR

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness OR/PACU Medication Code Blue Medication 24 -7 -365 Clinical Relevant Document Scanning Breast Milk Scanning Code Blue Medications Entered TAR into the EMR prior to patient transfer to next level of care

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness OR/PACU Medication Code Blue Medication 24 -7 -365 Clinical Relevant Document Scanning Breast Milk Scanning Clinical Relevant (<24 hours) TAR Clinically Irrelevant (<72 hours) Document Scanning into EMR

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness OR/PACU Medication Code Blue Medication 24 -7 -365 Clinical Relevant Document Scanning Breast Milk Scanning If NICU, Breast Milk scanning to TAR mom and baby

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness

Journey to HIMSS Stage 7 Award - GAPS Acute CPOE Pervasiveness Acute BMV Pervasiveness OR/PACU Medication >95% for 4 Consecutive 24 -7 -365 Clinical Months Code Blue Medication Relevant Document Scanning Patient and Product Scan TAR Breast Milk Scanning

Journey to HIMSS Stage 7 Award – Methodology Plan Adjust Do Check

Journey to HIMSS Stage 7 Award – Methodology Plan Adjust Do Check

Journey to HIMSS Stage 7 Award Lesson #3: Mock it Up

Journey to HIMSS Stage 7 Award Lesson #3: Mock it Up

Journey to HIMSS Stage 7 Award Vendor Mock Survey Self Mock Survey Vendor Mock

Journey to HIMSS Stage 7 Award Vendor Mock Survey Self Mock Survey Vendor Mock Survey with Presentation Formal HIMSS Survey

Journey to HIMSS Stage 7 Award – Mock with Surveyor Guide

Journey to HIMSS Stage 7 Award – Mock with Surveyor Guide

Journey to HIMSS Stage 7 Award - Presentation • 90 -120 Minutes • Key

Journey to HIMSS Stage 7 Award - Presentation • 90 -120 Minutes • Key Features – Demographics and Awards – Health System Overview – Pervasiveness Data and CDS – IT Governance – CIBI – 3 + Case Studies – HIE – Data Integrity, Security and Recovery

Journey to HIMSS Stage 7 Award - Presentation • Case Studies – >12 mos

Journey to HIMSS Stage 7 Award - Presentation • Case Studies – >12 mos RIO data • Required 80 -120+ hours • Honored Subject Matter Experts • Highlight previous Paper -spaces converted to revenue-generating spaces

Journey to HIMSS Stage 7 Award Lesson #4: Time Estimate 12+mos December 2015

Journey to HIMSS Stage 7 Award Lesson #4: Time Estimate 12+mos December 2015

Journey to HIMSS Stage 7 Awards Avera Mc. Kennan Hospital 12/2015 Avera Sacred Heart

Journey to HIMSS Stage 7 Awards Avera Mc. Kennan Hospital 12/2015 Avera Sacred Heart Hospital 10/2016 Avera Queen of Peace Hospital 12/2016

Journey to HIMSS Stage 7 Award – New HIMSS Tools

Journey to HIMSS Stage 7 Award – New HIMSS Tools

Journey to HIMSS Stage 7 Award- O-EMRAM • • • • Clinical Data Repository

Journey to HIMSS Stage 7 Award- O-EMRAM • • • • Clinical Data Repository HIE Clinical Charting Clinical Order Entry e. RX/Med Rec CPOE e. Messages (referrals, consultants, patient messaging) CDS Provider Documentation Incorporate Encounter, Growth Charts, Data in structured data Exam Results Patient Monitoring Summary of To. C Patient reminders letter Patient/Consumer Functions

Journey to HIMSS Stage 7 Award- Proposed New Stages Stage 7 • Anesthesia EMR

Journey to HIMSS Stage 7 Award- Proposed New Stages Stage 7 • Anesthesia EMR • CPOE Infusion Pumps Stage 6 • CPOE, BMV, TAR, Breast Milk, Barcode specimen collection • Security risk assessment submissions to authority Stage 5 • Provider Documentation/NLP create discrete data • Portable Device Security Stage 4 • >90% Allied Health & Nursing electronic documentation/e. MAR/TAR & ED Live • Business Continuity: Meds, Allergies, Problems, Labs Stage 3 • >50% Allied Health & Nursing electronic documentation/e. MAR/TAR & ED Live • Role-based security and intrusion detection Stage 2 • Clinical DR and context aware • Security, encryption, disposal policy, antivirus and firewall program Stage 1 • PACS • Non-DICOM image storage

THANK YOU FOR YOUR TIME.

THANK YOU FOR YOUR TIME.