OTTR The Transplant Business Objectives Introduction Change management
OTTR & The Transplant Business
Objectives Ø Ø Ø Introduction Change management and institutional buy in Go live Beyond the basics Future plans Lessons learned
Miami Transplant Institute (MTI) Ø Joint venture between University of Miami Miller School of Medicine and Jackson Memorial Hospital Ø Surgeons and Medical doctors are University of Miami Ø Program resides within JMH Ø Sister Liver transplant program at Broward General
Scenario First transplant October 1970 Largest “county” transplant center 3, 200 new patient referrals annually 1, 900 patients listed 10, 000 active post-transplant patients 450 -500 transplants annually 200 employees Home grown database, 15 y/o 4
The Early Stages Ø Transplant leadership commitment Ø 5 year process Ø Ø Profitability analysis Foundation Grant Site visits Strategic Plan Ø Enterprise Leadership Buy-in Ø 3 EMR (Cerner Jackson, Cerner Broward, Epic UM) Ø CIO, CMIO, CSIO & Lab Director Ø Data Sharing Agreement Ø Staff Ø Communication Ø Education
OTTR Ø Major goal for 2014 and beyond Ø All employees required to learn how to use and to adapt new work flows Ø Do not be afraid to ask questions and make suggestions Ø The system is only as good as we make it Ø Significant support for staff to learn OTTR Ø OTTR 101 – required Ø Lunch and learn sessions – employee suggestions welcome Ø Additional training on request – small or large groups Ø Tutorial and manuals
Go-Live Ø Ø Ø Ø May 2 nd, 2013 6 Organs, 10 Modules – Adult and Pediatric 25 Interfaces 100 User Licenses 450 fields of data conversion 80 hours of staff training 774 hours of customizations and configurations
History • MTI OTTR Go Live, May 2, 2013 • 6 Organs, 10 Modules – Adult and Pediatric
The Next Stage Ø Commitment to change and success Ø You OTTR Know Ø Hardware and Network infrastructure upgrade Ø Mirror workflows in OTTR Ø Integration beyond interfaces Ø Dictionaries (Referring physician, Medications, Diagnosis, Dialysis, Pharmacies) Ø The paperless chart, scanning Ø Ø Ø Physician Daily Note Web Portal UNet Interface Online referral Business development
? ? ? • The stakeholders • • MTI Jackson Memorial Hospital University of Miami Broward General • 5 years and a strategic plan latter • There is consensus… • we need a new database, we have funding, how do we get to go-live?
The Next Stage Ø Commitment to change and success Ø You OTTR Know Ø Hardware and Network infrastructure upgrade Ø Mirror workflows in OTTR Ø Integration beyond interfaces Ø Dictionaries (Referring physician, Medications, Diagnosis, Dialysis, Pharmacies) Ø The paperless chart, scanning Ø Ø Ø Physician Daily Note Web Portal UNet Interface Online referral Business development
The Paperless Chart
Physician Daily Note
Physician Daily Note
Physician Daily Note
Case Manager Referring Physician Web Portal
Case Manager Referring Physician Web Portal
UNet Interface
UNet Interface
Online Referral
Online Referral
Business Development
Future Plans Ø Ongoing education and communication! Ø Eliminate duplicate data entry Ø OR Interface – Surginet Ø Allergies and Problem List Interface Ø Others Ø OTTR Mobile Ø Nursing and Physician Documentation Ø E-Prescribing Ø Vascular Composite Allograft Ø Quality dashboards
Lessons Learned Ø Ø Ø Become closely acquainted with CIO, CMIO, CSIO Forget your old processes, embrace new ones Revisit flow charts Limit customizations until after go live, budget for them Limit data conversion Ø Consider UNOS data import Ø Interfaces Ø Engage directors in early stages Ø Validation and signoff Ø Change control Ø Develop newsletter for post go-live communication Ø Physician engagement
Lessons Learned Ø Ø Basic training upfront Develop a training manual and grid for all employees Set expectations continuously Implementation phase, start early Ø Patient letters Ø Lists by job function Ø Dictionaries Ø Dialysis facilities Ø Employees Ø Diagnosis Ø Providers Ø Allergies Ø Problem Lists Ø Medications
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