CHC 2013

How Content360 Solutions Helped Achieve HIMSS Stage 7

Jason BickfordHIMS Applications Director

7 states / 23 Hospitals 4,330+ Beds35,000+ employees9,000 employed physicians55 bed simulation medical center

“We exist to make a difference in people’s lives through excellent patient care”

Developed EMR Adoption Model in 2005.Stage 7 represents an advanced patient record environment.121 stage 7 US Hospitals.Final evaluation of Stage 7 status is conducted via an on-site visit

HIMSS Analytics

HIMSS Analytics – Stage 7

NO PAPER CHARTS: The hospital no longer uses paper charts to deliver and manage patient care and has a mixture of discrete data, document images, and medical images within its EMR environment.

ANALYTICS: Data warehousing is being used to analyze patterns of clinical data to improve quality of care and patient safety and care delivery efficiency.

DATA SHARING: Clinical information can be readily shared via standardized electronic transactions (i.e. CCD) with all entities that are authorized to treat the patient, or a health information exchange (i.e., other non-associated hospitals, ambulatory clinics, sub-acute environments, employers, payers and patients in a data sharing environment).

DATA COTINUITY: The hospital demonstrates summary data continuity for all hospital services (e.g. inpatient, outpatient, ED, and with any owned or managed ambulatory clinics).

Why HIMSS believes Stage 7 Organizations are Successful

An enterprise that uses data to drive improved outcomes related to:Process, Financial, Clinical, Quality & Safety

A paperless, or near paperless, organization  All clinically relevant data is in the EMR

An enterprise fully committed to continuous process improvement through collaboration

Strong IT leadership and executive championsClinician/end-user champions

An organization that has embraced their technology supplier as a partner

The Goal

Requirements for Stage 7 on paper documents

Clinically Relevant Documentation:  24 hours of creation of the document to be scanned into the EMR, for any medications, we expect those to be entered into the MAR before a patient is moved to the next unit of care.

Non-clinically relevant documentation: 72 hours after discharge is acceptable.

The Process

HIMSS Analytics surveyors conducted an on-site review of Banner’s EMR technologies at Banner Good Samaritan Medical Center located in Phoenix.

Suggested HIMSS Analytics Stage 7 Review Agenda:Determine if coding staff requires paper for any paper/scanned documents that they must review. Evaluate all documents being scanned to ensure they are being scanned in a timely fashion (critical information should be scanned ASAP, less critical information within 72 hours) and that no required electronic documentation is still on paper. Evaluate dictation/transcription procedures for turn-around times relative to patient care impacts Determine if floor space has been recovered from the removal of paper charts

The Test

The Solution: Content360 Document Imaging

Batch Capture: Complete capture within 24 hoursFrequent small batch scanning using Kofax

• 2005 Beginnings at Banner Estrella• Distributed point of service scanning for near real-time

capture• 2007-2011: Phased model approach: PFS, LABS, &

Clinical/CPOE• Hourly scanning and twice daily HIMS rounding

Single Document Capture: Real-time CaptureDirect scanning into Cerner applications Real-time capture within the workflow: Horizon Labs, Drivers License, Insurance Cards, and ROI Authorization.

Content360 Reports Management at Banner

COLD feedsPhillips EKG PDFAGFA Echocardiogram PDFProVation Endoscopy PDF

Content360 Forms Management at Banner

Previous Forms Storage

Conent360 eForms

Content360 Patient eSignature at Banner

PFS eSignature

Content360 Benefits

Content360 solutions provide sophisticated document capture, storageand retrieval — connecting users with relevant documentation within their daily

workflows.

Patient care and organizational performance are optimized by easy access to complete and usable electronic records.

Patients can sign electronic documents with a handwritten signature on a signature pad or tablet.

HIM staff can scan large volumes of paper in batches, flag and automatically route images for physician signature, and send coders home with remote access to images.

Physicians can electronically sign document images in the same application they sign transcribed documents and electronic orders.

HIMSS Stage 7 – Lessons Learned

Cultural ChangeStrong leadership and communicationTraining and ongoing support of both staff and leadership are essential

Perception and Diminish Individual AutonomyEvidence based best practices

Work Flow RedesignRapid-cycle work redesignDecision making includes participation of all stakeholders and functional area experts

Continued Partnership

• Banner/Kofax/Cerner Content360 visioning session – March 2013• Cerner/Banner Health Strategic Roadmap Session – August 2013

How Banner defines innovation:

"Innovation at Banner is defined as the rapid identification and deployment of strategies leveraging

Banner’s operating model and the science of care delivery to ensure an extraordinary patient

experience, which is safe, efficient and effective."

CHC 2013

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