Cpoe for Emory Healthcare

Business Case NEU Consulting grouping Prep atomic number 18d by Kuan-ling Chiu Wenjie Xie Executive Summary This business teddy outlines how the CPOE see to it for hastening address rate of flow business concerns, the benefits of the produceing class, and recommendations and justification of the go steady. The business baptistery also discusses detailed realize goals, work measures, assumptions, and constraints. 1 Issue Since the percept of persevering safety has arisen, many health check organizations were striving to correct medicine safety.Emory Healthassist, the largest and most comprehensive health c atomic number 18 body in Georgia, was wholeness of them who were seeking ways to prevent practice of medicine misunderstandings. In recent years, some highly influential studies revealed that medical errors occurred in in uncomplaining and out forbearing settings at alarmingly high strays. Researchers level out some 1. 3 million injuries occurred p.a. to lon g-sufferings in U. S. hospitals, at a high percentage of which were at least parti bothy due to errors in patient management.In the Emory Healthcare, physicians place fellowships by penning them on an influences sheet attached to the patient chart or they would shout a nurse and ask him/her to write the roams on the society sheet. recounts are paper- found or just by verbalization. Further much, medication orders ordered by radioscopy technicians or phlebotomists would be carried out by a unit shop clerk who is responsible for to fax or scan and then sent orders straight to the pharmacy. Such paper-driven work is not efficient and accustomed to errors without prototypeization, physicians carry no responsibility for orders, which is critical and directly touchs to medical errors.It was calculated that 37% of the patient cases had medication treatment fault in the Emory Healthcare because of its paper-driven prescription medicine transitwhich is prone to error. Around 9%of injuries werepartiallydue toinaccurate medical orderinput. Furthermore, 60% of the patients were not satisfied with theirtreatment. 2 Anticipated Outcomes In order to prevent medical errors and improve order truth, the suggestion of utilise CPOE (Computerized Provider Order Entry) has surfaced.CPOE bequeath establish order standard and permit physicians write orders electronically and directly, thus prevent order inaccuracy. Furthermore, paper-driven work pull up stakes be eliminated and replaced by electronic process. Computerized process will improve energy of work flow, accuracy of input and reduce embody. Ultimately, all physician orders will be regulate, electronic and traceable. Thus, medical errors caused by human negligence will be reduced to minimum. 3 RecommendationVarious options and alternatives were analyzed to meet the outdo way to improve physician order processes and reduce the error and comprise. The recommended CPOE abide will methodically migrate the physician orders and the patient records of current mainframe system to the red-hot electronic computer-based plan in order to save up data integrity. The pertly computer-based platform will improve the efficiency and accuracy of managing orders and records. The project will master its desired issues Physicians will directly draw in orders electronically by standardized requirements. The system will check the orders and bouncing the users with inappropriate entries. Orders will be fork overd and can be accessed immediately. Orders and patient records are traceable and indulgent to obtain. The system will turn in users with alerts and guides of better practice, duplicate, drug interactions when assigning prescription or orders. Business Case Analysis Team The followers individuals contain the business case analysis police squad. They are responsible for the analysis and human beings of the Emory Healthcare frame business case. Role description Name/ ennoble Exe cutive Sponsor Provide executive arrest for the project A, washrag expert Lead Provides all technology support for the project E, Chen, Technical Lead Process Improvement Advises team on process good techniques Leland Choi, Process Team Lead couch Manager Manages the business case and project team B Brown, confound Manager Software uphold Provides all packet support for the project Jack Xie, Software collection Lead Problem Definition 1 Problem Statement In the 1980s and 1990s, researchers point out approximately 1. 3 million injuries occurred p.a. to patients in U. S. ospitals, 69% of which were at least partially due to errors in patient management. In 2000, the Institute of Medicine published a plow that concluded that more people died apiece year from preventable errors in hospitals than from car accidents, breast cancer, or AIDS. Medical errors caused by human wariness are the main issue inside Emory Healthcare. In 1986, it was calculated that 37% of the patien t cases had medication treatment fault. The problems are due to the lack of standard for orders by physicians. Physicians would place orders by hand writing, and then they would call a nurse and ask him/her to write the orders on the order sheet. Orders are paper-based or just by verbalization.Such paper-driven work that without standardization is not efficient and prone to errors. Moreover, physicians carry no responsibility for orders, which is critical and directly points to medical errors. During the concluding five years, 60% of the patients were not satisfied with their treatment. Furthermore, works driven by paper are costive and quantify-consuming. 2 Organizational Impact The CPOE project will impact the Emory Health Care in different aspects. The succeeding(a) provides a high-level explanation of how the organization, tools, process, and roles. Tools COPE project mainly focuses on designing a late system to improve the accuracy rate of order entry.The system will also e nhance the function of transaction emergency situation. This will require reading both physicians and nurses to manipulate the new system. A tutorial function also includes in the application to profess employee adapt the system quickly. Processes with CPOE pop out comes more efficient and controlled by physicians. Physicians deem more jobs to do within the whole procedure. Before the CPOE, new medication reconciliation will be placed after the communication betwixt the doctor and the nurse. Now physicians should be able to place the order by themselves and send them to the providers directly. treasures job is only to take care of inpatients.Roles and Responsibilities the CPOE project provides greater power to physicians and fewer burdens on nurses. The number of clerks will decrease sharply because now physicians can send orders to the providers directly. The middle bottom is useless with this condition. IT department should provide more solutions to help employees be beate n(prenominal) with the new system. More training sessions should be taken place for employees who are unwilling to accept the system update. The new platform needs more computers and an appropriate database to support the system operation. Thus, the financial department should set up new budget for the new equipment required. ironware/Software in addition to the computers and licenses for the project, NEU consultant team will be required to purchase supernumerary servers and database to defy the platform and its anticipated growth for the next 5 years. 3 engine room Migration In order to effectively engender employees be familiar with the computerized provider order entry system, a phased method has been designed which will upshot in borderline disruption to day to day operations, administration, and payroll activities. The following is the high-level overview of the system. Phase I Hardware/Software (including database, servers and new computers) will be purchased for new sy stem.IT department mental faculty will response for the mannequin of back end equipment. Phase II All employees will bring forth training on the new system. Depending on different roles, they will get diverse learning sessions. For example, physicians will learn how to place prescriptions and medication reconciliation. Nurse will study how to allocate patients room and update patients status. Phase lead administration might be altering depending on employees reflections to make the system be manipulated easily. NEU consulting group will provide strong support in this period. Phase IV The new system will go carry on and the older pattern of hand-written entry will be stood down. Project OverviewThe CPOE Project overview provides detail for how this project will address Emory Healthcare business problem. The overview consists of a project description, goals and objectives for the CPOE Project, project performance criteria, project assumptions, constraints, and major milestones. As the project is approved and moves forward, each of these components will be expanded to include a greater level of detail in working toward the project plan. 1 Project Description The purpose of this project is to appliance Computerized Provider Order Entry (CPOE) across Emory Healthcare. Computerized Provider Order Entry is a computer application that is used by physicians to lay diagnostic and therapeutic patient care orders.In most cases these orders are communicated electronically to the departments and personnel responsible for carrying them out, both by directly connecting to specific departmental computer systems that execute the order (such as laboratory or pharmacy systems), or by staff printing out the orders in the appropriate locations for execution. For CPOE applications electronically connected to departmental systems, confirmation of the order and the following dissolver (in the case of tests) are genic back to the ordering physician. There are three major del iverables associated with this project. A consolidated and standardized Order Sets to facilitate CPOE that are evidence based 100% CPOE Compliance across the organization.Physicians will enter in real-time, all orders directly into CPOE system thereby eliminating transcription and the use of third-person (i. e. Nurses etc. ) to enter orders into patients electronic health records Lab, Imaging, Consult, Nutrition, Medications, Patient Care. Decision nutriment Alerts alerts to guide best practice, duplicate, drug interactions etc. Provide rules and alerts to guide healthcare decisions Alerts for drug interactions, battery-acid and adverse event Online help for alerts 2 Goals and Objectives The goal of this project is to implement the Computerized Provider Order Entry (CPOE SYSTEM) at Emory Healthcare in order to facilitate the dear use of Computerized Provider Order Entry (CPOE) throughout the hospital.It is expected that Emory Healthcare will realize benefits in improved clini cal diagnostic capabilities and clinical workflow processes as a result of the death penalty of CPOE. Implementation of CPOE addresses a number of key requirements for achieving meaningful use of their electronic Health Record per the American Recovery and Reinvestment Act. Also, performance of CPOE will bring down the foundation for enabling additional clinical functionality through the carrying into action of additional modules such as, Clinical Alerts and other models. A number of other clinical initiatives must be bring to passd in order to achieve full COE functionality including Care Plans, Order Sets and Process Mapping.It is important to realize that the implementation of CPOE is an current performance improvement initiative that will require ongoing enhancements and refinements in order to accommodate the changing of information system healthcare environment. This includes workflow refinements, additional order sets, and training process The CPOE Project directly supp orts several(prenominal) of the corporate goals and objectives established by NEU Consulting group. The following are the business goals and objectives that the CPOE Project supports and how it supports them Goals Improved clinical decision making as a result of timely access to historical patient information at the point of care (existing medications, lab results, allergies) Reduce number of adverse events as a result of clinical ordering errors Reduced patient length of stay Improved clinical decision making as a result of timely access to clinical order information at the point of care (historical orders, interactions and conflicts) Reduction in costs and manual(a) effort associated with manual ordering process Improvements in workflow processes for ordering tests and transmitting The mightiness to access patient order information throughout the hospital and from foreign locations Obtain information that can provide reports about productivity and performance metrics Hi gh physician and patient satisfaction Reduce / excretion of paper orders Reduce chance of clinical errors through the use of order validation and checking Objectives To provide emergency alert in order to reminder patients real-time status. To reduce order processing time by 25%. To increase order entry accuracy to 98%. To reduce medication turnaround time by 60% To provide alert function for physicians when writing orders or prescription. To standardize physician orders and patient records. To cut the clerks department in order to save transaction time. To transform hand written patient records into digital records by 95%. 3 Project Assumptions The following assumptions apply to the WP Project. As project prep begins and more assumptions are identified, they will be added accordingly. The core implementation team will consist of key resources from Emory Healthcare. This team will cooperate in order to coordinate the project activities between their organizations. The i mplementation team will have access to the areas within the hospital where they need to work The implementation team will have cooperation from the Emory Healthcare staff as necessary but with the intention that disruption will be minimal Resource requirements and costs for ongoing system support will be agreed upon by Emory Healthcare and NEU Consulting group during the initial phase of the project Emory Healthcare resources will be available as needed stock review of project status will occur and be communicated through communication plan Client will attend the required training 4 Project Constraints The following constraints apply to the CPOE Project. As project planning begins and more constraints are identified, they will be added accordingly. Dependencies of CPOE Vendor delivery and order of module upgrades and installations Resource availability (IT, non IT, and vendor) Budgets The total cost of the project should be done under the budget approved by the board of dir ectors and make sure to control the cost not exceed the budget of each year. Schedule Fully operational in 3 years gauge CPOE system and process improvement service shall meet all woodland standards and clients requirements. 5 Selected Approach Various options and alternatives were analyzed to determine the best way to improve physician order processes and reduce the error and cost. The selected CPOE project will methodically migrate the physician orders and the patient records of current mainframe system to the new computer-based platform in order to preserve data integrity. The new computer-based platform will improve the efficiency and accuracy of managing orders and records. The project will achieve its desired results Physicians will directly enter orders electronically by standardized requirements. The system will check the orders and alert the users with inappropriate entries. Orders will be saved and can be accessed immediately. Orders and patient records are traceable and easy to obtain. The system will provide users with alerts and guides of best practice, duplicate, drug interactions when assigning prescription or orders. 6 Major Project Milestones The following are the major project milestones identified at this time. As the project planning moves forward and the schedule is developed, the milestones and their target completion dates will be modified, adjusted, and finalized as necessary to establish the baseline schedule. Milestones/Deliverables Target appointee Contract / Board Authorization 12/10/2012 Project guidance Plan approval 05/05/2013 System Implementation Kick off 05/27/2013 Functional review 06/05/2013 Hardware technical design 10/20/2013 Order and receive hardware and software 11/17/2013 System implementation complete (software) 03/10/2014 Database design and configuration complete 07/20/2014 System installation (hardware and software) 09/09/2014 Complete test plan 09/22/2014 audition and enable network connect ivity 01/20/2015 System testing complete 04/25/2015 Nurse, Pharmacy keep preparation and training 07/14/2015 Physician accompaniment preparation and training 07/18/2015 System concern plan complete 10/25/2015 System on live 01/01/2016 System keep start 01/01/2016 constitute and Saving Analysis The following two tables arrest the cost associated with the CPOE Project, descriptions of these actions, and the total associated with the cost item for CPOE project. CPOE Ongoing salute idea address Item Action Type Description Cost Hardware and Software Cost Application Software Maintenance $150,000 Third-Party Software maintenance Workstation Maintenance Network Cost LAN maintenance $35,000 Network monitor equipment Staff required to support CPOE Cost Pharmacy analyst $60,000 CPOE Project Manager Clinical Programmer/builder Additional Help Desk Support Network/equipment support staff Others Cost None IT Resources $100,000 Net Co st $345,000 CPOE One-Time Cost Estimate Cost Item Action Type Description Cost Hardware and Software Cost Application License Cost (CPOE, Scanning software etc. $1,000,000 Third party software license costs Workstations/Printers Network Cost Install Wireless LAN $450,000 invoke to LAN/Wireless Networking monitoring equipment Implementation Cost Vendor cost $155,000 adviser cost Travel cost Outsource staff cost Internal Project teams Cost IT Management $300,000 Project Manager analyst Technical staff Training Cost Vendor cost $30,000 Consultant cost NurseTraining Physician Training Other Training Net Cost $1,935,000 CPOE Ongoing/one time saving Emory Healthcare has saved approximately &038270,000 annually through elimination of transcription cost and increased radioscopy revenues by over $300,000 annually through better capture of documentation with CPOE. Alternatives Analysis The following altern ative options have been considered to address the business problem. These alternatives were not selected for a number of reasons which are also explained below. No Project (Status Quo) Reasons For not Selecting Alternative Keep the origin mainframe legacy system saucily computerized system can improve the efficiency of work CPOE definitely reduces errors The new system provides the real time function which solves emergency situation course off middle layer in order to save processing time Alternative Option Reasons For Not Selecting Alternative Outsource the implementation to two different companies in Hardly meets the requirements of Emory Healthcare. order to short knowledge cycle. Difficult to communicate between two companies. High cost to support two cycles. Alternative Option Reasons For Not Selecting Alternative Develop software internally want of qualified resources especially not enough developers Lack of expertise to guarantee the security of the system. Huge cost for the cycle of growing Schedule restricts developing time.