Cpoe for Emory Healthcare

Business representative NEU Consulting Group Prepargond by Kuan-ling Chiu Wenjie Xie executive Summary This agate line case let onlines how the CPOE upchuck allow address authorized business concerns, the benefits of the visualise, and recommendations and justification of the project. The business case also discusses pointed project goals, exertion measures, assumptions, and constraints. 1 Issue Since the perception of tolerant safety has arisen, legion(predicate) aesculapian examination organizations were striving to amend medication safety.Emory healthc be, the largest and most comprehensive wellness c be formation in Georgia, was one of them who were seeking ways to retard medication errors. In recent years, some highly influential studies revealed that medical errors occurred in inpatient and bring come outpatient settings at alarmingly high rates. Researchers point out approximately 1. 3 million injuries occurred annu each(prenominal)y to patients in U. S. hos pitals, at a high percentage of which were at least partially due to errors in patient management.In the Emory health care, doctors place tramps by written material them on an outranks sheet prone to the patient chart or they would call a nurse and hire him/her to indite the orders on the order sheet. raises are paper-based or just by verbalization. Furthermore, medication orders ordered by radiology technicians or phlebotomists would be carried out by a unit clerk who is responsible for to fax or s merchant ship and then sent orders instantly to the pharmacy. Such paper-driven report is non efficient and prone to errors without standardization, physicians carry no duty for orders, which is critical and straight points to medical errors.It was calculated that 37% of the patient cases had medication intercession prisonbreak in the Emory Healthcare beca map of its paper-driven prescription drug processwhich is prone to error. Around 9%of injuries werepartiallydue toinacc urate medical orderinput. Furthermore, 60% of the patients were not satisfied with theirtreatment. 2 Anticipated Outcomes In order to prevent medical errors and alter order accuracy, the suggestion of implement CPOE (Computerized bearr Order ledger entry) has surfaced.CPOE lead establish order standard and let physicians write orders electronically and directly, then prevent order inaccuracy. Furthermore, paper-driven work leave be eliminated and replaced by electronic process. Computerized processing volition improve capability of workflow, accuracy of input and cut back speak to. Ultimately, all physician orders bequeath be similar, electronic and traceable. Thus, medical errors caused by human negligence leave be push downd to minimum. 3 RecommendationVarious options and substitutes were analyze to determine the best way to improve physician order processes and reduce the error and speak to. The recommended CPOE project leaveing methodically migrate the physici an orders and the patient records of current mainframe frame to the innovative computer-based computer programme in order to preserve data integrity. The impudently computer-based platform will improve the efficiency and accuracy of managing orders and records. The project will earn its desired results Physicians will directly enter orders electronically by standardized controlments. The system will preventative the orders and alert the users with inappropriate entries. Orders will be saved and can be deviled immediately. Orders and patient records are traceable and halcyon to obtain. The system will lead users with alerts and guides of best practice, duplicate, drug interactions when assigning prescription or orders. Business Case Analysis Team The pursuit individuals comprise the business case digest team. They are responsible for the analysis and creation of the Emory Healthcare regurgitate business case. Role Description Name/Title Executive Sponsor rear execut ive dungeon for the project A, White Technical conduct Provides all technology reserve for the project E, Chen, Technical Lead work out overture Advises team on process advancement techniques Leland Choi, Process Team Lead Project Manager Manages the business case and project team B Brown, Project Manager packet Support Provides all software support for the project Jack Xie, Software Group Lead Problem comment 1 Problem Statement In the 1980s and 1990s, researchers point out approximately 1. 3 million injuries occurred per annum to patients in U. S. ospitals, 69% of which were at least partially due to errors in patient management. In 2000, the convey of Medicine published a report that concluded that more community died each year from preventable errors in hospitals than from car accidents, breast cancer, or AIDS. Medical errors caused by human oversight are the main turn inside Emory Healthcare. In 1986, it was calculated that 37% of the patient cases had medicati on treatment fault. The problems are due to the lack of standard for orders by physicians. Physicians would place orders by relegate 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 last five years, 60% of the patients were not satisfied with their treatment. Furthermore, works driven by paper are costive and snip-consuming. 2 Organizational Impact The CPOE project will impact the Emory Health Care in different aspects. The spare- beat activity put ups a high-level history of how the organization, tools, process, and roles. Tools COPE project mainly focuses on designing a saucyfound system to improve the accuracy rate of order approach.The system will also enhance the part of dealing sine qua non situation. This will require education both physicians and nurses to manipulate the sensitive system. A tutorial function also includes in the application to make employee adapt the system quickly. Processes with CPOE Project comes more efficient and controlled by physicians. Physicians have more jobs to do inside the whole procedure. Before the CPOE, new medication reconciliation will be placed after the communication among the doctor and the nurse. Now physicians should be able to place the order by themselves and send them to the providers directly. Nurses job is only to take care of inpatients.Roles and Responsibilities the CPOE project provides greater forefinger to physicians and fewer burdens on nurses. The chassis of clerks will decrease sharply because directly physicians can send orders to the providers directly. The middle seam is useless with this condition. IT section should provide more solutions to protagonist employees be famil iar with the new system. More educational activity 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 compute 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 accommodate the platform and its anticipated developing for the next 5 years. 3 Technology Migration In order to in effect make employees be familiar with the computerized provider order entry system, a phased method has been designed which will result in minimal flicker to day to day operations, administration, and payroll activities. The following is the high-level overview of the system. kind I Hardware/Software (including database, servers and new computers) will be purchased for new sy stem.IT department rung will response for the configuration of back end equipment. Phase II All employees will receive 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 berth. Phase III governance 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 live 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 represents 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 out front, each of these components will be expanded to include a greater level of detail in working toward the project plan. 1 Project Description The innovation of this project is to implement Computerized provider Order Entry (CPOE) across Emory Healthcare. Computerized Provider Order Entry is a computer application that is used by physicians to enter diagnostic and therapeutic patient care orders.In most cases these orders are communicated electronically to the departments and personnel responsible for carrying them out, either 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 result (in the case of tests) are transmitted back to the ordinance physician. at that place are three major deliverables 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 etcetera ) to enter orders into patients electronic health records Lab, Imaging, Consult, Nutrition, Medications, patient Care. Decision Support Alerts alerts to guide best practice, duplicate, drug interactions etc. Provide rules and alerts to guide healthcare finishs Alerts for drug interactions, dosage 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 full use of Computerized Provider Order Entry (CPOE) throughout the hospital.It is expected that Emory Healthcare will realize benefits in improved clinica l diagnostic capabilities and clinical workflow processes as a result of the implementation 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, implementation of CPOE will lay the foundation for enabling additional clinical functionality through the implementation of additional modules such as, Clinical Alerts and opposite models. A number of other clinical hatchways must be spotless 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 on-going 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 supports several 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 end making as a result of timely access to diachronic patient information at the point of care (existing medications, lab results, allergies) annul 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 effort associated with manual ordering process Improvements in workflow processes for ordering tests and transmitting The ability to access patient order information throughout the hospital and from remote locations Obtain information that can provide reports about productivity and performance metrics High physician and patient satisfaction Re duce / excreta of paper orders Reduce peril of clinical errors through the use of order validation and checking Objectives To provide emergency alert in order to monitor patients real-time status. To reduce order processing time by 25%. To development order entry accuracy to 98%. To reduce medication flip-flop 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 planning 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 collaborate in order to line up the project activities between their organizations. The implementation 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 infallible but with the mark 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 Regular 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 approachability (IT, non IT, and vendor) Budgets The total cost of the project should be done under the budget approved by the board of directors and make sure to control th e cost not exceed the budget of each year. Schedule Fully in operation(p) in 3 years Quality CPOE system and process improvement service shall meet all quality 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 syste m 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 Date Contract / Board ascendence 12/10/2012 Project Management Plan approval 05/05/2013 musical arrangement 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 screw test plan 09/22/2014 Test and enable network connectivity 01/20/2015 System test ing complete 04/25/2015 Nurse, Pharmacy documentation dressing and training 07/14/2015 Physician documentation preparation and training 07/18/2015 System maintenance plan complete 10/25/2015 System on live 01/01/2016 System maintenance start 01/01/2016 be and rescue Analysis The following two tables capture the cost associated with the CPOE Project, descriptions of these actions, and the total associated with the cost item for CPOE project. CPOE Ongoing personify Estimate toll Item run Type Description toll Hardware and Software Cost natural covering Software Maintenance $150,000 Third-Party Software maintenance Workstation Maintenance Network Cost LAN maintenance $35,000 Network Monitoring equipment Staff required to support CPOE Cost Pharmacy analyst $60,000 CPOE Project Manager Clinical software engineer/builder Additional Help Desk Support Network/equipment support staff Others Cost None IT Resources $100,000 Net Cost $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 Upgrade to LAN/Wireless Networking observe equipment Implementation Cost Vendor cost $155,000 Consultant cost get cost Outsource staff cost Internal Project teams Cost IT Management $300,000 Project Manager Analyst Technical staff cookery Cost Vendor cost $30,000 Consultant cost Nurse prep Physician Training Other Training Net Cost $1,935,000 CPOE Ongoing/one time saving Emory Healthcare has saved approximately &270,000 annually through elimination of transcription cost and increased radiology revenues by over $300,000 annually through better capture of documentation with CPOE. Alternatives Analysis The following alternative 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 author mainframe legacy system Newly computerized system can improve the efficiency of work CPOE definitely reduces errors The new system provides the real time function which solves emergency situation Cut off middle layer in order to save processing time Alternative extract Reasons For Not Selecting Alternative Outsource the implementation to two different companies in Hardly meets the requirements of Emory Healthcare. order to short development cycle. Difficult to communicate between two companies. High cost to support two cycles. Alternative excerpt Reasons For Not Selecting Alternative Develop software internally Lack of capable resources especially not enough developers Lack of expertise to guarantee the credential of the system. Hu ge cost for the cycle of developing Schedule restricts developing time.