Team Case Project

Group 3: Case 12 (textbook) Implementation proposal. “ASSESSING THE VALUE OF

HEALTH IT INVESTMENT”

Your group needs to develop a 20–25-minute oral presentation to a hypothetical “Board of

Directors” discussing your plan for meeting the goals of the case assigned to you. Additionally,
you need to provide a 1–2-page handout for “them” to support your presentation. The
presentation should include:

Introduction: Alexis

The replacement of Southeast Medical Center’s ambulatory EHR system has been approved.
Current issues include using two different systems for inpatient and outpatient information,
negative views of using the systems, and difficulty retrieving aggregate data from the system.
To bridge the gaps within the current EHR systems (SMC) will replace them with Epic
ambulatory care EHR. The goal is to also replace the patient registration and billing software
with EPIC’s practice management system.

To implement EPIC, we will need to raise $120 million dollars.

-Background on why you identified this goal / why this goal is beneficial to your organization

Strategic Plan- (Emilia)

The mission was to provide

● Defining the Mission, Vision, and Values

● Strategy Formulation
1. Analyzing the external environment
2. Analyzing the internal environment
3. The SWOT matrix
4. Strategic Alternatives
5. Strategic Areas and Objectives
● Strategy Execution Plan
● Establish appropriate budget and resource allocation
● Execution review

Challenges and how they might be overcome (Heba)

Some challenges may include:

● Training staff on new system implementations

● Patients adjusting to a EPIC’s software
 ● Technical issues
● Accomodating for the cost of storage space for Southeast Medical Center data

Firstly, it requires sufficient training of staff so that they can use it accordingly. It is
possible to recommend to engage staff in continuous development of their professional skills and
knowledge. As a result, all the procedures that are to be managed with the help of Epic system
including patient registration, medical records, and a range of others would be provided at a high
level and meet the patients’ expectations. Another recommendation is that the focus of training
should be aimed at specialization. This means that it is essential to tailor training in order to
achieve adequate utilization of the system at all levels. For example, physicians and cardiologists
are to be trained with different focuses that can be identified based on their job requirements.

Secondly, it can also be recommended to implement one more feature associated with
online access of a patient to his or her medical information. In particular, it seems appropriate to
design a private or group chat to let the patients ask about their health problems or discuss it with
others, if required.

Thirdly,

Fourthly,

How you will gain organizational buy-in (Nicole)

Anticipated outcomes after full implementation (Aliza)

The anticipated outcome after the full implementation of the Epic EHR project is to provide
clinicians with access to a single, complete EHR that spans the patient’s continuum of care and
improves collaboration and coordination of care. By giving community providers, such as
primary care providers, access to the Epic EHR, they are able to retrieve important patient
information. Giving patients access to Epic EHR allows them to view their health information,
including lab reports, imaging reports, and medications. The patient portal through EPIC also
allows patients to schedule appointments and or pay their medical bills online. Implementing
EPIC allows Southeast Medical Center to have a secure data warehouse of patient data that
researchers and clinicians will be using more fully in the future to ensure that clinical research
drives best care.

As the “CEO” (or whomever would be making the presentation as presented in your case), you
must detail the various experts you need to include on this project (internal and external) and
their specific roles. Clearly and thoroughly provide a rationale, process, and expected outcomes.
A mock budget is not required but encouraged. The presentation should include both visuals and
speaking, and everyone in the group must present a substantial part of the project.

Both the quality and contents of the presentation will factor into the grade. You must include a
list of references as a final slide or as a 3rd page of your handout. Refer to the rubric in Canvas.
Presentations will all be in-class on April 18.

CASE 15: ASSESSING THE VALUE OF HEALTH IT INVESTMENT

Five years ago, senior leadership at the Southeast Medical Center made the decision to embark
on the implementation of a host of new clinical applications in the inpatient units enterprise-
wide. The four hospitals that comprise Southeast Medical Center include the Main Adult
Hospital, the Children’s Hospital, McKinsey Hospital, and the Institute of Psychiatry. They
contracted with McKesson to implement the following applications:

ED tracking system

Replacement pharmacy information system

Clinical documentation system (for all nurses and ancillary personnel; does not include
physician notes)

Medication administration using bar-coding technology

Computerized provider order entry (CPOE)

In addition, several administrative applications were implemented, including a new operative

scheduling system and materials management system. They also upgraded their clinical data
repository viewer (referred to as Oacis). All applications are now operational.

Most recently, the board of trustees has approved replacement of South east’s ambulatory care
EHR. A system known as EasyDoc (a McKesson product) has been in use for years. However,
the system was viewed by clinicians and IT staff members as antiquated and cumbersome to
navigate. It is also very difficult to retrieve aggregate data from the system. Much of this is
apparently because of its underlying database architecture and structure. EasyDoc also did not
interface with the hospital clinical applications, and leaders were concerned that the system was
not going to enable Southeast to achieve meaningful use criteria.

Clinicians have also been frustrated that Southeast has been using two different EHR systems,
one for inpatient and another for outpatient, and the two don’t interface or give a complete
picture of the patient’s health record. With payment reform and the need to be able to more
effectively manage patient care quality and outcomes, senior leaders recommended, and the
board approved, replacement of the EasyDoc EHR with Epic ambulatory care

EHR. The patient registration and billing system used in ambulatory care will also be replaced
with Epic’s practice management application. Long-term plans are to eventually replace the
McKesson clinical applications with Epic in the inpatient sector as well.

The total cost of ownership for the replacement ambulatory EHR and practice management
system is approximately $30 million. Included in this estimate are not only the software and
hardware upgrades but also the staff members needed to implement and support the new
applications. Replacing the McKesson clinical products with Epic inpatient EHR will cost an
additional $90 million. Again, this is an estimated total cost of ownership.

The primary purpose of the Epic EHR project is to provide clinicians with access to a single,
complete EHR that spans the patient’s continuum of care and improves collaboration and
coordination of care. Community providers and patients will have access to the system.
Community partners (such as primary care providers) will be able to retrieve important patient
information. Currently a local HIE exists that provides ED visit information to all local hospitals.
This is to be expanded to include continuity of care documents (CCDs) and other relevant health
information. Patients will be given access to their health information such as lab tests, X-ray
results, and medications. They will also be able to schedule appointments and pay their bills
online through a patient portal known as MyChart. Southeast physician leaders view patients as
partners in their own care and are pleased to provide them access to information electronically.

Southeast providers treat a large population of patients with multiple chronic conditions.
Managing chronic diseases using evidence-based, real- time support is considered essential. In
addition, Southeast Medical Center has a secure data warehouse of patient data that researchers
and clinicians will be using more fully in the future to ensure that clinical research drives best
care.

References