Pat Macy
Engagement Leader
July 13, 2015
Unity
What is your role as an attendee?
• Communicate gaps
• You will create a new future
• Reference your current state rather than replicate current state
Begin to understand the transformation of patient care delivery
• Did you see something to be excited about for the future?
• Do you have questions for your colleagues?
Communicate with your colleagues to validate what you saw and
share the future vision
• Understand what deliverables are due in the next 30, 60 and 90 days
• Communicate any challenges to completing the deliverables
• Understand who you can reach out to should you have any questions or issues
regarding deliverables
Understanding Next Steps and Deliverables
• Complete post-event survey
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
3
Project Startup Objectives
•
Provide overview of
Consulting Framework,
Value Planning and initial
project deliverables
•
Begin Data collection and
Regular Solution Group
Agenda – This Morning
•
Introductions and Overview
•
Your Value Objectives
•
Partnered For Success
•
Project Framework
•
Roles And Responsibilities
•
Value Planning
•
Adoption Approach
•
Communication Strategy
•
Project Reporting
•
Learning and Training
•
Administrative Notes
•
Next Steps
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
5
Welcome to the Cerner Millennium Migration
Project- Value Objectives and Project Scope
8:30
9:00
Cerner Consulting Framework, Model System,
Data Localization Process review, Project Portal
and Project Reporting
9:00
10:00
Break
10:00
10:15
Project Governance, Communication Plan, Risk
Management and Gateways
10:15
10:45
Learning Strategies
10:45
11:15
Virtual Walktrhough/Welcome
11:15
12:00
Day 1 Lunch
12:00
13:00
Agenda for the rest of the week
•
Breakout Groups – Data Collection of Current
State
•
Site Walkthroughs / Tours
•
Locations: All facilities including: Battle House,
SHAC
•
Please refer to Excel Spreadsheet
Value Objectives
•
One patient one record
•
Empowering our providers and staff to be their best
•
Optimize revenue cycle
•
Aid development of value
•
Supporting best practices
10
Project Framework
Assess current state
Define the value objectives
Identify stakeholders and governance
Align to the Vision
Engage Stakeholders
Show the future state
Apply Transition change strategies
Localize system configuration and
workflow
Measure Value
Measure and communicate
value achieved
Identify opportunities for
improvement
Learn and adapt
Activate and Support
Activate new processes
and technology
Support the team
Monitor performance
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
13
Consulting Framework
S
tr
a
te
g
ic
I
m
p
e
ra
ti
v
e
s
ALIGN
ENGAGE
ACTIVATE
MEASURE
V
a
lu
e
A
c
h
ie
v
e
d
People
Process
Technology
Program Management
Consulting Framework
Project Gateways
Project status checkpoints at critical milestones to ensure value achievement
Evaluation of critical items and key risk factors across people, process and
technology
Reviewed by Client and Cerner leadership teams
Assess risks to determine if they can be mitigated in time to prevent impact to
the project and keep the project on its current timeline
For incomplete items, a risk mitigation plan will be documented with an owner
and due date
Future
State
Validation
End User
Training
Leadership
Alignment
Project
Team
Readiness
Future
State
Review
Maintenance
Training
Integration
Testing
1 & 2
Go Live
Health
Check
ALIGN
ENGAGE
ACTIVATE
MEASURE
Project
Startup
Value
Achievement
Review
Value
Measurement
Workshop
Current
State
Review
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
15
Key Events
ALIGN
ALIGN
Gateway
#1
Project Startup
Project Startup
Duration: 6-8 weeks
Participants: Project Leadership
Objectives:
Identify key resources for project
Prepare for Current State Review
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
Key Events
Current State Review
Duration: ~1 week
Participants: Various members of the leadership team, clinicians, IT
Objective: Review current state and organizational readiness for change,
identifying opportunities and risks around people, process, and technology
PEOPLE: Evaluate impacted audiences’ readiness to change behaviors
PROCESS: Capture current state for key workflows
TECHNOLOGY: Assess technical infrastructure, Capture data needed to begin localizing
system configuration
Deliverables:
Executive Summary
PEOPLE: Draft Transition Change Plan
PROCESS: Mapping of Current State Workflows
TECHNOLOGY: Technical Assessment
ALIGN
ALIGN
Gateway
#1
Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
17
Key Events
Leadership Alignment
Duration: 1 Day
~11 day
Participants: Executive and project leadership team
Objectives:
Review the Current State Review results
Define the Value Objectives:
•
Understand the project goals
•
Review the defined organizational imperatives
•
Identify primary contacts
Discuss The Cerner Approach to Organizational Adaptability: :
•
Review draft Transition Change Plan
•
Define support activities for the change leader
•
Review project approach and key activities taking place
•
Identify next steps to action the Transition Change Plan
Plan for next steps and upcoming events
ALIGN
ALIGN
Gateway
#1
Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
Key Events
Value Measurement Workshop
Duration: 1 day
Participants: members of the leadership team, clinicians
Objectives:
Outline the measurement plan
Identify the process metrics that meet our value goals
Document the measure owners and required next steps
Deliverable:
Value Measurement Plan Draft
ALIGN
ALIGN
Gateway
#1
Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
19
Key Events
Project Team Readiness
Duration: ~.5 day
Participants: Project team
Objectives:
Align project team to the vision
Review identified value objectives
Review project details
Project plan/approach
Governance structure
Staffing model
Communication strategy
Project tools
ALIGN
ALIGN
Gateway
#1
Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
Key Events
Gateway #1
Your organization and the project team demonstrates they are aligned in their
goals, resources and plan.
Confirm change leader/s are assigned and engaged and the organizational adaptability
plan is approved and published to stakeholders.
Value objectives are defined.
Confirm the governance structure and resources are in place
ALIGN
ALIGN
Gateway
#1
Project Startup
Value
Measurement
Workshop
Project
Team
Readiness
Leadership
Alignment
Current
State
Review
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
21
ENGAGE
Key Events
Future State Review
Duration: ~1 week
Participants: Project team
Objectives:
Define future state workflows that support best practices
Describe points of workflow integration with other departments and roles
Apply client specific data to best practice workflows
ENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3
…
…
ENGAGE
Key Events
Future State Validation
Duration: ongoing
Participants: Project team
Objective:
Demonstrate localized system
Highlight system build that supports the value objectives
ENGAGE
ENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3
…
…
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
23
ENGAGE
Key Events
Gateway #2
Your organization confirms agreement on the future state workflows.
Confirm Future State Workflows
Future state workflows support the achievement of the value objectives
Training Delivery Plan Finalized
ENGAGE
ENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3
…
…
ENGAGE
Key Events
Maintenance Training
Duration: ~1 week
Participants: IT Maintenance Staff
Objective: Train IT staff to support ongoing maintenance of the system
ENGAGE
ENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3
…
…
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
25
Key Events
Integration Testing 1 (& 2)
Duration: 2 weeks (week 1: clinicals, week 2: revenue cycle) for each
round of integrated testing
Participants: Project team
Objective: Test end-to-end workflows to ensure proper integration
across the continuum
ENGAGE
ENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3
…
…
ENGAGE
Key Events
Gateway #3
Your organization confirms your people are ready to learn new workflows and
their supporting technology.
Validate solutions are configured and aligned to best practices
Model system is properly localized
Training materials and TRAIN domain reflect future state workflow
ENGAGE
ENGAGE
Future
State
Review
Future
State
Validation
Maintenance
Training
Integration
Testing 1
Integration
Testing 2
Gateway
#2
Gateway
#3
…
…
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
27
ENGAGE
Key Events
ENGAGE
End User
Training
Gateway
#4
Gateway
#3
Training
Duration: (dependent upon Training Plan)
Participants: Trainers, end users
ENGAGE
Key Events
ENGAGE
End User
Training
Gateway
#4
Gateway
#3
Gateway #4
Your organization demonstrates readiness for new workflows and technology.
Verify user training and Go Live support plan are complete.
Confirm value measure baselines are documented
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
29
ACTIVATE
Go Live
Key Events
Go Live
Duration: 2 weeks +
Participants: Full Project Team
Key Events
Health Check (Previously Post Conversion Assessment)
Duration: 2 weeks
Participants: Project Team
Objectives:
Week One: Onsite visit to complete data driven solution assessments
Week Two: Clinically focused executive summary/debrief
Solution resources most likely do not need to attend this week, just Cerner project leadership
Event should be data driven – review analytics data prior to event
Recommendations should be prioritized and used by leadership to
roadmap upcoming projects (continuous process improvement)
Deliverable:
Summary of recommendations by objective
End User Survey
Health
Check
Value
Achievement
Review
MEASURE
Gateway
#5
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
31
Key Events
Health
Check
Value
Achievement
Review
MEASURE
Gateway
#5
Gateway #5
Your organization achieved the value targeted by the project.
Super-user and end-user’s competency, confidence and satisfaction targets achieved.
Value measures trending toward goals.
Performance and operational metrics trending positively and no unresolved significant
solution issues.
Key Events
Value Achievement Review
Duration: 1-3 hours
Client Participants: Client leadership,
Cerner Participants: CRE, CE (optional), Clinical Strategist, EL
Objectives:
Review the post implementation Value Objectives data
Identify the top successes and any remaining areas to improve
Document the project story highlighting the value achieved
Deliverable:
Executive Summary of measured results
Project story with value statements
Health
Check
Value
Achievement
Review
MEASURE
Gateway
#5
Roles and
Consulting Framework
Event
Duration of Event
Location
Project Startup
6-8 weeks
Client Site
Current State Review
1 week
Client Site
Leadership Alignment
1 day
Client Site
Value Measurement Workshop
1 day
Client Site
Project Team Readiness
.5 day
Client Site
Future State Review
1 week
TBD
Future State Validation
ongoing
TBD
Maintenance Training
1 week
Kansas City
Integration Testing 1
1 week for Clinical
1 week for Rev Cycle
Client Site
Integration Testing 2
1 week for Clinical
1 week for Rev Cycle
Client Site
End User Training
~ 6 weeks (depending on training plan)
Client Site
Go Live
1 week
Client Site
Health Check
2 weeks
Client Site
© 2011 Cerner Corporation. All rights reserved. This document contains Cerner confidential and/or proprietary information which may not be reproduced or transmitted without the express written consent of Cerner.
35
35
35
35
Cerner
Cerner
Cerner
Cerner
• Guide Workflow Discussions
• Lead with workflow
• Clinical consulting experience
• Define Expectations and due
dates
• Begin with Standard and
Provide Solution Specific
Audits
• Troubleshoot Test Issues
• Support Integration Test Cycles
• Provide and maintain Project
Portal Site
• Provide Conversion Support
Project Team Responsibilities
USA
• Provide experience based on
current workflows and how that
relates to Standard
• Lead practice changes
• Supply Facility-Specific Data
• Localize Documentation, Policies
& Procedures
• Create Test Scripts/Testing
• Final Validation of System
• Facilitate Organizational Change
• Customize Training Manuals
• Facilitate End-User Training
Cerner Roles (and Acronyms)
•
Client Results Executive (CRE)
•
Manages full client relationship and ongoing Cerner support
•
Engagement Leader (EL)
•
Equivalent to Program Manager
•
Responsible for project delivery and management to scope, budget, and timeline
•
Technical Engagement Leader (TEL)
•
Responsible for technical project delivery and management to scope, and timeline
•
Clinical Strategist (CS)
•
Responsible for consulting of clinical adoption, change management, and workflow localization
•
Clinical expert
•
Integration Architect (IA)
•
Responsible for planning around solution integration points, domain strategy, change control processes,
testing strategies
•
Solution Architect (SA) / Technical Architect (TA)
•
Expert in design and build of a given solution
•
Delivery Consultant (DC) / Technical Consultant (TC)
•
Responsible for completion of all build for a given solution
•
Revenue Cycle Architect (RCA)
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
37
Client Roles - Subject Matter Experts
•
Collects information to be used in database configuration
•
Provides solution and process knowledge in support of workflow
localization, process changes and learning plan development
•
Actively participates in Kansas City events where decisions are made and
planned for implementation.
•
Works with team to develop and execute test plans, report issues, certify
readiness for conversion
•
Provides conversion support
•
Participates in training and conversion plan development and execution
•
Helps develop and execute system downtime and recovery/fail-over
procedures
•
Participate in the localization of Cerner Standard to better fit current
processes
•
Supports end-user training
•
Assists in defining a standardized work process
•
Be visible as a strong proponent of the new EMR
Client Roles – Analyst
•
Acts as primary departmental/functional resource
•
Actively participates in Kansas City visits where decisions are made
and planned for implementation.
•
Acts as liaison for Client and Cerner activities while in Kansas City,
responsible for the completion of homework deliverables outside of the
Kansas City events and engagement of those not traveling to Kansas
City
•
Works with the departmental/functional teams to develop and execute
test plans and scripts
•
Participates as an Integration Testing and Go Live team member.
•
Provides application assistance to the departmental/functional team
•
Attends Maintenance Training, investigates and helps resolve
application problems with Cerner team
•
Supports end-user training
•
Provides ongoing post conversion solution support for the IS
department
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
39
Client Roles – IT Lead
•
On-site hardware maintenance and management.
•
Maintain networks and communications.
•
Provides support for the facility’s information
technology, devices and computer systems to include:
•
Works with other departments to ensure IT needs are
met.
•
Attend and participate in project team meetings, as
needed.
Client Roles – Technical Analyst
•
Actively participate in project events where decisions
are made and planned for implementation
•
Works with departmental / functional teams to develop
the technology strategy and rollout.
•
Provides consultation on technical risk factors that must
be addressed to achieve a successful implementation
•
Acts as the primary contact for technical issues
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
41
Client Roles – Facilities and Engineering
•
Engineering and IT resources:
•
Configures, installs, and mounts Cerner Connectivity Engines
and Device Adapters
•
Device Maintenance
•
Low Level CCE and DA troubleshooting and replacement
•
Maintains and improves the efficiency of existing equipment
and systems while overseeing the installation of new
equipment and systems
•
Custodial services - Supports patient service and
operations by transporting patients and items; managing
staff
•
Bed Board management - responsible for the allocation
and provision of beds within the hospital
Clinical Adoption is the adoption
of new programs and/or
processes that patients,
physicians and clinicians may use
to support health and care.
Adapted From Clinical Transformation and Electronic Health Record
BRNDEXP 2.0 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner.
Framework
|
Clinical Adoption
Quality
Safety
Cost
Leadership
Alignment
Governance
Organization
Change
Management
Agile
Methodology
Data Driven
Training &
Workforce
Development
Process
People
Adoption
|
Critical Success Factors
Patient Centric
– Decisions made with a central focus on the patient
C
ri
ti
c
a
l
S
u
c
c
e
ss
F
a
c
to
rs
Clinician Led
– Engagement and leadership for initiatives provided by
physicians / clinicians
Organizational Leadership
– Deep involvement and accountability by
organizations’ leaders
Change Management
– Execution of training and adoption strategies to
advance learning organization
Governance & Program Management
– Oversight, decision making
process, and management to execute on projects
Communication
– Candid and frequent dialogue across organizations and
from CEO to project teams
Align
|
Adoption
•
People
•
Define Governance Model
•
Identify Clinical & Departmental Champions
•
Define Organizational Change Management Strategy
•
Develop Communication Plan
•
Process
•
Develop Guiding Principles for the EMR
•
Define Value Objectives
•
Technology & Tools
•
Support Device Assessment Activities
Align
Align
Align
Align
Launch
Launch
Launch
Launch
Align
Align
Align
Align
Engage
Engage
Engage
Engage Launch
Launch
Launch
Launch
++++
Align
|
People
•
Define Governance Model
•
Identify Change Leaders
•
Provides leadership, energy, enthusiasm, and
coordination for the EHR initiative
•
Vital role in the success of the transformation of the
organization
•
Identify Change Champions
•
Vital role in the success of the transformation of the
organization
•
Identifying Change Agents or other resources needed to
support the project
•
Resolving change management issues
•
Gauge readiness and progress of stakeholders within
their region, facility or entity
•
Hold employees within their area accountable
Align
Align
Align
Align
Align
Align
Align
Align
ALIGN
ALIGN
ALIGN
ALIGN
Align
|
People
•
Identify Subject Matter Experts (SMEs)
•
Clinical domain experts
•
Assist in Future State validation and Change Control
•
Representation required for every department &
specialty across all facilities/venues
•
Accountable for design decisions, clinical process
decisions and end-user adoption
•
Responsible for communications between councils
and end-users
•
Change Leaders, Change Champions and
SMEs must be identified by the end of the Align
Phase
Align
Align
Align
Align
Align
Align
Align
Align
ALIGN
ALIGN
ALIGN
ALIGN
Align
|
Process
•
Define strategy and guiding principles for managing
EHR change requests through Governance
•
Must be clinically led and IT supported
•
Must support agile process
•
Process must be defined to manage custom,
research & innovation requests
•
Define communication process for requests across each
Venue or Facility
Align
Align
Align
Align
Align
Align
Align
Align
ALIGN
Release #X
Discover
Demo
Validate
Train
Align
|
Technology & Tools
•
Device Assessment
•
Define desired future state
•
Assess Usability and Satisfaction
•
Assess workflow for opportunities to reduce number of
systems / devices end-users must access
•
Identify optimal devices to support workflow
•
Assess current state at current live sites
•
Align device strategy with future state workflows
•
Data Migration Preparation
•
Determine Data & Timeline for to be Converted
•
Engage SMEs and Super Users
•
Communicate requirements and recommendations
Align
Align
Align
Align
Align
Align
Align
Align
ALIGN
ALIGN
ALIGN
ALIGN
•
Better outcomes
•
Improve user and workflow efficiency
•
Optimize patient experience
•
Ensure regulatory compliance
•
Improve interdisciplinary communication
•
Reduce variability
•
Predictable outcomes
•
Connect the Piecesdesigning
without
seeing
STANDARD:
Optimized settings, content and recommended workflows that represent Cerner’s best practices across
their base of clients.
Developed by Cerner clinicians and experts, it is continually updated based on implementation
experience, client input, evidence-based content, and industry regulations.
STANDARD Settings & Configurations
BRNDEXP 2.0 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner.
53
•
Foundation for EHR Design
•
Content
•
Documentation (Templates, iView, PowerForms)
•
MPages
•
Fields (code sets)
•
Reports & Discern Rules
•
Playbooks
•
Recommended content and workflows for a specific rule,
department, venue
•
STANDARD Workflows
•
Workflow Designer
•
Design Quality Assessments
•
Alignment STANDARD audit tools
STANDARD Workflow Recommendations
•
Workflow STANDARDS represent
•
Workflows that impact patient safety, quality, cost and efficiency
•
Complicated workflows that involve multiple interactions to complete
an activity
•
Department specific workflows impacted by the HER
•
Localized to reflect client future state
•
Workflow Approval Process
EHR Guiding Principles: Example
•
Design decisions will be patient centric, evidence based and will support
revenue cycle operations, clinicians, and ensure patient safety.
•
The acute and ambulatory EHR design and build assumes universal
adoption of all care givers and a “Paperless” environment.
•
“Customization" of Cerner Standard Model will be limited to factors that
impact patient quality and safety.
•
Any major deviation that will impact time, scope and resources will be
approved through the Steering Committee.
•
Whenever possible, workflow processes will be standardized to drive to
consistent outcomes.
•
Whenever possible Niche software applications will be replaced by Cerner,
to preserve and enhance the integrity of the longitudinal patient record and
revenue cycle integration.
•
Make decisions and move on. Failure to attend a meeting is no reason to
postpone a decision.
BRNDEXP 2.0 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner.
EHR Guiding Principles: Example
•
"Perfect " is the enemy of "Good“
•
Design will be based on what is best for the patient, not what is best for
individual facilities, clinics or departments.
•
The EHR will be universally adopted and will be used as designed.
•
Design will focus on improving operational efficiency and promote patient
safety and clinical excellence.
•
Design must balance the workflow with system performance
considerations.
•
Processes will be streamlined to optimize workflow and eliminate
unnecessary steps.
•
Every end user will receive training that will allow for measureable,
objective outcome measures in order to ensure appropriate change
management, adoption and accountability
Engage
|
Adoption
•
People
•
Launch Communication & Change Management
Strategies
•
Educate & Activate Change Leaders
•
Develop and Approve Learning Plan
•
Define Organizational Adaptability Strategy
•
Process
•
Collect baseline measurements for Value Objectives &
KPIs
•
Validate workflow impact and role changes
•
Define and communicate organization and venue change
control processes
•
Monitor adoption and engagement reports
•
Technology & Tools
•
Communicate Technology and Device Strategy
Launch
Launch
Launch
Launch
Launch
Launch
Launch
Launch
++++
++++
Engage
|
People
Launch Communication Strategies
•
Solutions Gallery
•
Provider, Facility and Departmental roadshows
•
Focused workflow validation and education
sessions
•
Champions and SMEs learn to lead conversations
and demonstrations re: Future state
Identify and Resource Super Users
•
Ensure a smooth transition to the new care model
•
Become the local expert on EMR capabilities that
support clinical care processes
•
Provide coaching and support to end users as they
transition
•
Must have time allocated to support role
Align
Align
Align
Align
Align
Align
Align
Align
ENGAGE
Engage
|
People
•
Educate & Activate Change Leaders
•
Create Champion Communication Toolkit
•
Complete Influential Physician Assessment tool for all
service areas
•
Activate a Physician focused communication strategy
•
CEO Updates
•
Med Exec Meetings
•
Departmental Meetings
•
Division Meetings
•
House staff meetings
•
Affiliated providers
Align
Align
Align
Align
Align
Align
Align
Align
ENGAGE
ENGAGE
ENGAGE
ENGAGE
ALIGN
ALIGN
ALIGN
Engage
|
Process
•
Collect baseline measurements for Value
Objectives (Imperatives), KPIs and defined
metrics
•
Validate and communicate workflow impact
•
Workflow Validation Events
•
Roadshows/Demos
•
Monitor adoption and engagement reports
Align
Align
Align
Align
Align
Align
Align
Align
ENGAGE
Documenting The Impact
|
Tools
Workflow Diagrams
Workflow Diagrams
Start/Stop/Continue-Workflow Summary
Start/Stop/Continue-Workflow Summary
Data Collection Worksheets
Data Collection Worksheets
Policy & Procedure/Job Impact
Policy & Procedure/Job Impact
Downtime Procedure Impact
Downtime Procedure Impact
Test Scripts
Test Scripts
Training Tips/FAQs/Training Guides
Training Tips/FAQs/Training Guides
Engage
|
Technology
•
Technology and Device Fairs
•
Communicate device strategy
•
Provide hands-on sessions for clinicians
if indicated
•
Hands-on sessions for care team
•
Incorporate multiple roles
Align
Align
Align
Align
ENGAGE
Activate, Measure and
Activate, Measure & Sustain
|
Adoption
•
People
•
Learning principles, strategy and delivery defined
•
Activate Organizational Adaptability Strategy
•
Monitor End User Competency/Satisfaction/ Adoption
•
Process
•
Monitor Value Objectives and Key Performance
Indicators
•
Effective issue and change management
•
Monitor Clinical, Operational & Financial metrics
•
Continuously innovate and improve
•
Technology & Tools
•
Monitor adoption of tools and technology
Align
Align
Align
Align
Engage
Engage
Engage
Engage Launch
Launch
Launch
Launch
Launch
Launch
Launch
Launch
++++
Activate, Measure & Sustain
|
People
•
Learning Key Success Factors
•
Learning must be mandatory for all providers who
do not demonstrate competent use of the system
•
Pre activation competency assessment
•
Ongoing competency evaluations
•
Competency in tools, process and standards
•
Completion of learning must be tracked and
monitored
•
Patient education must be a key component of the
education strategy
•
Ongoing education related to the EMR Initiative
must become part of the ongoing organizational
education program
Align
Align
Align
Align
Align
Align
Align
Align
Activate, Measure & Sustain
|
Process
•
Activation Key Success Factors
•
Monitor Goal Progress/Achievement
•
Continuous monitoring of workflow adoption and staff
competencies
•
Effective issue and change management
•
Ongoing communication & reinforcement of workflow
standards
•
Data-driven with positive trends
•
Monitor operational metrics
Activate, Measure & Sustain
|
Technology
•
Pre-conversion personalization activities
•
Ongoing roadshows
•
Ongoing “refresh”, communication and education
•
Engage Learning Teams to incorporate new
technology into workflows and assess
competence
•
Manage & Communicate re: System
Performance
Align
Align
Align
Align
Launch
Launch
Launch
Launch
Align
Align
Align
Align
Artrice Love
Physician Strategist
Assess current state
Define the value objectives
Identify stakeholders and governance
Align to the Vision
Engage Stakeholders
Show the future state
Apply behavior change strategies
Localize system configuration and
workflow
Measure Value
Measure and communicate
value achieved
Identify opportunities for
improvement
Learn and adapt
Activate and Support
Activate new processes
and technology
Support the team
Monitor performance
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
71
Value Planning Objectives
•
Introduce and define Value Planning within the project
•
Clarify and communicate organizational priorities and the
story you’re hoping to tell after the project
•
Align your organization to meaningful data that allows for
continued improvement
•
Set Value Measurement expectations within your
organization and assign appropriate ownership to your
objectives
Value
A successful project includes not only a
not only a
not only a timely
not only a
timely
timely
timely conversion,
conversion,
conversion, but
conversion,
also measurable improvements to patient safety, quality patient
patient safety, quality patient
patient safety, quality patient
patient safety, quality patient
care, and reduced
care, and reduced
care, and reduced
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
73
How do we know the project was a success?
We Measure.
“Measures light the way, showing where systems are
breaking down and where they are succeeding to help
patients get and stay well.”
Good Measurement
Selecting the right tools for the job is
essential
Good Measurement
drives
Improvement,
informs
consumers, and
influences
payment.
Just as a ruler can’t determine air temperature, different measures are
required for different jobs.
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
75
Begin with the End in Mind
Different Measures result in different information, understand
which items will benefit your organization and elevate
accountability and world class patient care.
Measurement types:
Measurement types:
Measurement types:
Measurement types:
•
Process
•
Structural
•
Composite
•
Experience
Examples of Project Measures
•
Denied Patient Claims
•
Compliance with documentation requirements
•
Reduced Late Charge Entry
•
Supply Cost
•
By Patient Type or Department
•
Hospital Acquired Conditions
•
Clinician Compliance with Evidence Based Recommendations
•
Patient Throughput
•
ED arrival to Patient Admission
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
77
Questions to Consider
•
What do you want to improve with this project?
•
What do your clinicians consider as pain points?
•
What do you measure currently?
•
What would you like to measure in the future?
•
What is working well today?
•
What improvements could be made to your current
measurement process?
And last but not least
•
What story do you want to tell after our hard work is
Value Objectives
Guiding principles for value objectives selection:
•
Aligned with your organizational imperatives
•
Focused list
•
Understand outcome vs. process measures
•
Actionable
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
79
Value Objectives
Value achievement for your project starts with:
•
Executive ownership of each objective
•
Broad communication of the project value objectives
and expected outcomes
•
Collaboration from stakeholders across the organization
•
Clear measurement plans including pre- and
post-conversion comparisons and actionable data
Next Steps
•
Validate objectives with executive leadership team
•
Communicate your objectives
•
Align the project team to a common purpose
•
Continue to discuss and address any missing items or new
information
Governance Structures: Project
Teams
Pat Macy
Project Teams
Project Teams (Reports to Leadership Advisory Committee)
CPOE Orders Team/ Physician Advisory:
CPOE Orders Team/ Physician Advisory:
CPOE Orders Team/ Physician Advisory:
CPOE Orders Team/ Physician Advisory:
Physician Champions, Pharmacy, CPOE
SA, Physician Strategist, Clinical
Transformation Lead
Clinical Advisory/Medication Process Teams:
Clinical Advisory/Medication Process Teams:
Clinical Advisory/Medication Process Teams:
Clinical Advisory/Medication Process Teams:
Physician Champion, Pharmacy, SMEs,
PharmNet SA , Clinical Strategist, Clinical
Transformation Lead
Cerner Build/ Client Test Team:
Cerner Build/ Client Test Team:
Cerner Build/ Client Test Team:
Cerner Build/ Client Test Team:
Cerner SA/ SDCs, Client IS,
Project Manager, Testing
Coordinator, Clinical Staff for
Testing
Training Team:
Training Team:
Training Team:
Training Team:
Staff Development, Clinical
Transformation Team, Sub set
of Super Users/SMEs
Communication Planning:
Communication Planning:
Communication Planning:
Communication Planning:
Executive Sponsor and Project
Manager
Technical Team:
Technical Team:
Technical Team:
Technical Team:
Clinical Transformation Lead,
HIM, Biomed, and IS
Finance Sub Committee:
Finance Sub Committee:
Finance Sub Committee:
Finance Sub Committee:
CFO, HIM, Patient Access,
Patient Accounting, Care
Management
Clinical/Department Teams
Clinical/Department Teams
Clinical/Department Teams
Clinical/Department Teams
Clinical Transformation Lead,
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
83
Project Teams/SME Representation
•
Interdisciplinary Clinical Documentation
•
Nursing
•
Respiratory
•
Nutrition
•
Therapies/Rehab
•
Care Mgt/Discharge Planning
•
Maternity/NICU
•
Long-term Care
•
Laboratory
•
General Lab
•
Microbiology
•
AP Team
•
Blood Bank
•
Perioperative/Anesthesia
•
Surgery/Endoscopy Department
•
Surgery Scheduling
•
Supply Chain Management
•
Anesthesia
•
Integrated Medication Process
•
Medication Process
•
Point of Care/Barcode Scanning
•
Specialties – Oncology, Peds, NICU
•
Pharmacy
•
Radiology
•
Scheduling/Medical Necessity
•
Patient Accounting
•
Patient Accounting – Billing & Accounts
•
Supply Chain Management
•
Charge Services
•
Patient Access
•
ED Patient Access
•
Inpatient Registration
•
OB Patient Access
•
HIM/Clinical Reporting
•
EMPI/HIM/Medical Records/Transcription
•
Physician Track
•
CPOE, Orders, Medication Reconciliation, ePrescribe
•
Physician Doc
•
Ambulatory
•
Office Practice Management
•
Ambulatory Clinical/Physician Documentation
•
Prescription and Orders
•
Oncology Practice
•
Emergency Department
•
ED Nursing, ED Reg, ED Coding
•
ED Physicians – CPOE and Documentation
•
Quality/Regulatory
Project Teams And Sub-groups
•
CPOE Order Sets/Orders Teams:
•
IT Analyst for CPOE with Client Physicians and Clinical Leaders Develop Content
and Design of Ordersets (PowerPlans and/or IPOCs)
•
Develop Orderables, Order Sentences for Catalog
•
Develop Common Folders Structure & Content
•
Completes Design Decisions for PowerPlans and Order Management
•
May Require Sub-Groups by Specialty
•
Medication Process Team:
•
Develops Medication Orderables and Order Sentences
•
Develops Medication Protocol Order Sets
•
Completes the Medication Integration Design Decisions
•
Completes Point of Care Design Decisions, if needed
•
Department & Interdisciplinary Documentation Teams:
•
Completes Design Decisions for Department Orders and Documentation Content
•
Completes Future State Workflow Decisions
•
Completes Review of Specialty Content
•
Develops requirements for Standard Reports
BRNDEXP 2.1 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner
85
Project Teams
•
Build/Testing Team:
•
Approves the Build Model
•
Completes Testing Schedule and Reports Results to Physician and Clinical
Advisory Committees
•
Technical/IT/Reports Team
•
Manages and coordinates development of operational reports
•
Ensures system maintenance and support
•
Participates in Device Strategy
•
Provides Technical Support
•
Education Team:
•
Develops Integration Testing Scripts & Participates in Integration Testing
•
Develop Education Plans for each venue
•
Communication Team:
•
Develops and executes Internal and External Plan
•
Quality (Value) Team:
•
Ensures metrics are identified and built
Project Teams Discussion
•
Build/Test Team: Must have Clinicians to test
•
Performs the Building for CPOE According to Design Decisions
•
Completes Testing Schedule and Reports Results to Physician
and Clinical Advisory Committees
•
Education Team: Can be Clinical Advisory
•
Develops Integration Testing Scripts
•
Participates in Integration Testing
•
Develop Education Plans for each venue
•
Communication Team: Can be Executive Sponsor
•
Develops and executes Internal and External Plan
•
Technical Team: IT Department
•
Ensures system maintenance and support
•
Participates in Device Strategy
The plan to disseminate
information related to the
project and the changes
that will impact users
across the organization
and the community.
Communication Strategy
++++
Communication Strategy |
Approach
•
Define the Communication Scope & Strategy
•
Organization and Venues
•
Assign a Communication Lead
•
Facilitates internal and external messaging about the
project
•
Define Project Branding
•
Communication Planning
•
Define Governance communication procedures
•
Issue and escalation communication procedures and
schedules
•
Project team communication roles & responsibilities
•
Define communication owners for each stakeholder
group
•
Define Communication master plan, timeline & budget
•
Develops communication toolkits
•
Leadership, Facility/Venue
•
Change champion toolkits
BRNDEXP 2.0 0714 © 2014 Cerner Corporation. All rights reserved.
This document contains Cerner confidential and/or proprietary information belonging to Cerner Corporation and/or its related affiliates which may not be reproduced or transmitted in any form or by any means without the express written consent of Cerner.
