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FIRST SPEAKER: "E-Health Concepts" Mr. Jack McGuire, Senior Manager Cap Gemini Ernst and Young
Mr. McGuire provided an overview on E-Health which included utilizing portals for physicians and consumers as well as discussing customer relations management technology.
Jack indicated that the next wave of Internet change related to healthcare could possibly include personalized health offerings, increased emphasis on outcomes and quality of care, and the connectivity between physicians, providers, suppliers and payors in a real-time environment.
Leadership in the emerging health economy is being competed for by Dot com's, payors, providers, and other players (pharmaceutical companies, emerging alliances, large technology vendors, and medical devices companies.)
Mr. McGuire discussed the application of the Internet to the supply chain processes and potential benefits which include:
Ultimately, it translates to having the right supply at the right place at the right time. Specific areas which can be improved are utilization, logistics, distribution, and information management.
Mr. McGuire wrapped up with an explanation of the key components to making "connected care" successful which are:
SECOND SPEAKER “E-Business Applications” Mr. John Rodgers, Consulting Manager, SMS Technology Services
Mr. Rodgers presented an overview of different healthcare applications and technlogies available in today's marketplace that will enable e-business communication.
John enlightened the group that two of the primary uses for web site usage is promoting/marketing and employee recruitment. John conveyed that there is a lot of potential for growth related to e-applications.
John briefly discussed EDI/e-commerce/e-business/e-health, all forms of utilizing the internet for doing business over the web. He emphasized the importance of distinguishing your health care organization clearly to assure you have return customers.
Opportunities for e-business include payors, suppliers, physicians, employees, and patients. Physicians benefits include research data, timely and accurate result data, and clinical decision support. Employee interactions include self service, health benefits, update credentials, job searches, on-line EAP's, etc. Consumer convenience was also discussed which includes trusted health data, convenience, access to data(yours and theirs), pay bills, and interaction with other similar patients.
John gave a few final thoughts for success:
THIRD SPEAKER “Integration of E-Commerce into the Clinical Arena” Ms. Kathy Santini, VP of Materiel's Management/Surgical Services, Bon Secours Health System
Ms. Santini discussed the process Bon Secours went through to arrive at the integrated JIT system currently in place. Bon Secours, HBO&C, General Medical, and Omnicell were the four primary partners in place to make this process a success.
Direct Impact / Storeroom Benefits:
Direct Impact / OR Benefits :
The success of this system resides in the high level of integration of point of use technology(Omnicell) and direct electronic information transfer to the vendors. Simply put, it means the following:
FIRST SPEAKER: PACS “The Final Frontier” Mr. Robert Knox, PACS Sales Specialist GE Medical Systems
Mr. Knox informed the group about the benefits and structure necessary to support the PACS system. He indicated that PACS does not eliminate the general steps involved in the filming process, rather it makes the life easier for the clinician. Keys to success include identifying the customers of the system, documenting the expectations, and choosing indicators to assure the expectations are being met.
Benefits to Health System were identified as follows:
SECOND SPEAKER “Voice Dictation: The Wave of the Future” Mr. Lloyd Morris, Atlantic Voice Dictation Systems
Mr. Morris identified the benefits of employing voice recognition software in the workplace. The keys to success were shown to be as follows:
The software boasts 95-97% accuracy for a first time user with a 98-99% accuracy after a couple of hours.
THIRD SPEAKER “High-Tech Emergency” Ms. June Robertson, Director of Emergency and Ambulatory Services, Sentara Virginia Beach General Hospital
Ms. Robertson informed the group about the innovative processes in action at VBGH’s emergency services department. VBGH has an annual volume of 55,500+ visits with a total of 12,387 square feet. VBGH has a 56 minute visit time for fast track and a 2.6 hour visit time for all visits combined.
The fourth quarter program was a success despite one cancellation. The first speaker of the day was Mr. H. Douglas Sears, one of the Senior Examiners for the state of Virginia who spoke about the process and requirements for the Malcom Baldrige National Quality Award for Healthcare. 1999 was the first year that health care organizations were eligible to apply for the Award. Mr. Sears told our members that nine hospitals applied for the Award in 1999 with only one site visit performed. There were no winners for 1999.
The Award has a possible of 1000 total points for all categories combined. Overall, Mr. Sears said that the Motorola corporation has been the highest scoring organization with 750 points. The categories that make up the 1000 points are leadership(110 pts), strategic planning(80 pts.), focus on patients, other customers ad markets(80 pts.), information and analysis(80 pts.), staff focus(100 pts.), process management(100 pts.), and organizational performance results(450 pts.) Mr. Sears estimated that a hospital facility with approximately 200 beds would require between three and five years of self-assessment to be confident enough to apply. The process for achieving the Award takes three steps: application by the organization, consensus of the examiners, and ultimately a site visit.
Most organizations have excellent approaches, although the deployment is typically short on achieving goals. Mr. Sears emphasized that deployment is the key to the process. For additional information, please link to www.quality.nist.gov.
Our second presenter of the day cancelled but a panel composed of a few VHIMSS chapter members was happy to field questions about each’s individual perspective on various current “hot topics” in healthcare. Thanks to all who participated on such short notice!!!
The last presentation of the day focused on the Implementation of Outcomes Driven Care(ODC): Transformational Change. Karen Drenkard, RN, MSN and Judy Fisher, RN, MSN presented the methodology used by INOVA HEALTH SYSTEM to implement and measure ODC. Access management, quality/case management, care team and culture were the four primary ODC design components referenced by our speakers.
Implementing Quality Outcomes Reporting was also discussed. Communicating outcomes to the INOVA organization proved to be a challenge since they reported on items “from Board to Bedside.” To simplify this task, outcomes were categorized into four categories: 1-Growth, 2-Clinical Quality, 3-Service Excellence, and 4-Cost Management. Finally, re-measurement was emphasized to assure process balance and achievement of organizational goals and objectives.
The first speaker of the day was Ms. Michelle Johnson of Integrated Health Services (IHS). Ms. Johnson related her experiences in implementing an intranet in a decentralized long-term healthcare company with over 70,000 employees. The company spent over $140 million just on infrastructure and brought their site on-line in July of 1998. Some of their common uses for their intranet included distributing financial reports, an on-line prospective payment system and using it to distribute software updates. IHS has also trained business line managers to publish their own material on-line.
The day's other speaker was Ms. Carla Bryant of Sentara Healthcare. Ms. Bryant shared that Sentara currently has about 14,000 intranet users. They have deployed kiosks throughout their facilities to increase access and currently receive over 1,000,000 hits per month. Their intranet roll-out program focused on "e to the fifth" - excite, entertain, educate, enlighten and empower. The Sentara intranet features a place for employees to post their own news, desktop supply ordering and on-line medical records functions. Their three main intranet components are "Wave Net" (for employees), "Spin Web" (for MDs) and "Wave Health" (for consumers).
The third speaker of the day was detained by the weather, but a brief roundtable discussion of intranet uses was held instead. Thanks to all who attended.
The first speaker of the day was Mr. Francis Peropat of OACIS. Mr. Peropat reminded everyone of the drawbacks of the common paper chart. He stated that most vendors fall short when selling a system because they only install software and do not truly implement anything. Mr. Peropat shared stories of several hospitals in which his company had implemented systems.
The only other speaker scheduled to present at the meeting was Mr. Greg Pierce of Healthcare Technology Associates who gave an excellent overview of emerging speech recognition technology. Mr. Pierce educated the group on the four main branches of speech technology:
After lunch attendees viewed the exhibit hall to learn more about the latest information technology available.
The first speaker of the day was Ms. Cindy Hartless of Inova Health System. Cindy shared how the system's desire to be competitive in the next millennium led them to identify Materials Management as a key area for cost savings through reengineering its processes. Cindy related how the process was enabled by getting the Materials Management staff to focus on their customer's needs in much the same way clinical staff focus on patient needs. Successes included the following measures:
Ms. Welby Watkins of Watkins Consulting Corporation shared her experience with implementing a clinical documentation system at a community hospital in New England. Ms. Watkins reminded the group to use caution when selecting a system, keeping in mind that interfacing a documentation system with other existing systems often presents the biggest challenges. Ms. Watkins shared the following key steps to success:
Mr. Ijaz Bokhari of Olsten Health Services shared his success story of using business redesign principles to transform their Home Health business from 45 separate entities to a unified operation with virtually seamless information transfer. Prior to re-engineering, the company had hundreds of toll-free phone numbers for patient entry into the system, more than $100 million in outstanding accounts receivable and a totally manual billing process.
The first speaker of the day was Mr. Terrance Scott of Superior Consultants. Mr. Scott encouraged attendees to shift their paradigm and begin to think of Health Care as being primarily information management. He put forth the idea that Patient Care - defined as only hands-on tasks - is only a subset of Health Care. Mr. Scott challenged the group to think of health care in terms of information management and begin to adjust their budgeted resources accordingly.
Next up was Mr. Jon Loshbaugh of the Healthcare Management Council. Mr. Loshbaugh stated that a common pitfall in many mergers is a tendency to focus only on revenue. He reminded us that economies of scale do not just materialize and encouraged people to create an "operational plan" utilizing benchmarks prior to merging. Mr. Loshbaugh stressed that the two basic issues that impact operational efficiency are reduced costs and flatter management structures.
The last presentation of the day was given by Ms. Amy Hartt of Arthur Andersen and Mr. George Conklin, CIO of Sisters of Charity Health System in Texas. The presenters reviewed a case study of the various mergers that created Integris Health, Texas Health Resources and Christus Health systems in Texas. Mr. Conklin feels that long range IT planning can only look ahead 1 to 3 years now, as opposed to the typical 5 years seen in the past. Mr. Conklin said he also sees a trend emerging that IS departments are able to do less with more money due to rising technology costs.
The first speaker of the day was Mr. Brad Adams, who coordinated the planning of and subsequent move to the new MRMC facility. He shared his experiences - both good and bad - in transitioning from a 1950s vintage building and care model, to a 21st century, "family focused" environment, where the goal is to provide 80% of all care at the bedside. Among other things, MRMC has eliminated the need for an Admitting department and monitor technicians.
In the midst of designing and moving to a new facility, MRMC (formerly Richmond Memorial) merged with Bon Secours. This presented a completely new set of issues regarding information systems and processes. Mr. Adams ended his portion of the program by leading the group on a tour of MRMC's patient care centers.
Thanks to our second presenter of the day, who was a last-minute replacement. Mr. Dennis Antician from Superior Consultant spoke about using IS to automate and improve processes. Mr. Antician gave a couple examples of how they helped hospitals integrate technologies such as intranets and document imaging into their business processes. He reminded the group that you must survey your current processes before building an electronic substructure,
The last presenter of the day was Ms. Jean Ann Larson, FHIMSS of William Beaumont Hospital. Ms. Larson shared materials from her book "Healthcare Redesign Tools and Techniques." Ms. Larson told the group that when reengineering is done correctly, the juice is worth the squeeze. This statement was backed up by William Beaumont's $9 million reduction in operating expenses.
Ms. Larson's book can be ordered from Quality Resources by calling toll free 1-800-247-8519.
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Mr. Austin Brown, Project Executive, Cerner Corporation gave an overview of the process steps required for a successful computer system implementation. Austin reviewed the many dangers that arise during the various phases of implementing a new system. |
| Mr. Ronald P. Geist, President Geist Consulting, Mr. Howard Morrison, President Center 2000 Inc. and Mr. Rick O'Donnel, SAIC discussed the magnitude of the year 2000 problem (Y2K for short) and some potential solutions. Mr. Geist stated that the nation's top 250 companies alone will spend $250B on finding a solution for the Y2K problem. Mr. Morrison shared how important it is to have top level leadership driving your company's Y2K effort. Mr. O'Donnel reminded the group of the importance of allowing adequate lead time for the implementation of solutions. |
| Ms. Nancy Ann McFaddin, Director Product Development HealthMagic, Inc. informed attendees that there are about 62 million people currently on-line. Of those, 43% have accessed health and medical information. A recent survey found that 77% of people want their doctors to give them internet addresses of sites with reliable health information so they can research in the privacy of their own home. Ms. McFaddin demonstrated some applications that her company has developed in conjunction with Walt Disney for use in the town of Celebration, Florida. |
Mr. Michael Lundberg, Executive Director of Virginia Health Information (VHI) gave an overview of the history of his company as well as the data they collect and reports they generate. VHI is a broker of healthcare information for the state of Virginia and prepares many reports for businesses and consumers. VHI collects patient level data from UB92 claims, financial data from the Efficiancy & Productivity Collection System (EPCS) and Medicare state employee outpatient claims. Eighteen indicators are used to rank facilities in quartiles. Future distributions of data will include readmission information.
Dr. David Simmons, Chair Elect of the American Society of Quality (ASQ) Healthcare Division reviewed ISO9000 and how it can be utilized in healthcare. ISO9000 was originally developed from a military quality standard known as MILQ5898. He stated that ISO9000 in its simplest definition is "improving and rationalizing your business processes." ISO9000 consists of 20 clauses divided into three categories: 1) Management Responsibility; 2) Implementation Functions; and 3) Support Functions. Dr. Simmons discussed a hospital in Crowley, Louisiana that has been exempted from needing a JCAHO review to receive Medicare funds due to their ISO9000 certification. He did not recommend that all hospitals follow this action, but used the example to show the excellent quality standards that can be attained through ISO9000 implementation.
The last speaker of the day was Mr. Dan Rode, Director from Healthcare Financial Management Association (HFMA). Mr. Rode gave information on several key pieces of healthcare legislation, including the Health Insurance Portability and Accountability Act (HIPAA). He stated that the Justice Department considers healthcare fraud the number two problem in our country behind drugs and reviewed how hospitals can comply to avoid penalties.
Economist Robert F. Graboyes of the Federal Reserve Bank of Richmond discussed the inherent flaws in the calculation of the Consumer Price Index (CPI). The CPI has been based solely on cost and has not done an adequate job of capturing the effects of new technology on the economy and the true value of goods and services. Overstatement of the CPI has caused many to believe that inflation in healthcare has outpaced all other sectors of the economy, while in reality, improvements in technology have made healthcare a better value for the consumer.
Dr. Mandell Bellmore of Block, McGibony, Bellmore & Associates discussed unique ways to measure the health status of a given population. Dr. Bellmore reviewed data collected using the Short Form 36 standardized questions. Dr. Bellmore also discussed some creative ways to use patient satisfaction data as a comparative benchmark among physician practices.
The last speaker of the day was Dr. Wally Smith from the Medical College of Virginia (MCV). Dr. Smith has been studying the issue of measuring the value of healthcare. He asserted that cost is currently driving our healthcare system, not quality. Dr. Smith stated that quality alone is not the best indicator, and that we must eventually develop a measure that integrates the two - hence, value.
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