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Committee eyes three-year IM  priorities 

by Michael Irving
Emerald Communications and Training Committee
Like herding cats was the observation H. Biemann Othersen, M.D., made at a meeting 7:30 a.m. Saturday, Feb. 12.

It was a meeting in the Storm Eye Institute Auditorium of 85 clinicians, clinical support staff, administrators, technical staff, educators, and researchers with a single goal: To identify the information management (IM) priorities for the next three years.

To inspire the participants, Othersen, medical director for professional staff, offered a couple recent cat stories. Giving up their Saturday, he said, was like the woman who wants to spay all the stray cats living in the old Charleston High School building to control their population growth: It’s beyond the call of duty. And the task ahead is as “difficult as herding cats,” he said, alluding to an ad on the recent Super Bowl broadcast.

To organize and “herd” as efficiently as possible, Pam Cipriano, administrator for Clinical Services and meeting facilitator, welcomed the participants and provided a brief context for this retreat. The consensus developed from this retreat, she said, would be provided to the Clinical Information Systems (CIS) steering committee.  CIS will then return recommendations to the Clinical Council who will seek funding to commence in July.

Joanne Conroy, M.D., executive medical director, welcomed the participants and said that the Clinical Council will not micro-manage this process but wants to assist by finding the dollars to fund the top eight priorities.

At the conclusion of the welcoming remarks and prior to the break-out sessions, Dave Northrup, health care computing services director, and Larry Afrin, M.D., chairman of the MUSC Clinical Information Systems Steering Committee, provided the history of information management projects from 1994 to the present. Northrup emphasized three goals: easy access, evidence-based decisions and improved use of information management. 

Afrin spoke of the work that the Emerald projects have accomplished since 1997 and outlined future tasks.  Amongst these are completion of order entry, document imaging and nursing documentation.  He also spoke of the importance of an enterprise-wide master patient index (EMPI), data mining of the Oacis repository, and full-motion video. 

Afrin stressed the need for a comprehensive security and confidentiality policy as well as the institution’s obligation to comply with the provisions of the Health Information Portability and Accountability Act (HIPAA)

To conclude his remarks, Afrin said the grouping of IM projects into five categories had been done to help with the ranking. The five groupings are: 

  • Core electronic medical record (EMR) initiatives
  • Interfaces to Oacis
  • Administrative reporting systems
  • Infrastructure
  • Related IM initiatives
 Armed with colored stickers, scoring guidelines and scoring sheets, the participants broke into 11 working groups of eight for two hours of lively project discussion and ranking. Each group was carefully balanced to represent a mix of constituencies. 

With the aid of a facilitator to keep the group on track and a resource person to provide additional background information, each table embarked on a challenging voyage through 37 different projects.  Although seven of these had been removed from the voting process because they are regarded as mission critical and must proceed in any case, the challenge of picking the top eight from the remaining 30 was difficult. 

Final returns will be made available in a published report in March but preliminary returns indicate the following projects as being ranked as the most desirable:

  • Oacis Electronic Order Entry Pilot and Enterprise Deployment (inpatient)
  • Physician/Clinical Notes in Oacis
  • PMSI/Practice Partner Expansion
  • LanVision Medical Records Document Imaging/On-Line Chart Completion System
  • LanVision Document Imaging System Interface to Oacis\
  • Enterprise Master Patient Index  g.. Patient Accounting Administrative Records Document Imaging System
  • Oacis and Practice Partner Disaster Recovery Planning (DRP)
  • Security & Confidentiality
The following projects were included in the process for completeness sake but are regarded as mission-critical or contractually-committed and so were not ranked
  • Oacis Pharmacy Electronic Order Entry Pilot
  • PMSI/Practice Partner Interface to / from Oacis
  • Oacis High Availability
  • Agfa PACS (Digital Radiology) Upgrades and Expansion
  • Network Infrastructure Development
  • Major Lab Information System (LIS) Upgrade
  • Emerging Clinical Information Management Requirements and Needs
 Following the voting, Cipriano brought everyone back together and told the group that the next step would be a detailed analysis of the voting. Adjustments dictated by over- or under-represented constituencies as well as a consideration of the timing and sequencing of projects would be a part of this analysis, she said. 

The analysis will be conducted by Cipriano, Northrup and Afrin, and will culminate in a report to the retreat conferees and to the CIS committee. They expect the report will be made available to the university’s Board of Trustees in April with the plan to seek funding in the July budget.