OTTR: FROM CONTRACT TO IMPLEMENTATION IN 14 DAYS…OR LESS Audra Hutton Lopez MSN, ARNP, CNS, FNP Transplant Program Manager and Nurse Practitioner Liliya Slep RN, BSN Senior Quality Coordinator
OBJECTIVES • Introduce the Broward Health System and migration from joint program. • Discuss healthcare system required commitment for implementation • Discuss infrastructure in place to support rapid set up • Review implementation strategy
WHO WE ARE AS A HEALTHCARE SYSTEM • Broward Health is Broward County's largest healthcare services provider • Medical safety net for residents northern 2/3 Broward County approximately 1.2 million residents • 4 Acute Care Hospitals- BHMC, BHN, BHCS, BHIP • 1 Transplant Hospital (Adult Liver) - BHMC • 3 Urgent Care Centers • 10 Primary Care Centers • 43 Physician practice groups • More than 8,000 employees • 285,000 + ED visits/Annually • 60,000 + admissions/Annually • 275,000 + Outpatient visits/Annually
BROWARD HEALTH MEDICAL CENTER BHMC is a level 1 trauma center located in downtown Fort Lauderdale, in Broward County Florida. BHMC provides tertiary care across the continuum of care for all age groups. Its services include liver transplant, center services, Level 3 NICU, inpatient dialysis and other services which are delineated in the Scope of Program Section.
CONTINUE • BHMC saw a rate of 102/100,00 patients per year. This may be attributed to the facilities close proximity to Port Everglades, Fort Lauderdale/Hollywood International Airport, as well as its downtown location.
ABOUT OUR TRANSPLANT PROGRAM • BHMC is approved by the Agency of Health Care Administration (AHCA) to provide adult liver transplantation surgery in Broward County. Broward Health Liver Transplant Program in Organ Transplantation Service Area (4), which cover Broward, Palm Beach , Collier and Monroe Counties. Since 2004, BHMC has performed over 285 adult liver transplants.
DECISION ANNOUNCED ON 7/6/2015 TO IMPLEMENT STAND ALONE OTTR SYSTEM IN LESS THAN 1 MONTH... WHY? WHY? WHY? Can we make this project timeline??
PROJECT TIMELINE • Major Milestones: Get buy in from all stakeholders- (OTTR, BHIT, BH Clinical Staff, Administration) Kickoff 7/6/15 Technology assessment VM servers completed 7/8/15 SQL DB installed 7/10-7/13 Testing- 7/15-17 Go-live- HOW FAST CAN WE MAKE THIS HAPPEN?
CONCURRENT INITIATIVES (OF COURSE IT ALWAYS HAS THESE) • ICD-10 Preparation • Multiple EHR, Registration & Billing Systems • Cerner PowerChart Ambulatory EHR 75+ providers • Cerner Firstnet 3 Urgent Care sites
TECHNOLOGY ASSESSMENT • VPN: Grant access to OTTR for initial setup. SLA normally 7 business days. Expedited and complete in 1 day • Hardware assessment: Fat Client- too time consuming Web based- future plans TBD Virtual machines- quick install, infrastructure in place Develop both production and test environments • Interfaces: • ADT, Lab, Radiology, Transcribed Notes • Software: SQL database install- Broward Health Application install= OTTR team - Great team!!!!
ACTIVE/ACTIVE INFRASTRUCTURE This diagram represents a high level overview of what we accomplished at Broward Health from an Infrastructure design perspective. This design leverages several different technologies that our environment and how our environment is stretched across two physical locations for a highly available system. This design was used in order to create base templates for operating systems that were critical to the speed in which the OTTR liver transplant program environment was delivered.
ACTIVE/ACTIVE INFRASTRUCTURE DESIGN With our technology considerations being based on speed and performance. We were able to leverage this environment to build the OTTR environment from a virtual standpoint with in 1 day. We completed a server build for a total of 6 servers including (Application Delivery, Production and Test form both Database and Interface) We worked diligently with our different subject matter experts within several IT teams and were successful in delivering much faster than was anticipated by our customer. Virtualization was the key in us being successful with this project.
TESTING/ISSUE RESOLUTION/OPPORTUNITIES • Interfaces • Mapping labs in real time during go-live • Insurance information to correct fields • Custom reports- created on the fly • Data extraction from joint partnership system • This is still pending import (ETA- 10/2?) • Went live with blank database – patient demographics – Direct lab interface from Quest & LabCorp – Training on new look and feel (Clinical Staff & IT)
GO LIVE – 07/21/15 !!! • YES ! We went live in 12 business days • From contract, to planning, to training to cutover in rapid succession
LESSONS LEARNED • Have support and direction from Leadership- Corp CEO and CIO to remove all roadblocks • Identifying and dedicating key individuals to get the job done quickly • Concurrent projects able to still juggle other projects but they did suffer slightly • Never vow to never vow to not do something
INFORMATION TECHNOLOGY TEAM • Mayank Chadha- Snr Clinical Systems Analyst- Project Lead • Tracy Spier- Clinical System Analyst- project co-lead • Ralph Gonzalez- VMWare engineer • Gus Lowery- Interface engineer • Ivette Dumois- SNR DBA • Fabio Baron-Salazar- SNR DBA • Matt Akuntius- LAN Administrator • Sandy Swords- Citrix engineer • Jeff Picazio- Citrix engineer
WELCOME TO ADULT LIVER PROGRAM
LIVER TRANSPLANT PROGRAM STAFF PROGRAM DIRECTOR: ANDREAS TZAKIS MD, PH.D. TRANSPLANT HEPATOLOGIST: JOHN RIVAS & XARALAMBOS ZERVOS TRANSPLANT SURGEON: ANDREAS TZAKIS, GABRIEL SCHNICKEL, & MELISSA WATSON DIRECTOR OF NURSING, ADULT CARE : BARBARA SVERDLIK DNP, RN TRANSPLANT MANAGER & NURSE PRACTITIONER: AUDRA LOPEZ ARNP PRE - TRANSPLANT COORDINATOR: RICHARD HIRSCH RN, BSN POST – TRANSPLANT COORDINATOR: ELAINE JULIANO RN, BSN SOCIAL WORKER : MILAGROS SOUCHET, MSW FINANCIAL ELIGIBILITY SPECIALIST: BRYNN ARDUINI QUALITY SPECIALIST: LILIYA SLEP RN, BSN, MS DATA ANALYST: INA OLIVER MEDICAL SECRETARY: TAMMIE SANDERS
SMILE:
SRTR REPORT - RELEASED DATE: JUNE 16, 2015
Liver Transplant: Patient Survival Scientific Registry of Transplant Recipients Release June 2015 1 month: 1 year: 3 years: Patients Patients Patients Results receiving receiving receiving transplant transplant transplant between between between 97.73% 90.01% 81.16 % statistically statistically BHMC higher than higher than Results expected expected Expected 97.54 % 91.75 % 79.53 % 97.22% 90.86% 81.54% United States
Liver Transplant: Graft Survival Scientific Registry of Transplant Recipients Release June 2015 1 month: 1 year: 3 years: Patients Patients Patients Results receiving receiving receiving transplant transplant transplant between between between 97.78% 90.26% 77.78 % BHMC statistically statistically statistically higher than higher than higher than Results expected expected expected Expected 96.39 % 89.79% 77.73 % 95.87% 88.62% 78.32% United States The "expected" value is calculated based on transplant patient and donor characteristics which take factors such as age and patient diagnosis into consideration.
QUESTIONS
Recommend
More recommend
