OTTR: FROM CONTRACT TO IMPLEMENTATION IN 14 DAYSOR LESS Audra - - PowerPoint PPT Presentation

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

• ther 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
• verview 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
• f 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

• 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

LESSONS LEARNED

• 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

INFORMATION TECHNOLOGY TEAM

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 Results 1 month: Patients receiving transplant between 1 year: Patients receiving transplant between 3 years: Patients receiving transplant between BHMC Results 97.73% statistically higher than expected 90.01% 81.16 % statistically higher than expected Expected 97.54 % 91.75 % 79.53 % United States 97.22% 90.86% 81.54%

Liver Transplant: Graft Survival Scientific Registry of Transplant Recipients Release June 2015 Results 1 month: Patients receiving transplant between 1 year: Patients receiving transplant between 3 years: Patients receiving transplant between BHMC Results 97.78% statistically higher than expected 90.26% statistically higher than expected 77.78 % statistically higher than expected Expected 96.39 % 89.79% 77.73 % United States 95.87% 88.62% 78.32% The "expected" value is calculated based on transplant patient and donor characteristics which take factors such as age and patient diagnosis into consideration.

QUESTIONS