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Clinical information systems in line for major upgrade

Apr. 23, 2015, 9:01 AM

Vanderbilt University Medical Center has launched a comprehensive review of the clinical information technology used throughout VUMC hospitals and clinics, with an eye to replacing certain key applications.

Under Clinical Systems 2.0, as the project is called, a report on Vanderbilt’s clinical applications is due by August.

The report to leadership is to include recommendations for replacements for at least four VUMC clinical applications used throughout inpatient areas — the Horizon Expert Orders clinical decision support and clinician order entry application, the Horizon Expert Documentation nurse documentation application, Horizon Meds Manager and Horizon Admin-Rx.

The vendor for these applications, McKesson Corp., plans to shift resources elsewhere within its clinical IT product line and has announced it will no longer support these applications as of March 2018.

It remains to be determined whether any VUMC applications beyond the four McKesson products will undergo replacement under Clinical Systems 2.0.

“When McKesson made their announcement it was clear that vendor selection for replacement applications would require us to evaluate most of our inpatient IT applications,” said Eric Boehme, director of application development with HealthIT (formerly Health Informatics Technologies and Services). “And since any new applications must also work well with Vanderbilt’s electronic medical record application, which spans inpatient and outpatient settings, it was best that we broaden the review to also include applications used in the clinic.”

Boehme and Mark Ciampa, M.S., director of the HealthIT program management office, are co-leaders for the project.

The two project leaders said the field of contenders — the group of vendors that can supply these applications for centers of VUMC’s size and complexity — is limited to two companies: Cerner Corp. and Epic Systems Corp.

Horizon Expert Orders is based on an application developed at VUMC called WizOrder, which was licensed to McKesson in 2001; as a McKesson product, the application was later back-installed at VUMC.

“VUMC will continue its role as a leading test bed for clinical information technology,” Ciampa said. “We’ll collaborate with our chosen vendor to tailor any new applications to suit the needs of patients and users at the Medical Center.

“We want to understand where we are today with our functionality, and also what our clinicians say we don’t have and what we could really use. So we’ll be interviewing physicians, nurses and other staff in the hospital and clinics to help us evaluate current functionality and things that we don’t have today that we really need.”

Leaders have set out 12 guiding principles for the project, including streamlining and standardizing workflow, enhancing care coordination, supporting patient engagement and reducing redundancy and wasted effort.

While the timing of Clinical Systems 2.0 is prompted by the McKesson announcement, VUMC leaders say the three-year project to identify and implement key technology provides an important opportunity for the clinical enterprise.

“CS 2.0 is foremost about identifying new tools to help take our clinical systems environment into the future,” said David Posch, CEO of the adult hospital and clinics and executive director of Vanderbilt Medical Group.

“We’ll leverage Vanderbilt’s truly exceptional expertise in clinical information technology, and we’ll begin by gathering input from physicians, nurses and other users throughout our clinical enterprise.”

The executive sponsors for the project are Posch and Kevin Johnson, M.D., M.S., Cornelius Vanderbilt Professor of Biomedical Informatics and chair of the department, professor of Pediatrics and director of HealthIT.

“For this project to succeed it has to be a really tight collaboration between the clinical enterprise and HealthIT, and governance for the project is accordingly designed to ensure that leadership will work closely together through all stages of this work,” Johnson said.

Posch and Johnson head the project’s executive oversight committee, which also includes C. Wright Pinson, MBA, M.D., John Manning, Ph.D., MBA, Marilyn Dubree, MSN, R.N., Bill Stead, M.D., Cecilia Moore, MHA, CPA, and Ken Letkeman.

Dubree, Neal Patel, M.D., MPH, and Titus Daniels, M.D., MPH, lead the Clinical Systems 2.0 steering committee, comprised of clinical leaders, hospital and clinic administrators and HealthIT staff.

Deloitte Consulting LLP has been engaged to assist with vendor selection.

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