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UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project Sponsor: Dr. Michael Gropper, Acting Chair of Anesthesia Project Champions: Dr. Raman Khanna, Dr. Priyanka Agarwal, Min Zhu BCD Facilitator: Todd Elkin
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UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

Jan 03, 2016

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Page 1: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

UCSF Health SystemCTG – Aug 07, 2014

UCSF Health System

Project: Emerge Pilot– Reducing the 7 preventable ICU Harms

Department: 9-ICU, 13-ICU 

Project Sponsor: Dr. Michael Gropper, Acting Chair of Anesthesia

Project Champions: Dr. Raman Khanna, Dr. Priyanka Agarwal, Min Zhu

BCD Facilitator: Todd Elkin

Page 2: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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The ask:

Scope: Emerge Pilot Integration (all one way outbound): ADT & ADT Coded, Orders/Results (Lab, Path),

Results (Rad, Card), Doc Flowsheets, Pharm orders, Problems, Notes Standing up 2 Virtual Machine Servers and associated connectivity No request for data manipulation, device integration (both addressed by Emerge)

Size (IT/CS):  Large; 2,551 Hours IT/CS Total Cost (Vendor, Labor, …,): $354,825

IT Systems Engineering labor: 200 hours / $24,000 Hardware/software: Direct bill to project

IT Interfaces labor: 1,635 hours / $220,725 Epic (License fees and Implementation): $30,000

IT QA Team labor: 160 hours / $20,000 CS Reporting labor: 40 hours / $5,000 CS SMEs: Clin Doc, Orders, Pharmacy: 100 hours / $13,500 CDHI PM: 20%, 416 hours / $41,600 Maintenance: $3,500 (annual Epic vendor fees for net new interfaces)

$TBD (add’l IT interface support will require CTG approval, post pilot) Funding: Implementation is 100% Funded by the Gordon & Betty Moore Foundation

Maintenance is TBD, post pilot. Client & IT/CS negotiated timeline: Aug 2014 – Sep 2015

Page 3: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Overview: Project Goals

Project span 9 & 13 ICU – 32 beds

• Eliminate Preventable Harms• CLABSI• Delirium• Ventilator–Associated Harms• ICU Acquired Physical Impairment • DVT / PE • Loss of Respect & Dignity• Misaligned goals of care

• Optimize Patient Outcomes and Experiences• Reduce Healthcare Costs

Page 4: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Overview: Project Components

CultureComprehensive Unit-based

Safety Program (CUSP)

Patient Family Advisory Council (PFAC)

Page 5: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

The Goal

Page 6: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

Example: Ventilator Associated Harm

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Page 7: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

EHR

SensorsPatient &

Family MembersCare Team

Members

Emerge Ecosystem

Open Source Platform

Page 8: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Emerge Application – IT Integration

Page 9: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Key Outcomes

• Disparate data integrated in a single visual metaphor

• Provider, Patient, & Family Satisfaction

• Patient Quality Outcomes

Page 10: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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The ask:

Scope: Emerge Pilot Integration (all one way outbound): ADT & ADT Coded, Orders/Results (Lab, Path),

Results (Rad, Card), Doc Flowsheets, Pharm orders, Problems, Notes Standing up 2 Virtual Machine Servers and associated connectivity No request for data manipulation, device integration (both addressed by Emerge)

Size (IT/CS):  Large; 2,551 Hours IT/CS Total Cost (Vendor, Labor, …,): $354,825

IT Systems Engineering labor: 200 hours / $24,000 Hardware/software: Direct bill to project

IT Interfaces labor: 1,635 hours / $220,725 Epic (License fees and Implementation): $30,000

IT QA Team labor: 160 hours / $20,000 CS Reporting labor: 40 hours / $5,000 CS SMEs: Clin Doc, Orders, Pharmacy: 100 hours / $13,500 CDHI PM: 20%, 416 hours / $41,600 Maintenance: $3,500 (annual Epic vendor fees for net new interfaces)

$TBD (add’l IT interface support will require CTG approval, post pilot) Funding: Implementation is 100% Funded by the Gordon & Betty Moore Foundation

Maintenance is TBD, post pilot. Client & IT/CS negotiated timeline: Aug 2014 – Sep 2015

Page 11: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Appendix

Page 12: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Page 13: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

Platform

APIs

Apps

EndUsers

Clinicians, Hospital Leadership, Staff, Patients and Families

App Developers,Content Creators

App 1

Platform

App 2 App 3 App 4 App 5

EHR SystemsDevices

& Sensors

Hospital Data

UI Device

s

DataSources

Open Source Platform

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Page 14: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

Condition Specific Display

Page 15: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Example: VAHI

Page 16: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

Context and Background

Preventable harms in health care are the 3rd leading cause of death in U.S.

1/5 ICU patients will endure a preventable harm Patient / Family burden Societal burden Health care cost burden

Page 17: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Microsoft Excel Worksheet

Page 18: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Grant Details

Page 19: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Page 20: UCSF Health System CTG – Aug 07, 2014 UCSF Health System Project: Emerge Pilot– Reducing the 7 preventable ICU Harms Department: 9-ICU, 13-ICU Project.

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Thank you!