The lag between the discovery of more efficacious forms of treatment and their incorporation into routine patient care is unnecessarily long, in the range of about 15 to 20 years.

• Information organized & deployable
• Physician Agreement
• Information
• Translated Into Care

Other Drivers for Change

Physician productivity increases to keep pace with declining reimbursement

The amount of data generated in the care of both in-patients and out-patients has increased dramatically

• Volume of patients
• Volume per patient

Communication between physicians and other clinicians is more challenging

Benefits of Automation

Cerner applications will be housed at the National IT Centers

National network will connect the hospitals

Scope of the ACIS Project

• Clinical Data Repository (CDR)
• Results viewing – “Portal” (Powerchart)
• Pharmacy management
• Document imaging and digital document management
• ED documentation, triage, tracking, coding
• Medication administration and positive patient identification
• Clinical documentation – RN, ancillary services
• Clinical decision support
• Provider Order Entry
• Scheduling
• Lab
• Surgery

Not in scope:

• Ambulatory computerized medical record
• PACS

Functional ACIS Components

• Results retrieval
• Lab
• Reports & Summaries
• Imaging
• Demographics
• Medications

Workflow

• Document Imaging
• Positive Patient ID
• Online documentation
• Med Administration
• Order Sets

Knowledge Driven Care

• ADE Checking
• Medical Content
• Decision/Guideline/Pathway Support
• Clinical Data Repository (CDR)

Phase 1

• Clinical Data Repository
• Power Chart Viewing
• Document Imaging
• ED Triage & Tracking
• Lab
• Scheduling
• EMPI

Phase 2

• Basic Clinical documentation
• Orders
• ED Documentation
• ADE Checks
• Medication Administration
• Clinical Decision Support
• HIM Chart Tracking
• Coding & Abstracting
• Pharmacy
• Surgery
• HIM Deficiency Tracking

Phase 3

• CPOE
• Physician Documentation
• Advanced Clinical Documentation
• Care Coordination
• Pathways

Physician Advisory Committee

• Make policy recommendations to Medical Executive Committee
• Participate in setting agenda for clinical decision support
• Reinforce communication between clinicians and administration
• Coordinate with the P & T committee and other quality improvement committees
• Monitor physician training and physician utilization

Dependencies

• Executive leadership – strong support form Board, Leadership, and clinical directors 
• Physician champions and physician teams
• Collaborative relationships – presence of interdisciplinary cross-MBO teams that own the project
• Care standardization teams –establish standards of care, best practices and clinical pathways. Standards of care to be monitored for effectiveness and revised based on outcomes