Yesterday I led the Clinical IT Governance meeting at BIDMC and I thought it would be interesting for my readers to get an inside look of the kind of topics we’re discussing and how we’re implementing our most challenging projects.

1. Joint Commission debrief
Last week the Joint Commission visited BIDMC and the experience was very positive. When there are process variations and potential shortcomings identified by the Joint Commission, IT solutions are often suggested. In this particular visit, there were a few small software changes made during the visit to better support National Patient Safety goals such as ensuring all care team members know the preferred oral and written language preferences of each patient. We made modifications to ensure all our sites of care – ED, inpatient, outpatient, OR, and ICU gather this information consistently and display it routinely. That was the only issue involving IT in this Joint Commission visit.

One of the great challenges of IT governance is maintaining focus on the annual operating plan and avoiding the distraction of the day. Audits, visiting committees, and even Joint Commission visits have the potential of creating attention deficits which derail IT staff from long term must do’s. I’m grateful that Joint Commission preparation has become such an integrated part of our standard work that no projects were derailed.

2. Enterprise and Community interoperability
I’m often asked when interoperability will become a standard practice in communities. In many Massachusetts institutions, data exchange is already happening and the state HIE is processing over a million transactions a month. However, there are still gaps in offering hospital-based clinicians access to the EHRs of private practice referring physicians. I outlined the work we’re doing this Summer to ensure that opt-in consent to disclose is captured at referring clinician practices as this will enable us to complete the electronic linkage which provides 24x7x365 on demand data sharing.

3. Annual Operating Plan update
IT has 5 goals in 2013 and I reviewed our progress on all of them
Meaningful Use Stage 2 – we have achieved all MU2 hospital requirements except Electronic Medication Administration Records/Bedside Medication Verification. Our new EMAR/BMV application goes live in July and we are on track to have 10% of all medication orders processed through it for the October-December Meaningful Use reporting period.

ICD10 – our greatest challenges are clinical documentation improvement such that enough information is available to justify highly detailed ICD10 codes and outpatient coding strategies so that we do not need paper-based superbills hundreds of pages long for every clinic. We’re working with 2 established companies and one start up to create novel computer assisted coding workflows and real time documentation improvement, linking the act of documenting to the requirements for accurate billing in a single workflow.

Laboratory Information System – we go live …read more

Source: Clinical IT Governance Update