FY09 Operating Plan for Beth Israel Deaconess

BIDMCINFORMATION SYSTEMS

OPERATING PLANFY09

Information Systems FY09 Operating Plan

IntroductionThis document outlines the BIDMC Information Systems FY09 Operating Plan. In FY09, we will again align our goals with the operating goals of our customers. Highlights include:

1. Implementation of Inpatient documentation as part of our 5 year plan to implement electronic records throughout BIDMC

2. Implementation of a new intranet based on social networking best practices3. Implementation of a fully upgraded Peoplesoft suite in support of fiscal and HR

operations

We have developed this Operating Plan based on discussions with our customers within BIDMC. We will use this plan throughout the year as a yardstick to evaluate our performance in meeting our goals. All levels of Information Systems staff have contributed to the Operating Plan and are committed to seeing that these promises to the BIDMC community are fulfilled.

It is very important to us that the customers of Information Systems are fully aware of our activities and plans. We will be keep all stakeholders informed about our progress on the Operating Plan throughout the year. We value your feedback and welcome any comments or questions on the initiatives described in this plan.

John D. Halamka MD


Academic and Research ComputingLeader: Steve Berry

Strategy: To select, design, implement, and support research administrative applications, including grants management, human subjects monitoring, and compliance education.

Goals for FY09: Participate in CTSA planning and technology development processes Support the Grants.Gov requirement for electronic grant submissions Implement IRB and Human Subjects tracking tools (Human Subject Enrollment) Implement new Animal Protocol and Animal Ordering Management Tracking Provide space, grant activity, and animal management reports to research

administration

Staffing:Director4 Analysts/Programmers 2 Desktop and application support specialists


Clinical SystemsLeader: Larry Markson

Strategy: To build, implement and maintain clinical systems.

Goals for FY09:Inpatient/POE/Pharmacy Complete implementation of POE for NICU Finalize plans for POE for ED Enhance inpatient pharmacy for chemotherapy Implement outpatient pharmacy for oncology/chemotherapy Enhance inpatient applications as prioritized by ICA Expand scope of support for in-house developed applications

WebOMR Implement referral tracking to “close the loop” for outpatient referrals Add additional coverage and office workflow features for test results tracking Expand the roll out for test results tracking and webOMR Lite Enhance webOMR as prioritized by webOMR Users Group

Clinical Documentation Establish governance for developing and implementing inpatient documentation Refine inpatient H&P and medication reconciliation (piloted in FY08) Begin planning and development of progress notes Identify and implement short term workflow enhancements for the discharge process Continue expansion of MA Share notification and communication systems

Radiology Enhance radiology portal, including adding report signing Evaluate Radiology speech recognition technology solutions Complete long-term strategy for the Radiology Information System (build vs. buy). Work with Radiology to develop a strategy and staffing/budget for Teleradiology

OR Implement intra-operative documentation in PIMS (Perioperative Information

Management System) Enhance PIMS as prioritized by OREC

Scanning Integrate scanned notes and reports in webOMR as prioritized by the Users Group Enhance PIMS assist PAT and OR in managing documents faxed from external sites

LISContinue implementation of SCC Laboratory system including: Validation of lab system builds Integration with existing clinical and financial applications Implementation of a new SCC clinical viewer for results Redesign of revenue cycle and specimen labeling workflows


Criitical Care Complete roll out of Metavision and retire CareVue Implement online viewing of critical care notes and flow sheets via the web Evaluate and implement Metavision enhancements as prioritized by the ICUs Support/upgrade AIMS, OBTV, Patient Safety and other systems as prioritized by

clinical governance

Cardiology Collaborate with CVI to develop a roadmap for replacing existing Cardiology prod-

ucts with a more integrated CIS suite for as many areas as possible Continue to evaluate and develop a plan for short- and long-term storage including

implementation of GE products vs. third-party storage management systems Retire Gemnet as part of the above plan Continue implementing/supporting CVI Registries Implement Apollo Inventory Management and Peripheral Vascular modules as priori-

tized by CVI leadership Support Apollo, MACLab/CardioLab and Echo

EMAR/PPID Complete selection and implementation of bar-coded wristbands to remaining adult

inpatient populations. Evaluate, select and implement solution for newborn/NICU. Collaborate with Pharmacy and Nursing to begin eMAR planning

Enterprise Image Management Provide consultative and/or project and technical management to Radiology, OB, GI,

CVI and other medical center PACS projects as prioritized by the Enterprise PACS committee

Support G-Care/G-Med

Rad/Onc Implement enhanced functionality for IMPAC including an automated ADT interface Transition support for JCRT database to Partners IS Support existing systems including: Impac, Cyberknife and treatment planning

Community EMR Continue to support efforts to implement the eClinicalWorks EHR to non-owned

BIDPO clinicians Implement e-prescribing and tamperproof solutions to all Logician sites Implement Logician lab interface to Meditech Needham Support Logician and other community systems

Staffing:Director 8 Managers22 Programmers22 Analysts


Computer OperationsLeader: Bob Doherty

Strategy: Provide computer operator, production services, and data center management. Latter includes coordinating space, racking, electrical circuits, environmental settings, low voltage cabling, and maintenance services related to the data center. Production Services includes processing of 45,000 batch runs, 10,500 tape mounts, 3,000 manual interventions to complete Computer Operations 7X24X365 production requirements each month.

Goals for FY09: Expand or replace DataTrax environmental monitoring system Develop a roadmap for space, wiring and cabinetry in the ReCen data center Support RFP and outsourcing initiative for mainframe Complete Autosys upgrade Complete outsourcing evaluation of print production functions Evaluate methods to optimize command center space use

Staffing: 1 Manager1 Supervisor4 Production Control Analysts8 Computer Operators

Database Services Leader: Don Wood

Strategy: Provides installation, licensing, support, performance monitoring, tuning, high availability, disaster recovery, and problem management for over 400 Oracle and Microsoft SQLServer data bases.

Goals for FY09 Achieve 80% database mirroring to PBS Data Center for disaster recovery Implement a Oracle RMAN plan Support continuation of Data Domain Implementation Support conversion of HP-UX hosted data bases to Red Hat Linux Convince Vendors to upgrade from SQL Server 2000 to 2005 Help Decision Support Services convert DTS to SSIS Support PeopleSoft version Upgrade Support implementation of MetaVision Support implementation of new Intranet Support Veritas I3 version 8 install on Linux Begin migration to SQL 2008

Staffing: Manager8 DBAs


Decision Support SystemsLeader: Carolyn Conti

Strategy: To implement decision support systems, including data warehousing, master physician directory, web-based reporting, and workflow applications.

Goals For FY09: Implement Performance Manager reports and dashboards as needed to support orga-

nizational needs. Implement clinical data marts as needed to enable quality measurement, pay for per-

formance goals, and other decision support needs. Support production of a new release of the printed BIDMC referral guide. Enhance SOAR (Accounts Receivable workflow) to support denial tracking and ap-

peals workflow Explore the introduction of new BI tools as funding permits Support Cactus and NEHEN Express users

Staffing: Manager 1 Programmer2 Analysts2 SQL Developers

Finance and AdministrationLeader: Jeanette Blackler

Strategy: Provides central liaison with Finance and Human Resources for IT-related recruitment, payroll, job classification, budgeting, purchasing ,accounts payable, and accounts receivable functions. Manages the IT Allocation process to recover IT expenses BIDMC incurs in support of others.

Goals for FY09: Complete match-up and market surveys for IT jobs including managers Coordinate the development of a telecommuting policy for IT workers Coordinate the evaluation of a telecom expense management service Assist with development of coding staff proposal to reduce A/R days Administer IT allocation and budget to include 95% or better collection rate

Staffing:Manager2 Analysts


Fiscal SystemsLeader: Steve Herzog

Strategy: Provide support and assistance in the selection and implementation of critical financial and human resources based software applications that will improve the hospitals overall Revenue Cycle, Human Resources, General Financials, Payroll, Research and Supply Chain operations.

Goals for FY09: Continue to implement additional non NEHEN processing capabilities to payers

that are not currently NEHEN members in support of PFS Revenue Cycle im-provement opportunities.

Implement enhanced BIDMC Case Mix capabilities to better reflect all of the data submitted to DHCFP and MHDC.

Implement additional automated Patient Claims Status Inquiry (HIPAA 276/277) capabilities as a process improvement opportunity for PFS.

Provide post upgrade implementation support of the PeopleSoft 8.9 HRMS and Payroll applications.

Implement the PeopleSoft ‘Single Sign-on” Active Directory adaptor post the completion of the HRMS/Payroll upgrade.

Redesign the BIDMC Employee Connections ‘Open Enrollment” process in an effort to improve the employee benefits selection experience.

Complete the PeopleSoft V9.0, Financial and Supply Chain applications upgrade project during the third quarter of FY09.

Implement additional data segments from CCC to the 3M HRM product to further enhance the HIM portion of the revenue cycle process.

Implement NEHEN version 11.8 during Q1 of FY09. Support the existing BIDMC Fiscal and Decision Support based applications Implement CCC/IBAX revenue cycle enhancements as prioritized by Patient Ac-

cess Services and Patient Financial Services Provide eGate and HIPAA transaction support to all BIDMC and CareGroup cus-

tomers Support all SoftLab and 3M HRM Data Integration requirements

Staffing:Senior Director Fiscal Information systems4 Managers16 Programmer Analysts4 Integration Specialists


Health Information Management Leader: Gerry Abrahamian

Strategy: To support the transition from paper documentation to electronic while ensuring the integrity, functionality and legal aspects of electronic solutions.

Goals for FY09: Enhance use of 3M HRM software with report writer training and new alerts Roll-out eScription to radiation oncology Reduce paper printing for documents that are electronically available Enable scanning for dermatology and work with WebOMR User Group on addi-

tional scanning priorities Complete 3rd phase of third level of Dedham Records Center build-out Evaluate coding implications of AHRQ indicators Perform compliance review of Hem/Onc coding Introduce barcodes on medical record forms Electronically transmit disability requests to the Social Security Administration Initiate work-at-home program for Cancer Tumor Registry staff

StaffingDirector 2 Managers


IS Support ServicesLeader: Margaret Hyland

Strategy: To provide support, service and maintenance of all equipment. To develop policies and processes based on best practices to optimize and enhance the use of technology resources and improve the overall support provided to users. To optimize budget and financial management through evaluation and implementation of technologies, standardization and management of the environment.

Goals for FY09: Windows 2008 introduction including evaluation of Hyper-V Active Directory 2008 upgrade and install read-only Domain Controller instances

at major off-sites (MTA and potentially Needham) VMWare expansion Production deployment of Acopia file virtualization appliance Update Microsoft Operations Manager to Systems Center Operations Manager Exchange 2007 migration including quota improvements Anti-Spam filter/appliance evaluations and upgrade as warranted SMS SP3 upgrade to System Center configuration Manager Optimize use of group purchasing agreements for desktop products Implement power management policies for desktops and/or servers Continue support of expanded home-sourcing program Continue to expand application support to general systems; i.e., eScription, Cap-

tiva, 3M HDM and others

Staffing: Director4 Managers1 Supervisor8 Engineers 2 Project Coordinators 1 Move Coordinator28.75 Support Specialists


Media ServicesLeader: Peter Macaulay

Strategy: To provide photography, graphics and video services

Goals for FY09:Support Poster and Graphics needsSupport Web New Media needsUpgrade the Video Production CenterSupport Telemedicine/Videoconference needsContinue standardized electronification of conference roomsUpgrade the CCTV infrastructure

Staffing:DirectorManager6 Media Specialists6 Media Associates

Knowledge ServicesLeader: Margo Coletti

Strategy: Knowledge Services provides knowledge based information resources to Medical Center staff and students. Working in collaboration with other branches of IS, work to develop standards for clinical and patient-readable forms, expand electronic resource collections, and improve access to knowledge bases. .Goals for FY09:

Continue print-to-online migration and establish the medical library as an infor-mation commons. Gather new usage stats and adjust infrastructure as needed

Continue to support knowledge resources on the BIDMC portal including new content and design for knowledge services

Expand the Plain Language initiative to create standards for patient-readable forms and training for writers of informed consents

Staffing:Director3.1 Information Specialists


Network ServicesLeader: Hal MacGregor

Strategy: Provides configuration, installation, licensing, availability, capacity, performance, problem, life-cycle asset, and strategy management

Goals for FY09: Implement Proteus software option for DNS/DHCP services Complete Internet redundancy project to support full-function auto failover Identify options for improving high availability for WAN connections Support CLS-related backfill moves Support telecommunications expense management evaluation Plan and implement wireless access services for major offsite locations Develop a plan for reducing the reliance and expense of SONET services In conjunction with Telecom, pilot converged, IP-based WAN connection Support iSCSI trial Migration of West campus infrastructure to Pilgrim’s Corner Upgrade of Distribution Layer to add capability for 10G, as required Provide technical and infrastructure expertise for BID-Needham’s expansion Upgrade external DNS services to BlueCat technology

Staff: Manager5 Network engineers2 Network technicians


Technical SecurityLeader: Mark Olson

Strategy: Provide configuration, installation, licensing, availability, capacity, performance, problem, life-cycle asset and strategy management for intrusion detection and prevention, vulnerability assessment, technical security training and education, IT surveillance, forensic services, SSL VPN, and Transfer.BIDMC.Harvard.Edu services

Goals for FY09: Install four additional IDS sensors to increase granularity of captured data Acquire software to support log aggregation Complete deployment of Third Brigade agents on production WinTel servers Support redesign of access and authorization policies and procedures Continue to develop on-line request forms to replace paper forms within IT to

provide support of more automated auditing. Collaborate with ISSC on “data at rest”, mobile computing strategy Provide DR project management for phase II applications to include:

o OB TraceVue o CareVue/iMDSofto Impac Radiation Treatment Planningo Peoplesoft Financialso Anesthesia Information Systemo eScriptiono 3Mo Data network management toolso Peoplesoft HRIS/Payroll

StaffingManagerPolicy EngineerSenior Security Engineer


Technical Systems Support Leader: Rocky Grasso

Strategy: Provide configuration, installation, licensing, availability, capacity, performance, problem, life-cycle asset and strategy management for storage, Unix, Linux, mainframe, and Cache environments.

Goals for FY09: Complete Data Domain deployment to include tape library retirement Complete IBM Bladecenter POC and define strategic infrastructure role Migrate CCC Test and Development Environments to VMs under XEN on RHEL CCC on RHEL - Phase II: Integrate Caché ECP for high availability/scalability Issue outsourcing RFP for mainframe hardware production and DR site Complete IBM IMS/DB, IBM z/OS, Cache, and EMC Control Center upgrades Evaluate and select EMC DMX replacement options Support cardiology PACS deployment Integrate BladeLogic for change control, provisioning, and auditing Complete evaluation and selection of NAS Support iSCSI trial Implement tier 3 storage with cost per GB target of $1~

Staffing:1 Manager4 MVS and Unix Systems Engineers2 Storage Systems Engineers2 Caché Systems Engineer

Technology Facilities ManagementLeader: Ty Dell

Strategy: Manage the electrical and mechanical infrastructure supporting computer, storage, network, and telecommunications equipment

Goals for FY09: Complete upgrade of PBS DR center UPS, flywheel and PDUs Diversify ATS switchboard configuration at RenCtr Analyze thermal rise exposure in data centers and data/telecom closets Install roll-up generator connection and generator test load bank Assess energy savings opportunity with evaporative cooling at RenCtr Replace backup CRAC unit in PBS for redundancy and cooling efficiency Continue improving monitoring and visibility of energy consumption

Staffing:1 Manager


TelecommunicationsLeader: Sandra Denekamp

Strategy: Provide configuration, installation, licensing, availability, capacity, performance, problem, life-cycle asset and strategy management for voice communications, pager, call management, telephone operator, and low voltage wiring environments

Goals for FY09: Deploy emergency notification system, e.g. Varoli Replace voice mail system – delayed in FY08 due to CLS and other projects Initiate migration of Deaconess sub-basement to Pilgrim’s Corner Expand Spectralink to selective locations Complete backup connection to NEU private fiber lateral Support CLS-related backfill moves Maintain 99.99 percent availability for dial tone, voice mail and paging services Support telecommunications expense management evaluation In conjunction with Network Svcs, pilot converged, IP-based WAN connection Provide technical and infrastructure expertise for BID-Needham’s expansion Investigate “follow-me” service for voice communications to telecommuters

Staffing:ManagerSupervisorProject coordinator1.8 Analysts4 Telecommunication Technicians


Web Applications and Applied InformaticsLeader: Qiang Wang

Strategy: To implement the content management, search and integration tools that power the CareGroup extranet and intranet.

Goals for FY09: Continue to enhance the Adverse Events Manager to support further roll out to de-

partments by Healthcare Quality. Continue to integrate PatientSite with Google Health, Microsoft Health Vault. Plan the migration of account provisioning and metadirectory services to SQL Server

and ASP.NET. Develop services to support document scanning, metadata capture, and document dis-

play. Support implementation of a new BIDMC internal portal Create web services as needed for integration of BIDMC applications and for interac-

tivity with external collaborators Support PatientSite clinicians and the end-user community

Staffing:Manager4 programmers1 Web Administrator


Beth Israel Deaconess Hospital-Needham

Leader: Steve O’Halloran

Strategy: To understand, support, and define strategic direction of all current and future environments related to Information Systems at BID-Needham

Goals for FY09 Continue to maximize usage of information systems within BID-Needham to

improve communication, increase patient safety, meet compliance requirements and utilize other technology benefit

o Nursing Documentation – LIVE February 2009o Electronic MAR – Begin - May 2009o Electronic MAR - Complete October 2009o Upgrade PICIS OR Manager to v8.8o Implement integration with physician EMR’s including eClinicalWorks

and GE Logician

Deliver current hardware and network architecture to maximize productivity for end users at BID-Needham

o Continue to manage hardware lifecycle including replacement, upgrades, and net-new installation of devices at BID-Needham

o Manage and support public and private wireless networko Complete renovation and expansion of IT room. Additional space will

now be secure and have rack space to support equipment and initiatives.

Grow relationship and development of new staff in IS and BIDN staff, to allow for focus on more IT Strategy and execution of tasks

o Educate staff on IT environment at BIDN to be able to transition tasks and support including user maintenance, PICIS OR Manager, MEDITECH.

o Focus on IS strategy, identifying cost savings, increasing patient safety, and better workflow and processes within BID-Needham

o Continue to manage expectations and functionality between IS applications at BIDMC and BIDN.

Manage and maintain departmental costs by good decision-making and strong communication for all information systems projects/issues/strategies

o Continue to work with BID-Needham staff on involving IS for logistics, requirements, technology, and anything else that allows hospital projects to achieve success.

Staffing:DirectorBIDMC Desktop supportMTA AnalystsNeedham Analyst