This document summarizes a panel discussion on strategies for achieving excellence in healthcare IT. The panelists were the CIOs of Main Line Health, UKE Hamburg, and St. Michael's Hospital. They discussed their experiences implementing electronic medical record systems and overcoming challenges such as change management, clinical engagement, and balancing privacy with mobility. Key lessons included developing standardized processes, taking a top-down approach with hospital-wide responsibility, and moving quickly during implementation.

1. Worldwide Lessons in
Healthcare IT:
Hospital Leaders Share Strategies to
Achieve Performance Excellence
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2. How to Participate
• Submit your questions in the GoToWebinar presentation
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• This webinar will be recorded and available for
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3. About the Moderator
Marc Overhage, MD, Ph.D.
Dr. Overhage is the Chief Medical Informatics Officer for
Siemens Healthcare. Prior to joining Siemens he was the
founding Chief Executive Officer of the Indiana Health
Information Exchange and was Director of Medical
Informatics at the Regenstrief Institute, Inc., and a Sam
Regenstrief Professor of Medical Informatics at the Indiana
University School of Medicine. Over the last decade, Dr
Overhage has played a significant regional and national
leadership role in advancing the policy, standards, financing
and implementation of health information exchange.

4. About The Panel
Karen Thomas, Senior Vice President and CIO, Main Line Health, Bryn Mawr, PA- United
States
Since joining MLH in 1995 as Assistant CIO, Karen Thomas has served on various major IS
implementations and initiatives including patient, administrative and financial systems and the
technology infrastructure to support these initiatives. She began her information technology
career at Andersen Consulting; and later held a variety of IS management roles, including the
Director of Patient and Physician Systems, at Hahnemann University Hospital.
Henning Schneider, CIO, UKE Hamburg- Germany
Henning Schneider has been the head of the medical IT department at the University Medical
Center Hamburg-Eppendorf (UKE) since 2008. In 2011 the UKE was rated as the first stage 7
hospital in Europe by HIMSS Analytics for its complete digital workflow. In 2005 he invented and
established the Imaging Science Institute (www.isi-erlangen.de) which was a joint research
center between Siemens and the University Hospital of Erlangen to improve and develop
medical devices, IT systems and processes directly in a clinical environment.
Anne Trafford, Vice President, Performance, Information Management & CIO, St.
Michael's Hospital- Canada
Anne Trafford joined St. Michael’s Hospital, Ontario, Canada, as Chief Information Officer (CIO)
in September 2005. As a member of the Senior Management Team, Ms. Trafford helps to
define St. Michael’s information management strategy, and ensure the hospital is at the leading-
edge of health-care information management to enhance the delivery of safe, quality patient
care. The CIO portfolio at St. Michael’s Hospital encompasses the traditional Information
Technology and Communication services as well as the Process Redesign Office, Patient
Registration and Health Information Management.

5. IT Practices
September 2012
Karen Thomas
Main Line Health System

6. Recent Recognitions and Accomplishments
• HIMSS Analytics Stage 6
• Achieved MU Stage 1 Feb 2012

7. Current Initiatives
• Expansion of the Patient Portal beyond our pilot
• Conversion of Cerner Clinical Information Systems to Soarian
(recently acquired hospital)
• Enhanced Disaster Recovery Solution – secondary site
• Migration to Soarian ED system
• ICD10 preparation
• MU Stage 2
• Single Sign On

8. MLH Opportunities (Challenges)
• Resources:
– Staffing
– Capital
• Breadth and Complexity of IT solutions driving focus on IT practices
• Clinical Project Ownership/Championship
• Health Care Reform is driving new care models
– How does our current IT landscape support emerging models?

9. Information Management at St. Michael’s
Hospital
Anne Trafford, BSc. RN
Vice President, Performance,
Information Management and Chief
Information Officer
9

10. • $600+ M operating
budget
• 475 inpatient beds
• 26,000 inpatient
discharges
• 35,000 surgical cases
• 61,525 emergency visits
• 440,000 ambulatory visits
• 260,000 diagnostic &
other visits
• 5,000 staff
• 600 GFT physicians

11. Our Toronto catchment area is large and diverse
• 345,000 people (8% of Toronto’s
population)
• Diverse - ethnically, culturally and
economically
• Largest concentration of homeless
• High prevalence of mental illness
and addictions
• High concentration of socially
isolated seniors
• Many commuters
• Represents approximately 32% of
our patient care services

12. Li Ka Shing Knowledge Institute
SMH
A Culture of Caring and Discovery
Accelerated Bench
To Bedside Practice
Li Ka Shing Keenan
International Research Centre:
Centre in Health Translational
Care Education: Research
Evaluation
Vision:
The Li Ka Shing Knowledge Institute will provide an environment where
researchers, educators, health professionals, students, patients,
communities and the general public work together to provide the best
possible preventive and health care.

13. Project Gemini – 2003 - 2011
• Twinning of transformation
and technology
• Clinical transformation as the
underpinning to the project
• Harness power of workflow
technology to enable practice
and process change
13

14. SMH as a leader in eHealth
Only academic
health science
centre in
Canada to
achieve Level 6

15. Our Applications Environment
• Electronic Patient Record
• Soarian clinicals – Scheduling, Clin doc, orders, results
• MS4 ADT
• Syngo RIS
• Siemens Rx
• Home grown – eDischarge, eSignOut
• Ambulatory referral tracking
• Softmed Health Records
• Sovera document management
• Soft Lab
• Multiple diagnostic systems (GE, Philips)
• Practice Solutions EMR for Family Medicine
• Lawson ERP **
• Over 90 apps in inventory

16. SMH partners in Provincial eHealth
• Electronic patient referrals to Rehab, Long
Term Care and Home Care are electronic
• “Connecting GTA” will allow 20,000
clinicians to access patient record data
across Great Toronto Area
• “Image Repository” provides access to
reports and images for over 20 hospitals
(Canada Infoway program)
• SMH Family Practice units have an
Electronic Medical Record (funded by
eHealth Ontario program)

17. Challenges/Gaps
• Keeping pace with technology – BYOD
• Balancing privacy/security with mobility and access
• Change management sustainability
• Mismatch between incentives and funding
• Functional gaps: OR, ED, Critical Care, Ambulatory
• Enabling the quality strategy with good information
and analytical tools (currently implementing Soarian
Embedded Analytics for clinicals)

18. Implementation of an electronic patient record
Henning Schneider University Hospital Hamburg-
Chief Information Officer Eppendorf:
1.500 Beds
80.000 In-patients
263.000 Out-patients

19. UKE founded in 1889
Heinrich Curschmann,
„Hospitals are not built for centuries, they need to be constantly renewed“

20. UKE in 2004

21. s
ces
p ro
w s
llo
fo
IT
<>
ti ce
r ac
o fp
de
co

22. Lesson 1:
Develop standardized,
interdisciplinary processes
Departments / Departments /
Professions Center
Processes Processes

23. Central
Emergency Department
ZNA

24. “Lone fighters“
Work Dean
Doctors Clinic
council
Admin
CEO
Preclinics
Affiliates Chiefs
Teaching
CFO Research
Nurse
42 Departments, 33 Institutes, 167 Professors

25. Change …
Konrad Lorenz:
“People in-between Change”
•said is not heard.
•heard is not understood
•understood is not agreed
•agreed is not applied
•and applied is not maintained

26. Lesson 2: „Networked“ Expertise,
Top Down approach & Responisbility
An EMR-Project is not an IT-project it is a hospital project!

27. Lesson 3: Be fast

28. d
an
rs
Patient Census
cto
Clinical summary
EDTB
do
n
Clinical letter Results
! e
es e
Tumor board Patient record
rs etw
Workflows Archiv
nu s b
Soarian
ce
n
re
fe
Assessments
d if
Order Entry
Documentation
Service charges
Quality-
m
Consultation
Management
st e
sy

29. s
rm
t fo
en
ssm
se
as
d
an
s
ew
vi
ard
nd
ta

30. No Paper: Scan–to–EPR
er
External paper,  scan to archive pap
ith
w
ti on
n ta
e
m
ocu
d
a ry
nd
co
se in SOARIAN Health Archive
… safe storage
o

31. Soarian @ UKE
!
am
te
te
n si
o
m
fro
o rt
p p
su
d
ue
n tin
co

32. Stage 6 & 7: US vs Europa
Stage 7 / European EMR Adoption Model
2010: 0
2011: 1 (!) UKE, HAMBURG (D)
Stage 6 / European EMR Adoption Model
2010: 3
- HUG, Genf (CH)
- Odense (DK)
- ISMETT, Palermo (I)
2011: 6
- UKE, Hamburg (D)
- Hospital de Denia (E)
- Badalona (E)
- Kronoberg (SE)
-…

33. Profitability
n ly
o
it h
w
ts ff
n ta
a atie l s
P n
re itio
o d
m d
% a
60 0%
g 1
t in
r ea
T

34. 

35. 
Lesson learned:
Don‘t ask too many
or the wrong „decision makers“

37. Thanks for Joining Us
• This webinar will be available on-demand at
www.HealthWorksCollective.com. Stop by to learn more and
share your comments.
• Connect with our panelists on HealthWorks Collective using the
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