Plan Details: Key Components that Drive Integration

The Clinical Transformation Project, aiming to bring URMC’s infrastructure on par with the nation’s best AMCs, is considering five key components that could make this modernization possible. In light of the need to scale back costs by 20 to 25 percent, some of these have been modified; still, each component endeavors to better connect caregivers and promote more efficient, safer, patient-centric care. Listed in order of priority, these include:

• Like other top medical centers, the project’s keystone is a single, shared acute care EMR that will serve both Strong and Highland, making patient data available URMC-wide. Regardless of a patient’s point of entry, a comprehensive view of all records pertaining to him or her are at the fingertips of all his or her URMC caregivers under one unifying patient number. The initial roll-out will be to inpatient units (where it replaces the current CIS, or clinical information system), ED, pharmacy and oncology. Down the road – possibly in the next three to five years – remaining key areas will also be grafted in (including cardiology, peri-op, transplant, OBGYN, anesthesia and radiology).
• The platform chosen to power this communal EMR must accommodate select existing applications that we plan to maintain (likely, Allscripts Touchworks for ambulatory care, and Flowcast and HBOC Star for patient admissions and billing). Middleware, or computer software that connects different applications, will synch these systems with the acute care EMR.
• An enterprise master patient index, or EMPI, will enhance continuity of care between Highland and Strong hospitals. Though patients currently receive different identification numbers depending on where they are seen, this EMPI will match those numbers behind the scenes, allowing the caregivers to see a consolidated view of all records of an individual patient, regardless of if they are at Strong or Highland.
• The new solution supplies clinical decision-making support, and provides a more robust means for coalescing data (for clinical and translational research), tracking core measures, and conducting operations analyses and other required reports. Streamlining these processes will prove indispensable as healthcare moves to a Pay for Performance reimbursement model.
• Community physician access to the new EMR, to better support URMC's referring network. Running complimentary to the Rochester RHIO, but with broader geographic reach and different functionality, this tool is essential to our ability to operate as an upstate referral center.

To read a more comprehensive report on the state of the Clinical Transformation Project, download the Project Narrative Executive Summary, here.

The project’s original aim and scope, pictured above. Most aspects remain in place, though the EMR will be deployed with a more gradual, phased roll-out; the Business Intelligence/Enterprise Data Warehouse component also has been scaled back significantly. The project still spotlights an effort to find more streamlined ways to coalesce critical data – both for research and reporting purposes.

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