Automating, Interfacing & Integrating10 Years of Success

NEON Users Conference - Orlando, FL

November 15-17, 2000

www.fredhenning.com

Fred HenningSenior Technology AnalystAlexian Brothers Medical CenterElk Grove Village, IL

Alexian Brothers Health System

The Alexian Brothers 700 year old worldwide religious congregation

• Alexian Brothers Medical Center, Elk Grove, IL• St Alexius Medical Center, Hoffman Estates, IL• Alexian Brothers Behavioral Health Hospital, Hoffman Estates, IL• Retirement Communities & Nursing Homes

Milwaukee, WI Signal Mountain & Chattanooga, TN St Louis, MO

• Alexian Brothers Health Providers (managed care)• Bonaventure Medical Foundation (phy. offices)• Alexian Field

– Schaumburg Flyers Baseball Stadium• etc.

www.alexian.org

Alexian Brothers Medical Center

Alexian Brothers Medical Center, Elk Grove470 licensed beds700 + physicians2500 + employees

Elk Grove Village, ILChicago suburbwestern boundary of O’Hare airportpopulation 35,0005000 + industrial occupancieswork force of 90,000

Accessible Data:

• make data accessible to– all users– to & from all systems– in a user friendly format– and the data must be timely

ABMC

Alexian Brothers of Illinois

P.S.N

Digital/isdn

analoghbocvan

Internet

Schaumburg

Hoffman Est

Hanover Park

BensenvilleWood Dale

Woodlandsoffice complexWimmer

Bldg

BrockPlaza

NorthPavilion

Hospital

NiehoffPavilion

ABHP BMF

Acct., PFAMarketing

Mt Prospect

Clinic

isp

Elk GroveABHS

ABBHH

St Alexis

BMF, OH

BMF, MH/A

OH

BMF, OH

BMF

OH

other

Physicians

Data Center

Itasca 500 Park

AlexIS

decision support

order/charge managementpatient registration

advanced nursing

pharmacy radiology microbiology laboratory

medical recordschart tracking

Office Automation

central transcription

central supply equipment

tracking

switchboard doctors’ registry

general ledgeraccounts payable

patient accountinggeneral accounting

human resourcespayroll

medical records drg encoder

cancer registryquality management surgery scheduling

laboratory instruments blood bank

EKG

time & attendance

home based transcription

extended business office

Medicare reimbursement

EDIcontract

management

e-mailspreadsheet data base

word processing presentationwork group

Enterprise Data BankHealth Network Index

Clinical Data Repository - Longitudinal Medical RecordSecurity / Single Sign-on

Enterprise Decision Support

SchedulingRegistrationClinical

Workstation

Point ofCare

RegionalMental Health

Addictions

MetropolitanCHIN

PracticeManagement

PhysicianOffices

OccupationalHealth

HomeHealth DME

ManagedCare

PPO

PHO

EDI

SNF

Long TermCare ???????

© 1996-2000 fred henning

DiagnosticImaging

EAP

Integration Technology

Enterprise Integration - 1994-96 - the Reality in 2000

What do You Need?

What do your systems need? How do we get what we need?

• a message type data set • (HL-7 & other standards)

• specific data elements• (data base)

• anything & everything

Is HL-7, ‘The Standard’, the Answer?

Do we need an Integration Engine or Integration Tools?

HL-7 - specific classes of messages, defined data elements, triggers

HL-7 is not pervasive HL-7 is not universalHL-7 is a moving target

legacy systems do not support HL-7smaller departmental systems do not support HL-7Vendors only support what they need or want to It costs $$$ to turn on HL-7 segments

some cookies!

• just what can a tool or engine do?• SAVE MONEY and make you Look Good• some examples of projects and savings

Use tools to:

download

manipulate upload

move data between systems

Take Control of Your DATA!

Do it Yourself and Save $$$... No annual fees, No support fees! Early MicroScript Projects & SAVINGS• $30k PHS (Keane) to HBOC Star build• $30k Star to Terrano Lab interface (ADT)• $15k Star to EDSTAN doctors register interface (ATD)• $50k Data General CEO to WordPerfect conversion• $15k Star to ChartScript interface (ADT)• $30k Star to MIDS interface (ADT, Financial, Clinical)• $ 5k INFORM to ResQ-OR build• $20k Star / CAMS two-way interface (ADT, charges)• $15k TXEN to Star interface (GL posting)• $10k Star to DDI build (time & attendance system)• $15k Star to DDI interface (HR, Payroll)• $30k Star Chart Tracking conversion rebuild$265,000 Real Dollars in initial savings

• Message Engine (HL-7 from HIS)

– Pathways Healthcare Scheduling– Cortex (pathology)– ChartScript (Medical Transcription)– Xtend (Switchboard & Dr’s Answering Service)– CathCor (Cardiac Cath)– Dictaphone (Radiology Transcription)

ABMC NEON Implementation:

Note: the output may not be HL-7

ABMC NEON Implementation: cont.

• Component Technology– replace multiple DOS MicroScripts & add new ones

• MedStaff (Physician Coverage)

• Payroll Direct Deposit

• 401k, 403b placements

• Physician Billing Services - Radiology, Pathology, ER, EKG– tapes or electronic files

• Patient Refunds (St Alexius)

• OSI Sim & Fim project

• Item Master project

• MIDAS (Quality Management)

• ResQ-OR (Surgery)

• Extended Business Office Project $

Automation & Interfacing with NEON

Financial

Laboratory

Patient Care

Data Stream

Data Stream

Message Engine

ResQ-OR

MIDAS

ChartScript Cortex Xtend CathCor Dictaphone Rad

HBOC PHS

MedStaff Phy Coverage

Direct Deposit

401K 403B

Billing tape/files

St Alexius Patient Refunds

OSI Sim & Fim project

Item Master project

Extended Business Office & DDI Projects

Financial

EBO -1 & Special Projects

EBO -2

EBO -3

EBO -4

Bad Guy

DDITPS

Automate an Interface??a PC a day keeps the staff away!

ResQ-ORapplication

Ethernet LAN

NEON Data Stream

Did you think the “base” interface was automatically going tomove the data between the applications?

UNIX CPU Patient Care Applications

The ChartScript Interface Project:

LAN

Message Engine ADT Stream ChartScript Interface PCChartScript Application on Server

• two PCs are better than one• use the existing ADT data stream • let someone else keep up with the changes in

their software!

A Data Entry Tool:

not just when you are setting up a new system

• if a ‘one shot’ is the answer then a Data Stream Control may be a better one

• setting up files in DDI telephone time and attendance system– moving data from HIS to DDI

• Patient Accounting - Extended Business Office - telephone collections– use data from a SQL download as input and– change collector codes and account status in HIS

• Alexian Brothers Health Providers - Managed Care – TXEN (IBM AS400) to HBOC Star Financial GL

DDI - Time & Attendance

Please! Make it Simple

Data Entry into only ONE System - STAR

Update Daily - STAR to DDI

Custom Pay Rules without customizing

Reduce DDI system resources requirement

Easy access to Reports from any site

Paperless!

Extended Business Office Project:

getting around STAR’s “bad debt” limitations

$

Setting up accounts that will be placed

change Financial Class

place account on Hold

add a Note

placing accounts with Outsource Vendor(s)

daily - Payment & Adjustment data to Vendor(s)

Notes returned from vendor(s)

Accounts returned

take account off of Hold

add Notes

Pre List for Bad Debt

etc. !!!

Monitoring Systems:the user view vs. the technical view!

SNMP monitoring data

“sar” cpu and I/O data

“ping” response

application screen responseThe Data Stream acts as a ‘Virtual User’ and therefore sees the same response time of the user.

Browser - ‘Virtual User’ to html:

Browser request

tcp/ip

middleware conversions

Applicationsany number onany number of servers

Data Stream to Browser Example: Alexian Brothers Financial Account Revision Processor

Fri Aug 20, 1999 16:14 Account Name FC Type Admit Disch Balance Loc A99162-00NNN ABCDEFG,FIRST PO M/H 06/11/99 06/18/99 $349.99 AR 1 Total Charges 2 Total Adj 3 Total Payments 4 Refunds? 5 Exp? $7,234.35 $3,734.35- $3,150.01 No No 6 Ins Liability 7 Ins Adj 8 Ins Payments 9 Pre-Collection $0.00 $3,734.35- $3,150.01 10 Pt Liability 11 Patient Adj 12 Pt Payments 13 Last Pt Payment $349.99 $0.00 $0.00 14 Wkfl 15 Schd 16 Schd Type 17 Lst FU Dt Ty Sq 18 FU Hold 300 Custom 07/24/99 D 1 Yes 19 BD Pre-Listed 20 BD Date 21 Agency 22 BD Transfer Amount 23 Social Sec # 24 Birth Date 25 Bill Hld 26 Notes? 27 Adm By 28 Oth Accts 335-NN-NNNN 05/05/1977 No Yes BAM Yes 29 COB Ins Carrier #Clm LCS SubmitDt Est Amt Due Amt Pd Dsp Date 1 KVI 1 1 06/26/99 $7,234.35 $3,150.01 F 08/13/99 2 PPO 1500 PLAN Press NL for Menu, enter code, or '-' for list--

What is a Shadow HMO?

$$$,$$$.$$Recovered

What else can I do?

If the report gives you a hernia then let’s automate

Please SAVE some trees...