Case Studies

University of Rochester Medical Center
Three hospitals, plus other facilities including the Medical School, Dental School and Nursing School
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About the client
The University of Rochester Medical Center (URMC)/Strong Health is at the heart of medical knowledge and expertise for Central New York State and the Finger Lakes region of Upstate New York. It includes the University of Rochester School of Medicine and Dentistry, the School of Nursing, the Eastman Dental Center, the University of Rochester Medical Faculty Group, Strong Memorial Hospital, Golisano Children's Hospital at Strong and Highland Hospital.

About the project
University of Rochester Medical Center/Strong Health needed resources that could take over the majority of the responsibilities for implementing OAS Gold, Clinician View, Net Access, and Physician Order Entry Starter Set (POE SS). There were several firms considered, including the vendor. Stoltenberg won the business because of our prior engagements with URMC coupled with our clinical and application expertise. Our consultants became the only outside resource to be trained in POE SS and the only resource URMC needed for their project. Our consultants performed 85 to 90 percent of the work and provided valuable training to the staff. This training ensured their staff was able to support the new applications. Keeping to Stoltenberg’s values, we once again were on track for having the product installed and the pilot live in record time.

Facilitated new Invision region for the Highland Hospital:

• Master Patient Index load into Invision from HBOC Star Master Patient Index file
• Master Patient Index backload into Enterprise Access Directory after Invision load. Facilitating the backload so that minimal duplicates were created with the approximate 80 percent overlap of existing Strong hospital patients
• Ran Stoltenberg Consulting’s IntegraFind software to identify duplicates in the database that needed to be addressed
• Creating an Admit Discharge Transfer RTIF interface between HBOC Star admission and registration system into Invision and Enterprise Access Directory
• Worked with the Medical Records department to create functions necessary in the respective Invision systems to facilitate Enterprise Access Directory merges on an ongoing basis as well as other patient management issues including accounts and results. Basis of duplicates generated by day-end reports out of Enterprise Access Directory. Reports evaluated Highland Hospital and Strong Hospital and a combination of the two

Assisted in the implementation of the SoftLab laboratory system

• Worked on the results interfacing between SoftLab and Lifetime Clinical Record including much Common Vocabulary Engine work
• Rebuilt the Microbiology results and orders to accommodate processing for SoftLab
• Utilizing Job Control Language, SAS and SQL (Structure Query Language) reporting, monitored interface processing during go-live as well as duplicate results and pending status clean-up

Converted most of the printed documents from Invision to Printer Control Language coded documents

• Dynamic Results documents
• Order requisition documents
• Special departmental documents

Rebuilt the Admit Discharge Transfer RTIF interface between Omega and Invision for Strong Memorial Hospital to reduce/eliminate unnecessary errors and reduce the amount of time spent by the analysts on the interface issues.

Conversion of Invision Physician Order Entry order processing to Physician Order Entry Starter Set utilizing Net Access Interoperability to Siemens OAS Gold Re-Expressed.

Physician Order Entry Starter Set is Common Vocabulary Engine based which allows for a robust search capability as well as an enhanced ability to create “Order Sets.” During this process, we are implementing Siemens Gold Re-Expressed, Clinician View, and Net Access as their front end. This will take the client’s current Physician Order Entry System created in Invision to the next level.

Our design is focused around ease of use for the clinician. We are able to provide general views, which would provide the general clinical user to place typical orders via “Common Lists.” Uncommon orders can still be searched for and placed. The real strength of the design is for specialty areas. These “Common Lists” and Ordersets can be changed based on the user’s specific specialty. Since different specialties have different orders they commonly use, users can see their popular orders and not be worried with extraneous information unless necessary.

This design gives the users exactly what they need to accomplish their jobs -- without an overload of information on the screen. However, for those unusual times, access to more information is only one mouse click away. This allows the user to safely place their orders without confusion associated with complicated order entry pathways.

Since medication and IVs are part of the ordering process, a system was designed to allow the pharmacy department to notify the user of special information. This information could be used for prescribing medication or to alert the physician of medications that are not being provided in the pharmacy formulary as a standard. In the case of medications not being processed by the pharmacy, this notification process allows the pharmacy to provide selections of alternate medications for ordering. This has and will continue to save millions of dollars in medications alone. The pharmacy can now redirect the provider from a costly medication to a more cost-effective substitute. As always, however, the physician has the ability to override the process and continue with the order if it is available via the pharmacy.

This system has been designed with replication in mind. With minimal changes, this system can be implemented at the client's other facilities decreasing time required to build, implement and move into production. Stoltenberg Consulting was able to accomplish these procedural and system enhancements because we always consider the hospital business implications and needs during the implementation process from the project management down to the consultant level.

Client’s comments about Stoltenberg Consulting
“Working with Stoltenberg has assisted URMC/Strong Health in transitioning the current 3270 based CPOE system to the browser based OAS Gold system that the providers have been begging for. The Stoltenberg consultants assigned to the project were knowledgeable and diligent in keeping the project moving forward in a timely manner. Having them on site each week has assisted in the knowledge transfer necessary for the permanent staff to continue to enhance and maintain the system.”
      Dawn Robinson
      Clinical Systems Manager

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