Trinity Health - Optimal Resume

Trinity Health
An Information Systems Synopsis and Critique
Patrick Boudreaux Matthew Curtis Brian Frey Ibrahim Ghabra Julie Rutledge Nikita Shah December 9, 2009 TABLE OF CONTENTS SUMMARY Nature of Healthcare and Information Systems .................................................... 1 Trinity Health Background and Mission ................................................................ 2 Role of IS at Trinity .............................................................................................. 3 Specifics about Trinity .......................................................................................... 5 Project Issues ........................................................................................................ 7 Information Security & Risk Mitigation .................................................................. 8 CRITIQUE Information Systems Impact ................................................................................ 10 Project Investment Determination ...................................................................... 13 Systems Analysis ................................................................................................. 15 Culture and Organizational Change ................................................................... 18 Conclusion .......................................................................................................... 20 REFERENCES ............................................................................................................... 21-­‐22 APPENDIX A .................................................................................................................... 23 APPENDIX B .................................................................................................................... 24 APPENDIX C .................................................................................................................... 25 SUMMARY Nature of Healthcare and Information Systems Figure 1 Information Systems are highly integrated and the heart of infrastructure for any company. As seen here, they serve as the common link between management, technology and organizations. Information systems (IS) by their nature are complex, intertwined structures comprising all aspects of an organization. From communication to operations and financial infrastructure, IS are integral to any organization seeking to maintain continuity, viability, business growth and development. IS planning is a core part of an organization’s strategic platform, with the following goals: operational excellence, new products/services and business model development, consumer and supplier intimacy, improved decision making, competitive advantage and survival.7 This framework and design applies to all organizations in existence today. The same framework applies in healthcare, where technology, strategy and software are part of the IS’s core. However, patients and patient care add another layer to the existing complexity of these systems. Healthcare companies do not differ from other companies in terms of basic structure. However, Healthcare Figure 2 Information Systems (HIS) face increased levels of complexity, and since the need 1 for integration is attributed to the inherent nature of the business, the role of IS is extremely vital. As seen from Figure 2, IS in healthcare must account and accommodate for the delicate nature of patient care and its related components. Issues such as patient privacy, information disclosure, medication management, treatment interaction avoidance, access to medical protocols and adherence to laws and regulations must all be integrated into an HIS. A healthcare organization must balance the IS it employs with all the patient and care needs it must fulfill, as well as the physicians and clinicians who provide care. Complex systems that are not user friendly can result in mistakes that may cause harm to the patient. The ideal system makes patient information readily available, understandable to all parties and removes the human error component, which is innate in healthcare. HIS is rapidly evolving from paper charts and records to sophisticated Electronic Health Records (EHRs) and Computer Physician Order Entry systems (CPOE). While these developments create advancement opportunities, integration and standardization of care, it is important that hospitals and health systems maintain focus on the patient. As companies have their strategic goals for implementing IS, healthcare has similar goals to maintain: effective, safe, efficient, and patient-­‐centered care.6 Many organizations attempt to fulfill this monumental task, but success requires dedication from the organization, resources, and employee commitment. One such organization is Trinity Health, located in Novi, Michigan. Trinity is considered a leader in industry standards through the strides they have accomplished in the HIS realm. Trinity Health Background and Mission Trinity is the fourth largest Catholic health system based on operating revenue and the eleventh largest health system overall in the United States.2 Trinity’s Catholic background provides a unique perspective for the strategy and vision of its healthcare facilities. Their mission “...is to make sure the people who cannot get care get it,” which creates a personal tie for current employees, attracts new 2 talent, and drives the organization’s decisions.3 The mission and vision of Trinity are interconnected. While the mission is the guiding principle for the organization, the vision streamlines the organization and strengthens the resources to fulfill the goal of helping the underserved. Furthermore, the vision of Trinity is to be a leader in health care delivery and is illustrated through the various community and patient focused initiatives. Trinity Health and Information Services Figure 3 displays a detailed version of the Information Services structure. As illustrated, Trinity operates its IT department as a separate division. By having this central IS department, decisions can be made more easily for the entire company. This structure “is more likely to produce more compatible systems and more coherent long-­‐term development plans.” 7 Role of IS at Trinity As with any organization there are a number of IS utilized throughout Trinity. Each of the different systems meets the specific business objectives. Their IS goals, like other organizations, depend on system limitations.7 Following St. Johns’ merger with Mercy, Trinity needed uniform systems. This 3 process continues to evolve as the organization seeks department symmetry. Trinity hopes to fully integrate its management IS sometime in the next decade. Full systems integration will allow Trinity to remove the individual administrative and IS departments out of the hospitals.3 This goal has come to fruition with data centers, located in South Bend, IN and Novi, MI, servicing information across the United States. Two of the larger projects that Trinity has been working on are CPOE and the Genesis Initiative (Genesis). CPOE is effectively utilized as a checks-­‐and-­‐balances system for doctors and pharmacists to ensure that diagnoses, prescriptions, and pre-­‐existing conditions do not interact and cause adverse health effects. Furthermore, the speed at which information, treatments, and prescriptions are delivered to a patient will improve significantly as information flows directly from a doctor’s laptop to the pharmacy where the order is instantaneously processed and shipped. When Genesis was first implemented, it was viewed solely as an IT problem. As it became clear that all clerical and clinical settings should be included, it became more of a solution for everyone. The project includes Electronic Medical Records (EMR) between departments and care providers, online orders for tests and treatments, bedside charting abilities and automatic verification of lab results to pharmaceutical orders. Even though Genesis is still in its early stages, Trinity has already seen an array of positive effects stemming from it. Ideally, this project will eliminate small area variations, meaning patients in San Francisco, CA can take advantage of the same evidence-­‐based guidelines generated in Grand Rapids, MI. Specifics about Trinity IS Genesis aimed “to integrate electronic patient information with the latest in treatment standards and medical research”. 8 This was not a menial task; it is estimated to have cost Trinity $285 million to fund Genesis and the IS operating expense is currently about 3% of Trinity‘s total revenue. 2 4 The project was divided into two phases: Phase I launched in 2001 and included clinical data repositories, EHR viewer for lab results, diagnostic and procedure reports, pharmacy system patient medication profiles, and Adverse Drug Effects (ADE) alerts. 1 Phase II launched in 2003 and included CPOE, clinical documentation, decision support systems, and brand new systems for pharmacy, radiology, emergency tracking, finance, and medical records .1 However, the applications for each respective area were selectively chosen. Each application had to fit within the overall vision of the project. The vision was not only to implement a new IS idea, but to make it operationally feasible. Trinity had to change many of their processes, starting with updating all their workflows to be patient-­‐
centered and work towards common systems. Furthermore, they focused their resources on developing shared services. When selecting the applications, Trinity needed an off-­‐the-­‐shelf, customizable database-­‐driven system, which would allow them to add more tools and functionality and, ultimately, meet the goals of their project vision.3 Having common workflows and applications standardizes processes, which saves Trinity on exuberant resource expenses and detracts from their mission to care for underserved individuals.3 Trinity selected four major applications to meet its IT vision for each of the major roles: clinical (Cerner), patient administration/revenue management (McKesson), human resources/payroll (PeopleSoft), and supply chain/AP (Lawson). The IT organization is still in the process of implementing uniform applications at all of its hospitals. The application architecture somewhat resembles a quilt (Appendix A). Trinity's CIO, Paul Browne, refers to the quilt as a means to explain the multi-­‐colored spreadsheet that encompasses the different IT systems utilized by the Trinity organization. It illustrates how the four major software applications integrate and link the following departments: Revenue Management, Enterprise Resource Planning (ERP), Clinical Systems, Telecommunications, Tools, 5 Integration Tools, Hardware, Operating Systems/Software, Infrastructure Management Systems/Tools, and DSS Informatics Reporting, Analysis, and B/I capabilities (Appendix A). According to Tom Centlivre, Director of IS Strategic Planning, these systems represent shared services and common access points.3 Thus, the quilt explains how the aforementioned subdivisions link the home office with sixteen hospitals that are spread across six states, and how people within the organization access each of the various systems at Trinity through Continuing Care (TCCS) and Home Health Services (THHS).3 For example, the quilt allows the IS executives and employees to view the current systems linkages inside the organization, assess the progress of linking all of the hospitals together through common software and IS, and calculate where changes to IS take place. Furthermore, the quilt enables Trinity to implement organizational standards and common practices within its network. A common organizational platform permits Trinity to monitor each hospital’s daily activities and coordinate its operations with the organization’s mission statement. The integration of Trinity’s IS with its hospitals has contributed to its overall success. According to Mr. Browne, the key to Trinity's triumphs heavily depends on the organization's "early adoption" IS integration approach to new technology. 3 Over the last ten years, Trinity sought to be an “early adopter” of new hospital technology. Due to variations in health care and the need to eliminate waste, Trinity has been compelled to “push the limits” in order to provide people with cutting-­‐edge, high-­‐quality health care. 3 Paul Browne noted that this methodology involves risk and that it has frustrated a few physicians to a point where they have refused to refer patients to Trinity hospitals. The choice to be an “early adopter,” rather than a mainstream adopter or late follower has allowed the Trinity organization to offer quality and safety to its patients.3 An example [of Trinity Health’s early “adoption” approach, according to Paul Browne] is CPOE in hospitals. There are 5000 hospitals in the US, less than 10% with a CPOE system, so that with our business strategies around quality and 3
safety and using quality and safety as a way to distinguish ourselves from other organizations. 6 Trinity has spent one billion dollars over the last decade on new health care technology, with an eighty percent project success rate.3 Browne's vision to integrate Trinity IS has created an environment where all the hospitals operating within the quilt safely “behave and think as one organization, in order to bring knowledge to bare” across the entire organization. Thus, Browne's IS standardization of operations has allowed for successful integration of cross-­‐operational processes in order to improve efficiency, reduce costs, and achieve the mission. Project Issues IS projects can take a lot more resources to implement than originally anticipated, and yet never come to fruition. Project execution is probably the most important factor influencing its outcome. 7 Trinity has successfully implemented numerous projects in order to improve the efficiency and functionality of the health system. Although Trinity has a high rate of success with the execution of its applications, it occasionally experiences situations where the effectiveness and use of the system is impaired. During the implementation of Genesis, issues were encountered with the execution of the CPOE and ADE systems.4 Opportunely, they were able to effectively resolve those concerns, as well as develop a “readiness approach” to ensure the success of future projects. 3 The ADE system involves nineteen automated alerts that are driven by a series of values based on patient lab tests and drug allergy information. Typically, when a given value exceeds the acceptable range for drug dosage or type, the physician will receive notification of the error, and assistance regarding the proper course of action. The system’s initial problem dealt with system overload, “rule fatigue,” and a lack of flexibility for physicians. This recurring issue significantly influenced productivity and the patient care experience, which prompted Trinity to revaluate the values that signal drug alerts. A collaborative effort from the CIO, Chief Medical Officer (CMO), and Chief Pharmacy Officer led to the adjustment of system values to accommodate changes in diagnosis and treatment, thus providing 7 physicians with the necessary latitude to effectively treat patients.4 Trinity also experienced some apprehension from staff during the implementation of the CPOE system. Many physicians resisted the organizational and operational change required for the institution of the new system. With this trepidation, the initial adoption rate and proper use of the system were fairly low. During the early stages of the process, physicians were more partial to the paper system due to simplicity and ease of use.6 Furthermore, those who utilized the system first made paper notes and later had associates enter the information on their behalf. This practice reduced the effectiveness of the CPOE system and overall productivity.3 To resolve this concern, Trinity developed and implemented their “readiness approach” program. In doing so, executives, project teams and clinicians were able to evaluate and restructure the process to ensure that users had the necessary aptitude and comprehension of the system, and reduce opposition or misuse. 4 The “readiness approach” included organizing more training events, providing a flexible training schedule, as well as one-­‐on-­‐one training to accommodate individual learning curves and computer competencies. Additionally, Trinity has created a more user-­‐friendly interface that requires less input and navigation throughout the system. 4 These changes have significantly increased the proper use the CPOE system, which has proven to be a great success. The readiness approach stands as a central part of the implementation of new applications. This structured program provides the foundation necessary to ensure that the organization as a whole is knowledgeable and ready for the execution of new programs. The primary concern of Trinity with regard to new applications is the rate of adoption and the proper use of new systems.3 Information Security & Risk Mitigation IS departments across different types of organizations carry on the challenging task of ensuring private information is protected from malicious exploits. Inadequate security and control can lead to 8 legal liability, decreased employee productivity, and increased operational costs. 7 Healthcare IS personnel face an even tougher task, considering the sensitivity and personal nature of the information processed by their systems. With the overwhelming digitization of medical systems and processes, patients have a reasonable expectation that their health records are only accessible by authorized staff. Healthcare facilities also have a responsibility of abiding by privacy and data protection laws and regulations passed by the United States Congress, such as the Health Insurance Portability and Accountability Act (HIPAA). This federal law requires health care providers to protect the privacy and security of patient health information, and provides patients specific rights related to their health information.10 Trinity has taken certain measures to ensure information handled by the organization’s systems is handled properly and securely. It has also managed the intersection of local, state, and federal regulations that may contradict or otherwise negate each other.3 Privacy & Security Management To securely execute Genesis, a large volume of data is streamed across various networks, including the Internet. Before a technological upgrade is implemented across all the facilities, it is first introduced in a controlled manner in a few pilot locations. The organization also mitigates the risks of being an early technology adopter by focusing on people, process, and culture. This allows them to set an early expectation of goals and efforts to be undertaken.3 A substantial amount of resources was invested over the years into closing the gap with other industries when it comes to replacing paper-­‐based IS with digital ones. Executives assert that such information is best harnessed when it is shared with people inside and outside of the organization. For example, half of the people with authorized access to hospital records are not employed by the organization: 20% are physicians practicing at Trinity facilities but are not employed there and 25% are insurance company employees. The health system receives 45 million inbound messages from the 9 Internet monthly. Of those messages, 43.5 million are malware-­‐related. The process of monitoring and preventing such malware from affecting daily operations costs the organization $5 million a year.3 In order to actively manage and control information security, Trinity has designated an Information Steering Team consisting of Mr. Browne and several other senior executives. This team has the responsibility of developing the security policies. Such policies are enforced via automated alerts when security incidents occur. An alert is followed by a root cause analysis and a detailed review. They also employ external auditors who perform an annual study of the security processes and policies. Additionally, cyber insurance requires a separate annual security audit. Furthermore, Trinity utilizes a security firm that takes on the role of patching the firewalls several times a day, alerting the organization of current threats and actively preventing them. Vulnerabilities in a health organization’s systems not only threaten patient data and privacy, but now that most medical devices are computerized and some are remotely operated, such exposure could be detrimental to patient well-­‐
being.3 CRITIQUE Information Systems Impact Recession or not, healthcare disparities will prevail; but IS present within a healthcare organization will play a pivotal role by creating a more consistent climate for patients. Genesis works to eliminate this disparity through the integration of EMR. Simply put, doctors who work for Trinity are able to physically or remotely access and treat patients anywhere in the country; patients can seek and receive treatment in the same standardized and evidence based manner. Irrespective of the market we're in, that cardiologist practicing in Port Huron is [providing the same care as a patient] getting the same [treatment] as someone in an Academic setting or Columbus, OH or Fresno, CA. So, we have had the opportunity to raise awareness and hopefully provide care in a more consistent fashion 3
across Trinity. 10 The improvements IS could have on health care are immense. The question, however, is whether there are limits to the technological improvements from an ethical and capacity standpoint. Patient information will become more accessible as doctors will be able to retrieve information from their respective homes and private practices. Furthermore, technological advances aid in information dispersal allowing the opportunity for providers to treat patients from other locations. For instance, hospitals around the country are currently integrating robotic equipment into all of their departments. “Some of the robots have the ability to take their arm and lay it on the patient. It has sensors in the hand that can tell you things about pulse [and other vital signs].” 3 These technological capabilities cause ambivalence when it comes to religious, cultural, and individual debate. “IS raise new ethical questions for both individuals and societies because they create opportunities for intense social change, and thus threaten existing distributions of power, money, rights, and obligations.“ 7 Healthcare will always push the limits as it searches for a better and more efficient way to provide treatments to those in need. Thus, it is nearly impossible to determine where to draw the line of how much is too much. Advances like the aforementioned robotic arm show that Trinity is investigating innovative ways in its attempt to provide quality care to all its patients. “We have a cultural notion in the US, that wherever I am, I should have access to high quality healthcare. But, [if] we don’t have the high quality nurses and doctors to make that a reality that will become an even more prominent problem.” 3 Providing physicians and nurses the means to communicate from coast to coast exemplifies Trinity’s goal toward achieving safe, timely and equitable care for all of the populations it serves. Ideally, these advanced IS will allow all healthcare organizations to share information with each other regardless of the patient’s primary health system provider allowing ideas, research and knowledge to be accessible and applicable across the country. “The difference for Trinity is culturally, internally we are pushing idea to behave as one organization instead of individual hospitals that are loosely affiliated.” 3 11 One area on the forefront of most organizations is social networking via the Internet. “The Internet increases the accessibility, storage, and distribution of information and knowledge for organizations.” 7 Corporations and businesses are taking advantages of programs such as Facebook, Twitter, and MySpace to improve the workplace environment. “As a side note, one thing we have not done is make really effective use of social networking technology to foster the evolution of communities within Trinity, and I think that's a place we need to go in the future.” 3 Fostering relationships internal and external to the health system will go a long way in improving accessibility. Physicians and employees will be provided with another way to communicate with each other, while residents of the community in which a Trinity hospital is located will be able to stay abreast of current events within the health system. Competitive Advantage Throughout recent years, Trinity’s investments have resulted in improved IS that were supplied by reputable companies such as Cerner and McKesson. This led Trinity to be in the very small minority of healthcare organizations with a CPOE system. Taking a completely hands-­‐off strategy when it comes to design and development of information technology and relying on outside experts has benefits and limitations. For example, by utilizing the packaged Cerner systems and support, more resources are focused on the organization’s core competence: ensuring a satisfactory patient experience. This sets them apart from competitors who take on complex initiatives, under which they have to hire subject matter experts, go through a longer development cycle, and face a higher failure risk due to their inexperience in the IS field. In addition, Trinity remains competitive by shortening the time to market on new technologies. A potential limitation of this strategy can be the lack of direct system control. While a competitor quickly and effortlessly addresses any problems or concerns within their infrastructure, 12 Trinity utilizes technology vendors to accomplish the same procedure. This limitation can be avoided by choosing a reliable partner who has a proven track record in expedient response time. Ultimately, the focus on quality and safety through technology allows Trinity to make a clear distinction from other players in their field.3 Additionally, due to its size and number of locations, Trinity has the ability to adopt or test new technologies in a controlled manner before going through a widespread implementation. These controlled pilot runs allow Trinity to experiment with the latest technologies, while staying a step ahead of the competition.3 Telecommunications/Networks Trinity’s systems communicate using various telecommunication tools, hardware, and software systems. Much of these technologies are managed internally to ensure proper data flow throughout the organization’s networks. Trinity, however, does not have a standardized enterprise system or unified service platform. Each hospital utilizes a variety of systems and each employee has tiered-­‐level access. As Trinity continues to develop new IS policies in compliance with new healthcare regulations, it has an opportunity to achieve greater organizational efficiency through integrated IS and communication systems. Project Investment Determination “Even if a system project supports a firm’s strategic goals and meets user information requirements, it needs to be a good investment for the firm.”7 Making investment decisions is both difficult and complicated. “Healthcare organizations are dynamic, the problems they face are often poorly defined, and the information available for the decision-­‐making may be incomplete.” 5 Before any information technology decision is made, a technical and capacity requirements analysis must be completed and a governing strategy must be created. At the core of the strategy, there must be strong 13 management structure, as well as minimum standards, set and adhered to by all in the organization. 9 Trinity has done an outstanding job in its decision-­‐making process for the launch of Genesis, as well as the continuing IS decisions, which have had to be made on a day-­‐to-­‐day basis. Trinity follows both formal and informal approaches to decision-­‐making. The formal approach is the responsibility of the IS governance structure. Quarterly, IS executives meet with the IS executive steering team, which is similar to a board of directors, to discuss important strategic decisions. During these meetings, the “big” decisions are made. The IS executives discuss specific project issues, implementation costs associated with the project, the time frame of the project at hand, and the resources needed to complete the project. On the other hand, the CMO typically directs the informal approach. This decision process involves discussing the issues, addressing the decisions that need to be made, and weighing the pros and cons of each decision. Finally, the decision makers arrive at a consensus and make a final decision. Even with this structured approach to decision-­‐making, decisions are not easily made. Mr. Browne mentioned that the decision-­‐making process is like political bargaining: “It’s about building alignment across different constituents to move in a common direction.”3 He added that a wide range of IT adoption techniques exist in the healthcare industry. When it comes to the degree of clinical adoption, Mr. Browne believes that Trinity is in the 1-­‐3% when compared to other healthcare organizations that do clinical order entry.3 Trinity has made deliberate decisions in regard to following the IT "mainstream" or to become an early follower. This is evident with the launch of Genesis back in 2001. With the push from the American Recovery and Reinvestment Act of 2009, specifically the Health Information Technology for Economic and Clinical Health (HITECH), government money helps fund EHR in hospitals and clinics. Now, Trinity has an extra incentive to have their EHR system implemented sooner, plus an added bonus of incentive payments from the federal government. Earlier this decade, Trinity started the journey toward common practices and integrated 14 processes in health care delivery and still has a long list of hurdles to overcome. It has, however, acquired an enormous amount of expertise and knowledge by choosing to become an early adopter of some new healthcare technology. This approach has placed Trinity at the forefront of healthcare technology and has positioned Trinity to lead the way for the healthcare industry. Systems Analysis A large organization such as Trinity has to consider a multitude of factors when implementing a new technology or system. Factors mentioned in the previous sections, such as cultural acceptance, competitive advantages and large monetary investments, are all crucial factors in an IS structure. Another important component is systems analysis. This entails tools, procedures, measures taken to ensure systems run efficiently, accurately and safely at all times. Issues such as security enforcement, privacy, risk mitigation, and the simultaneous balance of multiple systems all need to be examined and proactively monitored to achieve employee productivity and patient safety. Executive Scorecard & Implications One of the critical tools that Trinity leadership and management use is the Executive Scorecard (Appendix B). The “scorecard is a framework for operationalizing a firm’s strategic plan by focusing on measurable outcomes…” 7 It allows them to continuously evaluate the status of an ongoing project once it reaches various stages called “milestones.” The scorecard categorizes components of projects into four simple areas: Completed (100% of task finished), On Track (Progressing as Expected), Not on Track (Watch list, Executive attention required) and Missed Milestone. These metrics are used for each facet of the project and are tracked on a cumulative, monthly, and annual basis. Areas that are Not on Track or Missed Milestones are detailed at the end of the scorecard. These sections are followed up with questions such as: “How do we manage issues? What do we do differently? Where do we need to pull someone in differently in order to achieve the accomplishments we are going about?” 3 This scorecard 15 methodology allows employees on the respective project teams to know the status of their part, as well as the overall strategy of the current status, and how to proceed. The scorecard facilitates a dialogue between the project teams’ needs and the executive leadership expectations. Risk Mitigation The Executive Scorecard is one tool that Trinity uses in order to assess their projects and IS endeavors; however, projects such as Genesis are large-­‐spanning, enterprise-­‐wide initiatives that are complex. They involve various teams, include multiple resources and money, and require a standardization protocol to reduce errors and risk. “The level of project risk is influenced by project size, project structure, and the level of technical expertise of the IS staff and project team.“ 7 Trinity has such a protocol to reduce this risk, readiness. It is basically 18-­‐24 month process where we know what the steps are that need to get from point A to implementation. We have a structured approach [conducting pilots in a controlled manner], a person that manages that approach, and their role in life is to badger, push, alert, identify for the org that we are marching from point a to this mission/accomplishment.” And now that we are doing site 14 [of Genesis] we have 13 previous experiences. We know we need to have a large crew on a certain site to implement, we 3
need to have back up numbers, we have been through the drill. It is part of the readiness approach. This approach is successful because it ensures that the risks faced by each implementation site use a standard methodology to handle various issues by maintaining a system of checks and balances in conjunction with organizational standardization. In order to mitigate risk, the executive leadership at Trinity strongly emphasizes the combination of people, process, culture, and technology with the active setting of expectations, roles and responsibilities. Security Measures, System Communication, and System Issues IS security stands as an extremely important aspect of Trinity's day-­‐to-­‐day business. As mentioned earlier, the organization’s holistic approach to healthcare relies on integrated technology that allows a doctor to remotely operate on a patient, as well as keep track of detailed patient information that ranges from the patient's social security number to the amount of morphine that a 16 post-­‐op patient automatically receives. Due to the amount of aforementioned incoming malware traffic the entire system is exposed to vulnerabilities that may result in total system failure. Mr. Browne states that the challenge is securing information appropriately while meeting federal and state privacy and security regulations. 3 In order to meet these regulatory guidelines, Trinity spends over $5 million per year in order to protect Trinity IS and databases. Mr. Browne wishes that security was not such an expensive endeavor, as he would rather see the money spent on valuable services that provide individuals with healthcare. Unfortunately, Trinity does not operate in an ideal world. A security breach of Trinity's IS could result in the integration of a virus into the patient record database, the identity theft of a patient, or increased dosages of morphine that could kill a patient.3 The stakes are high and Browne and his information security steering team have developed "a number of security policies [that are] enforced through the organization through a combination of technologies and non-­‐technology controls."3 The steering team continuously works to improve Trinity's security. This systematic process has proven to be quite effective in thwarting malicious security threats. Protecting Trinity's IS and patient information is not an easy process. As previously mentioned, Trinity's success arises from its ability to create, organize, and implement healthcare strategies. If only 3.3% of malware attacks breach Trinity's security systems, then Trinity's approach, which Browne admits is not perfect, comes close to achieving perfection. When Trinity's security fails, Mr. Browne is alerted. He states that Trinity has a formalized response plan that addresses each security concern. The steering team reactively identifies the security breach, addresses the solutions, and reviews whether or not the issue was successfully dealt with. The review process occurs immediately after the threat has been dealt with and on an annual basis. By utilizing outside security firms, Mr. Browne ensures that Trinity does everything within its power to protect itself. Multiple security perspectives are necessary to insure that Trinity, its patients, and its 17 employees are protected. Trinity's communication systems, just like its security, stand as an industry leader, but are far from perfect. Since the major IS products are utilized across seventeen hospitals, the TCCS, THHS, and the Trinity Standard, the integration of these entities and Trinity's different departments create issues that the members of the IS department deal with every day. Doctors and departments fail to effectively communicate with one another and, as a result, patients fail to receive immediate and effective care because Trinity cannot quickly access each patient's healthcare information. The different business departments utilize various business software applications, which increase the operating costs.3 The complexity of the IT quilt depicts the intricacy and enormity of Trinity's problem; however, today's Trinity quilt is not nearly as complex as the Trinity quilt from 2001 (Appendix C). This comparison depicts how Mr. Browne has effectively integrated Trinity's system, improved communication between the systems, enhanced the quality of patient care, increased IS security, lowered the costs associated with Trinity's inefficiency, and furthered Trinity's mission to help those who need care get it. Overall, the integration of Trinity's major IS products, as well as its security systems, is still evolving and maturing; however, in relation to industry standards, Trinity sets the industry standard for IS product integration and healthcare security. Trinity's approach and technologies are unrivaled. Culture and Organizational Change “Organizational culture is a powerful unifying force that restrains political conflict and promotes common understanding, agreement on procedures, and common practices.” 7 Trinity Health is committed to establishing and maintaining a unified culture. This is pertinent throughout the health system. While concentrating on improving its business structure, Trinity has transformed a strategic direction to develop a more centralized operation. This focus encompasses the fundamental facets of their values. Along with this common purpose, Trinity has aligned patient care, created industry-­‐leading 18 levels of staff excellence, created and integrated operational performance, as well as developed collaboration and growth, as vital units to focus on for improvement.12 This specific concentration allows Trinity to develop a more cohesive network that stands as a direct reflection of its new organizational culture. Holistically, Trinity’s success directly correlates with that of their employees. Trinity recognizes its employees as integral contributors to the success of the health system and focuses on their collective competency to evaluate system functionality.3 Keeping with its unified focus, Trinity has extended its continuous improvement and development efforts to their staff by offering various training opportunities .12 These programs are deeply rooted in Trinity’s core values and provide employees the opportunity to excel and become effective leaders. As a unified organization, Trinity hopes to improve system performance along with service efficiency. It approaches this task by focusing on the development of common systems, and having employees work together towards common goals.12 By doing so, Trinity ensures that these values radiate throughout the organization and become ingrained in organizational culture. The integration of technology and healthcare strongly influences the level of interaction and productivity among personnel, therefore strengthening the unifying efforts.12 By incorporating technology into their operations, Trinity has set the standard and assumed a leading role in the health care industry. From an IS standpoint, Trinity classifies itself as early followers or mainstream adopters, with the exception of being an early adopter in select situations.3 This standing coupled with a continuously improving health system, has solidified Trinity’s stature among other health institutions. Furthermore, Trinity takes a comprehensive approach to the execution of projects.12 Implementing Trinity's readiness program, along with the application of new systems, guarantees that all personnel are supported throughout the process. The successful execution of programs, as well as having competent and enthusiastic staff reinforces Trinity’s competitive advantage. This unifying factor is exhibited throughout 19 the organization and is integral to their ability to provide industry-­‐leading, excellent patient care. Conclusion Trinity Health is transforming the health care industry and setting the standard for healthcare quality and efficiency. By standardizing IS and clinical practices throughout the health system, Trinity promotes uniform decision-­‐making that increases consistency and reduces variability, as well as vital patient errors. Furthermore, by focusing on providing a positive patient experience, Trinity has consolidated and implemented several applications in order to improve the functionality of the current system. Thus, the steps taken by Trinity not only serve as a solution to current patient demands, but also provide a method to managing future system requirements effectively. Along with the adoption and implementation of new programs, Trinity has also transformed its business structure to incorporate a more unified direction. This new strategic plan encompasses the development of various systems that foster collaboration and growth among personnel and related departments within the system. Overall, the merger of technology and health care at Trinity has positively influenced the patient care experience and the operational effectiveness of the organization. 20 Trinity Information Services
Paul Browne
Trinity Health
Chief Information Officer
Vicki Coffey
Sr. Executive Secretary
Jim Elert
SVP
IT Shared Services
Carla Robelli
Vice President
Program Management
Teri Hohentanner
Director
Infrastructure
Kyle Johnson
Vice President
Applications
George Goble
Director
Enterprise Information Security
Deb Rockey
Director
Learning & Development
Tom Centlivre
Director
Benefits Management
Toni Pratt
Vice President
Finance and Administration
Sue Paris
Vice President
Client Services - IT Ministry Operations
Karen Eickemeyer
Financial Consultant
Doug Fenbert
Division Director
Western MI Region
William Kercorian
Manager
Telecomm Services
Maureen Meneguzzo
Manager
Finance
Elaine Trautman
Facilities and Special
Projects Coordinator
Vicki Schroeder
Vice President
UEM PMO, Readiness
Tauana McDonald
Sr. UEM PMO Consultant
Dave Koch
Division Director
Eastern Region / TIS Planning
Steve Larson, M.D.
Division Director
Iowa Region/Silver Spring/Fresno
John Lawson
Division Director
Ohio / TIS Resolution Center
Mark Wennstrom
IS Director
Boise, ID
June 16, 2009
August 19, 2009
Grey shaded functions =
Core
Page 1
Major IS Products in Trinity Health
TRINITY
Standard
Silver Spring, MD
Columbus, Port Huron,
Mt.
OH
MI
Clemens, MI
Pontiac, MI
Ann Arbor, Battle Creek,
Grand
MI
MI
Rapids, MI
Livonia, MI
Muskegon,
MI
South Bend,
IN
Clinton, IA Dubuque, IA
Mason City,
Sioux City, IA
IA
Boise, ID
Fresno, CA
TCCS
THHS
MDI
McKesson
Horizon
Homecare
Revenue Management
Registration
McKesson HealthQuest
Patient Accounting
McKesson HealthQuest
Downtime Registration
Cerner
Millennium
Registration Kiosk
TBD
Customer Contact Center
TBD
Coding for Billing Outpatient
Coding for Inpatient Billing
DRG Grouper
APC/APG Grouper
Revenue Management
Decision Support (Including 3rd
Party Logs)
McKesson HealthQuest
McKesson
STAR
McKesson Health-Quest
McKesson HealthQuest
Cerner
Cerner Profile
Cerner /
Smart
3M ARMS
QuadraMed
Patient Statements
Account Follow-up and
Collection System
Medical Necessity
Compliance Software
Document Management
Administrator
Care Medic
McKesson Patient McKesson Patient McKesson
Compass (paper) Compass (paper)
STAR
McKesson
Receivables
Workstation
McKesson
Pathways
Compliance
Advisor
Physician Practice
Management
Third Party Contract Mgmt.
Bed Tracking
CDM Maintenance Tool
Craneware
TBD
Form Generation
Trinity DSS
McKesson
Horizon
Productivity
Manager
DSS
MDI
McKesson
Claims
Administrator
McKesson
Claims
Administrator
Care Medic
Emdeon /
Accel
DSG
Emdeon /
Accel
McKesson Patient Compass (paper)
ACS
McKesson Pathways Compliance Advisor
Cerner
Cerner
ChartMaxx
McKesson STAR/ DSSv2
Cerner
McKesson
Pathways
Healthcare
Sched. / Cerner
Sched. -Surgery
MISYS PM MISYS Tiger
McKesson Pathways
Contract Management
Teletracking
Technologies
Bed Tracking
Teletracking
Technologies
McKesson
Pathways
Compliance
Advisor
Cerner /
Freedom
Imaging
EC2000
IDX
MegaWest
Legacy
McKesson
Pathways
Contract
Management
Teletracking
Technologies
Bed Tracking
Legacy
McKesson
Pathways
Contract
Management
Aramark HRS
Bed System
McKesson Pathways Compliance Advisor
Cerner
McKesson
Pathways
Healthcare
Sched. / Cerner
Sched. -Surgery
McKesson Pathways Healthcare
Scheduling
McKesson
Pathways
Contract
Management
Care
Medic
MISYS PM
McKesson Pathways
Healthcare Scheduling
MISYS Vision
for Windows
MISYS PM
ER Log
Standard
Register
PLUE
GBS
Filenet
Cerner (Radiology only)
Medical Manager
IDX GPMS
NextGen
McKesson
STAR/
DSSv2
Teletracking Technologies
Bed Tracking
Teletracking Technologies Bed Tracking
McKesson
Patient
Care/ABN
System
McKesson
Horizon Patient
Folder
McKesson Pathways
Healthcare Scheduling
BCA
McKesson Pathways Contract Management
Craneware
Craneware
Standard Register Standard Register Patient Works/
Liquid Office
PLUE
PLUE (7/08)
Care Medic
Cerner
McKesson Pathways
Healthcare Scheduling
Medical
Manager/
NextGen
Teletracking
Technologies Bed
Tracking
Point of Service Payment
3M
McKesson Receivables Workstation
NextGen
McKesson
Pathways
Contract
Management
Care Medic
Emdeon /
Accel
McKesson Patient
Compass (paper)
Enterprise Patient Scheduling
Cerner
Scheduling
3M / APR DRG
Ingenix / HSS
EasyGroup
McKesson Claims Administrator
McKesson
Claims
Administrator
McKesson Claims
Administrator
TBD
Cerner
Documentum
3M
Trinity DSS /
Trinity DSS
Trinity DSS
ARTS
/ ARTS
Trinity DSS
McKesson
STAR
SMART
Ingenix / HSS EasyGroup
Administrator
Medicare Claims Submission
(secondary)
Cerner / Smart
3M
3M
Trinity DSS
3M ARMS
Cerner
Cerner /
Smart
3M / APR DRG
Ingenix / HSS
EasyGroup
McKesson
McKesson
Cerner
McKesson
STAR
Electronic Claims Submission McKesson Claims
(primary)
Cerner
Galvanon
Cerner
Medicare Claims Submission McKesson Claims
McKesson
Health-Quest
Cerner
McKesson
3M ARMS
3M
McKesson STAR
McKesson
Pathways
Contract
Management
Aramark
ISIS-Pro
Craneware
U Pay
GEMPay
Standard Register PLUE
Patient Pay
ViaWarp
Optio Medforms
Standard Register PLUE
August 19, 2009
Grey shaded functions =
Core
Page 2
Major IS Products in Trinity Health
TRINITY
Standard
Silver Spring, MD
Columbus, Port Huron,
Mt.
OH
MI
Clemens, MI
Pontiac, MI
Livonia, MI
Ann Arbor, Battle Creek,
Grand
MI
MI
Rapids, MI
Muskegon,
MI
South Bend,
IN
Clinton, IA Dubuque, IA
Mason City,
Sioux City, IA
IA
API
Laborworkx
Kronos
Workforce
Central
API
Payrollmation
Boise, ID
Fresno, CA
TCCS
TimeTrac
Kronos
Workforce
Central
THHS
Enterprise Resource Planning (ERP)
General Ledger
Fixed Asst Management
PeopleSoft
PeopleSoft
PeopleSoft
Time & Attendance
TBD
e-Performance
e-Profile
e-Pay
Payroll/Human Resources
Performance Management
Project and Activity Tracking
Accounts Payable
Supply Chain
Kronos
Workforce
Central
BioMedical Device Inventory
Inventory Dispensing
PeopleSoft
SMS Med
Series 4
PeopleSoft
Staff/Nurse Scheduling
Case Management
Physician Credentialing
Learning Management
System
API
Laborworkx
Kronos Workforce
Central
PeopleSoft
PeopleSoft
ADP
SMS Med
Series 4
SMS Med Series 4
GEAC
SMS Med Series 4
Business
Objects
TBD
Visionware/
Solucient
Lawson
Quickbase
Lawson
Lawson
McKesson
Trinity DSS
Self
Developed
(Analysis &
DSS)
Lawson
Lawson
GEAC
SMS Med Series 4
Lawson
Trinity
DSS
TSI
Mainframe
Trinity DSS
ESSBASE
AVR
EPSI
Trinity DSS
Trinity DSS Trinity DSS
/ TSI
/ Avega
/ EPSI
Mainframe
Trinity DSS
Trinity DSS
TSI AS400
Business
Objects
Business Objects
ESSBASE
McKesson
TrendStar
Trinity DSS /
Self
Developed
(Analysis &
DSS)
McKesson
Horizon Perf.
Mgr/DSS
Business Objects
StrataCap
StrataCap
TBD
DiCarta
DiCarta
DiCarta
Contrak (home
TSI AS400
AIMS
AIMS
AIMS
grown)
TrackManager
McKesson
AIMS
Maximo
TBD
TBD
Insurance & Risk
Management
Quality Assurance
API Payrollmation
PeopleSoft
Ceridian
Facility Management
Financial Consolidation
Kronos Workforce
Central
PeopleSoft
PeopleSoft
Budgeting - Operating
Contract Management
API Payrollmation
PeopleSoft
Trinity DSS
Equipment Tracking RFID
Kronos
Workforce
Central
PeopleSoft
Cost Accounting
Budgeting - Capital
API
Payrollmation
AIMS
TMA
Sodexho
Trammell
Crow Service
Express
ServiceMaster
ISIS Pro
AIMS
Facility
Center
VasTech
MIDAS
VasTech
API Active
Staff
MAXSYS
ANSOS Staffing
Kronos
MIDAS
VasTech
MIDAS
API Active
Staff
API Active
Staff
DataQual
Kronos
API Active Staff
MIDAS
MIDAS
Healthstream
Learning Center
Maximo
AIMS
Yamas
Controls
Quality
Compass
MedMined
Aramark
ISIS Pro
AIMS
Marsh STARS
MIDAS
TBD
Morrisey
TMA
Hyperion Enterprise
Hyperion
Marsh STARS
MIDAS
AIMS
Visual
Cactus
MIDAS
Morrisey
MAXSYS
Morrisey
ANSOS
One-Staff
MCCM
MIDAS
ResQ Rn
Kronos
MIDAS
MIDAS
Morrisey
E-PRIV
Morrisey
Healthstream Learning Center
Echo
Morrisey
CBR
Healthstream
Learning
Center
August 19, 2009
Grey shaded functions =
Core
Page 3
Major IS Products in Trinity Health
TRINITY
Standard
Silver Spring, MD
Columbus, Port Huron,
Mt.
OH
MI
Clemens, MI
Pontiac, MI
Livonia, MI
Ann Arbor, Battle Creek,
Grand
MI
MI
Rapids, MI
Muskegon,
MI
South Bend,
IN
Clinton, IA Dubuque, IA
Mason City,
Sioux City, IA
IA
Boise, ID
Fresno, CA
TCCS
THHS
Clinical Systems
Patient/Consumer Portal
Physician Portal
Physician Order Management
Physician Electronic
Signature
Order Entry
Trinity Health
Consumer Portal
V1
Trinity Health
Physician Portal
V2
Cerner
Millennium
Adverse Drug Event
Cerner
Millennium
Laboratory General Clinical
Lab
Lab - Anatomic Pathology
Lab - Blood Bank
Cerner
ChartMaxx
TDS &
Dolbey
McKesson
STAR
TDS
Inhouse/3M
Pharmacy
McKesson Horizon
Patient Folder via
Horizon Physician
Portal
Cerner
McKesson
Care
Manager
Cerner
Millennium
TDS
McKesson
Horizon
Eclipsys
Cerner
PowerNotes
Cerner Mil.
Pathnet
Cerner Mil.
Pathnet
Cerner Mil.
Pathnet
Cerner Classic
SoftLab
Cerner
Classic
MISYS
Cerner
CoPath
Misys
Cerner Classic
RML
IMPAC
PowerPath
Cerner
United
Clinical
Labs
Labtest
Cerner Gajema
Cerner
Cerner
PharmNet
McKesson
STAR
Cerner
Cerner
Millennium
Misys
StarLab
CoPath
CoPath
Misys
Misys
Mediware
Mediware
WORX
McKesson
STAR
Cerner Classic
Labtest
(1/08)
BrioLink
Brunston
Brio
Cerner
MsMeds
Cerner
Cerner
StarLab
Micromedix
MicroMedix
Cerner POC
CareMobile
Cerner
MedPoint
QS1
McKesson
McKesson
STAR
Pharmacy
Cerner SurgiNet
RES-Q Healthcare
Per-Se'
ORSOS &
Apexion
Cerner RadNet
Cerner RadNet
McKesson
STAR
Retail Pharmacy
Surgery Management
Radiology
Dictaphone
McKesson STAR
Cerner
Pharmacy Drug Information
POC Med Administration
McKesson
Portal
CDWeb
Lab - Outreach Solution
Lab - Specimen & Inventory
Saintals.com
TDS
Cerner In Box
Cerner
Millennium
Physician Documentation
TIS Clinician Portal
AccessPt
Cerner
Millennium
Results Reporting
Clinical Documentation
Trinity Health
Physician Portal
V2
MyStAis.com /
www.saintalph
onsus.org
Medseek
In-house
Cerner
Bridge
Cerner POC CareMobile
McKesson
TREX1
Cerner
IDX
QS1
Omni-server
QS1
QS1
TREX1
Cerner
Omni-server
Cerner
Cerner
McKesson
Horizon
Surgical
Manager
Omni-server
DR
Systems
McKesson
STAR
August 19, 2009
Grey shaded functions =
Core
Page 4
Major IS Products in Trinity Health
TRINITY
Standard
Silver Spring, MD
eScription
Softmed
Chartscript
Spryance /
eScription
Spheris
Columbus, Port Huron,
Mt.
OH
MI
Clemens, MI
Pontiac, MI
Livonia, MI
Ann Arbor, Battle Creek,
Grand
MI
MI
Rapids, MI
Muskegon,
MI
South Bend,
IN
Clinton, IA Dubuque, IA
Mason City,
Sioux City, IA
IA
Softmed
Chartscript
Softmed
Chartscript
Boise, ID
Fresno, CA
TCCS
THHS
Clinical Systems Continued
Transcription In-house
Transcription Outsource
Transcribed Document
Distribution
eScription
Backend - Voice Recognition
Transcription
eScription
Front end - Voice
Recognition Transcription
Dictation
Softmed Chartscript
Softmed
Chartscript
Dolbey
Central
Transcription
Services /
Heartland
Spryance
eScription
eScription
Dragon
Naturally
Speaking
TBD
eScription
Dictaphone
Dolbey
Lanier
MedPlus
ChartMaxx
Cerner
SMART
SMART
SMART
3M ARMS
3M ARMS
Cerner I-Net
Critical Care Info SystemRemote Monitoring (eICU)
TBD
SMART
Cerner FirstNet
Clinical Decision Support
Cerner CSW /
EDW
Cerner CSW /
EDW
Clinical Decision Support
Cerner PI Explorer
Cerner PI Explorer
Physician Office Record Employed
Cerner
Powerchart
Office
EKG - 12 Lead
Incident & Near Miss
Reporting
Homecare Reg/Clinical
A4
Healthmatics
McKesson
HEC
Cerner
Med
Manager /
ChartMaxx
Cerner
Power Chart
A3Office
PMSI
Cerner
Cerner
IPOCs
(10/09)
Cerner
GE Cardio Mac Lab Witt Calysto
Siemens
Cbord
AT Your
Request
Cbord
McKesson
Horizon
Homecare
Softmed
Chart
Release
SMART
Cerner
McKesson
MEDCON
Peers
Lanier DVI
Saline &
Livingston Cerner
AA - A4
Healthmatics
A4
Homegrown
Healthmatics ER SYS
McKesson
MEDCON
Draeger
Crescendo
Eclipsys
Integrated Plan of Care
TBD
Dictaphone
VISICU
Cerner FirstNet
Cerner IPOCs
Softmed
Cerner INet
Cerner I-Net
Emergency Dept.
Dietary
eScription
Softmed
Chart 1 /
Versacar
Critical Care Info SystemEMR/Workflow
Cardiology Imaging (PACS)
Focus
Informatics
eScription
eScription
eScription
SMART
Hemodynamic System
Spryance /
Focus
Informatics
Dictaphone
Dolbey
Release of Information
Quality Documentation Knowledge Management
Tool Inpatient
Quality Documentation Knowledge Management
Tool Outpatient
eScription
GE Muse
CathCor
Siemens
AT Your Request
Draeger
GE Muse
Draeger
Verisys
Cbord
GE Muse
McKesson
MEDCON
Witt
McKesson
MEDCON
GE Muse
STAT
McKesson
Horizon
Homecare
Heart Lab
AT Your
Request
Cbord
Draeger
Peers
MIDAS
McKesson Horizon Homecare
Witt
McKesson
McKesson MEDCON
Cerner
PowerWorks
Cerner
PowerWorks/N
extGen
Cerner
Witt
AcomNet
Cerner
GE Muse
MIDAS
McKesson
Horizon
Homecare
McKesson Horizon
Homecare
PTCT /
Maestro
Witt
McKesson
McKesson MEDCON
Heart Lab
DFM
Cbord
McKesson
MEDCON
Computrition
Peers
McKesson Horizon Homecare
Cbord
Quiton
Pyramis
GE Muse
Draeger
McKesson
Horizon
Cardiology
Qstatim
MIDAS
Peers
Misys
McKesson
Horizon
Homecare
McKesson
Horizon
Homecare
August 19, 2009
Grey shaded functions =
Core
Page 5
Major IS Products in Trinity Health
TRINITY
Standard
Silver Spring, MD
Columbus, Port Huron,
Mt.
OH
MI
Clemens, MI
Pontiac, MI
Livonia, MI
Ann Arbor, Battle Creek,
Grand
MI
MI
Rapids, MI
Muskegon,
MI
South Bend,
IN
Clinton, IA Dubuque, IA
Mason City,
Sioux City, IA
IA
Boise, ID
Fresno, CA
TCCS
THHS
Clinical Systems Continued
Medicine Dispensing System
Obstetrical Information
System - Fetal Monitoring
Radiation Record - EMR
PYXIS
TBD
GE Quantitative Sentinel
Watchchild
Radiology / Mammography
Patient Monitors
IV Pumps
GE
Quantitative
Sentinel
GE
Phillips OB Quantitative
Tracevue
Sentinel
OBIX
Phillips OB
Tracevue
McKesson
Horizon
Kodak
RadNet
Mammography
RadNet Mammography
TBD
IMPAC
IMPAC
METRIQ
McKesson
Horizon
GE
Lantis
Oncolog
IMPAC /
MRS
Oncolog
Varian
Lantis / IMPAC
METRIQ Basic
McKesson Horizon
GE
CNet
EMED
DR
Systems
GE
RadNet
Mammography
RadNet Mammography
MEDCON
CardioTrac
MEDCON
IMPAC
IMPAC
IMPAC
Merge e-Fusion
RadNet
Mammography
IDXrad
CardioTrac
McKesson
Horizon
MRS
MEDCON AXIS - PATS
RML
Developed
App
TBD
Phillips & GE
GE Quantitative
Sentinel
GE Quantitative Sentinel
Varian
Varis
Oncolog
MRS
Cardiology Database
(STS - ACC)
Pathology Images
Phillips OB
Tracevue
Cerner
PowerPlans
Radiation Oncology (Record
& Verify)
Cancer Registry
Radiology PACS
McKesson
Acudose
PYXIS
Philips
GE
TBD
Alaris
Abbott
TBD
Nortel Meridian
Avaya
Siemens
GE
Baxter
GE
Philips
Abbott
Baxter
Alaris
Data
Scope
Philips
Philips
Spacelabs
Philips
Alaris
Sigma
Hospira
Sigma
Baxter
Baxter / Alaris
/ Sigma
Avaya
Eclipse
Avaya
Difinity G3
Nortel
Succession
NEC 2400
Nortel
Succession
Nortel
Succession /
CS1000
Abbott /
Alaris
Telecommunications
Telephone System Platform
Call Center
Nortel
Symposium/
Avaya CMS
Long Distance
Sprint / Qwest
(Intrastate/Interstate)
Long Distance (IntraLata/Toll)
Local Access
Nortel/ ACD
Nortel Succession
Nortel ACD
& TeleCorp
Avaya
Nortel Symposium
Qwest DNS
Siemens
9751
Nortel
Nortel
Succession
Succession
Siemens 9751
Telecom Expense
Management
Intelligent Switchboard
Web Conferencing
Teleconferencing
Videoconferencing
Multipoint Video
Wireless Phones
Qwest
Sprint
Cerner Net Application
Reporting
General Report Writer
AT&T
Qwest
Sprint
AT&T
AT&T
AT&T MDA
Verizon
AT&T/Verizon
AT&T MDA
Verizon
Avotus Call
Accounting
Avotus Call
Accounting
Avotus Expense
Management
Avotus Expense
Management
SDC InteliDesk
w/Speech
Amcom
Long Lines
Xiox Atcom
SDC InteliDesk
Extend
Avotus Call
Accounting
Optivity
Telephony
Mgr
SDC InteliDesk
Amcom
AT&T 1-800-Conference
MCI
PolyCOM
PolyCOM
Global Crossing
Global Crossing
CISCO
Spectralink
Spectralink
Cerner CCL
Cerner
Cerner Power
Vision
Cerner
Business
Objects/ Crystal
Business Objects/Crystal
Avotus Call Accounting
Avotus Expense
Management
SDC
InteliDesk
w/Speech
Centra
Centra
ECAS
Avotus Expense
Management
Avotus Expense Management
AT&T 1-800
Conference
Spectralink
AT&T MDA
TapIt Call
Accounting
Avotus Call Accounting
Telemate
Tools
CCL Report Tool
Nortel
Contact
Center
Qwest
Sprint
Sprint
Local Calling
Call Accounting
Nortel
Symposium
Nortel Symposium
Roman
Nortel Succession
Avaya
Spectralink
Web Ex
*Centra
Avaya
AT&T 1-800-Conference
Verixon
Wireless
August 19, 2009
Grey shaded functions =
Core
Page 6
Major IS Products in Trinity Health
TRINITY
Standard
Silver Spring, MD
Columbus, Port Huron,
Mt.
OH
MI
Clemens, MI
Pontiac, MI
Ann Arbor, Battle Creek,
Grand
MI
MI
Rapids, MI
Livonia, MI
Muskegon,
MI
South Bend,
IN
Clinton, IA Dubuque, IA
Mason City,
Sioux City, IA
IA
Boise, ID
Fresno, CA
TCCS
THHS
Integration Tools
CCOW
Interface Engine
Middleware
Patient Index
CareFx
CareFx
CareFx
Quovadx
Cloverleaf
Quovadx
Cloverleaf
TIBCO
Business Works
Oracle
Middleware
Sybase
(Impact)
Sentillion
Quovadx Cloverleaf
TIBCO Business Works
Quovadx Initiate
Quovadx Initiate Quovadx Initiate
Portal Tool
TIBCO Portal
Builder
Oracle Portal
AccessMc /
AccessPt
McKesson
Horizon
Physician
Portal
TIBCO Portal Builder
TIBCO Portal Builder
Hardware
PC/Laptops
Wall Mount Arms
HP
HP
Ergotron HD
Combo Arm
TBD
Ergotron VL
Series
Carstens
Ergotron /
InfoLogix
Stinger
Wall A Roo
Mobile PC Carts
JACO ZXP &
Ergotron
Printers
HP
Wintel Servers
HP
Routers Switches
Wireless Access Points
Eclipsys
Remote Access Authentication Component
Remote Access - Application
Presentation Component
Ergotron
Carstens
CISCO
Cygnus /
Proximity /
Carstens
CISCO
Bluesocket
Checkpoint
AFIrenet
(Raptor) &
Allegiance
Carstens
DataLux
Stinger
HP
HP Fujitsu
Ergotron
Stinger/
Howard
JACO
InfoLogix
Proximity
Ergotron
HP / Lexmark
HP / Lexmark
HP
HP / Lexmark
HP
HP / Dell
HP
HP
CISCO
CISCO
Checkpoint
Checkpoint
Cisco PIX
Checkpoint
Checkpoint
EasyAccess
HP Fujitsu
Ergotron
Proximity
Stinger /
Ergotron
InfoLogix
Nortel /
CISCO
CISCO
HP
Ergomart
HP
Firewalls (local)
Firewalls (Corporate Data
Center)
Remote Access - Access
Component
HP Fujitsu
TBD
EasyAccess
RSA
Security
EasyAccess
Safeword (fob) /
RSA
Safeword (fob /
Novell ENovell E-Director Security
Directory
(SecureID)
(fobless)
(fobless)
Citrix / Web
Apps /
Reflections for
Web
Citrix / Web
Apps /
Reflections for
Web
Citrix
IBM
IBM
EMC / HP
IBM (LTO)
IBM / EMC
StorageTek /
HP / IBM
Citrix Secure
Gatway
EasyAccess
Safeword (fob / Novell E-Director (fobless)
Novell EDirectory
(fobless)
Active
Directory /
Secure ID
Hardware
Token
Safeword (fob) /
Novell E-Directory
(fobless)
Citrix / Web Apps / Reflections for Web
Citrix
Citrix Desktop
/ Web Apps
Citrix / Web Apps /
Reflections for Web
IBM / EMC
EMC
IBM (LTO) /
Sony (LTO)
Spectrologic
Storage Area Network (local)
Tape
IBM
IBM
IBM (LTO)
IBM
IBM (LTO)
August 19, 2009
Grey shaded functions =
Core
Page 7
Major IS Products in Trinity Health
TRINITY
Standard
Silver Spring, MD
Windows 2000
Windows 2000
Windows
XP /
Windows
XP Tablet
Novell Netware
Novell Netware
Microsoft
Novell
GroupWise
Novell EDirectory
WRQ
Reflections
Novell
GroupWise
Novell EDirectory
Microsoft
Office 2003
Columbus, Port Huron,
Mt.
OH
MI
Clemens, MI
Pontiac, MI
Livonia, MI
Ann Arbor, Battle Creek,
Grand
MI
MI
Rapids, MI
Muskegon,
MI
South Bend,
IN
Clinton, IA Dubuque, IA
Mason City,
Sioux City, IA
IA
Boise, ID
Fresno, CA
TCCS
THHS
Operating Systems/Software
Desktop Operating Systems
Windows 2000 / Windows XP Tablet
Windows XP
Windows 2000
Network (File/Print)
E-Mail
Directory Services
Terminal Emulation
Word Processing
Spreadsheets Presentation
Thin Client Application
Delivery
Back-up Recovery
Microsoft
Novell Netware
Novell GroupWise
Novell E-Directory
Novell E-Directory
Microsoft
WRQ Reflections
PowerTerm
Microsoft
Microsoft Office Microsoft Office
Office 2003
WRQ Reflections
ICOM
Informatics
WRQ Reflections
EMC (EDM)
/ SyncSort
Backup
Express
IBM Tivoli
Microsoft Office
Citrix
Citrix
IBM Tivoli
Novell Netware
Microsoft
IBM Tivoli
Veritas &
AdviseX
IBM Tivoli /
Arcserve
IBM Tivoli
Infrastructure Management Systems/Tools
Email Virus Protection &
Encryption
Virus Protection (Desktop)
Tumbleweed
Tumbleweed
McAfee
Nortron
Bindview
Security Configuration
Management Vulnerability
Assessments
Desktop Management
Software Distribution
Spam Filtering Software
Spyware Malware Adware
Symantec &
Bindview
Novell
Zenworks
Novell Zenworks Management
Tumbleweed
EMS
Network Assoc. McAfee
Network Assoc. McAfee
CISCO
Works
Bindview
LANDesk
Novel Zenworks
Suite
Tumbleweed EMS
SmartFilter
Tumbleweed
/ Symantec
Tumbleweed EMS
Tumbleweed
EMS /
SmartFilter
Tumbleweed EMS
HEAT (Fresno
install)
Front Range HEAT
Microsoft
SmartFilter
Websense
SmartFilter
Front Range
Heat
Novell
Zenworks
Bindview
Bindview
Bindview
URL Filtering
Help Desk
Symantec
LANDesk
Management
Suite
Inventory
Symantec
Front Range
Heat
HEAT
(Columbus
install)
Front Range HEAT
August 19, 2009
Grey shaded functions =
Core
Page 8
Major IS Products in Trinity Health
TRINITY
Standard
Silver Spring, MD
Columbus, Port Huron,
Mt.
OH
MI
Clemens, MI
Pontiac, MI
Livonia, MI
Ann Arbor, Battle Creek,
Grand
MI
MI
Rapids, MI
Muskegon,
MI
South Bend,
IN
Clinton, IA Dubuque, IA
Mason City,
Sioux City, IA
IA
Boise, ID
Fresno, CA
TCCS
THHS
Infrastructure Management Systems/Tools (cont'd)
Performance Testing
Monitoring Tool
Enterprise Operations
Monitoring
HP Openview
Internet Services
(OVIS)
Mercury
Windrunner/
Loadrunner
HP Openview
HP Openview
Print Management Tool
Project Accounting
HP
Openview
(UNIX)
Redwood
Report 2
Web
Vista Plus
Mercury
MRTG / Sniffer
Windrunner/
Pro
Loadrunner
HP Openview Internet Services (OVIS)
HP Openview (UNIX, Windows, NNM); BMC
HP Openview (UNIX, Windows, NNM); BMC
Vista Plus
H.P.
Cisco works
HP Openview (UNIX,
Openview /
Netscout
Windows, NNM); BMC
MRTG
Ngenius
iPrint
Empire Time
Empire Time
Patchlink
Patchlink
Mercury Windrunner/
Loadrunner
McKesson
LaserArc
Vista Plus
Patch Management
Intrusion Detection
Prevention (Client)
Intrusion Detection
Prevention (Network)
Tipping Point
WAN Management
Wireless Management
Symantec
McAfee
Symantec
Tipping
Point
HP & CISCO
HP & CISCO
HP
Openview
CISCO WLSE
CISCO WLSE
Bluesocket
AirMagnet
Network
General
Wireless Analyzer Surveyor
AirMagnet
HP NNM, CISCO Works, Vitalnet
CISCO WLSE
AirMagnet
CISCO
Works
H.P.
Openview /
MRTG
WLSM /
WCS
Sniffer
Wireless Pro
HP NNM, CISCO
Works, Vitalnet
CISCO WLSE
AirMagnet
Draft - February 8, 2008
Grey shaded functions = Core
Page 9
Major IS Products in Trinity Health
TRINITY
Standard
Silver Spring, MD
Columbus,
OH
Port Huron,
Pontiac, MI
MI
Livonia, MI
Ann Arbor,
MI
Battle
Creek, MI
Grand
Rapids, MI
Muskegon, South Bend,
MI
IN
Clinton, IA Dubuque, IA
Mason City, Sioux City,
IA
IA
Boise, ID
Fresno, CA
TCCS
THHS
Home
Office
DSS Informatics Reporting, Analysis, and B/I capabilities
Physician Peer set Analysis
Opportunity Analysis (LOS)
Resource Consumption
Case Volume Analysis
CPOE Peer Set Analysis
DSS
DSS
DSS
DSS
PI
DSS
DSS
DSS
PI
PI
PI
PI
PI
PI
PI
Clinical Reporting
Power Insight Classic (CSW)
Power Insight Explorer
Power Insight EDW
DRG Reporting
PI
PI
PI
PI
Medicare Severity(MS) DRG
All Payer Refined (APR) DRG
Severity
National, Regional, Trinity
Health Benchmarks
All Payer Refined (APR) DRG
Adjustment Mortality
Net Revenue
DSS
Net Revenue Budgeting
Net Revenue Write Down
Net Revenue Benchmarking
Patient Payment Benchmarking
Cost Accounting
RSW
RSW
RSW
RSW
DSS
DSS
DSS
DSS
DSS
DSS
RSW
DSS
Standard CDM
Product Line Analysis
ALL
Clinician
Product (DRG, ICD, CPT, PType, Dept, APC)
Item/Consumption
Payer (Insurance, Fin Cls)
General Ledger Statistics
DSS
DSS
RSW
May-08
RSW
RSW
ALL
ALL
RSW
DSS
ALL
DSS
DSS
DSS
DSS
DSS
DSS
DSS
DSS
Jul-08
ESSbase Data Marts/Tools
Financial Consolidation
ESSbase
Cost reporting
ESSbase
Budgeting
ESSbase
Flex Budget
ESSbase
HRIS
ESSbase
SCIS Economic Order Qty
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
ESSbase
RSW Operations Reporting
STD: PA, A/R, QA, Payment
recovery, denial management, etc
Semi Custom: PA, A/R, QA,
Payment Recovery, Denial
Management, etc
3rd Party Logs
RSW
RSW
RSW
RSW
RSW
RSW
RSW
RSW
ALL
ALL
ALL
ALL
ALL
DSS
DSS
DSS
DSS
DSS
RSW
RSW
RSW
Dashboards
Operations Dashboards
Product Line Dashboards
Clinical Quality Indicator
Scorecard
CRM
RSW
DSS
DSS