Ambulatory EMR Selection Project Update

1. Ambulatory EMR Selection Project Update OCIO Cross-team Meeting 2/1/2011

2. Selection Advisory Committee (SAC) Recommendations: 12/30/2010 • [It is] the strong consensus of the SAC is that Epic is the sole vender of choice most likely to meet our outpatient ambulatory electronic medical record needs.

4. Current Status (Summary) • Conducted phone reference checks: 7 vendors responded to RFP (August) • Completed onsite vendor demos (Sept 14- Oct 20) • Completed faculty survey re: 5 vendors • Completed site visits (Allscripts: GWU/Nov 12; Epic: OSU/Nov 19) • Completed technical conference calls and onsite vendor meetings (Dec 1st/Allscripts-Chicago & Dec 2nd/Epic – Verona Wisconsin ) • Completed follow-up Allscripts virtual site visit with Columbia University • Met with ‘executive’ Selection Advisory Committee members (travel team) on Dec 10 to draft recommendations. • Met with SAC members on Dec 15 to review/modify/approve recommendations. • Met with eCareNet Steering committee on January 10th – endorsing SAC recommendations. • Contacted all other vendors to let them know MUSC is working toward a final solution and that we will contact them with another update in January or February. • Currently in contract discussions with Epic. • Conducted preliminary implementation and conversion discussions (Epic). • Notified all 7 vendors that an ‘intent to award’ to Epic was signed on Monday January 31; the award will be final Tuesday February 8.

5. Onsite Vendor Demo Attendees (one or more) Carullo, Jennifer V. Cardiology (RN) Cave, Courtney Medicine Resident (MD) Cleaves, Rebecca Pharmacy Coefield, Virginia Pharmacy Costello, Philip Radiology (MD) Daniels, Mark OCIO Davis, Kimberly S. Internal Medicine (MD) Demos, Harry A. Orthopedic Surgery (MD) Forinash, Melissa OCIO Foulois, Bonnie Nursing Informatics Fox, James B. Psychiatry Resident (MD) Garrett, Hope UMA Patient Accounting Gillespie-Miller, Sherry Ambulatory (RN) Grover, Sandra OCIO Hargrove, Michelle UMA Patient Accounting Acker, Julie Compliance Afrin, Lawrence B. Hem/Onc (MD) Alexander, Amy OCIO Balassone, Mike UMA Bartlett, Nathan UMA Battaglia, Rosemarie Pediatrics (RN) Benton, Ann Therapeutic Services (RN) Borg, Keith T. Emergency Medicine (MD) Brooks, Gladney CT Surgery (RN) Brown, Hope Carolina Family Care Brown, Linus Radiology Bucknam, Judith Ambulatory (RN) Burdick, Jeff OCIO Caraviello, Kellyanne DDC (RN) Carr, Christine M. Emergency Medicine (MD)

6. Onsite Vendor Demo Attendees - continued Mauldin, Jill OB/GYN (MD) Mayes, Laura UMA Patient Accounting McGinnis, Mikelyn UMA Marketing McMurray, William UMA Administration McNeil, Mose OCIO Merrill, Mary-Eliese Clinical Effectiveness Morgan, Lisa R. Cardiology (RN) Naugle, Sheryl Rheumatology (RN) Neff, Dave Ambulatory Administration Northrup, Dave OCIO Nutaitis, Matthew Ophthalmology (MD) Oates, Jim Rheumatology (MD) Obeid, Jihad Biomedical Informatics Owczarske, Stefanie Surgery (RN) Pletcher, Susan Medical Records Jackson, Johnna Pediatrics (RN) Jordan, Allison Psychiatry Resident (MD) King, Dana Family Medicine (MD) Kinsman, Stephen Pediatric Neurology (MD) Koko, Heather Pharmacy Koval, Mary Jane Medical Records Kratz, John M. CT Surgery (MD) Lewis, Mary Carolina Family Care Liddy, Casey T. Med Ctr Strategic Planning Lin, Angello Surgery (MD) Madory, Jim Pathology (MD) Mahoney, Pat UMA Patient Accounting Makley, Colleen Carolina Family Care (PA) Malpas, Phyllis DDC (RN) Marley, Fran Carolina Family Care

7. Onsite Vendor Demo Attendees - continued Scheurer, Mark Pediatric Cardiology (MD) Sellars, Kathy Ambulatory Administration Seyfried, Brett OCIO Shayban, Ghadi OCIO Skipper, Chuck Ophthalmology Smith, Estelle Hospital Patient Accounting Smith, Jim OCIO Soper, David OB/GYN (MD) Sturdivant, Rachel Nephrology (MD) Tufts, Ed OCIO Waller, John Anesthesia/OCIO (MD) Walsh, Tasia OCIO Whelan, Timothy P. M. Pulmonary/Transplant (MD) Woodman, Annabelle OCIO Zwerner, Peter L. Cardiology (MD) Potts, Sally Therapeutic Services (RN) Powell, Jodie OCIO Pridgen, Kathleen UMA Patient Accounting Puckhaber, Melanie Dept of Medicine Rames, Ross Urology (MD) Raney, Lawrence H. Emergency Medicine (MD) Rees, Chris Medical Center Quality Risher, Sandra OCIO Robinson, Christopher OB/GYN (MD) Rodden, Ann M. Family Medicine (MD) Rogers, Ben Dept of Medicine Russell, Scott Peds Emerg Medicine (MD) Sachs, Bart Orthopedic Surgery (MD) Sanders, Denise Radiology Saul, J. Phillip Pediatric Cardiology (MD)

8. Members of the ‘Travel Team’ • Mike Balassone, UMA • Rosemarie Battaglia, RN, Manager of Pediatric clinics • Courtney Cave, MD, Recent Chief Resident (Internal Medicine) • Kim Davis, MD, Internal Medicine • Sandra Grover, OCIO • John Kratz, MD, CT Surgery, Committee co-Chair • Jill Mauldin, MD, OB/GYN • Dave Northrup, OCIO • Tasia Walsh, OCIO • Chris Rees, Director of Quality • Phil Saul, MD, Pediatric Cardiology • Mark Scheurer, MD, Pediatric Cardiology • Tim Whelan, MD, Pulmonary/Transplant • Peter Zwerner, MD, Cardiology, Committee co-Chair

9. Vendor Scoring Approach • Functionality 45% • Onsite Demos (20%) • Site visits (25%) • Interoperability 20% • Technical Environment 15% • General Vendor Assessment 10% • Strategic/Future Considerations 10%

15. Strategic/Future Considerations • Allscriptshas an ED module as an option. Allscripts also has merged with Eclipsys for inpatient functionality. • Eclipsys is not a 'one data base' approach with Allscripts (interfaces). • Score: 2.0 • Epic has the following integrated modules for future consideration: ED, Inpatient, Hem/Onc, Transplant, Inpatient Pharmacy, Ophthalmology and others. • Score 5.0

17. Vendor Cost Scores - Detail

20. Overall/Final Scores - Detail

21. SAC Recommendations • Need more due diligence in order to determine #2 ranked vendor. • Epic recommended top vendor to pursue: • Highest ranking vendor resulting from Selection process (and according to independent KLAS reports). • Epic’s client base is only in Academic Medical Centers or ‘mega’ hospital/health systems; they have less than 300 customers which allow Epic to focus better on fewer customers. • Physician utilization at Epic’s site visit was fairly extensive. • Epic’s company culture is impressive.

22. SAC Recommendations – cont’d • Epic recommended… • MUSC’s IT experts rate Epic’s technology the highest. Epic appears to be more than an application software company as they are more-so a ‘technology company’. Specifically, Epic pays meticulous attention to testing and the underlying components such as the data base and server hardware.

23. SAC Recommendations- cont’d • Epic recommended • Has the most ‘single database’ modules that could be implemented in the future if desirable (e.g., ED, Ophthalmology, Inpatient); Allscripts has an integrated ED module, but not inpatient or Ophthalmology. Epic would allow MUSC the future opportunity to implement a fully integrated electronic medical record.

24. SAC Recommendations- cont’d • The committee understands that success of an ambulatory electronic medical record will in large part be influenced by appropriate implementation of the system. Therefore, the committee is also recommending the following receive the full support from MUSC Health clinical leadership: • Workflow changes in all clinics well in advance of go-live (e.g., standardization, policies, accountability, etc.). • Appropriate levels of implementation support and resources. • Appropriate levels of post go-live IT staffing levels. • Well-structured governance that is inclusive of all clinical practices.

25. Next Steps • Receive best/final pricing from Allscripts (as they were the #2 ranked vendor). • Finalize contract /award/sign (early February). • Develop project plan with vendor. • Identify project team members to go to vendor training. • Official kick-off of project with vendor (TBD – April?)

26. Questions?