As I've said in my blog about "The Number 5" I tend to organize my life and my projects in groups of 5. My 2009 Review has five segments - Harvard Medical School, State projects, and Federal projects which I presented yesterday plus Beth Israel Deaconess and my personal life which I'll present today.
Beth Israel Deaconess had a turbocharged 2009 which included a new alliance with Atrius Health, numerous new applications, and significant infrastructure improvements.
Community EHR - the first step toward care coordination among all providers associated with BIDMC is to ensure all PCPs, specialists, and referring clinicians have electronic health records. In 2009 we built a data center filled with virtual servers, clustered databases, and software as a service EHR applications fully integrated into our statewide data exchange for administrative transactions, e-prescribing and clinical data sharing. It's a huge change management project as well as a technical one.
Infrastructure - Just as with Harvard, BIDMC experienced explosive growth in the need for storage, especially of medical images. We developed a tiered storage system of SAN, NAS, and Cloud Storage using EMC products. The end result is the right storage platform for the business requirements of the data. We continued to virtualize our servers, cluster our databases, build redundant electrical systems, and ensure business continuance through geographically separated data centers. We elected to move our mainframe to an external hosting facility/vendor - a major transition for us. We enhanced our security capabilities significantly, revised our network architecture for robustness, and upgraded to Exchange 2007, expanding email box size tenfold.
Clinical - We completed our ICU automation efforts, implementing Metavision through all critical care areas including fully electronic documentation and device interfacing. We completed the programming for provider order entry in the NICU and Emergency Department, our last remaining areas with paper orders (both go live in 2010). We implemented electronic Emergency Department documentation, an electronic ED Dashboard at BID-Needham, automated inpatient Oncology management that is fully integrated with our existing outpatient system, pharmacy initiated renewals as part of e-prescribing, results sign off, scanning of the inpatient record, and created a plan for enterprise image management of all modalities over the next year. We enhanced our extranet, redesigned our intranet (goes live in mid 2010), created web-based radiology workflow tools, increased our business intelligence capabilities, and brought new focus to our laboratory information systems project. Interoperability projects linking BIDMC, community providers, patients, government and payers via the NEHEN gateway accelerated and will continue to flourish in 2010 with our Boston Public Health and Community Quality Data Warehouse projects.