BTS: Information technology team powers UHealth operations
Friday, May 29, 2020
The UHealth information technology team continues working alongside University of Miami Health System colleagues to deliver better patient care, education, and research.
Serving UHealth’s comprehensive network, which includes three hospitals and more than 30 outpatient facilities across South Florida, a team of information technology professionals provides innovative technology solutions and services in support of the medical and research activities throughout the entire University of Miami Health System. Known as UHealth IT, this group of about 270 individuals—including physicians, nurses, and pharmacists—remain focused on innovations in health care IT and ensuring the health system is at the forefront of new technologies that deliver better patient care, education, and research.
“In the world of health care, and particularly health care IT, what’s next is always evolving,” said Dr. Maritza Suarez, chief medical informatics officer. As a practicing physician who heavily utilizes UChart, Dr. Suarez understands the need to bridge the gap between the technical build—or programming and related activities in a software development project—and clinical application.
Even before the pandemic, and during some of the most crucial moments the past few months, the team at UHealth IT has worked alongside health system colleagues to build workflows, develop systems, and implement technologies that equip caregivers to do their jobs better.
Harnessing the power of technology.
Among their contributions to facilitate a rapid response to COVID-19, the business intelligence team created a leadership dashboard using Microsoft Power BI—a data visualization and analysis tool—which includes patient data from UChart that is refreshed every 30 minutes, as well as data from Florida county statistics. “The dashboard helps ensure that real-time data points are easily accessible and can be used to drive decisions which focus on optimizing patient care,” said Michelle Hurtarte, assistant vice president of finance and operations, UHealth IT. If an issue or question comes up, IT is on call to troubleshoot and answer questions regarding the dashboard.
With each system, application, or workflow that is implemented, training is required to ensure the clinical staff is able to maximize its time on the job. The UHealth IT training team—which consists of 11 employees—plays a vital role in supporting more than 13,000 UHealth employees and 1,300 providers. Shifting to virtual classes in less than 24 hours, the team utilizes webinar technology to conduct all UChart training for every newly hired employee who requires access to patient documents. During the past few months, the team has conducted more than 325 virtual classes for physicians, nurses, clinical staff, ancillary support staff, and non-clinical staff who handle patient registration, billing, and health information management, including cross-training. Additionally, the team has provided enhanced COVID-19 training for clinicians on new workflows created for the emergency department, inpatient units, call centers, and drive-thru tents.
Supporting telehealth.
“With the increased pace and pressure placed on everyone because of COVID-19, the training team has created, developed, and maintained instructional material for UHealth’s massive telemedicine initiative,” said Gloria Sanjur, director of training. The team created detailed, user-friendly instructional materials and videos to explain the process of connecting patients with providers during virtual visits, which has enhanced the new experience of telemedicine and increased satisfaction.
Since Jan. 1, UHealth has logged more than 70,000 virtual visits, providing patients with a safe way to receive medical care during the COVID-19 pandemic. “Telehealth is here to stay,” said Ravi Akkiraju, executive director of UHealth IT. “We are just scratching the surface and a lot still has to be done to completely utilize various technologies to provide a seamless service to the patients.”
In addition to virtual visits, the IT team made information more easily accessible to patients though the MyChart app, a mobile platform that allows patients to access health records and care information from anywhere. Utilized by more than 370,000 UHealth patients, the app allows patients to request or cancel appointments, share health information, connect to and learn about telehealth visits, pay bills, and communicate with providers, to name a few things.
Enabling safe, efficient patient care.
Through medical device integration in the hospital setting, critical information flows from the device into the patient’s electronic health record, UChart. “The goal is to have an automated, timely, and accurate patient data documentation flow, which saves valuable time on manual data documentation and increases the visibility of trending data through retrospective analysis of data event snapshots,” said Mary Stein-Ferrer, director of clinical informatics.
In the situation with acutely ill COVID-19 patients on ventilators, the remote data capture also allows close monitoring and management of the patient data without the need to enter the isolation rooms frequently. “The remote monitoring functionality allows nursing and respiratory therapists to closely manage and monitor COVID-19 patients on ventilators without having to be physically close, limiting the caregivers’ exposure to infection and reducing the consumption of personal protective equipment,” said Stein-Ferrer.
Getting the medical device integration system up and running at UHealth Tower involved preparing the patient rooms with the necessary hardware and network components, setting up each device, and mapping data points from the machine into UChart. In preparation for the pandemic, UHealth IT set up 133 rooms to treat COVID-19 patients, which involved integrating 102 bedside monitors to send patient vitals to UChart and configuring 79 ventilators, 59 anesthesia machines as back-up ventilators, 20 high-flow respiratory support machines, and 11 dialysis machines. Concurrently, the team installed 133 cameras—one per room—and deployed new technology to meet the remote alarm surveillance and monitoring needs of ventilated COVID-19 patients.
The medical device integration system removed duplicated effort of respiratory therapy technicians by automating the admit/discharge function. Once the patient was admitted and attached to the ventilator, the data capture was automatic at the centrally located workstation, in addition to being available in UChart for documentation purposes.
The team worked closely with intensivists Dr. Daniel H. Kett, Dr. Tanira D. Ferreira, and Dr. Hayley B. Gershengorn, who were advocates for adopting several additional features and expansion plans in the near future. These include expanding the technology to the intensive care units, setting up a command monitoring center in the respiratory department to readily view all ventilators throughout the hospital, and sending notifications to identified phone numbers or certain alarm alerts.
“The University of Miami can proudly say we were one of the first Epic Organizations to implement Epic Monitor as a method of observing patients with airborne precautions from a remote workstation and in a time frame of 4 weeks when the initial plans were estimated to be 3 to 4 months,” said Thomas Benel, senior clinical analyst. “COVID-19 required a lot of teams to collaborate together quickly to allow this project to launch.”
Multiple system configurations provide clinical staff the ability to view a census of the unit or toggle through individual patient-specific information, including vital signs and lab results in a dashboard. At a glance, clinical staff members can view a patient's status using 10 camera/room feeds at one time and by accessing key vital statistics—including code status and infection, temperature, heart rate, blood pressure, and oxygen saturation levels. Camera operators can pan or zoom into a particular area of the room from their remote workstation and have two-way communication with the patient using built-in microphones. All camera feeds have encryption to prevent unintended access.
“The feedback has been positive as monitoring patients quickly without risking patient contact was important. The dashboard information with metrics and trends is also impressive,” added Benel. The team is working to scale the possibilities into ICU monitoring and remote sitter capabilities, which allow at-risk patients to be monitored remotely.
The team continues driving change in clinical practice and providing technology solutions. “Our focus is centered on anticipating the needs of our operational and clinical partners,” said Dr. Suarez. “Most recently, ramping up due to COVID-19 has shown us the importance and role of a technology push.”
National Cybersecurity Awareness Month kicked off this October with an emphasis on taking personal accountability for cybersecurity and practicing safe habits as we use technology. To unpack this concept, we sat down with UHealth’s chief information security officer, Cory Hall.
Hall, a veteran of the information technology field and champion of cybersecurity awareness, also gives insight into the UHealth IT Cybersecurity team’s efforts to protect the Health System against threats and shares one step he wishes everyone will take this month to be cyber smart.
Q. The concept of cybersecurity may seem overwhelming for those outside of the industry. Can you break it down for us?
Cybersecurity is everything we do to keep our electronic data safe. The cybersecurity industry uses the CIA Triad: Confidentiality, Integrity, and Availability.
Confidentiality is restricting access to information to only those who have an authorized need. It is probably the most visible because it’s in the news all the time. People have had their personal and financial information stolen from companies like Facebook, Equifax, Target, Anthem Healthcare, and others.
Integrity is making sure only authorized changes are made to information. A hacker accessing our payroll system and changing the direct deposit of employees to another account is an example. Corrupted medical records can result in misdiagnosis, medical errors, bad outcomes, or worse. A bad outcome could be as simple as modifying a known allergy in a patient record.
Availability is making sure that information is readily accessible to authorized individuals. A ransomware attack is an example that restricts the availability of information. Flooding our systems with benign transactions, called a denial of service attack, is another way of restricting availability of information.
Q. How important is cybersecurity within a health care environment, especially at UHealth where we rely on technology solutions in almost every aspect of our work — from routine administrative tasks to delivering cutting-edge patient care?
Health care is one of the biggest challenges in cybersecurity because health care related records and processes are more diverse, dynamic and regulated than most other industries.
I strongly believe we have both a regulatory and ethical responsibility to protect the information we hold in trust for our patients. To use email as an example, our team monitors over a million emails a day looking for malicious activity while doing our best to ensure timely and secure delivery.
UHealth uses approximately 600 software applications to facilitate patient care. And, since we can’t protect what we don’t know about, we’re currently focused on visibility and control. We’re mapping out a comprehensive view of our cybersecurity risks and status and introducing a series of processes intended to control high-risk activity.
Q. What can we do to better understand our individual role in the health system’s fight against cybersecurity threats?
Be vigilant and have patience, please.
Be vigilant by keeping an eye out for cybersecurity issues such as email phishing. Many cybersecurity issues start as phishing emails designed to compromise user IDs and passwords.
Have patience with new processes that come with an increased cybersecurity posture. It took years for the nation to get accustomed to using seat belts, but most people today use them without thinking; it’s a reflex. So, buckle up every time you log onto a UM electronic system and drive defensively.
Q. This year’s theme for National Cybersecurity Awareness Month is Own IT. Secure IT. Protect IT. What does this mean for our providers, faculty, staff, and patients?
To me, the theme is all about personal responsibility and action. The chain of cybersecurity is only as strong as the weakest link. Own IT, by recognizing the impact of your actions online; Secure IT, by logging off of workstations before leaving; Protect IT, by reporting cybersecurity issues you see.
Q. If you could magically get every member of the health system community to do one thing to improve cybersecurity on campus, what would it be? And why?
Become cybersecurity aware. Take advantage of an excellent series of 13 online courses on LinkedIn Learning designed to improve your cybersecurity awareness. Search “Cybersecurity Awareness” in ULearn or LinkedIn Learning. The first course, “Security Overview,” is about 30 minutes. All courses on LinkedIn Learning are free for faculty and staff.
Hereare some more practical tips you can put into practice to be cyber safe.
Launch of PatientAtlas Opens New Paths for Discovery
Monday, March 25
A new self-service web application, developed by the UHealth IT Research team, was unveiled at the 5th Annual Department of Medicine Eugene J. Sayfie, MD Research Day.
PatientAtlas allows clinicians and researchers to delve into patient data from a Population Health perspective using custom search criteria for data exploration and visualization. It combines data from UChart, Genomic Sequencing, Clinical Trails, US Census, and EPA.
“Research Day was the ideal launching point for PatientAtlas,” said David Seo, M.D., Chief Information Officer, UHealth IT. “Our Research IT team was able to speak directly with researchers and clinicians and show them how the tool provides unprecedented access to unified data and facilitates the analysis of aggregate patient data,” he said.
One of the features found most interesting to several Research Day participants who stopped by the UHealth IT booth was the interactive visualization of patient cohorts by zip code. Through custom search functionality, the identification of patient cohorts for research purposes is also made easy.
Unlocking Improvements to Patient Care through Technology Optimization
Friday, December 21
Taking a bold approach to enhancing the level of support provided by UHealth’s Information Technology team has paved the way for an expansion of IT’s efforts into perioperative optimization across eight areas at the health system’s flagship hospital, UHealth Tower.
This optimization initiative, which ran from November to December 2018, was a tremendous undertaking for the UHealth IT department in an attempt to deliver solutions which improve both the experience we offer to our end users and our systems. We successfully bridged the people, process, and technology workflows with this pilot as we optimized technology, standardized IT workflows, and increased OR efficiencies.
With 27 members of the UHealth IT team working on this project, we addressed over 230 areas of optimization in a short 6 weeks. Updates included a combination of enhancements and break fixes impacting a wide range of user groups in the UTower’s Main OR, Ambulatory OR, Departmental Surgical Scheduling, Insurance Verification, Registration, Revenue Integrity, Charge Poster, and UPAC. Impacted groups included surgeons, anesthesiologists, residents, schedulers, and nursing staff. To access resources and re-education materials, visit uchart.it.miami.edu/periop.
Following the success of the Perioperative Optimization, the UHealth IT Optimization team will strategically move into additional operational areas across the health system, starting with the Cath Lab and Heart Station in January 2019.
Technology Solutions Drive Transformational Change across the UHealth System
Thursday, September 27
In line with the strategic objectives defined through the 5 to Thrive initiatives, UHealth Information Technology (UHealth IT) is preparing for the double upgrade of UChart, the health system’s electronic health record (EHR), on Sunday, September 30.
Once complete, UHealth will be the first health system in South Florida to be on the latest version of UChart. The new system features will play a key role in providing our healthcare workers with the tools needed to achieve a standard of excellence that will make UHealth a preeminent health system for the 21st century.
Tanira Ferreira, M.D., chief medical officer at UHealth said, “With the EHR integrated in our clinics and hospitals, patients gain because their information is available not only to them but also to any healthcare provider who touches that patient throughout the health system.”
“As the drivers of the technology solutions and services supporting the medical and research activities throughout the UHealth System, we at UHealth IT are keen to partner with physicians, nurses, health care providers, researchers, and staff,” said David Seo, M.D., chief information officer. “UChart is a robust solution, and with a strong partnership between IT and clinical operations, we are able to leverage our systems to their fullest potential to best serve our patients and the community.”
With the enterprise-wide implementation of UChart and the latest system upgrade behind us, the continued partnership between health care providers and the UHealth IT team will be critical to delivering better, safer and more efficient care to all.
“We are entering an era of optimization that requires the IT team to work hand-in-hand with physicians to customize the applications for their practice,” said Dr. Ferreira. “We are ready to take our care to the next level.”
UHealth is Transformed into a Fully Integrated Academic Health System
Written by Christine Morris
The hospital command center on Sunday, October 29.
The change, which launched Sunday, October 29, after more than a year of preparation, is the first major step in the transformation of UHealth into a true single academic health center, with the goal of providing the system’s world-renowned care in patient-centric clinics and hospitals throughout South Florida.
“By eliminating silos and consolidating our three hospitals into a single operational model, we have created a tremendously high performing ‘team of teams’ that will continue to soar to new heights,” said Thinh H. Tran, M.D., MBA, chief operating officer of UHealth. “This is a momentous effort for us, a transformation of how we work together and collaborate.”
Operating under a single hospital license will not only provide an exceptional experience for patients , it will also simplify the administrative burden for the health system’s partners. It will reduce redundancies and consolidate services across UHealth facilities. These improvements will further streamline finances and enhance the health system’s revenue stream, ensuring that through the tumultuous changes in the national health care system, UHealth will continue to be able to deliver the highest level of care to all patients.
“This is also about ease of care for our caregivers,” Tran said. “Among our entities we had more than 3,000 policies and corresponding procedures that we have now simplified to a central core of 85 policies. As patients and caregivers go from site to site, there is one single operating model. This is a revolutionary culture shift for the health system, highlighting how we all work together to achieve a collective win.”
Leaders at the command center, from left, Pat Ivory, assistant vice president for strategic operations and clinical informatics; hospital CEO Michael Gittelman; Martiza Suarez, M.D., associate chief medical information officer; Steven Falcone, M.D., MBA, executive dean for clinical affairs; Tanira Ferreira, M.D., chief medical officer; Kymberlee J. Manni, Ph.D., chief operating officer; and David Seo, M.D., chief medical informatics officer.
A huge piece of the transformation was the implementation of UChart, an Epic-based electronic medical record (EMR) system, at University of Miami Hospital, which will now be known as the University of Miami Hospital and Clinics – UHealth Tower. The health system now has a true enterprise-level EMR, accessible to both providers and patients. It will allow providers seamless access to all of a patient’s UHealth records, as well as additional health information from other hospitals and clinics outside of UHealth that use the Epic system.
“These monumental tasks have impacted every aspect of our health care system, and they could not have succeeded without the team approach now being implemented across UHealth’s growing footprint,” said Edward Abraham, M.D., acting executive vice president for health affairs, CEO of UHealth, and dean and chief academic officer of the Miller School of Medicine. “This is an exceptional example of how we work in collaboration to deliver on our promise to our patients and our community.”
In addition to the consolidation of the entities, all the physicians practicing at UHealth Tower are Miller School of Medicine faculty or voluntary faculty. This is critical because it completes the hospital’s transformation to a true academic teaching hospital.
“This integration has been an aspiration for our health system since we bought Cedars Hospital,” Tran said. “It’s been 10 years in the making, and took the dedication of multiple teams working together for the past 18 months to arrive at where we are today. I’m very grateful and proud of our staff for this accomplishment.”
Hospital operations across the UHealth system will be legally, administratively and functionally under the University of Miami Hospital and Clinics. Patients will continue to receive world-class care at such distinguished centers as Sylvester Comprehensive Cancer Center and Bascom Palmer Eye Institute, and the names of key locations such as The Lennar Foundation Medical Center, Sylvester at Deerfield Beach, and UHealth at Plantation will still be used. The Anne Bates Leach Eye Hospital will now be known as the Anne Bates Leach Eye Center.
Dr. Thinh Tran and Pat Ivory at the command center.
Other steps are being taken to unify the health system, including a nursing harmonization project that outlines a clear ladder for career advancement.
“This is a foundational piece, but there is much more work to be done,” Tran said. “We are shifting our focus to optimization of our ambulatory care network, which extends throughout the tri-county area as well as Naples. Our efforts will focus on the continued harmonization of a superior experience and business model.”
Richard Ballard, chief administrative officer of UHealth corporate services, agrees that this is “the first big step to position the health system to be more effective and more competitive in the future. This is a journey, not a destination.” The restructuring and unification of financial areas such as billing, revenue cycle and procurement, information technology, regulatory compliance and many other functions will continue to advance.
“We’re an academic center, which means we’re a learning organization, and now we’ll have a better ability to learn from one another,” Ballard said. “This is an opportunity for us to really think as a unified health system.”
On Sunday, when the command center at UHealth Tower officially launched Epic and ensured that other changes were initiated smoothly, Ballard says it was clear that a “bonding process” had happened. The staff was proud and pleased that health system leaders rounded to show their appreciation for the employees’ dedication to the scope and importance of the project.
David Seo, M.D., chief medical informatics officer for the health system, was among the leaders at the command center. “It has been great to see the whole UM family pull together in such a collaborative way,” he said. For him the Epic launch “is the single largest transformative event for the health system. While we focus on the tool, which is UChart, this is really a change in the way we take care of our patients and manage our business. There is still plenty of work to be done, and we will stay focused on the job.”
Ballard says the tools for the job are in place. “We basically did everything in the past year or so that would be required if you were building a brand new hospital,” he said. “We designed a process as well as getting all the work done. The next time we do a large-scale project like this we’ve got the tools and a process for it.
“The biggest change beyond the obvious ones when you do these kinds of projects is that you take three cultures and create a fourth one. When we feel that that has really happened, that’s when we know this has been successful.”
University of Miami Hospital Implements State-of-the-Art Electronic Medical Record System
Friday, May 12, 2017
University of Miami Hospital is significantly transforming its patient care experience by upgrading its electronic medical record (EMR) system to UChart. The upgrade will positively impact patients and the entire University of Miami Health System community, and once completed in October it will mark the final phase of the University’s creation of a true enterprise-level EMR.
When UChart is implemented, health care providers and patients alike will benefit in many important ways. Providers at UMH will now have a 360-degree view of patients that was not available before. They will not only have seamless access to all of a patient’s UHealth records, but also to their health information from other Epic hospitals and clinics outside the UHealth system.
“UChart is a state-of-the-art clinical information system, developed by Epic, which integrates functionality of clinical software applications into a single system accessible across UHealth,” said David Seo, M.D., Chief Medical Informatics Officer. “Once the project is complete, it will be the first time that all UHealth clinical faculty and staff members will have around-the-clock access to an integrated EMR. This will foster a more connected and unified approach to patient care.”
A significant shift for health care providers at UMH will be the transition from Meditech and paper documentation to fully electronic medical records. To ensure this transition causes minimal disruption to current workflows, the UHealth Information Technology implementation team is leveraging best practices from previous implementations at Sylvester Comprehensive Cancer Center and Bascom Palmer Eye Institute.
“We will be better, safer and faster,” said Tanira Ferreira, M.D., Chief Medical Officer of UMH. “UChart will facilitate communication among providers and caregivers, as notes and orders will be immediately available.”
The UHealth IT training team has developed role-based training tracks for nurses, physicians, and staff at UMH. This streamlined approach was developed to minimize impact on day-to-day operations and will offer all health care providers the knowledge, tools, and access needed to effectively use UChart.
In the coming months, more information regarding the UChart implementation at UMH will be communicated to affected health care providers. Dates to remember:
IBM Watson Selects University of Miami Health System for Inclusion in the Imaging Collaborative
Wednesday, June 22
Following the announcement by IBM Watson, David Seo, M.D, Chief Information Officer and Chief Medical Informatics Officer, said, “This initiative represents the transition from the theoretical potential of Big Data to the application of Big Data to improve human health. I am very excited for UHealth IT to be involved in this one-of-a kind initiative. I believe that we will look back on June 22, 2016 in ten years and point to it as the day the paradigm of health care was changed.”
The University of Miami Hospital ( UMH) is pleased to announce Meditech, our electronic health record ( EHR) system, has been upgraded from 5.6.6 to version 5.6.7.
UChart Expansion at Sylvester Comprehensive Cancer Center and Bascom Palmer Eye Institute: Go-Live is June 26, 2016
Saturday, May 10
On June 26, 2016, Sylvester and Bascom Palmer are going live with two additional UChart modules: OpTime Operating Room Management System (OpTime), and Anesthesia Information Management System (Anesthesia). At Sylvester, we are also expanding the implementation of Radiant to include the Interventional Radiology department.
Registration is currently available through ULearn. This required training is needed for you to effectively prepare for the use of the additional UChart modules and to access them at Go-Live. For step-by-step registration instructions and information on which role-based class to take, please view the appropriate Training Flyer:
