Great Patient Care: The Intersection of Clinical Excellence and Advanced Technology. C. Martin Harris, M.D.

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1 Great Patient Care: The Intersection of Clinical Excellence and Advanced Technology C. Martin Harris, M.D. Chief Information Officer, Cleveland Clinic

2 Pr of Medicine Observation Paper Chart Testing Analysis Diagnosis Treatment Follow-up

3 Pr of Medicine Observation Paper Chart Testing Analysis Diagnosis Treatment Follow-up

4 Pr of Medicine Film Libraries and Other Storage Media Paper Chart

5 Pr of Medicine Film Libraries and Other Storage Specialized Media Visualization Paper Technology Chart EMR = EMR Aggregation

6 Pr of Medicine Specialized Image Visualization Aggregation Technology EMR = Aggregation Image Aggregation Encounter Encounter Encounter Encounter

7 Pr of Medicine Patient-Specific, Image-Enabled Longitudinal Medical Record EMR = Aggregation Image Aggregation Encounter Encounter Encounter Encounter

8

9

10 Operations Care Quality and Regulatory Compliance Business and Financial

11 Clinical Operations 9:45 AM Dr. Patient Scheduled 60 M 11:00 AM Dr. Patient Scheduled 68 F 11:30 AM Dr. Patient Scheduled 62 M Care Quality and Regulatory Compliance Business and Financial

12 03/26/2013 9:45 AM Office Visit Dr. INT MED Patient Rash and Cough Scheduled 60 M G10 03/26/2013 Office Visit INT MED Description G10 03/26/ :00 Office AM Visit Dr. INT MED Description Patient Scheduled 68 G10 F 03/26/2013 Office Visit INT MED Description G10 03/26/2013 Office Visit INT MED Description G10 03/26/ :30 Telephone AM Dr. FHCSTR Description Patient Scheduled 62 G10 M 03/25/2013 Office Visit FHCSTR Description INT1 03/25/2013 Office Visit FHCSTR Description INT1 03/25/2013 Office Visit FHCSTR Description INT1 03/25/2013 Telephone FHCSTR Description INT1 03/25/2013 Telephone FHCSTR Description INT1 03/25/2013 Telephone FHCSTR Description INT1 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Telephone INT MED Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Telephone INT MED Description G10 03/21/2013 Office Visit FHCSTR Description INT1 03/21/2013 Office Visit FHCSTR Description INT1 03/21/2013 Office Visit FHCSTR Description INT1 03/21/2013 Office Visit FHCSTR Description INT1 03/21/2013 Telephone FHCSTR Description INT1

13 03/26/2013 Office Visit INT MED Rash and Cough H11 03/26/2013 Office Visit INT MED Description G10 03/26/2013 Office Visit INT MED Description G10 03/26/2013 Office Visit INT MED Description G10 03/26/2013 Office Visit INT MED Description G10 03/26/2013 The patient Telephone is a 62 year FHCSTR old male with a history of Description G10 03/25/2013 Office Visit FHCSTR Description INT1 diabetes who complains of a swelling of the middle 03/25/2013 Office Visit FHCSTR Description INT1 finger of his right hand, and a mild cough. 03/25/2013 Office Visit FHCSTR Description INT1 03/25/2013 Telephone FHCSTR Description INT1 03/25/2013 Telephone FHCSTR Description INT1 03/25/2013 Telephone FHCSTR Description INT1 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Patient, Office presents Visit with INT swelling MED of middle finger, right Description G10 03/22/2013 hand. Also Telephone describes INT a MED moderate, dry cough. Description G10 03/22/2013 Swelling Office is warm Visit to INT the MED touch and sensitive, Description G10 03/22/2013 including Office an itching Visit INT sensation. MED The swelling began Description G10 03/22/2013 approximately Office Visit 6 days INT prior MED to visit. Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Office Visit INT MED Description G10 03/22/2013 Telephone INT MED Description G10 03/21/2013 Office Visit FHCSTR Description INT1 03/21/2013 Office Visit FHCSTR Description INT1 03/21/2013 Office Visit FHCSTR Description INT1 03/21/2013 Office Visit FHCSTR Description INT1 03/21/2013 Telephone FHCSTR Description INT1

14 White Cell Count The patient is a 62 year old male with a history of diabetes who complains of a swelling of the middle finger of his right hand, and a mild cough. Chest X-Ray Patient, presents with swelling of middle finger, right hand. Also describes a moderate, dry cough. Swelling is warm to the touch and sensitive, including an itching sensation. The swelling began approximately 6 days prior to visit. Antibiotic

15 White Cell Count Diabetes Care Checklist Visit Recommendation: Up-to-Date 4 times per year Chest X X-Ray Laboratory Tests: Up-to-Date Antibiotic X Click for Result List Eye Care Exam Click for Result List Blood Pressure: Up-to-Date X Click for Result List

16 White Cell Count Diabetes Care Checklist Visit Recommendation: Up-to-Date 4 times per year Chest X X-Ray Laboratory Tests: Up-to-Date Antibiotic X Click for Result List Eye Care Exam Click for Result List Fundoscopic Eye Exam Blood Pressure: Up-to-Date X Click for Result List

17 White Cell Count Laboratory Test Result: Evaluation of laboratory blood differentiation test for patient indicates a normal range, considering age, geographic altitude and other standard, potentially related criteria. Chest X-Ray Results are: RBC count: 4.9 million cells/mcl Antibiotic WBC count: 6,500 cells/mcl Hematocrit: 45.6% Fundoscopic Eye Exam Hemoglobin: 16.4 gm/dl

18 Laboratory Chest Fundoscopic X-Ray: Test Eye Result: Exam: Result Evaluation This Utilizing is a chest a fundoscope, of laboratory image of which a blood 62 year-old is an male differentiation taken instrument, specially test for designed patient On the top serve portion indicates as of the a normal magnifying chest range, is the glass, neck considering including and the age, collar a number bones of geographic (clavicles). lenses that On altitude can the magnify bottom, and other an object standard, chest by cavity potentially is nearly bordered 15 times, related by the this criteria. diaphragm procedure under was which is performed the abdominal on, cavity On either Beginning side of by Results anesthetizing chest are: wall, the eye bones with of drops the shoulders of RBC and atropine, arms count: the are exam easily was recognizable. performed to identify 4.9 million any existing cells/mcl abnormalities of the Inside optic disc the chest that, once cavity, identified the vertebral can signal WBC column count: the onset can of be such seen disorders down the as middle diabetic of the chest, 6,500 splitting cells/mcl retinopathy or glaucoma, it nearly in and equal that halves. may On Hematocrit: each also indicate side of the midline, presence the of dark intracranial appearing lung pressure. 45.6% fields are seen. The white shadow of Hemoglobin: the heart is in the middle of the field, atop the This 16.4 diaphragm is gm/dl important and because more to increased the

19

20 Image Acquisition Sources Women s Health (Departments / Devices) No Image Acquisition System; Stand-Alone Devices; Not Integrated Cardiology Imagine Mgt. System Radiology Imagine Mgt. System VNA Viewer Viewer Viewer

21 Women s Health Cardiology Radiology ICIS Workflow Service Imagine Mgt. System Imagine Mgt. System Imaging Clinical Information System (ICIS): Smart Image VNA Library

22 Women s Health Cardiology Radiology ICIS Workflow Service Imagine Mgt. System Imagine Mgt. System Imaging Clinical Information System (ICIS): Smart Image Library Viewer

23 Women s Health Cardiology Radiology ICIS Workflow Service Imagine Mgt. System Imagine Mgt. System Imaging Clinical Information System (ICIS): Smart Image Library Viewer

24 Patient Mana

25 agement Enhanced Documentation Image-Enabled Ordering

26 Experience Advanced Technology

27 Experience Advanced Technology

28 Advanced Technology Consulting Services: Introductory Workshop Project Planning Site and Technology Assessment Solutions Design and Planning Project Management and Implementation: Project Management and Oversight System Implementation Services Integration Go-Live Support

29 Consulting Services: Introductory Workshop Project Planning Site and Technology Assessment Solutions Design and Planning Project Management and Implementation: Project Management and Oversight System Implementation Services Integration Go-Live Support Imaging Clinical Information System (ICIS) Imaging Infrastructure: Imaging Infrastructure Infrastructure-as-a- Service Application Hosting Managed Imaging Services: System Administration and Support Systems Management Application Support Operations Support Image Lifecycle Management

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