More than 1,100 comments from 268 individuals who participated -- a large proportion of whom were physicians -- were collected during this first step in a three-phase process to select a proven clinical information technology system.

The feedback has been catalogued into various categories, is being critically analyzed and will be used to develop clinical system and operational requirements. Initially, with the help of project facilitators from IBM Healthlink, it will serve as a prioritization tool to limit the vendor pool based on the capabilities of their systems to achieve Cedars-Sinai's vision for the future.

The 12 Future State Sessions included two physician review sessions, one Pharmacy session, one Technology session, three concurrent Clinical Documentation sessions, three sessions on CPOE/Orders (Computerized Physician Order Entry) and two on eMAR (electronic Medication Administration Record). Clinical Documentation and CPOE/Orders were the most well attended.

The major themes of the sessions were:

• CLINICAL DOCUMENTATION: Multi-disciplinary documentation across the continuum of care;
• ORDERS: Standardized order placement and the ability to see order status in a single CSHS clinical system;
• CLINICAL DECISION SUPPORT: Clinically relevant alerts without alert fatigue and evidence-based clinical content in the order sets;
• RESULTS REVIEW: A single source to view results across the continuum of care in multiple formats (e.g. trending, graphing);
• MEDICATION MANAGEMENT: A standardized medication management process throughout CSHS (e.g. order entry, documentation, order fulfillment); and
• TECHNOLOGY: An interoperable system that supports access and retrieval of information from an integrated electronic record.

Requests for Quotation (RFQs) will be developed within the month and sent to that shortened list of qualified vendors whose systems can supply the needed functionality. The RFQ will employ a scenario approach that will require vendors to demonstrate specifically how their systems will handle Cedars-Sinai's unique needs, rather than simply presenting their system capabilities. Vendor demonstrations will be held for an approximate three-week period in early April in order to encourage widespread participation by and feedback from medical staff and CSMC employees.

Throughout all phases of system selection, the process itself is being assessed and modified based on feedback. The volume of participation and the verbal and written comments received regarding the Future State Sessions show a significant multi-disciplinary interest in the project and enthusiasm for a collaborative effort. Session participants felt they received a good overview of the plan for vendor selection and an understanding of the process to get there.

Those who attended expressed thoughts and concerns associated with both system selection and ultimately implementation and operations, and those issues will become a part of the vendor review criteria. Common themes from the sessions included: ensuring there is a clear understanding of "what" and "how" staff do their work and how that workflow is part of the technology; comprehensive training and readiness for all staff; and adequate technical support and downtime procedures.

The next scheduled Physician Advisory Team meeting will be held from 11 a.m. to noon in the Board room on Thursday, Feb. 22. It is open to anyone interested.

Watch for updates on the systems selection process in future issues of Pulse.