Mount Auburn Hospital / MAPS / MACIPAOne IS

Journey to an Integrated Database

October 2014

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Journey to an Integrated Database Phase I –Assessment FY13-15

Assessment of various information systems: Surveys, Demos, System Reviews

Market Assessment Total Cost of Ownership Scope of Project Evaluate options for financing Approvals

Phase II Planning and Preparation FY 14-15 Phase III Implementation FY 16-17 Phase IV Optimization FY 17-

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Journey to an Integrated Database Phase I –Assessment FY13-15 Phase II Planning and Preparation FY 14-15

Contracts for software (Epic and 3rd party) Determine hosting Determine staffing needs Determine legacy system strategy 3rd Party Application implementation Determine data conversion/archiving strategy Begin hiring/training

Phase III Implementation FY 16-17 Phase IV Optimization FY 17-

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Journey to an Integrated Database Phase I –Assessment FY13-15 Phase II Planning and Preparation FY 14-15 Phase III Implementation FY 16-17

Data conversion, archiving “Big bang” go-live Implement practices in several waves Legacy Strategy

Phase IV Optimization FY 17-

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IS Assessment Process

Press Ganey – 2011 CMIO Hire – Feb 2013 User Survey – March 2013 RFP – May-July 2013 Demo Evaluations – August 2013 One IS Summit – September 2013 Epic Visits – November 2013 TCO Development – September –

December 2013 ROI Development – February 2014 Private Practice Assessment – July

– September 2014 End-to-end Functional Assessment

– July – September 2014

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IS Assessment

Multiple systems, multiple instances, multiple data sources Currently 130 software applications in MAH 50+ instances of eCW

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IS Assessment

IS Assessment

Strong Dissatisfaction with current systems

Strong Desire to share records more efficiently

Many systems need immediate replacement

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IS Assessment

Strong desire for integration

Strong willingness to switch to a new platform

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IS Assessment

Epic Clear winner in RFPs in every category

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IS Assessment Fragmented Network Complex IS Service

Delivery System Multiple Helpdesk Communication challenges

Limited training Desire for more physician

involvement Excitement for a new IS

system

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Market Assessment

Epic dominant platform in the United States (54% of population)

Epic late to market in Boston but will become dominant EHR in Boston market

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Market Assessment

Epic interoperability capabilities has become standard of health information interchange Care Elsewhere -

Information can come from a non-Epic EMR that complies with industry standards, or directly from the patient.

Care Epic - Epic system is on both sides of the exchange, a richer data set is exchanged and additional connectivity options, such as cross-organization referral management, are available.

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Physician referrals to MAH

MACIPA, Atrius, CHA, etc.

276,500 EHR physicians158M-188M patients,

50% to 59%

54% of the U.S. population 173M people will be cared for by EpicCare

RED > 40% of patients are

or willbe covered by

EpicCare

PINK 1-40% of patients are

or willbe covered by

EpicCare

GREYNon-Clinical Customers

TCO Modeling

Examining true IT costs of combined costs at MAH, MACIPA, Caregroup and non-IT departments

Software licensing, hardware, labor, etc. Includes back-end replacement and 3rd party software associated with

Epic, legacy costs EVERY department analyzed 5 year modeling Does not account for possible discounts from negotiating Does not include potential revenue and expense improvements Examined:

Status Quo: Meditech 5.66 + eCW v9 Meditech 6.1 eCW v10 Epic (hosted by self) Epic (hosted by Epic) Epic (hosted by 3rd party)

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5 Year CostScenario 1:Status Quo

(MEDITECH Magic +

eCW + Athena)

Scenario 2:MEDITECH 6.x +

eCW.v10

Scenario 3a:Epic

(on-premise)

Scenario 3b:Epic

(partner-hosted)

Scenario 3c:Epic

(vendor-hosted)

Total Capital Expenses $6,377,978.65 $39,396,731.49 $63,080,705.22 $69,361,254.12 $61,151,382.62

Total Operating Expenses $62,266,165.72 $74,294,253.95 $65,584,337.49 $64,794,816.29 $70,697,311.29

TOTAL $68,644,144.37 $113,690,985.44 $128,665,042.71 $134,156,070.41 $131,848,693.91

15% Contingency $78,940,766.03 $130,744,633.26 $147,964,799.11 $154,279,480.97 $151,625,997.99

Back-end Financials $0.00 $0.00 $9,195,222.07 $9,195,222.07 $9,195,222.07

Legacy System Support & Sunsetting $0.00 $25,433,439.28 $25,433,439.28 $25,433,439.28 $25,433,439.28

GRAND TOTAL $78,940,766.03 $156,178,072.54 $182,593,460.46 $188,908,142.32 $186,254,659.34

TCO Findings

Continuing current state non-sustainable—high degree of dissatisfaction with current systems, does not meet future needs for population management, quality, reporting, coordination of care

Costs to maintain status quo with no improvements is expensive ($80M) Costs to upgrade to Meditech 6.1 are very expensive and new platform

brings risks Costs to implement Epic similar to Meditech but will be implementing

top rated product ROI not included in TCO modeling

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Why Epic? Alignment with business

strategy/improve communications Within MAH/MACIPA With other providers

Atrius (22% of volume) CHA Lahey Partners

Best strategic product for MAH/MACIPA needs

RFP/demo winner Best product by KLAS ratings Superior Performance/Quality

reporting

Superior Patient Engagement (Patient portal)

Integrated Data for business/clinical intelligence and data mining

Standardize workflows Superior Clinical Decision Support Superior Population Management

Capabilities Improve Efficiencies Platform for Performance/Quality

Improvement Other expense/revenue

improvement

Questions?