On Tuesday, Feb. 23, hundreds of healthcare professionals listened in as Archie Galbraith, CIO, UCLA Medical Sciences, discussed about his organization’s experience with implementing a clinical portal. The task was not an easy one, for two primary reasons:
1. The size of the network. UCLA Health System includes four hospitals and a medical group, sees 1.2 clinical encounters annually, with the hospitals admitting 80,000 patients per year.
2. When the project was being launched in 2007, the IT environment was “relatively complex,” as Galbraith mildly put it. UCLA had more than 250 applications, of which 30 percent were developed in-house, and there was no single sign-on application.
What’s more, the system had seven (yes, seven) different portals for the clinical staff, and all of them were home grown. The reasoning behind the different portals was that faculty and staff with different credentials needed to access different information. The problem is that all seven portals were developed in silos and didn’t speak to each other. What’s more, the user groups were extremely loyal to the systems they knew and the applications they used — even if they weren’t the best apps available (Galbraith referred to this as the “worst of breed” approach).
So as UCLA kicked off a significant IT initiative in 2007 (which coincided with the building of a new facility), the challenges were significant. The IT team wanted to provide effective, efficient technologies that would drive IT adoption and cut the organization’s dependency on paper-based solutions. And they knew that any systems that were rolled out must be able to accommodate mobile users, and must have flexibility built-in.
Creating a single portal was a huge piece of that. But when UCLA approached vendors asking if they could contract their services just to develop a portal, they didn’t have much luck —until the medical informatics department reached out to Orion Health. So UCLA began working with the Santa Monica, Calif.-based vendor to create an optimal solution, and learned some very interesting lessons along the way:
Using a leading systems integrator as the prime contractor was a mistake. The contractor didn’t bring enough clinical expertise to the table, and as a result, UCLA went through seven different project managers and burned through a lot of money trying to right the situation.
Not knowing its own technical environment and technical and user requirements resulted in a great deal of time lost.
Having a broad scope in terms of what they wanted in a portal and allowing the IT team to be dynamic about the functions and features it would have paid off immensely. Galbraith says these types of decisions are too important for small-minded thinking.
As much as organizations don’t want to be too ambitious with go-live deadlines, it’s almost important not to be too modest. UCLA underestimated how quickly this would go.
The traditional approach of first making an investment, then agreeing to specifics isn’t the way to go. UCLA came up with a blueprint and followed it closely. The point, says Galbraith, was not just to replace the portals, but to replace them with something better.
Users have high expectations — they want a one-stop shop, and they want it fast. They don’t want to hear that portals can’t do certain things, they just want it to work. It’s important to keep that in mind.
As a result of its hard work and collaboration with Orion Health, UCLA is moving toward a single portal that has greater user functionality (including remote access) and enables staff to more easily control what data is available to which clinicians. The health system also replaced the legacy clinical documentation system that is seen as an extension of the portal and can be customized by department.
According to Galbraith, the organization plans to continue to deploy clinical documentation, and will closely monitor the portal to make sure it meets the users’ expectations. For more information on UCLA’s story, click here.
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