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Clinical System Progress Report

Guiding Principles and Function Requirements Identified

By John G. Harold, M.D., & William W. Brien, M.D.
Co-Chairs, Physician Advisory Team, Clinical System Selection

Significant progress was made this week in the process to select a new clinical system for the medical center. Following Steering Committee approval of the suggested Guiding Principles and Key Functional Requirements that will set the stage for narrowing the vendor list, they were presented to and reviewed by the Physician Advisory Team.

The interactive process to get us to this point, as we have detailed in earlier editions of Pulse, began with the Future State sessions held in January. In addition to the insight gained from the physicians and other multi-disciplinary staff who attended those sessions, the consultants from IBM/Healthlink added real-life clinical care observations to the mix by shadowing several physicians, pharmacists and nurses during their rounds.

Technology requirements, system assumptions and key questions were developed from the information compiled during that process. With a formal vote from the Care Delivery Advisory Team at their meeting last week, a prioritized list of assumptions and key questions was used to develop the Guiding Principles and Key Functional Requirements that were ultimately presented to the Physician Advisory Team. They will be used to narrow the vendor list to only those whose technology can support the basic Cedars-Sinai requirements, and will then be incorporated into a request for proposal that will go out to those qualified vendors in late March.

The 10 Guiding Principles establish a big-picture agreement on what the core system must include. For example, they specify that there will be two-way real-time interfaces between the departmental systems and the new clinical system to support integration for orders and results.

As a reminder, this will be a "core" clinical system that will encompass Computerized Physician Order Entry (CPOE), Electronic Medication Administration Record, Multi-disciplinary Clinical Documentation, Pharmacy and Decision support. In choosing that core system, we will be asking each vendor to show how their system will integrate with several of our other existing clinical systems, such as CareVue, Centricity, EmSTAT, SIS, Watchchild, Lab and Imaging.

The Key Functional Requirements are extensive and drill down to more detail about what we need to fulfill our collective vision of the future clinical care environment at Cedars-Sinai. They are categorized into 74 requirements for clinical documentation, 52 for orders management, 50 for medication management (which includes the pharmacy requirements), 67 for clinical decision support, six for results review, and 107 for technology and general requirements.

Click here to view the 10 Guiding Principles and the Key Functional Requirements.