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University of Pittsburgh
IAIMS Progress Report to IAIMS Consortium
November 2003
Background
The IAIMS implementation initiative at the University of Pittsburgh, also engaging the closely affiliated UPMC Health System, is based in the Center for Biomedical Informatics. Pittsburgh IAIMS has as its primary theme "Advancing the Academic Mission Across a Distributed Enterprise" through information technology. The effort has four specific aims that have directed tactical goals and strategies since the effort began:
- To implement a management and governance structure for information technology.
- To develop an architecture for information technology integration.
- To develop a set of focal activities, spanning the academic mission, that demonstrates the value of technology integration.
- To evaluate the effort.
Our IAIMS planning began in the spring of 1996 coincident with the establishment of the Center for Biomedical Informatics. This was actually a "re-planning" effort since our institution was awarded an IAIMS planning grant in 1988 that resulted in a circa-1990 IAIMS plan that was obsolete by 1996. The re-planning was undertaken without grant support in 1996-97 and resulted in the submission of an IAIMS implementation grant application in July 1997. Following a December site visit, we received implementation funding commencing in May 1998.
Over this seven-year period, the organizational scope and complexity of Pittsburgh IAIMS has increased dramatically. The boundaries of the effort were initially (1996) drawn to embrace the union of the University's six health sciences schools and the University of Pittsburgh Medical Center (UPMC) which was in the process of being divested from the University and beginning a period of unprecedented expansion. Several important organizations and resources were, at the time, excluded from the formal scope of Pittsburgh IAIMS--including the non-health sciences schools of the University, the separately owned children's and women's hospitals in the university health complex, and the three Pittsburgh VA hospitals. Over time, UPMC became the UPMC Health System (UPMC-HS) and expanded rapidly to 20 hospitals and 300 other delivery venues, emerging as the largest employer in western Pennsylvania. UPMC-HS now has merger agreements in place with Children's Hospital and Magee Women's Hospital.
Current Environment
At a high level of abstraction, in light of the organizational changes involving the university and health system over seven years, Pittsburgh IAIMS should be understood as an exercise in leverage and influence as much as an exercise in technology development and deployment. It perhaps should also be understood as the centripetal force promoting the coordination of information technology resources for faculty, staff, and students in the central Oakland campus where six major teaching hospitals and the six university schools of health sciences are collocated and interoperate. A notable constituency for IAIMS, because of the information integration challenges they create, is the ~1400 clinical faculty members based in Oakland who are formally employees of both the university and the health system. IAIMS, with a $575K annual budget, could not possibly take responsibility for all information technology across an enterprise (health sciences plus health system) with a combined annual budget exceeding $4 billion. Nonetheless, it could and was designed to influence how most information technology across this enterprise is developed, deployed, and integrated. Also by design, IAIMS would be more influential within defined sub-spheres of the organization, creating specific deliverables for the larger organization to use and establishing examples of good IT practice for the larger organization to emulate. Following are developments in the four major areas:
Networking:A Network Security Agreement has been consummated between the university and health system providing for:
- Creation of a joint security policy advisory committee to recommend policies, standards, definitions, and guidelines for ensuring privacy and security for patient records
- Establishment of a joint advisory committee, comprised of faculty members that use both networks, administrators responsible for managing the two networks and administrators responsible for overall policy coordination within the two institutions
- Development of a detailed service level agreement that defines the roles and responsibilities of each institution.
The first major test of the agreement has been the conversion of certain university facilities to the UPMC voice and data network.
Clinical Care:The Electronic Health Record (EHR) is being implemented across the UPMC Health System. As the project has matured, the UPMC has moved into a co-development role with Cerner Corporation to build functionality not previously available in the vendor's system. A number of non-Cerner applications are being integrated into the EHR, including the Stentor system (radiology images) and the pathology informatics system.
Health Sciences Information Technology:The family of applications for the academic community has made several major strides in the last year. These include:
Evaluation:A summative and formative evaluation process has continued across the five years of the funded project. Information has been gathered from multiple constituents and analyzed in collaboration with an external consultant. An overview of evaluation data was presented at the annual retreat with the external advisory committee in October 2003 and will be used as the basis for an intensive strategic planning and visioning process to determine:
- Maintenance of the IAIMS vision in the post-funding era
- Future structure of IAIMS committees and organizational structure
- Sustainability of financial support for current IAIMS activities
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