THE IT&S 2015 ANNUAL REPORT

patientkeeper

2015AnnualReport

THE IT&S 2015 ANNUAL REPORT

© Copyright 2016

HCA Information Technology & Services, Inc.


MESSAGE TO STAKEHOLDERS

The theme for this year’s IT&S All Hands meeting was “the Big Picture.”

True to this theme, 2015 had all the drama and excitement of a great

movie. The thrill of new projects. The rush of shared victories. An

often heart-pounding pace. Of course, a great movie is the result of

great collaboration, and we feel especially fortunate to enjoy great

partnerships across HCA.

Collaboration begins with the unique relationship our division teams

have with hospital, division, and group operations. We have worked

closely with these counterparts to prioritize, create, and deploy a wide

range of innovative and progressive solutions.

Our relationship with the Outpatient Services Group also continues to

evolve as we work together to incubate and grow many of the company’s

emerging technologies, like the service lines of Sarah Cannon and CRM

and other approaches such as telehealth and care continuum. The IT&S

Strategy team has joined forces with the Strategic Resource Group on

several initiatives, and we’ve enjoyed working through many of the new

challenges developing in today’s healthcare.

Another partnership that has seen a lot of technology change recently

is the Physician Services Group. From the refinement of our employed

physician base to the exciting emergence of Urgent Care, our IT team

looks forward to supporting their all-important initiatives. We continue

to work closely with Clinical Services Group as well, and even though

our work on PatientKeeper has been challenging, we’re confident we

are approaching the deployment of a differentiating solution. Other

emerging technologies, such as iMobile and EBCD, are just a few of the

ways we believe we will improve efficiency and caregiver satisfaction in

the near future.

HealthTrust’s growth has created a surge of technology opportunity, and

our teams have been responsive to this growth with new technologies

along with the fortification of our foundational applications. Meanwhile,

Workforce Solutions has taken center stage with several technology

products that are critical to our workforce and staffing management

priorities. Business Performance Group, too, is making major strides,

introducing iPads to change how we interact with our patients at

registration and how we use data science to discover insights in areas

like denial management.

It was also a big year for our relationship with Human Resources. OneHR

and the various new technologies that were introduced went mainstream

in 2015, and this transformation has had tremendous success. It was

thrilling for us to see the technology get off to a good start.

These are just some of the examples of the great relationships we’ve

strengthened and the technological advances we achieved over the

past year. There’s much more detail in the pages that follow. Our

partnerships and the work that results from them serve as a reminder of

IT&S’s privileged position within HCA and today’s healthcare landscape.

In between the duties and deadlines, we sometimes lose sight of the

important work we do every day. We often need to step back to see

the Big Picture, to understand how each one of us is contributing

immeasurably to the future of healthcare IT and the present care of our

patients. In 2015, we continued to emphasize the importance of being

Healthcare Inspired.

Marty Paslick

Senior Vice President, CIO, HCA

President, HCA IT&S


LEADERSHIP

TABLE OF CONTENTS

Marty Paslick

Senior VP & CIO, HCA IT&S

(615) 344-6030

Lee Adams

VP, Field Operations

(615) 344-8460

Danny Schunk

VP, Service Line & Corporate

Solutions

(615) 344-5465

Michael Seestedt

CIO, Parallon Workforce

8

By the

Numbers

10

IT&S

All Hands

16

Strategy &

Accomplishments

Solutions

Maria Benedetti

(954) 514-1607

VP, Human Resources

(615) 344-5332

Nicole Tremblett

Paul Brient

President & CEO, PatientKeeper

(781) 373-6301

Paul Connelly

VP, Strategy & Planning

(615) 344-6599

Chad Wasserman

CIO, Parallon Business

Performance Group

40

Alliances

54

Data & Analytics

VP & CISO, Information

(615) 807-8930

Protection

(615) 344-8450

Shahzad Fakhar

VP, Infrastructure Services &

Operations

(615) 344-5401

Chris Pair

Curtis Watkins

President & CEO, Parallon

Technology Solutions

(615) 344-4043

Chris Wobensmith

VP, Clinical Informatics

(615) 344-7935

64

Architecture

76

Information

Protection

VP, Data & Analytics

(615) 344-6254

Chris Wyatt

Kent Petty

CIO, HealthTrust Technology

Innovation

(615) 807-9309

VP & CFO, Finance &

Administration

(615) 344-2424

84

Field

Operations

104

Empolyee

Engagement

116

About

IT&S


BY THE NUMBERS

7,366

Backup Jobs

(Daily)

HOSPITALS SUPPORTED

840

Websites

4,631

Employees

(Corporate & Field)

15

IT&S

Service Centers

5

Regional

Data Centers

HCA 168 Lifepoint 73 Capella 14 Other 19

OTHER FACILITIES SUPPORTED

238,231

342,365

41.281

million/month

Enterprise Desktops/Laptops

Enterprise-wide Email Boxes

Internet Email Received

862

Projects in Portfolio

343

Approved Projects

Physician Practices 850 Surgery Centers 116 Endoscopy Centers 15

2015 Portfolio Allocations by Business Unit

Client Support Tickets 2,506,469 Incidents / 265,221 Work Orders

HOURS CAPITAL OPERATING

33,078

Mobile Devices

Managed

3,171

Software Applications

1,435

9,496

Physical Servers - RDC

Virtual Servers - RDC

203 / 1,350

physical

virtual

MEDITECH Servers

Shared Storage in Use

16.718 petabytes available

10.384 petabytes used

IT&S CSG OSG PSG SCRI Parallon Other

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The Big Picture

2015 IT&S All Hands

A grand Hollywood spectacle featuring

a cast of thousands.


EMPLOYEES GOT A GLIMPSE of Hollywood glamour at this

year’s All Hands event, a red carpet spectacle where the people

of IT&S were the stars. The theme for the year was “The Big

Picture.” The All Hands event reflected this concept with classic

Hollywood décor and messages reminding employees to see

IT&S’s place in the “big picture,” to be proud of their own

privileged place in the grand landscape of today’s healthcare.

THE BIG PICTURE: THE MAIN EVENT

This year marked our ninth All Hands event, an annual mixed

media presentation and production that has featured renowned

keynote speakers such as Seth Godin, Patrick Lencioni, and

conductor Roger Nierenberg with a full orchestra.

For several years now, the

All Hands event has been

a cultural touchstone for

the organization, a time for

socializing with colleagues,

gaining inspiration from

leadership, and enjoying a

variety of specially designed

entertainments, including

short movies starring IT&S’s

own employees and leadership

team. The centerpiece

of the show was keynote

speaker Jeffrey Tambor,

award-winning actor from

Arrested Development and

Transparent, who used live

performance to convey

pertinent messages about

leadership, collaboration,

and authenticity, gleaned

from several decades in show

business.

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The event again took place

at the elegant Schermerhorn

Symphony Hall, dressed

for the occasion with giant

Oscar statues, old-fashioned

concessions stands, and

IT&S-themed movie posters.

CIO Marty Paslick served as

host, celebrating our year’s

accomplishments, casting

a vision for the future, and

setting the stage for leaders

from the Clinical Services

Group: Jonathan Perlin (Chief

Medical Officer), Jim Jirjis

(Chief Health Information

Officer), and Edmund Jackson

(Chief Data Scientist).

All in all, it was an epic-scale

spectacle, as an ensemble of

leaders, presenters, and artists

gave an inspiring wide-angle

view of the Big Picture of IT&S.

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Strategy and

Accomplishments

We pictured. We planned. We produced.


WE ACHIEVED MAJOR ACCOMPLISHMENTS in 2015,

supporting in particular the four strategic goals established for

our organization. In 2015, we explicitly aimed to: improve the

clinician experience with our systems, enable a positive patient

and consumer experience when they come into contact with our

technology, take full advantage of the power of our data analytics,

and help enable Parallon as the sales entity of IT&S systems and

back-office services. Many key projects and initiatives directly

supported these areas over the past year, executed by our expert

teams in Product Development, Infrastructure, Field Ops, and all

across the organization.

From major strides in

cornerstone technologies,

such as eClinicalWorks and

Epic, to new advances in

several burgeoning spaces,

like MyHealthOne, mobility,

and PatientKeeper (which

is detailed more in the

“Our Alliances” section of

this Annual Report), our

accomplishments in 2015

were significant, benefitting

not only our organization but

our patients, our clinicians,

and ultimately the entire

healthcare industry.

Daily work can often be

a grind, full of complex

processes, unforeseen

obstacles, and incremental

advancements. It’s typical

of work so complicated and

an organization so vast. But

once you step back, and get

a sweeping look at the big

picture, the impact of our

accomplishments comes into

focus, and we can see how

much tremendous progress

we made in just one year.

THE BIG PICTURE: CREATING AN EXPERIENCE

Today, healthcare technology is about experience. While

technology is certainly the foundation of what we’re

implementing, we must focus on delivering an exceptional

experience for all involved in patient care, physicians and patients.

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Strategy for Success

The strides we make each year starts with our all-important

strategy. This past year, our Strategy & Planning department

codified a number of tactics and practices into valuable

new resources that had powerful impact on the way

we direct activity in the organization. For instance, we

introduced Strategy Tubes, a new way of depicting future

plans and touchpoints for consolidation, integration,

and prioritization of differentiating and transformational

technologies. We also continued development of our library

of Strategy Guides, aimed at providing specific long term

vision and guidance for enterprise technologies.

STRATEGY GUIDES

Strategy Guides provide

facilities and divisions

with use cases, vendor

recommendations, and

considerations for some of

the biggest opportunities

for healthcare technology,

opportunities that will

increase efficiency, improve

patient satisfaction, and give

clinicians better visibility

throughout their workflow.

In 2015, new Strategy

Guides were developed for

Interactive Patient Technology,

Telehealth, and Virtual Sitter.

Additional guides are available

for Nurse Call and Awareness

Technology solutions.

STRATEGY TUBES

Strategy Tubes are fashioned

after the simplistic styling

of the London public transit

system maps, and they show

the necessary evolution of

important technologies from

current state to 36 months

in the future. Among the

technologies documented

this way are messaging,

physician user experience,

care management, acute

patient intake, and ambulatory

referrals. Strategy Tubes

educate and level-set the

organization on expected

evolution of given lines of

technology while informing

roadmaps for individual

products within those lines.

In 2016, we’ll continue to

use these in executive

settings where decisions are

made about consolidation,

integration, and prioritization

of technology assets.

NORTH WIND REPORTS

The IT&S Strategy team’s

monthly North Wind blogs

continued to be trusted

resources in 2015 for

information about some of

the latest strategies under

development as well as

insights into other industry

trends. For each initiative, the

report includes a description,

indication of project phase

(discovery, proof of concept,

pilot, or deployment), as

well as capabilities, current

status, next milestone, and

primary contact. Among the

initiatives included in the

deployment phase, as of

the end of 2015, are Mobile

Excellence and Patient Portal.

In discovery phase are:

Enterprise Care Management,

On Call Management, and

Notifications. PatientKeeper is

in proof of concept phase, and

Telehealth and Strategy Tubes

are in pilot.

20

Clinician Experience

Mobility

No industry-leading clinical

experience strategy would be

complete without attention

to mobile and patient-facing

technologies. Our Mobility

Center of Excellence is

working across IT&S to ignite

a community dedicated to a

consistent look and feel to our

mobile applications, as well as

a consistent way to develop, to

engage with third parties, and

to purchase apps.

21


iMOBILE: BY THE NUMBERS

11

facilities

where iMobile is live

2,667

phones

currently in use at live beta sites / 7,150+ shared

devices will be in use at the end of the project

9,533

total unique logins

across all facilities

In 2015, the iMobile pilot

offered clinicians the ability

to leverage mobile devices

for smart and secure

communication. We are

working with the mobile

industry’s giants to refine

offerings making mobile

devices a key convergence

point for future technologies.

Using the Mobile Heartbeat

app, the staff can integrate

with nurse call systems to

receive alerts on their mobile

device, and physicians can

view patient information

and receive important

clinical alerts. Overall, the

technology being piloted

and implemented by the

iMobile project has improved

the efficiency and care

coordination for physicians,

nurses, and the patient care

team; has reduced wait times

for patients as they transition

through the facility; and

has helped improve patient

satisfaction.

VoIP Implementations

IT&S continued to deploy its innovative voice-over IP (VoIP)

solution to HCA hospitals, replacing the legacy telephony

infrastructure which has become increasingly unreliable. The

project was initiated in 2011 and by the end of 2015 had been

deployed to 54 hospitals. An additional 21 sites have received VoIP

as part of Design and Construction initiatives. VoIP continues to

be one of the largest projects in the IT&S portfolio and provides a

necessary foundation for key clinical initiatives including iMobile,

eWhiteboard, and telehealth.

eClinicalWorks (eCW)

Focused on improving physician and patient satisfaction,

eClinicalWorks (eCW), the electronic medical record (EMR) used

by HCA physician practices, deployed several winning pieces of

functionality this year.

THE BIG PICTURE: TECHNOLOGY AT THEIR FINGERTIPS

Ten years ago, iPads didn’t exist, and physicians couldn’t imagine

life without a paper chart. Today, providers and patients alike can

use intuitive technologies such as eClinicalTouch on their iPads to

view records and make notes during visits.

22

* all stats as of January 1, 2016

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eCLINICALWORKS:

BY THE NUMBERS

PILOTING A TABLET

SOLUTION.

In pilot by providers in all

of the eCW regions, the

PILOTING KIOSKS FOR

PATIENT CHECK-IN.

The eCW Kiosk allows

patients to check themselves

SIMPLIFYING ACCESS.

The eSAF provisioning bridge

marries technology and

process improvement to help

CONTINUING TO ADD

FEATURES.

Physicians can view radiology

reports in the eCW in all

1,800 +

providers

eClinicalTouch solution allows

in when they arrive for

ensure physician staff have

divisions and regions. We

providers and clinicians to

access a patient record and

enter clinical documentation

data via an iPad application. All

their appointment. The data

entered by the patient syncs

in real-time with the client

eCW system. In addition

access to the eCW on their

first day. By taking advantage

of a workflow request that

kicks off automated backend

also launched a soft go-live of

physician-to-physician cloudbased

electronic referrals.

And now several options are

500

practices

of the data entered through

to check-in, patients have

processes and improving

available for voice recognition

the eClinicalTouch app is

available in real-time from the

eCW client application. Using

the iPad, both physician and

patient feel less encumbered

by equipment, so patient care

the opportunity to update

personal information, verify

insurance, complete consent

forms, and complete any

questionnaires related to

medical and social history.

the access request form,

accurate access requests

can be processed quickly

and automatically. Prior to

this enhancement, it took

3 to 5 days to complete the

with Dragon, Nuance, and

M*Modal for tablets, offering

greater flexibility, depending

on physician preferences and

technology choice.

720

new providers

this year (approx)

can remain the focus, instead

We are also in the process

provisioning process. Now it

of the technology.

of integrating a payment

processing feature for the

kiosk, which will allow patients

to use a credit card to pay

their co-payment. Initial

feedback from pilot locations

takes a matter of minutes.

150

new practices

this year (approx)

has been positive, and patients

and staff are enjoying the

streamlined workflow this

kiosk is providing.

650

providers

slated to convert in 2016 (approx)

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Epic

This year, the presence of Epic expanded its implementation

beyond St. Mark’s Hospital to Lone Peak Hospital and into a

new market at Alaska Regional Hospital. Epic is one of three

electronic medical record (EMR) systems installed across HCA’s

care settings. Although having multiple clinical transaction

systems (MEDITECH, Epic, and Cerner) often makes support

more difficult, converting Alaska Regional from MEDITECH to

Epic is allowing HCA to remain competitive through technology.

Physicians in the area have been using Epic with a competitor,

and facility leadership saw value in the ways the Epic platform

can help support growth strategies, not only in the ordering and

physician documentation capabilities, but in patient portal and

mobile features.

Knowledge and expertise of the Epic system continues to grow

with each implementation, and lessons learned during the

implementation in Alaska are making a difference at previous

implementation sites. In addition, team members working on

Epic, MEDITECH, and Cerner actively collaborate together to

ensure the EMR systems are accomplishing similar goals and

offering like capabilities across the enterprise.

Additional accomplishments

with Epic include:

MOBILE AND SPEECH

RECOGNITION.

Speech recognition on a

mobile device integrated

with an EMR is a feature in

high demand by physicians

who need to place orders

on-the-go. Approximately

80 physicians between

three practices at St. David’s

Cardiovascular Imaging Center

are taking advantage of Epic’s

mobile apps that allow them

to create orders via voice

dictation.

UPGRADE TO THE CURRENT

VERSION OF EPIC.

The upgrade introduced

changes with security,

simplifying user provisioning

for long term management,

and order sets, improving

overall physician experience

and ease of use.

SUPPORT MODEL AND

STAFFING.

At times Epic’s integrated

nature has challenged

our current HCA support

processes. This year we

refined our support model,

balancing resource needs

and defining efficient

and reproducible support

processes, to enable the rapid

resolutions our customers

deserve.

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Patient and Consumer Experience

MyHealthOne

Our in-house-developed patient portal MyHealthOne continues

to expand its reach in Nashville and Denver markets with

initial focus on MEDITECH networks and hospital clinical

information. While HCA facilities currently use the MEDITECH

patient portal, Epic MyChart, and many HCA provider offices

use the eClinicalWorks Health Portal, the long term vision is

for MyHealthOne to replace these portals so that HCA patients

can access their hospital and physician office information in

one place. It is an incredibly flexible, scalable platform that can

expand and accommodate additional “modules” to meet the

emerging needs of patients.

This year, MyHealthOne received certification as a Meaningful

Use Portal and will be working to expand certification for

Meaningful Use Stage 3 compliance in 2016. As of January 2016,

close to 8,400 users had already enrolled in MyHealthOne

already, with much of that growth occurring organically. Fueling

enrollment are the most popular online features: scheduling an

appointment with a physician and completing pre-registration

and pre-procedure paperwork.

In early 2016, MyHealthOne will complete deployment in the

TriStar, Continental, and MidAmerica Divisions. All of the

remaining HCA eligible hospitals will have MyHealthOne live

before 4th quarter 2016. Meaningful Use Stage 3 attestation

requirement testing will also occur in the 4th quarter. In order

to encourage maximum growth and user adoption, features will

be strategically selected for market release. Planned features for

2016 include the following:

• IMPROVED REMOTE ENROLLMENT

• ONLINE PROXY ENROLLMENT

• MICROBIOLOGY RESULTS

• RADIOLOGY RESULTS

• SERVICE LINE LAUNCH FOR SARAH CANNON

• CONSOLIDATED BILL PAY FUNCTIONALITY

• PRE-REGISTRATION INTEGRATION

• ADVANCED ANALYTICS FOR USER

JOURNEY MAPPING

• PRODUCT INSIGHTS

MyHealthOne is an important step in bridging the mobility gap

for patients, and the natural, daily growth in enrollment we

witnessed in 2015 is evidence that this new technology provides

the quality online experience our patients desire and deserve.

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Data Analytics

Care Management

As a means of supporting service line growth and expansion

as well as enabling value-based reimbursement programs,

our organization needs a well-researched strategy for Care

Management related technologies. Initial evaluation of existing

care coordination and clinical navigation products began in 2015

in an effort to arrive at an enterprise consensus on approach.

Research on service line specific initiatives to extend care

post-discharge was started as was discovery into an enterprise

solution, and research into involvement in bundled payments was

initiated. By the end of 2015, we had produced a framework of

enterprise care management domains and capabilities.

Health Information Exchange (HIE)

HIE connects and shares clinical data from a variety of sources

in near real-time so that clinicians can view a more complete

picture of a patient’s care history at HCA facilities and physician

practices. Working to connect the continuum of care, HIE is

stabilizing and establishing a secure data exchange among a

multitude of care settings across the enterprise.

This year, much of our work focused on connecting our assets

and affiliated physicians to clinical data while improving overall

user experience. The Clinical Viewer provides healthcare

professionals an integrated view of single patient records

whether in MEDITECH, eClinicalWorks, or PatientKeeper

across various points of care and displays harmonized data

including encounters, conditions, allergies, lab results, imaging,

immunization, and more.

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Other applications tap into the most current patient information

to obtain a full list of medical records associated with a single

patient. Applications such as CareLink and MyHealthOne rely on

HIE’s patient index as its source of data, and other applications

continue to be integrated, taking advantage of the over 37 million

patient records available since 2012. The Patient Index receives

about 1.5 million update records daily and processes over 2

million Web Services requests daily. Key HIE accomplishments in

2015 include:

• ACCESSING MORE PATIENT • SHARING DATA. We piloted

RECORDS. We implemented

Electronic Patient Record

the HIE Clinical Viewer as a

Transfer from a non-HCA

one-click, integrated workflow hospital into an HCA hospital

to all of MEDITECH and eCW

using ONC approved direct

providers, which provides

messaging.

access to patient records in

• SUPPORTING MEANINGFUL

the HIE that are outside of

USE. We provided patient

their EMR.

records for the MyHealthOne

• VIEWING IMAGES. We

patient portal to achieve

deployed PACS radiology

patient portal Meaningful

image viewing from within

Use certification and go-live

the HIE Clinical Viewer to the

for TriStar and Continental

TriStar Division.

Divisions.

• EXPANDING TECHNOLOGY.

We piloted Smart Agent as

an enhanced HIE viewer

for one transfer center and

one practice using the next

generation EMR system.

Optimized Reporting

Advancements were made to centralize the source of truth

for our data and expose that to the enterprise. We expanded

our Clinical Data Management (CDM) product to include lab,

encounter, and perinatal data with more expansion slated for

2016. And we introduced data preparation and prototyping

enhancements for a new tool that accesses and presents data

from our CDM. From the Operating Room to the Emergency

Department, we’re collecting the meaningful data providers need

and getting it to them when they need it.

Data Monitoring

Other technologies are helping us ensure data integrity for

patient care decisions. For instance, the Transaction Lifecycle

Management application monitors HCA’s data flows, ensuring

that data is flowing accurately and timely for initiatives like

HCA’s Blood Sepsis project which is designed to use data to

identify sepsis. This product means we can see data exchanges

between systems every step of the way, and we can diagnose data

issues in minutes rather than days. Every day, the Transaction

Lifecycle Management platform monitors over 6.5 million unique

clinical messages in real-time as they traverse over 150 disparate

systems.

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HEALTHCARE INSPIRED

The New Data Center

One of the major feats of the year was our monumental move to

the new Nashville Crossings Data Center, which has saved the

company $4.4 million in utilities and outsourcing costs. We moved

more than 1,000 applications, 2 petabytes of data, 1,350 devices,

and 4,567 virtual servers. Our teams installed approximately 32

miles of cable. The building is resource-efficient too, achieving

the official LEED (Leadership in Energy and Environmental

Design) certification.

I am Healthcare Inspired

because whether I’m working

with the Epic team on

new capabilities, system

performance, or product

support, the result of my efforts

directly affects a physician and

a patient during care. Imagining

that encounter and desiring

the best possible outcome

continuously challenges me to

be a great leader for my team

and innovator for IT&S.

Jamie Ledford

Senior Director, Epic

IT&S Clinical Informatics

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ICD-10: BY THE NUMBERS

Other Accomplishments

ICD-10

Project spanned

5 years

Preparations for the transition to ICD-10 codes began five

years ago. The first phase of the ICD-10 regulatory project was

implemented successfully on October 1 and was completed in

early December with final coding, reimbursement, and Patient

Accounting system changes. During the month of October,

experts from various applications (MEDITECH 5.6, MEDITECH

6.0, Cerner, Epic, 3M, Patient Accounting, HPF, Cloverleaf, and

the NPR/Extract team) staffed the ICD-10 Command Center

to resolve issues that often affected multiple systems. Other

product representatives participated virtually in the Command

• USER ACCEPTANCE TESTING.

In 2013 user acceptance

testing uncovered a more

efficient way to set up the

MEDITECH MIS and ABS

modules so they would be

easier to use and maintain.

• DUAL CODING PILOT. In early

2014 the first pilot of dual

coding software unexpectedly

broke the vendor medical

necessity software in Patient

• STRATEGIES TO MITIGATE

RISK. The team developed

strategies to mitigate risks,

which was challenging since

the technology supports

multiple companies with

different applications,

software platforms, and

multiple operational strategies.

• TRAINING. Training and

instructions were developed

for HCA and Parallon

and experienced

2 governmental delays

52

enterprise wide

corporate applications and

dashboards remediated

Center efforts, all devoting countless hours to ensure a smooth

transition for the 52 products affected.

As this multi-year regulatory project progressed and evolved, a

number of widespread collaborative efforts were integral to the

successful transition to ICD-10.

Access. One of the best things

we did as a company was to

conduct dual coding pilots

throughout the enterprise.

These pilots helped confirm

whether transactions would

pass successfully to Patient

Accounting, find and resolve

Technology Solutions (PTS)

clients based on the way

companies planned to use the

software. During this time,

HCA IT&S worked closely

with PTS to demonstrate

and explain how each

of the systems worked

26

key vendors

employed on remediations

unexpected issues prior to full

independently and together to

implementation, and ensure

all facility databases were

appropriately configured to

accommodate ICD-10 without

impacting current coding

produce an ICD-10 compliant

bill.

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projects included

operations.

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OneHR

OneHR, HCA’s enterprise Human Resources (HR) organization,

continues to transition to a shared services model, a model that

has proven to be highly efficient and effective in other business

areas. While software and technology tools have reduced paperbased

processes throughout HR, working with business partners

has increased the standardization of processes and has played a

significant role in process improvement during this enterprise-

Infrastructure Services

& Operations Top

Accomplishments

A big part of advancing the solutions we provide to our facilities

is improving the technologies and capabilities we use ourselves.

Our Infrastructure Services & Operations teams made key

accomplishments in 2015, allowing IT&S itself to operate more

efficiently and effectively.

wide transition.

Brand-new resources like hrAnswers, the employee self-service

portal and knowledgebase, give employees anytime, anywhere

access to request services and look up information instead

of calling a local HR department. In addition, the HR Support

Center offers HCA employees 24/7 support, further improving

employees’ ability to obtain information more quickly, so they can

focus on their primary objective of patient care.

On the recruiting front, CareersatHCA.com now offers a more

appealing, modern user experience. Search engine optimization

is helping increase web traffic to the site, and enhanced

content management is supporting the timely maintenance and

posting of recruiting information. OneHR has been deployed to

approximately 50 percent of HCA so far, and the remainder of the

company is slated to go-live by mid-2016.

ENHANCED CAPABILITIES

FOR THE ENTERPRISE

• We delivered additional

network bandwidth and

redundancy for our data

centers and facilities

through the WAN

Improvements project.

• We enhanced business

continuity capabilities for

our MEDITECH systems

with Recover Point for all

of our markets.

• We also improved

response times for our

clinicians and facilities

with faster servers and

storage technologies.

HIGH-TECH TOOLS FOR

BETTER INSIGHT INTO

CUSTOMER EXPERIENCE

• Tools such as Aternity’s

Real End User Experience

Monitor, CA’s Cloud

Monitor, Microsoft

GSM, and Splunk have

significantly expanded our

ability to monitor, analyze,

alert, and optimize our

services.

• Our Cloud Services team

completed the design and

build of our private cloud.

They are now supporting

both production and nonproduction

workloads,

with virtual machines

being created in less than

30 minutes.

• We have implemented

a hybrid email capability

with 2,000 Exchange

(Office 365) users already

in the cloud and counting.

• By adding IBM’s Data

Power platform along with

advanced management

capabilities, we are giving

our customers increased

availability through

Logical Partition Mobility

automation.

• Our new On Call Directory

application allows Client

Support Service analysts

to reach the right person

for help after hours, saving

precious time during

problem efforts.

• The new iUniversity

continuing education

program developed

within Client Support

Services gives extensive

cross training to analysts

to further develop their

core competencies and

better enable them to

assist clients in a variety of

areas.

PRODUCT LIFECYCLE

• Upgrading Windows 2003

instances to supported

operating systems in

advance of Microsoft’s

termination of support

ensured that our products

and services remain

viable, supportable, and

more secure for the next

several years.

• We updated 315,000

mailboxes to Exchange

2013 and upgraded our

SharePoint system to

version 2013.

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Alliances

Delivering the best technology with the best of

partners. At HCA, we’re in good company.


HEALTHCARE INSPIRED

IT&S PRIZES its collaborations with our partner companies who

also leverage HCA’s vast expertise and homegrown innovations

to offer healthcare solutions for hospitals, physicians, and other

customers throughout the industry. Our shared work with

Parallon, HealthTrust, Sarah Cannon, and PatientKeeper allows us

to have a stronger, more far-reaching impact on the healthcare

industry, influencing everything from business and workforce

solutions to application interfaces to leading-edge cancer

research.

As a Director of IT, it’s easy to

walk around our award-winning

Orange Park Medical Center

and notice how we’re putting

patients first and how our

Healthcare Inspired technology

is changing lives. Through the

innovative technology that the

team and I develop, support,

and integrate throughout our

facility, our physicians and

clinicians have the newest and

most relevant tools to save lives

and enhance patient care.

Jason Walker

IT Director, Orange Park Medical Center

South Atlantic Division

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Parallon: Business Performance

Group and Workforce Solutions

CIO OF PARALLON BUSINESS PERFORMANCE

GROUP: CHAD WASSERMAN

CIO OF PARALLON WORKFORCE SOLUTIONS:

MICHAEL SEESTEDT

Born out of HCA, Parallon is a leading provider of healthcare

services divided into several expert organizations specializing

in unique solutions for today’s healthcare operational needs.

Parallon Business Performance Group, for instance, helps improve

healthcare business performance through strategic consulting,

revenue cycle management, payroll, health information

management, and physician credentialing. HCA launched Parallon

Business Performance Group in 2011 to take advantage of HCA’s

collective experience, scale, and expertise to further shape the

healthcare industry and allow Parallon customers to benefit

from their knowledge. This same purpose is behind Parallon

Workforce Solutions, which provides strategic healthcare staffing

and recruiting solutions to improve patient care and enhance

operational performance. Amidst all of its affiliates, Parallon

employs more than 26,000 professionals and serves more than

1,400 hospitals and 11,000 non-acute care providers.

2015 Accomplishments

Parallon’s IT teams had a productive year, with its Business

Performance Group making impressive strides with new

technologies that improved workflow for operators, supported

physician practices, and improved the overall registration

experience of patients.

• MEETING A UNIQUE NEED

THROUGH IN-HOUSE

DEVELOPMENT. Parallon

and Shared Service Center

(SSC) development teams

joined forces to develop and

implement the Medicaid

Eligibility application. Because

this was so specific to our

industry, similar tools did

not exist in the marketplace.

Now, the Medicaid Eligibility

application automates

workflow and facilitates the

Medicaid eligibility process for

operators.

• IMPROVING PATIENT

EXPERIENCE. At Southern

Hills Hospital in the TriStar

Division, Parallon piloted tablet

technology for self-service

check-in, as well as eCapture.

This enables patients to

complete patient visit forms

on Surface and iPad devices.

In 2016, use of tablets during

the patient visit will continue

to expand and will include

express checkout. Additional

patient experience initiatives

in 2016 will work toward

intelligent notification for

scheduling and reminders,

further integration with

MyHealthOne, and an Apple

Pay pilot.

• CREATING A NEW STATISTICAL

LENS FOR DECISIONS. The

Business Intelligence team

provided new reporting

capabilities through the

Visual Insight suite of 18

dashboards, which rolled out

to approximately 400 users in

business operations. The Data

Science team is using data

and analytics tools providing

new insights that will begin

to influence decisions and

efficient actions in areas

such as ICD-10 impact,

specialized coding for sepsis,

denial prevention. and data

completeness. Momentum

is building, and plans for

2016 include incorporating

these new insights into SSC

workflows.

Parallon Workforce Solutions also made important advancements

in 2015, as they continued the deployment of Workforce 2.0 and

reached major milestones, such as the implementation of the

vendor management solution to run the HCA IT&S contingent

labor program. They also began roll out of Facility Scheduler 3.0

to both HCA affiliates and non-affiliates.

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HealthTrust Technology

Innovation (HTTI)

CIO: KENT PETTY

HealthTrust Technology Innovation (HTTI) is a division of HCA’s

partner organization HealthTrust, a company that negotiates

national contracts with market-leading suppliers for clinically

recommended products and services. HTTI develops and

manages world class supply chain systems, processes, and

analytics, serving 1,498 hospitals and over 22,600 alternate

sites of care. Their breadth of services includes the systems

management of 1.5 million items and approximately 3,000

national contracts, a complex pharmacy distribution and

pharmacy point-of-entry solution, operating room point-of-use,

and mission critical supply distribution.

2015 Accomplishments

HTTI boldly progressed in 2015 with new applications for Group

Purchasing, Supply Chain, and Total Spend Management. They

partnered with the HealthTrust business to enable significant

wins with major clients that will propel HCA to multimilliondollar

contract savings. Their most proud achievements included

advances in automated testing and UI design to accelerate

development, a new leadership structure poised for further

growth, mergers with Cardiac Data Solutions and InVivoLink, and

a world class platform design for Total Spend Management. These

developments will further prepare HTTI to enable evidencebased

clinical supply chain platforms that, for example, support

bundled payments and allow support for a National Registry of

surgical implants. Other achievements include:

• ePROCUREMENT

Developed and piloted

eProcurement, which

optimizes the procurement

user experience for clinicians

and medical professionals

via a web-based application,

accessible by both internal

and external users. By

unifying all requisition types

to a single point of entry,

users experience intuitive

and streamlined interaction,

reducing training and

implementation associated

with the previous multiple

systems.

• CATEGORIZATION TOOLING

Launched categorization

tooling to provide better

insight into conversion

opportunities and compliance,

enabling HealthTrust to more

accurately and efficiently

onboard new hospitals and

give facilities the right cost

management data to improve

their bottom line by millions of

dollars.

• PHARMACY DISTRIBUTION

Implemented pharmacy

distribution at 7 warehouses,

which provide services to

more than 57 hospitals and

hundreds of hospital Pyxis

and Optiflex PAR locations,

protecting close to $17 million

in at-risk cost.

• SOLUTIONSTRUST PORTAL

Created an engaging user

portal for Supply Chain

consultants to more effectively

manage their consultant

engagements for future

commercialization growth.

• STREETWISE II

Modernized a commercially

usable collaboration site

for doctors and medical

professionals to share best

practice and procedure

learnings to improve patient

care at HCA and with HCA

partners.

• PATIENTKEEPER

Implemented the

PatientKeeper instance of

MedComm for the JFK and

Summit Medical Centers

while also providing Nursing

COE access to the pharmacy

sites. This allows the Nursing

COE to review and verify each

PatientKeeper order while it’s

being processed in MEDITECH

by pharmacists.

• DATA CONSTRUCTION AND

PROCESSING

Developed and released new

data processing capabilities

to exponentially increase the

scale of processing for facility

data and indexing needs,

providing better analytical and

management capabilities with

new facility partnerships.

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2015 Accomplishments

The cancer registrar and cancer navigator are two key roles

who interact with cancer patients at HCA, and this year several

advancements in core systems are making a difference in the big

picture of cancer care.

Sarah Cannon Research

Institute (SCRI)

CIO: ANDY CORTS

Sarah Cannon Research Institute is the research arm of HCA’s

global cancer institute. Focused on advancing therapies for

patients, it is one of the world’s leading clinical research

organizations, conducting community-based clinical trials

through affiliations with a network of more than 1,000 physicians

across the United States and United Kingdom. Sarah Cannon

has led approximately 200 first-in-man clinical trials since its

inception in 1993 and has been a clinical trial leader in nearly

80 percent of approved cancer therapies in the last ten years.

Additionally, Sarah Cannon offers management, regulatory,

and other research support services for drug development and

industry sponsors as well as strategic investigator sites.

CANCER REGISTRY

A cancer registry is a systematic collection of data about cancer

and tumor diseases and is collected by cancer registrars. Cancer

registrars capture a complete summary of patient history,

diagnosis, treatment, and status for every cancer patient

diagnosed within the HCA health system. Consolidating more

than 150 registries into a single database benefits patients and

cancer care in a number of ways.

• STANDARDIZED ANALYTICS • AVAILABILITY OF MARKET

ON 1.9 MILLION UNIQUE

AND ENTERPRISE DATA

CANCER PATIENTS SUPPORTS ALLOWS FOR IMPROVED

ANALYTICS ON CLINICAL

ANALYSIS AND REPORTING

OUTCOMES AND QUALITY OF

(PARTICULARLY REFERRAL

CARE.

PATTERNS), GREATER

INSIGHT INTO MIGRATION

• PLATFORM

OF PATIENTS TO COMPETING

STANDARDIZATION REDUCES

HOSPITALS, AND ADHERENCE

CANCER REGISTRY SUPPORT

TO NATIONAL QUALITY

COSTS BY $300,000 A YEAR

METRICS.

ACROSS HCA.

• CONCURRENT COLLECTION

• STANDARDIZED

OF QUALITY METRICS

OPERATIONS SIMPLIFIES

FACILITATES DATA REVIEW

COMPLIANCE WITH

PRIOR TO SUBMISSION TO

NATIONAL ACCREDITATION

THE NATIONAL CANCER

REQUIREMENTS,

DATABASE.

POTENTIALLY ENABLING

MORE CANCER PROGRAMS

TO BECOME ACCREDITED.

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CANCER NAVIGATION

Cancer navigators are responsible for coordinating the care of

our cancer patients from the point of diagnosis to survivorship.

iNavigate is used by our navigators to capture data for

accreditation programs, quality improvement initiatives, and care

management. This system has enabled Sarah Cannon to drive

clinical quality improvements, an improved patient experience,

and an ability to meet compliance standards. Cancer navigators

have access to an updated Survivorship Care Plan, which aligns

with the Commission on Cancer reporting standards that must

be fulfilled for accreditation. Currently, iNavigate serves 30,000

patients and is used in 79 facilities by 127 navigators. In 2015 this

project met successes in the following ways:

• PILOTED THE NAVIGATION

• TRAINED 96 NAVIGATORS ON

MODULE IN KANSAS CITY AND iNAVIGATE.

SAN ANTONIO. AFTER PILOT,

• UPDATED THE SURVIVORSHIP

THE NAVIGATION MODULE

CARE PLAN TO BETTER ALIGN

WAS DEPLOYED TO DENVER

WITH THE COMMISSION

AND OKLAHOMA CITY.

ON CANCER REPORTING

• DEPLOYED iNAVIGATE TO

STANDARDS.

AN ADDITIONAL 71 NEW

• PILOTED THE INTEGRATION

NAVIGATORS AT 15 FACILITIES.

OF NURSING NOTES WITH

MEDITECH.

Plans for 2016 include deploying a Genomics Warehouse and

further developing our capabilities for clinical trial matching and

real-time patient identification. These initiatives continue our

progress toward enabling a coordinated journey for our patients

as they receive the best of care through an integrated delivery

system of healthcare providers and partners.

PatientKeeper

CEO: PAUL BRIENT

In 2014, HCA purchased PatientKeeper, an industry-leading

provider of intuitive software and mobile applications that

help physicians access and work with patient information.

PatientKeeper technology runs on an innovative architecture

that overlays hospital IT systems, allowing a single view of patient

health information (PHI) across a variety of hospital systems, to

streamline workflow and to help improve patient care. Physicians

at HCA-affiliated hospitals had been using PatientKeeper for

years, but the purchase of the company helps facilitate the

continued development of HCA’s Electronic Health Record (EHR)

and enable HCA to provide physicians a number of capabilities,

including computerized physician order entry (CPOE),

medication reconciliation, and documentation.

THE BIG PICTURE: THE BEST IN THE BUSINESS

Technologies, such as PatientKeeper, now play a differentiating

role in the healthcare marketplace for physicians and patients

because of convenient, secure access to clinical information via

portal and mobile platforms.

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2015 Accomplishments

PatientKeeper is developing the first version of the front end to

HCA’s electronic health record (EHR), which currently features

an intuitive, physician-facing user interface. By bringing together

data from HCA’s EHR transactional layer (MEDITECH) via bidirectional

interfaces, this first iteration of the front end aims to

immediately improve overall user experience while simultaneously

establishing our platform for the future. This year, PatientKeeper

INTEGRATING SYSTEMS

PREPARING FOR BROADER

teams have been collaborating with pilot physicians in two

By mid-year, integrations

DEPLOYMENT

facilities, JFK Medical Center (East Florida Division) and Summit

between PatientKeeper and

Projected timelines have been

impact, modern functionality

Medical Center (TriStar Division), in the use of CPOE, NoteWriter,

MEDITECH were established

adjusted based on current

to providers and should

Medication Reconciliation, E-Signature, and Patient List (version

and tested. While our initial

knowledge, and PatientKeeper

have a relatively short, cost-

2). CPOE, NoteWriter, and Patient List are also available in an

assessment projected that

teams are assembling toolkits

effective implementation.

enhanced mobile application for iOS; Android will be available

system integration would

for deployment. Work will

For providers who already

later this year. Overall initial feedback from pilot physicians has

progress quickly, there were

continue in the first half of

use PatientKeeper Physician

been positive, with caregivers citing a short learning curve, a more

some additional integration

2016 to expand the use of the

Portal and/or PatientKeeper

modern and intuitive EHR interaction, and strong potential for the

requirements that needed

full PatientKeeper Advanced

Charge Capture, the addition

mobile capabilities.

addressing to maintain

Clinicals product at our pilot

of PatientKeeper NoteWriter

HCA’s current advanced

facilities JFK and Summit.

could offer significant

BUILDING INFRASTRUCTURE

clinicals workflows for non-

Following that, PatientKeeper

workflow advantages.

Although PatientKeeper has enjoyed early success with

PatientKeeper users. Along

will be deployed to a selected

physicians, there have been a variety of areas that

the way, we found a few areas

set of additional hospitals in

required further development for HCA’s scale and

for process improvement

our East Florida and TriStar

scope. This led to an investment in a new hardware

and are applying them going

Divisions. A PatientKeeper

infrastructure to host the system and a series of

forward. While maintaining

NoteWriter pilot is also

product enhancements to better match the system

momentum and confidence

planned to offer physicians

with the electronic workflows already in place at HCA.

in our strategy, our goal is to

this important functionality

A notable impact of this is that the 20,000-plus read-only

deploy PatientKeeper as fast

ahead of the full CPOE rollout.

PatientKeeper portal and mobility healthcare providers across

as responsibly possible.

NoteWriter offers high-

HCA will see improved response times and additional functionality.

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53


Data &

Analytics

We have the information we need.

Now the investigation begins.


“DATA IS THE NEW OIL.” This statement has been bandied

about tech industries for years and is a powerful reminder of

the foundational importance of data, which is especially true for

healthcare. As far back as 2006, marketing commentator Michael

Palmer elaborated on its significance: “Data is just like crude.

It’s valuable, but if unrefined it cannot really be used. It has to

be changed into gas, plastic, chemicals, etc., to create a valuable

entity that drives profitable activity; so must data be broken

down, analyzed for it to have value.”

THE BIG PICTURE: FROM DATA TO DELIVERY

The US produces 1.2 billion clinical care documents each year.

Our Data & Analytics team is working to understand HCA’s

massive quantity of information and turning it into quality

healthcare solutions.

That’s why it’s critical that

HCA has its own Data &

Analytics team. So we can give

proper focus to harnessing

the power of our data

repositories, turning the raw

data material into valuable

information, and enabling

HCA to achieve the next level

of quality, effectiveness, and

growth. Established in late

2014, the Data & Analytics

department has quickly

become a cornerstone of IT&S,

a knowledgeable, forwardthinking

team that explores

this new data and analytics

frontier, setting direction

across all HCA business lines.

Through strong relationships

and alignment with business

partners such as Parallon, the

Clinical Services Group (CSG),

the Physician Services Group

(PSG), and many other HCA

teams, the Data & Analytics

team provides technical

expertise on emerging

technologies, shares industry

knowledge, and implements

standard data technology to

the entire HCA organization.

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Major Moves

The Data & Analytics organization had an exceptionally

productive year in 2015, connecting and collaborating with

management, analysts, data scientists, and others throughout

HCA, expanding HCA’s analytics and reporting capabilities, all

while teams were defining and developing this new area of focus.

Major strides were made in several key areas:

Big Data

Working in close collaboration

with CSG’s Chief Data

Enterprise Data

Warehouse

We upgraded the Data

Consolidated

Patient Data

Our Enterprise Master Patient

Identified and

Unidentified

Claims

Business

Intelligence (BI)

Tool Upgrades

Scientist Edmund Jackson

and his team, we built and

configured the consolidated

infrastructure, which now

serves as foundation for

data science research and

development across the

company. Partners Cloudera

and Digital Reasoning have

been and will continue to be

Warehouse platform, Teradata,

adding significant capacity

for ever-increasing data

and users. This improves

performance by between

70 and 90 percent and will

lower operating expenses

by approximately $1 million

annually, beginning in 2016.

Index (EMPI) was unleashed

in new ways, facilitating

the analysis of patient care

across all HCA care settings.

This area of Enterprise Data

Warehouse (EDW) analysis

joins hospital, ambulatory, and

physician practice data and

has been our most strategic

accomplishment in giving

Our existing EDW data was

augmented with external

claims data representing non-

HCA encounters, providing

much greater insight for

numerous use cases and

serving as a key component

for many reports and

analytical applications.

2015 saw upgrades to key

technologies, such as Tableau,

Arcplan, DRM, and DataStage,

and work is still in process at

year-end (e.g. Microstrategy

and Essbase).

key collaborators in much of

a linear look at continuum

this work.

of care from inpatient to

outpatient.

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Notable Releases

Several key technologies were introduced in 2015, propelling the

use of data and analytics into exciting new areas of exploration:

Meaningful Use

Dashboard

Shows facility compliance

to Meaningful Use criteria

on a daily basis.

Blood

Utilization

Dashboard

Measures performance

against established

Sepsis

Dashboard

Combines performance

metrics, clinical

Surgical Services Dashboard

Measures operating room throughput on a daily basis.

It has additional metrics, most important of which is

physician block utilization, and also includes operational

reports supporting the Surgical Services Growth Initiative.

TrackER

Measures Emergency Department (ED) throughput on a

daily basis. It reports throughput and other operational

metrics in near real-time. Reports supporting the ER

Growth Initiative are also delivered via this dashboard.

best practices for

transfusing red blood

cells.

interventions, and

outcome data to provide

trended reporting and

detailed analysis for

sepsis experience in the

Clinical

Excellence Care

Coding Compliance Reporting

facilities.

New Reporting Initiatives

were rolled out for Blood

Reporting solution used to ensure coding and billing

aligns with standards.

and Critical Care.

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A Look to the Future

As we consider next steps in our development, one principal

objective is to move HCA to higher levels of insight and capability,

pushing the analytics from types that are “descriptive” (where

the analysis informs and creates awareness) to those that are

“predictive” (where we can take that data and then identify likely

outcomes).

All of these efforts reflect a key HCA Strategic Initiative focused

on leveraging our industry-leading data assets and tools to

help HCA mature as an information-driven organization. Our

achievements this past year and in the years ahead will be pivotal

in boosting HCA’s data-driven power and presence in the always

evolving healthcare industry.

This will direct our guiding principles and analytics strategy for

next year and beyond:

• WE WILL MATURE IN THE

USE OF PREDICTIVE AND

PRESCRIPTIVE ANALYTICS

AND VISUALIZATION.

• WE WILL DEVELOP OUR

PEOPLE—SIGNIFICANTLY

INCREASING THE SKILL

LEVELS OF OUR IT AND

BUSINESS ANALYSTS.

• WE WILL IMPROVE OUR

DATA QUALITY, ESPECIALLY

CLINICAL DATA, DEFINING

AND IMPLEMENTING

INFORMATION GOVERNANCE.

• WE WILL DISCOVER

THE “GOLD” IN OUR

UNSTRUCTURED DATA (SUCH

AS PHYSICIANS’ NOTES,

NURSES’ NOTES, AND

PATHOLOGY REPORTS).

• WE WILL BUILD THE

CAPABILITY TO DEVELOP AND

MAINTAIN SOPHISTICATED

PREDICTIVE MODELS.

• WE WILL BUILD THE

CAPABILITY TO SUPPORT THE

USE OF COMPLEX LOGIC AND

BUSINESS RULES.

THE BIG PICTURE: THE POWER OF ANALYTICS

It’s estimated that by making sense of complex healthcare data,

Big Data analytics can enable more than $300 billion in savings

per year in US healthcare alone.

• WE WILL SUPPORT SELF-

SERVICE DISCOVERY

WITHOUT CREATING IT

BOTTLENECKS.

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Architecture

Our framework of IT strategies and solutions

is our blueprint for success.


ARCHITECTURE 5-5-5

Emerging

Technologies

KEY TO OUR SUSTAINED SUCCESS as a technologically stable

yet ever-advancing organization is our strong architectural

environment, the blueprint for structuring and optimizing

our technology investments. IT&S strategy is dependent upon

constant transformation of our IT architecture, introducing

new technologies while also modernizing, or sometimes

retiring, technologies currently in use. For this purpose, the

IT&S Architecture team has again developed what they call the

Architecture 5-5-5, a three-fold “Top Five” list that has proven

to be an essential roadmap for understanding where we are and

where we’re going, detailing the key technology transformations

in the year to come.

Modernizations

BEING CONSIDERED

FOR INTRODUCTION

OF HCA’S EXISTING

TECHNOLOGIES

Sunsetting

OF HCA’S

EXISTING SYSTEMS

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Emerging Technologies

Developer Technologies

Healthcare has held onto development languages, techniques,

and tooling that has been around since the late nineties, even

earlier. There is a growing recognition, however, that with the

introduction of varying access needs (whether phone or tablet,

PC or Mac) systems need to become more modernized in their

underlying architecture. The newer tools and technologies

provide increased agility, resiliency, and potentially time to

market in delivering solutions that leverage commodity-based

techniques. We will therefore apply specific focus to Node.js and

its like, Functional Programming, NoSQL, and several other newer

technologies.

Augmented Reality

Augmented reality describes any technology that overlays digital

interfaces onto the physical world. Unlike virtual reality, which

immerses you in a simulation using stereoscopic 3D on a screen,

augmented reality technologies embed opaque holograms

directly into the environment. Spurred by developments in

mobile computing and graphics processing, both augmented

and virtual-reality technologies have finally become wearable,

portable, and affordable enough for popular use, and solutions

such as Microsoft Hololens and Magic Leap present opportunities

that could be used in a healthcare environment for many

purposes.

Internet of

Everything (IoE)

The Internet of Everything

represents both a thought

process and a technology,

providing foundational

support through aggregation

of data and analytical

processing in large-scale

environments. Ultimately, it

enables the capture, analysis,

response, and action cycle

to further improve overall

environmental, personal, and

organizational processes and

functions. IT&S is positioned

well to gather, monitor,

and respond to IoE as an

overarching technological

approach, while further

ensuring the appropriate

security models are engaged

early.

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Modernizations

IT as a Service

(ITaaS)

The continued evolution of

public cloud services (IaaS,

PaaS, and SaaS) is causing

the IT industry to rethink its

core business and causing

us to ask questions: Is IT&S

in the business of running

data centers or running

applications? What is the

right mix for HCA? We must

determine when we do host

applications, when we have

others host for us, and when

we purchase a service. These

answers will eventually

lead us to retool some of

our employees away from

traditional hardware and

software roles to automation,

DevOps, and service broker

roles.

Patient

Engagement

Solutions

As HCA’s patient base

continues to require new

avenues for technological

engagement, we must

consider a broader spectrum

in defining how we deliver our

content. This strategy should

be all-inclusive, defining

standards and best practices

for mobile applications

(front-end and back-end

development), patient portal

customization, the physical

web, telehealth, wayfinding,

as well as enhanced audio/

video capabilities in patient

rooms, finding multiple ways

for patients to “connect” from

wherever they are.

Data Center

IT&S is at a tipping point

regarding the future of our

data centers with three major

factors currently influencing

our direction: First, our

traditional enterprise data

centers have the ability to

continue consolidation to

further reduce costs. Second,

the growing use of cloud

services will offset the need

for IT&S to host applications.

Third, many of the divisional/

facility data centers are facing

security, space, and power

constraints. IT&S will need

to find the right combination

of enterprise data centers,

cloud services, and microdata

centers (on premises or

colocation) to address these

changing dynamics.

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Backup as a Service

(BaaS)

Most divisions currently lack offsite

backup. Providing centralized backup

services within regional data centers is a

cost effective way to provide a location

for their data. Technology is now available

that would allow for the integration

between our PACS object store and the

backup applications deployed in our field

offices. Centralized de-duplication and

compression-enabled storage subsystems

would also provide similar benefits.

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Endpoint Computing

The endpoint computing space is

transforming and evolving constantly,

from the bring-your-own-device

approach to new operating systems

to leading-edge hardware. IT&S needs

a concerted focus on these emerging

technologies to not only be able to

sunset aging products but also move the

company to more innovative solutions.

Addressing some of the key endpoint

technologies will be paramount in the

coming years to deliver a great user

experience for our employees and

especially for our physician community.

Mobile Application Management

(MAM)

MAM refers to the software and services responsible for

provisioning and controlling access to internally developed and

commercially available mobile apps used in business settings on

both company-provided and “bring your own” smartphones and

tablets. HCA needs to apply sharp focus to this area in order to

further its investment in the growing, complex mobility space.

Managing and delivering applications to mobility products is the

most prevalent request of so many of our physician, clinical, and

knowledge-worker communities, and we want to get them the

data they need when they need it with whatever tool they wish.

Telephony

As the Cisco OneVoice implementation enters its fifth year of

deployment, the field—as well as some HCA subsidiaries—are

asking for more choices in telephony endpoints. We must

develop a telephony offerings menu that leverages our existing

investment and reflects our enterprise-wide strategy for

telephony interoperability, while still allowing business units and

divisions the flexibility to adapt their telephony environments to

local needs.

73


Sunsetting

Internet Protocol Version 4 (IPv4)

IPv4 is a core network protocol that enables the internet, HCA

data centers, and our facilities to transmit data such as web based

Eliminate

Physical Tape

Physical tape has been the

Windows 7 and

Windows Server

2008

Browser Plug-ins

Whether they’re Flash or

Silverlight, QuickTime or

traffic, email, and clinical applications. IPv4 addressing for the

internet is now exhausted and will require HCA to develop a dual

internet protocol stack deployment strategy for both IPv4 and

Internet Protocol Version 6 (IPv6) in the HCA data center systems

and enterprise network.

Wireless Security

The Wired Equivalent Privacy (WEP) and Wifi Protected Access

(WPA) were developed for wireless security in the late nineties

and early 2000 respectively. These technologies have been

deprecated and are not secure enough for the HCA environment.

We need to migrate our clinical and endpoint systems to current

wireless security standards.

staple for backup services for

a long time, yet despite its

advertised life span, restores

are often very problematic.

The primary incentive for

continuing to use tape has

historically been around cost,

but prices for disk storage

in the forms of object-based

and de-duplication-enabled

storage subsystems have

declined to the point where

physical tape is no longer

necessary. We should look to

Both Windows 7 and Windows

Server 2008 (and 2008R2)

have left mainstream support

and are rapidly approaching

the end of extended support.

These operating systems are

far and away the most broadly

used operating systems at

HCA, and with them fast

approaching obsolescence,

we need to focus efforts onto

moving to the next current

versions of the Windows

Client and Server operating

Adobe Reader, plug-ins

tend to slow down browser

performance, offer a platform

for the introduction of

malware, and generally cause

browser errors. Furthermore,

the use of browser plug-ins by

a website can cause challenges

and issues when viewed on

different devices.

eliminate physical tape over

systems.

the coming year to reduce

operational overhead and

improve the quality of our data

recovery services.

74

75


Information

Protection

In a world of vicious hacks and cyber-attacks,

protecting our patients is job number one.


REPORT AFTER REPORT from the FBI, the Secret Service, and

other government agencies indicated that healthcare companies

were being maliciously, relentlessly targeted in 2015. In fact,

the FBI revealed that, on the black market, a medical record is

worth ten times the value of a credit card. Behind the scenes

at HCA, though, we stood strong in defense against outside

threats. Information Protection worked with every hospital

division, Parallon, Sarah Cannon, Physician Services Group, and

HCA International to strengthen each organization’s information

protection program.

Our 2015 accomplishments adhere to the Framework for

Improving Critical Infrastructure Cybersecurity, released by

the National Institute of Standards and Technology (NIST). This

framework is a nationally recognized set of industry standards

and best practices for managing cybersecurity risks and

establishes a big picture structure for our enterprise Information

Protection program. The framework allowed us to focus on the

following specific areas in 2015.

THE BIG PICTURE: TO PROTECT AND SERVE

Every day HCA’s sensitive data is targeted for financial gain and

other malicious purposes. The Information Protection team

works with all HCA employees to protect our patients, our

people, and our business.

Identification of Our Assets

and Our Risks

Understanding what information we need to protect and what

risks our organization faces are foundational activities for the

Information Protection team. This understanding enables us to

prioritize efforts and resources, making risk-based decisions

consistent with business needs.

Key accomplishments in 2015 included:

• FORMALIZING THE STRATEGY

AND RISK MANAGEMENT

TEAM IN INFORMATION

PROTECTION TO FOCUS

ON RISK MANAGEMENT

STRATEGY FOR THE

ENTERPRISE

• MATURING THE

INFORMATION PROTECTION

DATA GOVERNANCE COUNCIL

AND FACILITY SECURITY

COMMITTEES, WHICH ARE

DESIGNED TO FACILITATE

RISK-BASED DECISIONS AND

INCLUDE KEY STAKEHOLDERS

FROM LEADERSHIP, CLINICAL,

FINANCIAL, LEGAL, HUMAN

RESOURCES, AND IT&S

• REFRESHING PHYSICAL,

ADMINISTRATIVE, AND

TECHNICAL ASSESSMENTS

FOR ALL HOSPITALS AND

AMBULATORY SURGERY

CENTERS; DOCUMENTING

RISKS; AND DEVELOPING

CORRECTIVE ACTION PLANS

• CREATING HIPAA SECURITY

RISK ANALYSIS AND RISK

MANAGEMENT DOCUMENTS

FOR EACH FACILITY TO

PROVIDE A CONSOLIDATED

VIEW OF THE HOSPITAL’S

APPROACH TO SECURITY

RISK ANALYSIS AND RISK

MANAGEMENT

78

79


Protection of Our Assets

It’s absolutely crucial that we ensure the confidentiality, integrity,

and availability of all our data. The goal of the Information

Protection team is to implement safeguards that focus on strong

user access controls, awareness and training of the workforce,

data security, processes and procedures, and protective

technology.

Key accomplishments in 2015 included:

Detection of Threats, Data Loss, and

Inappropriate Access to Sensitive

Information

HCA is, unfortunately, the target of innumerable external threats

such as nation states, cyber criminals, and hacktivists. We also

face internal threats, like dishonest insiders, and even honest

staff members who make errors or decisions out of urgency or

ignorance. This all means that the Information Protection team

has to be constantly on guard and on the lookout for potential

threats to our company.

• REENGINEERING BUSINESS

• IMPROVING DATA QUALITY

• INTRODUCING MONTHLY

PROCESSES AND SYSTEMS TO

REDUCE THE USE OF SOCIAL

SECURITY NUMBERS

WITH PROVIDER DICTIONARY

STANDARDIZATION EFFORTS

AND COLLABORATION WITH

iPROTECT SESSIONS AIMED

AT CORPORATE IT&S PROJECT

MANAGERS AND BUSINESS

Key accomplishments in 2015 included:

• PARTNERING WITH

ENTERPRISE DATA

WAREHOUSE BUSINESS

OWNERS TO IMPLEMENT

AN IMPROVED USER ACCESS

REQUEST PROCESS, DEVELOP

TRAINING, AND CREATE

OPERATING PROCEDURES

• PARTNERING WITH

INFRASTRUCTURE SERVICES

& OPERATIONS TO IMPROVE

NETWORK AND FIREWALL

PROTECTION

CLINICAL SERVICES GROUP,

INFORMATION PROTECTION,

AND IT&S

• ESTABLISHING THE

CORPORATE ACCESS

TEAM, ROLLING OUT ESAF

TO CORPORATE USERS,

IMPROVING ACCESS REQUEST

PROCESSES FOR USERS

IN MULTIPLE DIVISIONS,

AND TURNING ON NON-

EMPLOYEE CONTRACT END

DATE NOTIFICATIONS

ANALYSTS TO PROVIDE

AWARENESS ON KEY

PROJECT DELIVERABLES AND

TOPICS INCLUDING SARC, ISA,

ISAM, RECORD RETENTION

REQUIREMENTS, AND IT&S

POLICIES AND STANDARDS

• 70% OF OUR WORKFORCE

COMPLETED “BE THE HERO:

YOUR IDENTITY DEPENDS ON

IT” TRAINING AS WELL AS AN

ADDITIONAL COURSE FOR

MANAGERS

• DEPLOYING DATA LOSS

PREVENTION (DLP) ACROSS

THE ENTERPRISE, WHICH

PROVIDED EDUCATION

TO CFOS, DEPARTMENT

MANAGERS, AND

WORKFORCE MEMBERS

ABOUT PROTECTING FILES

THAT CONTAIN SOCIAL

SECURITY NUMBERS WHEN

SAVING, EMAILING, AND

PRINTING

• IMPLEMENTING THE

ACCESS REVIEW TOOL (ART)

SOLUTION THAT AUTOMATED

MONITORING OF USER

ACTIVITY IN MEDITECH,

HCARE PORTAL, AND HPF

TO IDENTIFY AND TRIGGER

REVIEW OF POTENTIALLY

INAPPROPRIATE ACCESS

EVENTS

• BLOCKING MORE THAN 1,300

MALICIOUS WEB EVENTS

AND 6,000 MALICIOUS EMAIL

ATTACHMENTS

80

81


Response to and Recovery from

Potential Threats and Incidents

Responding to potential threats in a timely manner is vital to

limit or contain the impact of incidents, and the Information

Protection team made some impressive strides this past year in

preparing for danger.

Key accomplishments in 2015 included:

Protecting Our

Patients, Our Staff,

and Our Name

Paul Connelly, VP and Chief Information Security Officer, visited

divisions in 2015 to paint the very complex and textured

picture of information protection for division and hospital

leaders. The number of facilities, systems, users,

vendors, and volume of data to protect is massive,

making our risks for compromises especially high.

The primary goal of the Information Protection team

is to protect HCA’s patients, staff, and company’s

reputation.

• ESTABLISHING A BREACH

RESPONSE FRAMEWORK

• DEVELOPING A MATURE

REPORTING PROCESS

This won’t be accomplished, though, without everyone’s

diligence and vigilance. That’s why it’s the responsibility of

AND PROCEDURES TO HELP

BUSINESS, LEGAL, AND IT

RELATIVE TO HCA’S

CYBERSECURITY INSURANCE

each and every workforce member to:

PERSONNEL RESPOND IN THE

COVERAGE

EVENT OF AN INCIDENT

• PERFORMING INCIDENT

RESPONSE TEST EXERCISES

TO IDENTIFY OPPORTUNITIES

FOR IMPROVEMENT

• UPDATING EMAIL RETENTION

GUIDELINES AND TRAINING

RECOGNIZE THAT THE

RISKS ARE REAL. THE

EXTERNAL AND INTERNAL

THREATS ARE INCREASING.

CONSEQUENCES FROM

BREACHES COULD BE

PROTECT THEMSELVES

AND THEIR FAMILY. FROM

PHISHING EMAILS AND

PASSWORD PROTECTION

TO SOCIAL MEDIA

USE AND TRAVELING

INCORPORATE THESE SIX

WORDS INTO DAILY ROUTINES

AND DECISIONS: “HOW

WILL OUR INFORMATION BE

PROTECTED?” ALL EMPLOYEES

MUST MAKE INFORMATION

CATASTROPHIC FOR OUR

SAFELY, EMPLOYEES ARE

PROTECTION A PRIORITY

PATIENTS AND COULD BADLY

ENCOURAGED TO KEEP

WITH TEAM MEMBERS AND

DAMAGE THE REPUTATION

CURRENT ON WHICH

VENDORS. THEY’RE ALSO

OF OUR FACILITIES AND

ACTIONS WILL PROTECT

ENCOURAGED TO CHALLENGE

ORGANIZATION.

THEM AND WHICH ACTIONS

THE “WAY WE’VE ALWAYS

WILL PUT THEM AT RISK.

DONE IT” AND ENGAGE

INFORMATION PROTECTION

WHEN NECESSARY.

82

83


Field

Operations

A sprawling organization, spanning fifteen

divisions and thousands of IT solutions.


86

NOTHING CAPTURES the epic-scale vista of our organization

quite like a wide-angle look at our operations in the field.

Stretching all across the country, and even beyond, with

technologies reaching right to the patient’s bedside, our Field

Ops organization is a vast ensemble of talented, tenacious frontline

experts who use their skills to shape healthcare at the local

level. Each year they pilot new IT&S technologies while also

improving current solutions, producing strategies and solutions

through our fifteen divisions that are propelling HCA into a new

golden age of healthcare IT.

THE BIG PICTURE: TECHNOLOGY AT THE BEDSIDE

In the field, MyCare Boards are giving power to the patient.

These electronic in-room dashboards, which display goals,

medication tracking, procedures, and caregiver history in real

time, allow patients to be more engaged in their healthcare.

TOP ACHIEVEMENTS FOR 2015

Simplifying IT

The Capital Division led the enterprise in Simplify IT

cost savings for 2015, with $3.4 million dollars in savings

and avoidances. Experts at driving a culture of continuous

improvement and propelling IT&S towards more efficient

processes, this division achieved its stellar results through the

significant repurposing of hardware across facilities, renegotiated

vendor contracts, and the virtualization of more than 100 servers.

Division Growth

In 2015, Loudoun County, Virginia, saw its first new hospital in

over a century. The new 230,000 square foot, 124-bed stateof-the-art

StoneSprings Hospital Center increased access

to innovative and high-quality healthcare for area residents,

improved emergency preparedness capabilities, and provided

new jobs and tax revenue to fund important community services.

The new hospital center was an enormous IT undertaking, and

through the collective efforts of the enterprise, the community

now has access to HCA’s high-quality healthcare close to home.

Coordinated and Connected

Patient Care

Streamlining communication throughout the Capital Division

was a key focus for the team this past year. Honing in on the

relationship between patients and clinicians, the division

deployed nurse call technology interoperable with key hospital

departments and functions. Featuring automated call routing,

escalation and notification features, and smart phone device

integration, this foundational technology improved the

coordination and management of administrative functions,

increased staff efficiency, enhanced clinician and patient

communication, and contributed significantly to positive patient

experiences.

CIO: Gina Ragans

Capital Division “The Strategists”

87


Central & West Texas Division “The Allies”

CIO: Mike Blom

Simplify IT Success

A major component of enabling and delivering on the Central

& West Texas Division’s 2015 strategic plan was its Simplify IT

strategy. The IT team implemented a carefully conceived mix of

solutions for preserving time, streamlining efforts, and saving

money, in particular virtualizing over 130 servers for a cost

savings/avoidance totaling more than $1.1 million dollars.

A Focus on the Physician

TOP ACHIEVEMENTS FOR 2015

Satisfaction ratings and the quality of patient care continued

to be top priorities for the Central & West Texas Division in

2015. Working collaboratively with clinical staff and physicians,

they developed a new rounding initiative, which contributed to

a positive increase in both patient and physician satisfaction.

They used their rounding techniques to improve the physicians’

experiences with PC workstations, providing more timely patient

identification and reporting of issues.

TOP ACHIEVEMENTS FOR 2015

Strengthening Physician

Relationships

This year, physicians took center stage in the

Continental Division. Adoption of mobile technologies

increased 100 percent in 2015, allowing even more

physicians to experience anytime/anywhere access to clinical

data, many for the first time. Additionally, hundreds of physicians

adopted new ED voice recognition software, which resulted in a

significant jump in patient satisfaction scores. Great strides were

also made in improving workflows, strengthening connections

between HCA, physicians, and the largest medical group in the

region.

Innovation in Cardiovascular Care

The Continental Division forged new ground in cardiovascular

care with the installation of an interoperable cardiovascular

information system that contributed to enhanced patient

care, optimized staff productivity, and improved revenue cycle

efficiencies. It’s the first installation of its kind at HCA, with

enhancements continuing in 2016/2017 that are expected to allow

for more accurate documentation and streamlined supply cost

management.

Enhancing Surgery Management

Physicians and clinicians were able to further streamline their

surgical workflow process through an enhanced OR Tracker

solution, developed by the division for the HCA enterprise.

Scheduling, materials management, clinical documentation,

and robust reporting capabilities enabled caregivers to manage

hospital operating rooms with maximum efficiency. Up next in

2016: real-time locating services to track patients and devices.

CIO: Andy Draper

Continental Division “The Leaders”

89


East Florida Division “The Facilitators”

CIO: Fariba Borjian

Breaking Barriers in Healthcare

The East Florida Division forged new ground through its use of

wearable remote patient monitoring, specifically wrist-worn

devices that monitor pulse, blood oxygenation, respiration rate,

heart rhythm, and skin temperature for early detection of critical

warning signs. This new technology, VisiMobile, was one of many

solutions introduced as part of East Florida’s Connected Care

initiative that also includes real-time location services (RTLS),

nurse-call integration, iMobile for clinician communication,

and other offerings focused on improving patient safety and

satisfaction.

Information Protection

TOP ACHIEVEMENTS FOR 2015

Information protection enhancement was a top priority in the

East Florida Division as evidenced by their print/fax minimization

project, which helps reduce security risks by transferring health

information in a more secure environment, on an as-needed

basis. Through 2015 efforts, more than 1,159 printers, 67 faxes,

and 819 spooled MEDITECH reports were removed, which

substantially reduced costs, supported green environment

initiatives, and lowered resource consumption.

Enhancing Patient Experiences

Customers were able to be more connected and more

involved in their care in the East Florida Division

through an innovative, near-real-time communication

application developed at the division. The application

texts patients and their families notifications on

admission/discharge status, order and results status,

and patient progress through the OR, from pre-op

to recovery. This application, now a foundational

platform for division messaging, will be leveraged for

other alerting functions in 2016.

TOP ACHIEVEMENTS FOR 2015

Innovation in Cardiac Care

The Far West Division introduced the Cardiac Cath Lab

Charge Capture project in a focused effort to enhance

and standardize the care provided to their cardiac

patients. This intuitive tracking application, which won

a national award for innovation, provides a comprehensive

view of cardiac episodes, tracking the clinicians involved in the

procedure, as well as their equipment and supplies. Developed

entirely in-house, this technology will now benefit all hospitals in

the Far West Division.

Life-Saving Data & Analytics

The Far West’s talented IT team collaborated with HCA’s patient

quality group to develop a first-of-its-kind application to identify

patients with sepsis infections. The application, developed with

data at its core, collects large amounts of information and then,

using analytics, creates alerts for physicians and clinicians.

The resulting Sepsis Real Time Report has allowed earlier

identification of dangerous sepsis infections, improving patient

safety and ultimately saving lives.

Harnessing Mobile Technology

The Far West Division took the lead with a couple of on-thego

healthcare technologies that take advantage of mobile

technology. At the Los Robles Medical Center, nurses were armed

with iPhones featuring secure and interoperable applications

that empowered them to quickly respond to patient requests

and communicate with physicians in real-time. At the Sunrise

Hospital and Medical Center, the Far West team replaced more

than 1,500 phones, implementing the new OneVoice technology.

This too was a transformational upgrade that moved the facility

to the next step in the Connected Care life cycle.

CIO: Cae Swanger

Far West Division “The Automators”

91


TOP ACHIEVEMENTS FOR 2015

HEALTHCARE INSPIRED

Community Access to Healthcare

Our Gulf Coast region grew this year with the addition of

Gulf Coast Division “The Advocates”

CIO: Mark King

Pearland Medical Center, a 144,000 square-foot state-of-the-art

facility. Despite a challenge-filled construction and abbreviated

schedule, IT&S successfully installed and configured 828 devices

and more than 105 applications to support our physicians,

clinicians, and patients from opening day. Through collective HCA

enterprise efforts, the new facility increased access to innovative

and high-quality healthcare for area residents, improved

emergency preparedness capabilities, and provided new jobs

and tax revenue to fund important community services. Most

important of all, the community now has access to the inspired

care that HCA models each and every day.

Cost Savings and Improved Patient

Experience

While the maintenance of medical equipment is typically not

categorized as IT, it does have an influence on IT support

and ultimately the patient experience. With that in mind, the

Gulf Coast team architected a plan and realigned a support

structure with a primary equipment vendor to leverage

technology and processes that enhanced equipment support,

while also mitigating risk. The Gulf Coast Division gained more

than $700,000 in savings and cost avoidance due to this

realignment, and earned more than 6 percent of an

increase in customer satisfaction.

As an engineer in the field,

I provide education to our

technicians. I support our

division’s current IT solutions

and architect new ones. I

give physicians and clinicians

access to the tools they need to

provide the exceptional patient

care for which HCA is known. I

do my job right, so others can

do their job—and their job is

the weighty task of caring for

patients and saving lives.

Anthony Bartley

Engineer, Division Senior Systems

Capital Division

93


HCA International “The Re-creators”

CIO: James Chaloner

Laying a Digital Foundation

In 2015, the HCA International team developed and introduced

a comprehensive enterprise content management platform,

creating the foundational infrastructure for our international

operation. This platform, which provides streamlined access

to automated contract functionality, policy documents, and

clinical audits, while also integrating asset management, vendor

management, and supply chain functions, replaced manual/

paper-based processes that are often inefficient and time

consuming. Substantial efficiencies and cost-savings continue to

be realized through this digital upgrade as the division readies for

the future while continuing its excellence in patient care.

Human Resources Tools

TOP ACHIEVEMENTS FOR 2015

HCA International turned its focus to HR tools in 2015 to take

care of their greatest asset, their people. Through a significant

cross-functional effort between IT&S and the HR, payroll,

and finance departments, HCA International developed

a comprehensive human resources platform to integrate

business systems, manage documents, and provide an identity

management framework that automates provisioning and users.

Global Healthcare Connections

Our clinical specialist teams enjoyed connectivity on a global

scale this year with the introduction of smart video

conferencing technology, providing secure conference

capabilities through mobile devices, laptops, PCs, and

our video conferencing suites. Supporting our belief

that borders should not exist in the delivery of topnotch

healthcare, this technology allowed virtual

multi-disciplinary team meetings that connected

patients to healthcare experts, and experts to each

other, facilitating radical new ways for collaboration and

consultation.

TOP ACHIEVEMENTS FOR 2015

Dreaming Big

The MidAmerica team architected and implemented an

idea collaboration platform, empowering employees to

share their innovative ideas. The platform provides the

framework (from inception to incubation to execution),

the guidance, and the resources necessary for employees

to focus on the work that drives and motivates them. In 2015,

more than 500 ideas were submitted, and hundreds of process

improvements were initiated that, combined, had an enormous

impact on the way the division works. Some of the more profound

ideas may even eventually change healthcare as we know it.

Making Mobile Connections

Throughout 2015, the MidAmerica team deployed hundreds

of mobile ready devices to provide the right technology in the

right way to optimize and enhance clinical initiatives and patient

care. Two examples: the deployment of Surface Pro 3 tablets to

physicians for optimizing workflows and the delivery of iPhones

to clinicians and physicians for allowing secure messaging and

immediate access to the latest vital signs for patients. In addition,

through a partnership with HCA’s Physician Services Group,

the mobile optimization of the eClinical Works EHR platform

increased performance by up to 75 percent in our physician

practices.

Going Green and Saving Money

Through Simplify IT efforts, the MidAmerica team developed and

implemented a print reduction and managed services program

across the division that resulted in $1.8 million of savings in

printer related costs over a three-year period.

CIO: Jared Mabry

MidAmerica Division “The Pioneers”

95


Mountain Division “The Progressives”

CIO: Bruk Kammerman

EHR Implementation

The Mountain Division applied its highly-engaged and broadlyskilled

team to the implementation and ongoing support of

multiple clinical information systems in 2015. Epic, for instance,

was successfully implemented at HCA’s most geographicallychallenging

facility, Alaska Regional Hospital. Other

accomplishments included successful MEDITECH upgrades

and conversions throughout the division, giving our Healthcare

Inspired caregivers the tools needed to provide stellar patient

care.

Remote Flight Academy

TOP ACHIEVEMENTS FOR 2015

Following the success of the Flight Academy program, the

development program for staff-level employees, the Mountain

Division altered its curriculum and created the foundation for a

first-of-its-kind offering, serving employees in geographicallydispersed

locations such as Nevada, Idaho, and Alaska. Early

efforts have been well-received, and plans are already underway

to expand the initiative in the future.

Employee Engagement Gains

In 2015, the Mountain Division aligned employee engagement

goals with HCA’s “Embrace Accountability” core value. Division

employees were asked to create performance plans aimed

at improving their personal engagement and helping

colleagues become more engaged. In addition, they

were asked to provide specific input on how leaders

could support them in their effort to improve

engagement. Subsequently, overall engagement

scores in the division increased by 10 percent.

TOP ACHIEVEMENTS FOR 2015

Service Excellence

The North Florida IT&S team has a proven track record

in the development of new healthcare technology

applications for the HCA enterprise and is especially

regarded for the high level of customer service they

provide to customers, vendors, partners, and patients. To

operationalize the standards of excellence the division has

embraced, the North Florida team developed a Service Excellence

program in 2015. Already introduced to multiple divisions, the

program will be shared with the enterprise throughout 2016,

reinforcing IT&S’s mission to ensure the patient is always at the

center of technology, support, and innovation.

Improving the Patient Experience

Using a foundation of technology developed by their own

IT team, the North Florida Division gives patients access to

enhanced information about their care through the MyCare

Board. MyCare Boards are electronic dashboards that pull EHR

information and display patient goals, medication tracking,

scheduled procedures, and caregiver history. In 2015, they were

enhanced with real-time location technology, tracking staff as

they entered and exited patient rooms. This allows patients to

be more engaged in their healthcare and provides them an extra

sense of security.

Community Approach to Patient Care

A key component of North Florida’s Clinical Data Management

strategy, hCare Health Information Exchange (HIE) technology

encourages a community approach to patient care and allows

key clinical information to move across all care settings.

Understanding the value and importance of connectivity in

care, the division leveraged HIE technology to provide secure

information sharing throughout the enterprise and led the

organization in training, support, and utilization.

CIO: Janet McCallister

North Florida Division “The Coordinators”

97


North Texas Division “The Architects”

CIO: Leah Miller

Empowering Patients

TOP ACHIEVEMENTS FOR 2015

The North Texas Division empowered the patients it serves with a

robust, interactive patient experience platform. Through a tablet

application that integrates text, audio, and 3D visual imagery into

an intuitive touch screen solution, patients can actively engage

in healthcare education, appointment scheduling, and other

tasks. This puts more control into the hands of patients and has

contributed to positive growth in patient satisfaction scores. Due

to the overwhelming success of the program, new features are

planned for 2016.

Connected Emergency Care

The North Texas Division deployed new emergency

communication technology with integrated EMS telemedicine

that enhances care for patients even before they arrive at the

hospital, and as they transition into the emergency department.

This new technology offers real-time connections, whether by

recording a patient episode in an ambulance and transmitting it

to an ED or performing telemedicine sessions with a physician

on a tablet. The further development expected in 2016 will

include technology integration with helicopter life flight medical

transport.

Keeping Patients on Track

Follow-up patient care after an ED visit is critical.

That’s why North Texas launched an ED discharge

texting program in 2015, so patients would receive

follow-up care that reinforces physician instructions

and encourages individuals to get the continued care

they need. Future plans for 2016 include an in-patient

texting model to help our most critical patients avoid

readmission.

TOP ACHIEVEMENTS FOR 2015

Wearable Patient Monitoring

The San Antonio Division forged new ground in 2015

boasting the first HCA hospital to provide physicians

and nurses with immediate access to wearable vital

patient monitoring through their automated EHR vital sign

integration. Collaborating with the Specialty and Transplant

Hospital of Methodist Hospital, the team implemented a wearable

vital signs monitoring system that keeps clinicians connected

to their patients 24/7. A comfortable body-worn censored cuff

provided patients with the freedom of movement while enabling

accurate and continuous monitoring of vital signs and blood

pressure.

Catering to Children

Recognizing the special needs children have in a healthcare

setting, especially in the ED, the San Antonio team implemented a

pedi-specific MEDITECH Emergency Department module at their

Methodist Children’s Hospital. The implementation substantially

enhances pediatric content, and the pediatric customization

matches the unique requirements for children patients. There

are plans to deploy this terrific new technology to the entire HCA

enterprise.

Breaking Barriers in Secure

Healthcare Communication

The San Antonio Division took secure mobile communication to

a new level in 2015 with a suite of capabilities for Metropolitan

Methodist Hospital. Through a special iMobile “Copper” initiative,

care teams were given secure connectivity for sharing patient

specific information instantly. This new mobile initiative insures

HIPAA compliance and provides a secure communication solution

without major infrastructure investments, while also laying a

baseline for a more comprehensive secure messaging capability

in the future.

CIO: Eddie Cuellar

San Antonio Division “The Innovators”

99


HEALTHCARE INSPIRED

At the end of the day, we all

want to know that what we

do matters. As a member of a

support team, we have begun to

view the work we do not by how

many tickets we complete, but

by how many people each ticket

helped. Once you start to see

the number of people we enable

each day, it makes me proud

to know that I am part of an

organization that does so much

good for so many, and part of a

team that helps empower others

to accomplish HCA’s mission.

TOP ACHIEVEMENTS FOR 2015

Streamlined Solutions for

Enhanced Patient Safety

Focusing on smoother admittance and improved safety

for patients, the South Atlantic Division introduced

interoperable vein-scanning biometric technology, which

easily captures patient photos upon registration. The new

technology has streamlined the registration process, reduced the

time to match patients in the medical record database, prevented

duplicate medical records, and helped reduce the risk of medical

identity theft.

Online Tools that Drive Efficiencies

The South Atlantic Division expanded its use of the

eClinicalWorks EHR platform with the addition of an

eClinicalWorks Kiosk module. The module, which combines Apple

technology with a consumer-friendly kiosk stand, allows patients

to check-in for appointments on an iPad. Information gathered

is then directly integrated into the patient’s electronic health

record in eClinicalWorks, improving patient satisfaction, offering

operational efficiencies, and further ensuring the security and

accuracy of patient information.

Connecting Patients with

Comprehensive Care

The South Atlantic team introduced innovative technology that

aligns the care of patients in an ED with a subsequent care plan,

CIO: Vince Doyle

South Atlantic Division “The Developers”

improving the management of their health through the entire

100

Todd Bates

Manager, Network Operations Support

Infrastructure Services & Operations

continuum of care, from ED to primary provider and back into

the community. Since its launch, the Care Alert technology

has contributed to comprehensive treatment plans for chronic

patient conditions and reduced repeat visits to ED departments

in the region.

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TriStar Division “The Trusted Advisors”

CIO: Kim Lewis

Top Ratings for IT&S Service

HCA strives to provide the highest level of responsive and

compassionate care to our patients, their families, and members

of our communities every day. The TriStar Division exemplified

this with their high service excellence standards which continued

to distinguish them among peers in the healthcare industry.

With new initiatives that focused on improved communication,

responsiveness, and accuracy, the TriStar Division saw their

Studer survey satisfaction scores soar. IT&S received an overall

rating of 91 percent, a major jump from the first quarter baseline

of 72 percent.

TOP ACHIEVEMENTS FOR 2015

Creating Efficiencies and Streamlining

Workflows

A key focus this past year was to endow physicians and clinicians

with relevant tools to streamline workflows, increase efficiency,

and cut the cost of information delivery. The TriStar team helped

accomplish this by removing outdated EHR and paper driven

workflows and successfully implementing an eClinicalWorks EHR

solution to more than 293 providers in 76 practices.

Taking Advantage of the Cloud

TriStar used the cloud to standardize, automate, and track patient,

employee, and department information, integrating it with

their MyRounding application. This provided key data and

valuable analytic detail used to enhance patient care

in real-time and allowed support teams to be more

proactive and responsive to IT requests. More than

60,000 rounds were captured between the third and

fourth quarter of 2015, laying the data foundation

for a standardization of templates, questions, and

escalations that helped TriStar evolve and enhance the

care and direction provided to patients and physicians.

TOP ACHIEVEMENTS FOR 2015

Cerner at Citrus Memorial

Working in close collaboration with acquisition and

product development teams, the West Florida Division

forged new ground by supporting HCA’s first installation

of the Cerner Millennium EHR at Citrus Memorial Hospital.

Spending more than 30,000 hours on the acquisition and

integration of this new technology, the West Florida team

implemented sixteen applications in 2015.

Breaking Records in Employee

Engagement

Employee engagement is a critical component to the overall

success of HCA. The West Florida Division exemplified their

dedication to this, achieving the highest IT&S employee

engagement score while receiving numerous awards for

employee recognition from regional hospitals. Among their

successes: a division-high score of 89 percent on its engagement

survey, IT&S employees acknowledged as top monthly hospital

employees, and technical support and nursing professionals

receiving employee-of-the-year recognition.

Application Development

The West Florida application development team had a busy 2015,

forging relationships and partnerships to grow its technology

suite and enhance the care provided to patients. New technology

of note: a staffing manager tool, a mobile phonebook app for

customers, and a discharge notification tool. The team also

introduced a reporting/dashboard application to support

business intelligence and access to the clinical data warehouse.

CIO: Sheree McFarland

West Florida Division “The Trailblazers”

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Employee

Engagement

Thoroughly engaged, vigorously inspired,

our workforce is what matters most.


Employee Feedback

Employee engagement surveys have consistently revealed that

IT&S employees are a very engaged workforce. The results from

2015 were no exception. With an overall favorable rating of 82%,

we have great direction on what practices to continue and what

kind of culture to create, while also identifying a number of areas

for improvement.

THE BIGGEST PART of the Big Picture in IT&S is, of course,

the people. Our workforce is the organization’s most vital asset.

That’s why it’s imperative that our employees are satisfied with

their workplace—so satisfied, in fact, that HCA is where they stay

for the remainder of their career. And it’s why great emphasis is

placed on enabling, empowering, and fortifying them with the

right resources and programs, as well as recognizing them for the

tremendous creativity and dedicated work they bring to HCA.

Our leadership is most proud of scores earned in the general

outcomes category where employees indicate if they would

recommend our workplace as a great place to work (89% said

they would), if they plan to work for IT&S in one year (93% said

yes), if they are proud to work for this company (94% say yes),

and if they would recommend HCA facilities to family and friends

for medical care (89% would). IT&S scored higher than the overall

company percentages on every question in these categories.

Having employees say they would recommend our company to

others for their employment and/or care is, in fact, the highest

compliment we could receive.

THE BIG PICTURE: AN ENGAGED WORKFORCE

IT&S consistently leads HCA in employee engagement scores, as

revealed in the annual engagement survey. An exceptional 94% of

respondents said they were proud to work for the company.

With 88% of employees reporting their work gives them a feeling

of accomplishment and 90% saying they are willing to contribute

more than what is expected of them in their job, it’s clear the

people of our organization relate to the noble cause of our

“Healthcare Inspired” mission and culture.

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107


Social Media

In 2015, IT&S placed unprecedented focus on social media and

saw enthusiastic adoption by our employees. By December, our

social media impressions had almost doubled from the beginning

of the year, and so had our followers. In fact, we have had more

than 625,000 impressions on our social media sites so far, and

our presence will only continue to expand, aptly reflecting the

innovative, industry-leading company we have become.

628,794

social media impressions

1,273

followers

239,200

impressions

1,071

link clicks

753

retweets

THE BIG PICTURE: DEVELOPING OUR OWN

(approx. 100%

growth in 2015)

IT&S prides itself on it professional development

programs, especially those that nurture and

elevate the leaders of today and tomorrow. Since

its inception in 2011, 45 employees have graduated

from its prestigious Emerging Leaders program,

and in just three years, the Aspiring Managers

program has graduated 127 employees.

1,460

followers

380,034

impressions

7,867

profile views

108

* all stats as of January 1, 2016

109


Employee Recognition

Bringing attention to the good work of others and showing

gratitude has become increasingly important to the people of

IT&S, as evidenced by over 150 message board posts of employeeto-employee

recognition (more than double the number posted

in 2014). A suite of other recognition options, including Token,

Spot, and Star awards, are also exercised regularly and eagerly.

The pinnacle, however, of employee recognition is the Noel

Williams Award of Excellence, which honors two exemplary

employees who well represent the mission and Healthcare

Inspired culture of IT&S, show above-and-beyond engagement

and dedication to HCA, and produce extraordinary results in their

respective role and responsibilities.

The 2015 award drew attention to two of our finest: Janet

McCallister, Division CIO for the North Florida Division, and

Tommy Ratton, Consulting System Engineer for the MyHealthOne

project. Continuing a tradition, the winners were commended

at the IT&S All Hands event, while the other esteemed nominees

were given due recognition through the IT&S blog.

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111


Employee

Engagement

Highlights

Evaluation and

Development

Excellence

Opportunities for employees to develop professionally

and engage with their workplace community continued to

attract widespread participation from all areas of IT&S:

IT&S’s Performance Excellence

Program ensures that

our organization places

appropriate priority on

Last year, in addition to

standard professional

development opportunities,

employees were required to

evaluating and developing

expand their understanding

IT HEALTHCARE CONNECTION

CONTINUED TO INSPIRE

PARTICIPANTS THROUGH

IMMERSION INTO THE

HEALTHCARE SETTING,

ENTERPRISE HIMSS

MEMBERSHIP REMAINED

A SOURCE OF IMPORTANT

RESOURCES AND

OPPORTUNITIES FOR

SOCIAL MEDIA WAS

UNCHARTED TERRITORY

FOR IT&S UNTIL 2015, WHEN

UNPRECEDENTED FOCUS

AND ADOPTION TOOK PLACE.

personnel, to maintain our

highly rated workplace culture

and to ensure managers at

all levels are aware of our

of Continuous Improvement

through a mandatory Simplify

IT course led by IT&S

leadership, where everyone

WHERE THE IMPACT OF

TECHNOLOGY IS READILY

APPARENT. SINCE THE

PROGRAM’S INCEPTION IN

INFLUENCE AND

UNDERSTANDING,

WITH MORE THAN 800

MEMBERSHIPS, PASSES

THIS RESULTED IN MAJOR

IT&S PRESENCE ON TWITTER,

FACEBOOK, LINKEDIN, AND

YOUTUBE, GENERATING

employees’ contributions

and career plans. Supervisors

hold regular one-on-one

was challenged to imagine and

submit process improvement

and cost saving ideas. By

2010, 502 EMPLOYEES HAVE

PARTICIPATED.

CENTENNIAL CONNECT, THE

ONE-DAY VERSION OF THE

WEEK LONG IT HEALTHCARE

CONNECTION EXPERIENCE,

WAS INTRODUCED IN MAY

TO THE ANNUAL HIMSS

CONFERENCE, AND OVER

25 SEATS IN THE HIMSS

LEARNING ACADEMY.

IT TRAINING DAY, AN EVENT

OFFERING TECHNICAL AND

CULTURAL/BEHAVIORAL

MORE THAN 625,000 ONLINE

IMPRESSIONS.

conversations to discuss

performance evaluation, goals,

and professional development,

confirming that employees are

heard, understood, and valued.

year’s end, after many of these

ideas were implemented

and enacted, our Simplify IT

program reported $41.5 million

in cost savings and more than

76,000 hours saved.

OF 2015 WITH A TOTAL OF 60

TRAINING TO ALL IT&S,

EMPLOYEES TAKING PART BY

ATTRACTED RECORD

THE END OF THE YEAR.

PARTICIPATION AND MORE

THAN 5,000 VIEWS ON THE

EVENT SITE.

112 113


iTrain

Continual professional

development is critical to

the ongoing success of any

information technology

team. That’s why IT&S

established iTrain, our

professional development

curriculum collected for the

specific education needs

of our organization. In

2015, 163 live iTrain events

were presented, and IT&S

employees completed 71,619

online offerings, accessible via

HealthStream, while record

numbers participated in our

annual IT Training Day (the

event website attracted almost

5,000 views).

163

live events

30,664

courses

6,339

students

71,619

course completions

(Healthstream)

2015 marked the year of

over 500 participants for the

IT Healthcare Connection

(ITHC) program, where

employees are immersed into

the hospital environment to

help them further appreciate

IT&S’s Healthcare Inspired

cause. ITHC, first introduced

in 2010, has proven to be a

powerful means of connecting

technology professionals to

the real impact of their work.

Participants can witness

firsthand how the solutions

IT&S imagines, develops, tests,

implements, and supports are

critical and time-sensitive

in a multitude of healthcare

environments. In fact, ITHC

has shown us, in no uncertain

terms, the immeasurable value

of the work we do every day,

which is why the program was

expanded to other facilities,

to accommodate more of the

demand for this invaluable

experience.

114 * stats for 2015

115


About IT&S

Our mind is focused on technology, but our

heart is committed to healthcare.


HCA Mission & Values

WE IN IT&S are IT professionals and are certainly proud of our

technical expertise. But what makes us unique as a technology

company is that our solutions ultimately impact the care of

patients. Although our skills are demanded in a number of

industries, we in IT&S apply them specifically to the noble cause

of healthcare. It’s this “Healthcare Inspired” cause and culture

that brings employees together in a shared enthusiasm for their

work and sets IT&S apart as a uniquely purpose-driven company

in the IT industry. It’s an attitude that informs and positively

influences our mission and guiding principles and is a direct

reflection of the mission and values of HCA.

Above all else, we are committed to the care and improvement

of human life. In recognition of this commitment, we strive to

deliver high quality, cost effective healthcare in the communities

we serve. In pursuit of our mission, we believe the following

value statements are essential and timeless.

• WE TREAT ALL THOSE WE

• WE TRUST OUR COLLEAGUES

SERVE WITH COMPASSION

AS VALUABLE MEMBERS OF

AND KINDNESS.

OUR HEALTHCARE TEAM

AND PLEDGE TO TREAT ONE

• WE ACT WITH ABSOLUTE

ANOTHER WITH LOYALTY,

HONESTY, INTEGRITY, AND

RESPECT, AND DIGNITY.

FAIRNESS IN THE WAY WE

CONDUCT OUR BUSINESS

• WE RECOGNIZE AND AFFIRM

AND THE WAY WE LIVE OUR

THE UNIQUE AND INTRINSIC

LIVES.

WORTH OF EACH INDIVIDUAL.

THE BIG PICTURE: OUR INSPIRED CULTURE

Our “Healthcare Inspired” mantra was launched in 2013 and has

become a crucial part of our individual and corporate identity,

shaping our culture and providing daily inspiration.

IT&S Mission

Our mission is to help transform healthcare by delivering

information technology and solutions that dramatically

improve patient care and business operations.

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119


HEALTHCARE INSPIRED

The reason I’m Healthcare

Inspired is best summed up by

a quote from Albert Einstein,

‘Only a life in the service to

others is worth living.’ When my

mother was battling cancer, the

dedicated professionals that

cared for her, at the bedside

and behind-the-scenes, were

a powerful inspiration to me.

Now that I’m here at HCA, I want

to be that caring, dedicated,

knowledgeable professional for

someone else.

Healthcare Inspired

As employees of IT&S, we could apply our technical skills

anywhere, but we choose to employ them toward the noble

cause of improving healthcare. That’s why we say we are

“Healthcare Inspired,” which serves as a guiding vision for

our purpose and culture. Healthcare will be inspired by our

technology solutions. Our solutions will be inspired by our

uniquely talented team of experts. And we should all be inspired

by the meaningful work we do.

We are Healthcare Inspired because:

WE BELIEVE IN IT&S’S

POWERFUL IMPACT ON

THE LIVES OF OTHERS

WE KNOW OUR UNIQUE

EXPERTISE PLAYS A

CRUCIAL ROLE IN THE CARE

GIVEN IN OUR HOSPITALS

Mark Hayes

Client Support Analyst

Infrastructure Services & Operations

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IT&S Guiding Principles

Because we are Healthcare Inspired we will:

BE INNOVATIVE AND RESOURCEFUL

Leveraging HCA’s powerful influence, we will use

our unique expertise to transform healthcare with

original IT solutions.

DELIVER ON OUR COMMITMENTS

Nothing is more urgent than advancing healthcare IT,

so we must deliver the highest quality capabilities on

time and within budget.

ELIMINATE INEFFICIENCIES

Discovering ways to conserve time, save money,

and streamline processes is essential for delivering

quality care.

PROTECT OUR INFORMATION

We must always safeguard our most precious asset,

protecting the information of our patients, our

people, and our business.

LISTEN, LEARN, AND LEAD

To thrive as an organization, it is critical that we

creatively collaborate with each other, constantly

improve our own skills, and look to lead when

necessary.

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