John Muir Health
Walnut Creek CA
Mr. Chris Pass
Senior Vice President & Interim Chief Financial Officer
Having provided advisory consulting services to John Muir Health (JMH) in 1995 and 2003, again Dak was retained by the three, not-for-profit, community hospital enterprise located in Walnut Creek/Concord CA to provide guidance in their search for and implementation of one, integrated, Health Information Management product that included a replacement Encoder solution with Groupers, a new Computer-Assisted Coding solution, a replacement Clinical Documentation Improvement solution, and related services. Specifically, JMH was no longer looking to employ an IT strategy based on a "Best of Systems Solution" (aka "Best of Breed Solution"). Also, the one, integrated product was required to demonstrate a history of successfully interfacing with JMH’s recently installed Epic EHR. As the project’s manager, Dak coordinated the evaluation of several potential vendors that met JMH’s technical and functional requirements and services, consulted in the selection of JMH’s vendor-of-choice, and negotiated a complex contract with the vendor.
Genentech, a Member of the Roche Group
South San Francisco CA
Ms. Jennifer Fisk
Manager – Corporate Records
Ms. Irene Loeffler
Associate Director – Corporate Records
For over 35 years, Genentech, considered the founder of the biotechnology industry, has been using human genetic information to discover, develop, manufacture and commercialize medicines to treat patients with serious or life-threatening medical conditions. In 2009, Genentech became a member of the Roche Group, and Genentech's South San Francisco campus serves as the headquarters for Roche pharmaceutical operations in the United States. Genentech’s Corporate Records Division focuses on electronic records management principles to develop enterprise policies and deliver enterprise training. Dak was retained to develop records management strategies to both structured and unstructured electronically stored information throughout its lifecycle. This required working with a large number of collaboration platforms, such as Google Drive and several versions of Microsoft SharePoint, a plethora of electronic document management systems provided by vendors such as OpenText, EMC Documentum, and IBM FileNet, and an automated records management system provided by Hewlett Packard Autonomy. Functions included gathering information for system decommissions and electronic record retention periods as well as analyzing the long term preservation of electronic records for virtual data rooms and file sharing and synchronization (FSS) applications.
Mr. Dan Kinsella
Executive Vice President & Chief Information Officer
Cadence Health is an Illinois integrated healthcare delivery organization that includes two acute care facilities – Central DuPage Hospital (CDH) in Winfield and Delnor Health System in Geneva. Cadence is a locally-governed health system delivering healthcare to more than 1 million patients in Chicago’s western suburbs. Cadence maintains affiliations with the Ann and Robert H. Lurie Children’s Hospital of Chicago for pediatric specialty care and The Cleveland Clinic for cardiac surgery, adult medical oncology, and cardiology services. For Cadence’s unstructured data-based information systems and technologies, specifically those that manage patient diagnostic image data, Cadence’s large number of image-generating disciplines utilize a plethora of PACS (Picture Archiving and Communications System[s]). This led to a fragmented diagnostic image infrastructure that required interoperability between its unstructured data-based specialty departments and sites across the enterprise. To resolve this challenge, Cadence retained Dak, who assisted Cadence in developing an enterprise image management (EIM) “road map” / strategy. The EIM “road map” / strategy began with the storage of Cadence’s diagnostic image data in a single, shared, and centralized repository, often referred to as a vendor-neutral archive (VNA). In addition, Dak recommended a radiology technology solution between Cadence and Lurie Children’s Hospital, cardiology technology solutions between Cadence and Lurie Children’s Hospital and The Cleveland Clinic, and a standard enterprise diagnostic image-sharing solution.
John C. Lincoln Health Network
Mr. Robert Slepin
(formerly) Vice President and Chief Information Officer
Mr. Charles Dickens
IT Project Management Officer
623-434-6200, Ext: 304526
John C. Lincoln Health Network (JCL) is an integrated healthcare delivery organization that includes two acute care facilities – Deer Valley Hospital and North Mountain Hospital – as well as physician practices, community programs, and a charitable foundation. JCL selected a well-known vendor for the acquisition and implementation of the vendor’s Computer- Assisted Coding (CAC) and Clinical Documentation Improvement (CDI) systems. Dak Systems Consulting provided professional contract assistance services to JCL so that JCL was able to secure favorable contract Terms and Conditions, warranties and other key contract provisions.
Ms. Anita Gregory
IT Director – Financial Management Systems
Ms. Marion Swaim
Vice President – Health Information Management
Sentara Hampton Roads Hospital Division
Sentara Healthcare is a large integrated healthcare delivery organization that operates ten acute care hospital facilities across Virginia – seven as part of the Sentara Hampton Roads Hospital Division, one as part of the Sentara Northern Virginia Hospital Division, and two as part of the Sentara Blue Ridge Hospital Division. Also, Sentara operates over one hundred ancillary sites of care, including imaging centers, urgent care facilities, skilled nursing facilities, and home health / hospice agencies, and Sentara operates three medical groups consisting of over six-hundred primary care and specialist physicians. Dak was retained to assist Sentara in the planning and acquisition of a Computer-Assisted Coding (CAC) solution that would help Sentara maintain its coding productivity levels once Sentara converted to the expanded ICD-10 code set as well as reduce its estimated ICD-10 resource needs. Dak's services included the creation of a formal Request for Proposal (RFP). The RFP focused on providing a CAC solution for Sentara's acute care hospitals' inpatients (adult, pediatric, newborn), emergency patients, and facility outpatients (observation patients, surgical outpatients, diagnostic outpatients, and recurring outpatients) as well as Sentara's medical groups' ambulatory patients for office-based services and inpatients (adult, pediatric, newborn) and surgical outpatients for (hospital) facility-based services. The plethora of existing and diverse Sentara information systems that needed to be integrated with the CAC solution was challenging. For example, existing Electronic Medical Record systems consisted of Epic, Meditech and NextGen. Existing Electronic Financial Record systems consisted of McKesson's HealthQuest, Meditech, GE's Flowcast and NextGen. Existing encoder systems consisted of Optum Insight's Webstrat and 3M's Coding and Reimbursement System. Existing Clinical Documentation Improvement systems consisted of Navigant and an MS Access database. Existing Voice / Text systems consisted of M*Modal, 3M's ChartScript and Nuance (formerly eScription). And, existing Speech systems consisted of Nuance's Dragon and Agfa's TalkTech.
MemorialCare Health System
Fountain Valley CA
Ms. Penny Dobb
Executive Director – Information Services
Ms. Patti Tondorf, MHA
Executive Director – Patient Financial Services
MemorialCare Health System (MHS) is a not-for-profit integrated-delivery network that includes five community-based, acute care hospitals in Los Angeles and Orange Counties, several walk-in clinics, a medical group foundation, and numerous outpatient health centers throughout southern California. In association with ELIPSe, Inc. (Los Angeles CA), Dak was retained to assist MHS in assessing the impact on MHS' hospital and hospital-related support services technologies and payers for MHS' Phase I Planning & Assessment Phase for HIPAA's ICD-10 code set conversion. The technologies' assessment was organized into the following categories: Information system applications (commercial and in-house developed) that contain ICD-coded data or code sets and / or support data that will be affected by the new ICD-10 codes and processing requirements; Contracts for commercial information system applications that contain ICD-coded data or otherwise be affected by the new ICD-10 codes and processing requirements; Information system interfaces that uni-directionally or bi-directionally pass ICD-coded data through one of MHS' two Interface Engines as well as those information system interfaces that directly pass ICD-coded data to other information systems; Information system inputs (forms and file imports) and Information system outputs (reports, reporting processes, and file exports) that contain ICD-coded data; Biomedical devices that store or transmit ICD-coded data; and, Data analysis business processes (i.e., data analytics) that contain ICD-coded data or code sets, including MHS' data warehouse/ business intelligence, decision support, and research processes. The payers' assessment was organized into the following categories: Payers that are HIPAA Covered Entities (e.g., State of California Worker's Comp is not a HIPAA Covered Entity) and Managed care contracts that are affected by ICD-10 codes and processing requirements. Eight months of Dak data collection involved conducting approximately 45 stakeholder interviews, developing a dozen inventory listings for the above categories, and preparing / delivering / analyzing 40 Information System Application Requests for Information (RFI) and 40 Payer RFIs to 24 Health Plans and 15 Medical Groups. Dak's comprehensive report deliverable included several Technologies and Payers Gap Analysis Tables with corresponding Findings as well as approximately 55 detailed Technologies and Payers ICD-10 Conversion Recommendations for MHS' Phase II Implementation.
Los Angeles County
Department of Health Services (LAC-DHS)
Los Angeles CA
Rancho Los Amigos National Rehabilitation Center (Downey)
Mr. Al Mateik
Director – Information Management Services
Ms. Diane Waskul
Enterprise and Special Projects
Having provided process mapping services with process reengineering recommendations for patient-related clinical documents at all six LAC-DHS facilities, Dak, in association with Doculabs, Inc. (Chicago IL), was re-engaged specifically by the Rancho Los Amigos facility to provide process mapping with process reengineering recommendations for patient-related financial and administrative documents. Dak supported Rancho Los Amigos by conducting five days of on-site data collection with stakeholder interviews in the following, seventeen areas: Continuum of Care – Central Admitting and Referral Office (CARO): Inpatient Admission (CARO Business/CARO Clinical); Continuum of Care – Inpatient Case Management; Continuum of Care – Outpatient Case Management; Outpatient Care Center – Outpatient Registration; Finance – Patient Financial Services (Outpatient Registration); Finance – Patient Financial Services (Inpatient Admission); Finance – Patient Accounting Unit (Government Billing Unit); Finance – Patient Accounting Unit (Financial Records); Finance – Patient Accounting Unit (Insurance/Specialty Programs Unit), COMMERCIAL INSURANCE; Finance – Patient Accounting Unit (Insurance/Specialty Programs Unit), POSTING UNIT; Finance – Patient Accounting Unit (Insurance/Specialty Programs Unit), TROCA; Finance – Patient Accounting Unit (Insurance/Specialty Programs Unit), MAIL BACKS/VENDORS; Finance – Patient Accounting Unit (Revenue Document Unit), TAR PROCESSING; Finance – Patient Accounting Unit (Revenue Document Unit), DENIAL MANAGEMENT/APPEALS/LITIGATION; Finance – Patient Accounting Unit (Revenue Document Unit), RELEASE OF INFORMATION; Finance – Expenditure (Cashier's Office); Health Information Management – Coding (Outpatient Charging). A comprehensive report including process maps for the above areas and seven recommendations for workflow and process reengineering were delivered for Information Management Services redesign.
Southcoast Hospitals Group
New Bedford MA
Mr. Ron LaFleur
Vice President - Hospital Revenue Systems
Ms. Bettyann Carroll
Director - Health Information Services
Having provided advisory consulting services to Southcoast Hospitals Group (SHG) during 2007, again Dak was retained by the three, not-for-profit, community hospital enterprise located in southeastern MA to provide guidance on policy development for SHG’s Electronic Health Record (EHR) for legal purposes. Specifically, Dak developed an enterprise-wide, legal, electronic health record strategy, focusing on an enterprise information governance structure. For the EHR strategy, Dak applied SHG’s analog records principles to its digital records, defined an enterprise EHR that will protect SHG in legal proceedings and not become a liability, and examined SHG’s risks of not identifying SHG’s legal record needs. For the information governance structure, Dak helped to establish governance tasks, such as developing the content of credible and compliant business records for disclosure and e-discovery purposes and defining what processes / policies should be developed and adopted. Dak provided a presentation to SHG’s senior leadership of Dak’s findings and recommendations, and an Information Governance Committee soon was established.
University of Alabama
Birmingham Health System
Ms. Joan Hicks
Chief Information Officer
Ms. Peggy DePiano
Project Director Ambulatory EHR Implementation
Having provided advisory consulting services to UAB Health System (UAB) during 2008, again Dak was retained by the large, academic / research-based, tertiary care delivery network to assist UAB with the implementation of the Cerner Millennium Electronic Health Record system in UAB’s approximately 76 ambulatory clinics, specialties, and related subspecialties. Specifically, Dak supported UAB in 1) incorporating documentation not available electronically (e.g., advance directives, consent documents, externally-generated patient documents) into the ambulatory EHR (AEHR) system / record; 2a) standardizing staff processes for managing the Release of Information / Accounting of Disclosures and related legal uses of the AEHR; and, 2b) managing the hard copy printing of computer output as defined by policy. Regarding documentation, Dak defined document types to be captured, the folder structure/methodology for saving and viewing document images in Cerner, the processes for batch capture done after the patient visit, and the processes for single document capture performed at point of care. Regarding output management, Dak defined intake processes for the ambulatory clinics as well as a standardized format for all output generated by the AEHR, provided cost information related to printing hard copy output, and updated standards related to the AEHR output.
Los Angeles County
Department of Health Services (LAC-DHS)
Los Angeles CA
Los Angeles County+USC Medical Center (Los Angeles)
Harbor-UCLA Medical Center (Torrance)
Rancho Los Amigos National Rehabilitation Center (Downey)
ValleyCare (includes OliveView-UCLA Medical Center) (Sylmar)
High Desert Health System (Lancaster)
Martin Luther King Multi-Service Ambulatory Care Center (Los Angeles)
Mr. Stuart Suede
Senior IT Project Manager
Health Services IT Project Delivery Division
LAC-DHS, one of the largest integrated healthcare delivery networks in the country, operates two public multi-service ambulatory care centers, one national rehabilitation hospital, and three public academic medical centers through affiliations with the University of Southern California School of Medicine and UCLA School of Medicine. In addition, LAC-DHS operate six public comprehensive health centers (CHCs) and multiple public health centers (HCs) throughout Los Angeles County, many in partnership with private, community-based providers. One of LAC-DHS’ current projects is to implement an Electronic Medical Record (EMR) system for its providers and patients. Such a system includes multiple components and processes. One key component of the EMR is an electronic document management system (EDMS), or, as it is called at LAC-DHS, the Patient-related Electronic Document Imaging and Management (PEDIM) solution, for use in patient clinical, administrative, and financial processes. Beginning in late 2004 and in association with Doculabs, Inc. (Chicago IL), Dak delivered numerous deliverables for LAC-DHS’ PEDIM project, including a Current State Assessment, Requirements Definition, Future State Definition / Conceptual Design, Deployment Strategy, Forms Redesign Services, and Process Mapping with Process Reengineering Recommendations for Patient-related Clinical Documents at all six facilities.
The Johns Hopkins Health System Corporation
Howard County General Hospital (Columbia MD)
Mr. Paul M. Gleichauf
Senior Vice President
Howard County General Hospital (HCGH) is a 200-bed, private, not-for-profit, acute care hospital and autonomous member of Johns Hopkins Medicine. Within the past years, several HCGH “patient-centric” departments, such as Health Information Management (HIM) and Revenue Cycle Management (RCM) realized the critical need to migrate from their primarily analog, paper-based, and manual records / processes to digital, document management-based records / processes. Other “non-patient-centric” departments, such as Administration, Human Resources (HR), Materials Management and Finance, realized the important need to complement their already automated or less-than-automated technology solutions with document management-based solutions. Beginning in late 2006, Dak was retained to provide the following deliverables: 1) Needs Assessment (including Process maps / flowcharts prior to and after EDMS): HIM, Patient Admitting / Registration, Patient Financial Services / RCM, HR; 2) ROI Analysis / Budget Preparation; 3) EDMS Implementation Plan / Solution Analysis; 4) RFP Preparation / Distribution 5 vendors; 5) Assistance Vendor / Product Evaluation and Quotations.
Bay-Arenac Behavioral Health Authority (BABHA)
Bay City MI
Mr. Randall McCracken
Information Systems Director
Information Systems Alliance (ISA)
BABHA is the state of Michigan’s Medicaid contract-holder for behavioral health service consumers in five, affiliated, public, community behavioral health services programs located in six Michigan counties. BABHA provides its affiliates and constituencies a range of managerial, financial and information system services. These services are provided through two BABHA divisions: Access Alliance of Michigan and Information Systems Alliance (ISA; Saginaw MI). In association with the CCI Group, Inc. (Chicago IL), Dak performed a high-level yet targeted Strengths, Weakness, Opportunities, Threats (SWOT) analysis of ISA’s Clipper and Gallery information systems. The scope of this analysis addressed the capabilities and robustness of these systems as they currently exist so that BABHA could assess their competitiveness within the Michigan behavioral health marketplace. To accomplish the project’s Assessment deliverable, Dak conducted onsite interviews with selected staff, gathered information, reports and forms, and performed direct observations of the functions of the current and next releases of the Clipper and Gallery information systems. A report documented the findings based on the interviews / demonstrations / data collection, provided conclusions and strategic recommendations based on the findings, and accomplished the project’s deliverable.
University of Alabama
Birmingham Health System
Ms. Joan Hicks
Chief Information Officer
UAB Health System is a large, public, academic / research-based, tertiary care delivery network. On a daily basis, the UAB Health System receives a huge volume of critical patient information from external sources. However, well-established UAB Health System information management processes and standards were geared toward internally-generated patient information, not externally-generated patient information (EPI). From a clinical perspective, this represented a significant risk in managing patient care and complying with pertinent regulations. Consequently, UAB Health System retained Dak to develop an enterprise strategy and to define a proposed solution for the management of its EPI. A thorough report documented ten findings based on twenty-two onsite interviews and ten strategic recommendations based on the findings. The enterprise strategic plan with solution was successfully presented to UAB Health System’s CIO, physicians, and related department directors.
Southcoast Hospitals Group
New Bedford MA
Mr. Ron LaFleur
Vice President - Hospital Revenue Systems
Ms. Bettyann Carroll
Director - Health Information Services
Since 1996, three, not-for-profit, community hospitals located in southeastern MA and known as Southcoast Hospitals Group (SHG) have been united as part of Southcoast Health System. A decade later, SHG was still using two, disparate information systems for Voice (dictation) and Text (transcription) that were not only not meeting its enterprise-wide clinical needs but were posing significant technical and functional challenges for the organization. In addition, these unstructured, voice and text data-based, clinical document information systems needed to exist in tandem with SHG's structured, discrete data-based Health Care Information System and unstructured, diagnostic image data-based Picture Archiving and Communications System (PACS) so to move SHG toward a full electronic health record (EHR). Consequently, in 2006, SHG retained Dak to assess SHG's existing voice and text information systems / services and to develop a comprehensive 3 - 5 year strategic plan. This involved 1) identifying the requirements and challenges for SHG's Health Information Services, Radiology Imaging Services, Cardiology Services, Pathology Services, and other SHG areas where dictation and transcription systems existed; 2) identifying transcription staffing requirements for all SHG areas (e.g., On-Site [on-campus], Remote [at home], Outside Services [outsourcing agencies]); 3) evaluating dictation and transcription system models (e.g., Premise-based [in-house], Application Service Provider-based [ASP; hosted], Speech Recognition - Self-Correction / Correctionist-based); and, 4) investigating vendor / product solution options. During 2007, Dak's professional services culminated in assisting SHG as Project Manager for the enterprise-wide Voice / Text / Speech (with Correctionists) vendor / product selection process.
Mr. Joe Lanius
Vice President - Finance
Memorial Hospital is a full-service community hospital licensed for over 300 adult and pediatric beds. Over 300 physicians have medical staff privileges at the hospital and use a wide variety of Physician Practice Management systems. During 2005, Memorial Hospital’s (then) President determined that the hospital must provide its medical staff physicians, other clinicians / caregivers, employees, and patients a single common access point to Memorial Hospital’s clinical data and / or services, as well as a secure mechanism to easily exchange the data all the while effectively retaining its physicians, employees, and patients and continuing to deliver the highest quality of care in the Belleville area. After retaining Dak in 2006, Memorial Hospital’s plan for meeting its strategic goals was articulated to deploy and expand Memorial Hospital’s existing use of Internet technologies. This consisted of implementing Web portal technology initially for Memorial Hospital’s physicians, utilizing a Web content management system to manage Memorial Hospital’s internal and external Web sites, implementing a clinical messaging system to efficiently and securely distribute Memorial Hospital information to Memorial Hospital’s community of physician offices, and expanding the use of the Web portal technology for Memorial Hospital’s other caregivers, employees and patients. In addition, Dak assisted Memorial Hospital in the procurement of these Internet technologies by preparing and distributing a Request for Proposal and managing the system selection process.
Mr. Ron Cowan
Vice President - Information Management / Chief Information Officer
In association with Cardinal Consulting, Inc. (Chicago IL), Dak prepared a comprehensive Report of Findings and Strategic Recommendations regarding Lewistown Hospital’s enterprise Picture Archiving and Communications System (PACS) and Computed Radiography (CR) selection project. Lewistown Hospital is a 140-bed, not-for-profit, rural, community-based healthcare delivery organization serving a population of approximately 80,000 people in Pennsylvania’s Mifflin, Juniata and surrounding counties. During 2006, in continuation of its strategic telemedicine initiative, Lewistown Hospital received a generous United States Department of Agriculture grant to procure and install 1) a CR system that would allow Lewistown Hospital to digitize its remaining (approximately 65%) analog (i.e., film-based) diagnostic radiology services modalities (x-ray and mammography) and 2) a Cardiology/Cardiovascular services-based (C/CVS) PACS to begin digitizing Lewistown Hospital’s existing, analog diagnostic cardiology services modalities as well as capturing and storing digital “objects” (e.g., waveforms, motion video / cine) and still-frame images from Lewistown Hospital’s diagnostic cardiology and cardiovascular “object” and image-generating modalities (e.g., ECG/stress test, Holter Monitor, echocardiography, nuclear cardiology equipment, etc.). The report successfully answered all of the following technical and clinical options, which included the fate of its existing radiology-based PACS: 1) a single vendor PACS solution that could serve radiology and cardiology equally well, excluding CR; 2) a single vendor PACS solution that could serve radiology and cardiology equally well, including CR; 3) a best-of-product solution that potentially could consist of a CR system, a radiology PACS, and a cardiology/cardiovascular PACS; and 4) a single archive platform solution that could support not only radiology and cardiology but other Lewistown Hospital digital image/object-generating disciplines, if required in the future.
Mr. Rich Rogers
(formerly) Vice President / CIO
(currently) Vice President / CIO
Greenville Health System, Greenville SC
Ms. Judy Gizinski
President - Palm Bay Hospital
Health First consists of three, not-for-profit, community hospitals located in Brevard County FL. This integrated healthcare delivery network consistently rates in the Top 15 of Verispan's yearly Top 100 Integrated Healthcare Networks. During the 1990s, Health First procured and implemented an Electronic Document Management System (EDMS) to support Health First's Patient Business Services Department, which manages patient financial record documents. In 2005, Health First procured and implemented an EDMS to support Health First's Admissions and Health Information Management Departments, which manage patient administrative and patient medical record documents, respectively. But by the beginning of 2006, Health First realized that one EDMS component technology, Computer Output to Laser Disk (COLD; a.k.a. Enterprise Report Management [ERM] or Enterprise Output Management [EOM]), required an "unanticipated", significant amount of effort in terms of labor hours and personnel. For example, Health First required at least 10 COLD interfaces and 130+ COLD report templates. As such, Health First began to question whether it was doing "the right thing" by developing and maintaining so many COLD interfaces and COLD report templates for its EDMSs, and if the same large number of labor hours and personnel would be required to maintain / sustain its EDMS COLD component technology. It was in this context that during 2006 Dak was retained to assess this technologically esoteric yet important EDMS challenge. Dak's findings based on a plethora of vendor and staff interviews and recommendations based on the findings were enthusiastically adopted to continue system operations yet develop newer IT strategies.
University of California
Office of the President
Ms. Katherine Kim
(formerly) Executive Director
Healthcare Operations and Technology Clinical Services Division
During 2005, the five University of California (UC) Medical Center CEOs and CIOs approved the development of a recommended, UC system-wide, Legal Electronic Health Record (LEHR) strategy. UC's Office of the President (UCOP)'s Clinical Services Division's Executive Director of Healthcare Operations and Technology was designated as the coordinator for this project. The project required meeting with the five UC Medical Center CIOs, Health Information Management Directors, Legal Counsel, and Medical Directors to review any existing, organizational definitions of the LEHR and determining the organizations' information systems that contributed or would contribute to the LEHR. It was in this context that UCOP engaged Dak to provide professional services to support this project. Dak's deliverables included educating the five UC Medical Centers on the national development of the LEHR; researching the best practices within the UC Medical Centers and external hospitals / integrated delivery networks; assisting the Medical Centers in defining a UC system-wide definition of the LEHR; preparing a strategy for implementing the LEHR into the UC Medical Center's existing information systems (e.g., EHR systems / clinical systems, paper systems, etc.); and, preparing a strategic report of Dak's Findings and Recommendations.
Bay Area Community Informatics Project
Coos Bay / North Bend OR
Jeffery Givens, MD
Principal Investigator and Project Director
Mr. Benjamin Pfau
Vice President - Clinical and Support Services
The Bay Area Community Informatics Project (BACIP) is a consortium of rural Oregon coast healthcare provider organizations implementing information technology to transmit patient data. During 2004, the US Department of Health and Human Services’ (DHHS) Agency for Healthcare Research and Quality (AHRQ) awarded BACIP grant money to plan and implement a secure, fiber optic cabling connection between and among BACIP’s stakeholders. This infrastructure portion of the Project allowed BACIP to develop a network for the eventual application portion of the Project, involving the sharing of patient administrative and clinical data between and among BACIP’s stakeholders. Combined, the infrastructure and application portions of the Project allowed BACIP to demonstrate the value of health information technology in an area consisting of approximately 50,000 persons. Dak was engaged to assist BACIP in identifying each patient and the options for addressing this in the BACIP environment, which consists of disparate provider organizations and information systems; sequencing the required events given the stakeholders’ diverse information systems; integrating stakeholder offices when there might be non-standard information systems or no information systems; and, ensuring that decisions made today would be viable in the future.
Albany Medical Center
Mr. George Hickman, FHIMSS, CPHIMS
Senior Vice President / Chief Information Officer
Mr. Kristopher Kusche, M. Eng., CISSP
Assistant Vice President Clinical Systems / IT Security
Albany Medical Center (AMC) is the only academic health sciences center in the twenty-five counties of eastern New York and western New England. AMC consists of the 631-bed Albany Medical Center Hospital, the Albany Medical College, the Albany Medical Center Faculty Group Practice staffed by approximately 225 full-time clinical faculty members of the College, and the Albany Medical Center Foundation, Inc. During 2005, AMC began and concluded its formal due diligence process to choose a radiology-based, enterprise-wide Picture Archiving & Communications System (PACS) vendor and product. Because of the 2005 Philips Electronics’ (Netherlands) Medical Systems acquisition of AMC’s PACS vendor-of-choice, Stentor, Inc. (Brisbane CA), AMC retained Dak to obtain strategic, technical / user assistance with regards to its (now) Philips PACS. After reviewing several AMC documents, Dak provided AMC with a report of Findings and Strategic Recommendations that was used for AMC's PACS contracting and negotiations.
The University of Utah
Health Sciences Center
Salt Lake City UT
Pierre Pincetl, MD
(formerly) Chief Information Officer
The University of Utah Health Sciences Center Hospitals & Clinics (UUH&C) is a large, public, academic/research-based, integrated healthcare delivery organization. UUH&C consists of three hospitals, approximately thirty-six UUH&C Medical School faculty-affiliated ambulatory care clinics, seven community-based ambulatory care clinics, many regional health centers and outreach healthcare programs, and approximately 900 Medical School faculty members. UUH&C is implementing a comprehensive, transaction processing-based, electronic medical record (EMR) system. Dak was engaged to assess UUH&C’s primary Health Information Department’s current operations, systems, and related processes and develop strategic recommendations that would articulate UUH&C’s objectives for transitioning the department to electronic systems and processes. Dak prepared a complex Report of Findings and Strategic Recommendations that additionally involved the following, high-level, EMR-related business plans:
- Transitioning to Enterprise-wide Revenue Cycle Management
- Transitioning to the EMR-based Legal Medical Record
- Transitioning to the EMR with Existing Clinical Systems, which included Enterprise-wide Document Management, Dictation / Transcription, Speech Recognition, and Electronic Signatures
WNC Health Network
Mr. Gary Bowers, JD
(formerly) Executive Director - WNC Health Network
(currently) Chief Operating Officer - CarePartners Health Services
The WNC Health Network (the Network) is a collaboration of fifteen independent hospitals, several county health departments and a plethora of associated healthcare providers in western North Carolina. During 2002, the Network established the WNC Regional Healthcare Data Link Project. The purpose of the Project was for the Network’s acute and post-acute care organizations to collaboratively implement and maintain an electronic information system and technical network that would allow for the secure transmission of patient medical data between and among the organizations. Dak was retained to assist with the Project’s strategic planning efforts and, upon Project completion, to conduct a Project evaluation. Dak successfully interviewed and surveyed approximately sixty-five stakeholders, assessed the feasibility of electronically transferring patient medical information between the Project’s organizations, identified the specific technology options to accomplish this, and provided strategic recommendations to achieve the Project’s short and long-term goals. In addition, Dak assisted the Network in the successful preparation of a Request for Information and Request for Proposal that were distributed to several vendors that provided the recommended solutions.
Taconic IPA, Inc.
John Blair, MD
President and CEO
Taconic IPA is a not-for-profit Independent Physician Association with approximately 2,500 physicians who serve approximately 2,000,000 covered lives in six Hudson Valley NY counties. Taconic IPA is the exclusive physician network for the region’s payor, MVP Health Care (Schenectady NY). Dak was retained to assist Taconic IPA in assessing the feasibility of implementing web portal technology for its physicians. Dak identified the advantages / disadvantages, implementation costs and timeframes, and infrastructure and resource requirements of several portal technology vendor and product options to accomplish this. In addition, Dak provided strategic recommendations for deploying and adopting the technology. Dak’s report of findings was successfully presented to Taconic IPA’s Board of Director to facilitate consensus regarding the Taconic IPA’s future technology plans.
WestCare Health System
Mr. Shawn Remacle
Director - Information Services
WestCare Health System is a not-for-profit, integrated healthcare delivery organization providing a wide range of Healthcare services to over 80,000 people living in Western North Carolina. Over the last two decades, WestCare invested in and received benefits from a variety of electronic information systems. However, the organization was struggling with silos of independent systems that did not “talk” with one another and no longer supported WestCare’s fast-growing and expanding delivery network. Dak conducted twenty-four user, executive, and clinician interviews representing eight, system-wide service areas and gathered data on the functions performed and information systems used within several, enterprise-wide patient administrative, clinical, and financial departments. A report of findings was based on the customer interviews and included strategic recommendations for new systems.
Park Nicollet Health Services
St. Louis Park MN
Mr. Francis Cheung
(formerly) Chief Information Officer
Park Nicollet Health Services (PNHS) is an integrated healthcare delivery network consisting of the 426-bed Methodist Hospital, a general, acute care organization with more than 1,100 physicians on staff, and the 45 medical specialties and subspecialties of the Park Nicollet Clinic, an ambulatory care organization with 25 clinics located throughout Minneapolis/St. Paul. Dak was retained to assist PNHS with the development of two business cases for two, unstructured data systems projects a Picture Archiving and Communications System (PACS) for Radiology, consisting of diagnostic image data, and a Document Management System (DMS) for Health Information Management, consisting of document image data. Dak estimated the required technology, networking, staffing, facility, and other, complex, related, system costs for PNHS' Fiscal Year 2003 budgetary requirements. These estimates resulted in several million dollars of projected costs and anticipated benefits over the next five years.
Wishard Health Services
Ms. Colette Lasack
Vice President - Revenue Cycle
Dak conducted a discovery and planning session to determine the scope and timeframes for a project managing and installing Siemens' Image Management System for Wishard's Patient Financial Services and Registration/Admitting departments. The deliverables included several project plans for Wishard that estimated milestones, dates and staffing requirements. These plans were used as the basis of this system's implementation at this county-supported and Indiana University School of Medicine's acute and primary care organization.
Allina Health System
Ms. Mary Onstad
(formerly) Director - Print and Document Management
Dak was retained to provide professional IT strategy services for this large, not-for-profit, multi-institutional, integrated healthcare delivery network. Prior to 2001, several, diverse Allina business units individually acquired Document Management Systems (DMSs) to efficiently manage their paper and computer-generated documents. Other diverse Allina business units were seeking IT direction on DMS vendors, technologies, enhancements, systems integration and project plans. However, Allina's Information Systems Division had no explicit standards or guidelines for electronic document management and its various component technologies. Dak was engaged to assist members of Allina's Print and Document Management Department in interviewing fifteen, diverse business units with major DMS financial and compliance ramifications. A Report of Findings and Strategic Recommendations was prepared and delivered to Allina's Information Systems Steering Committee.
Children's Memorial Hospital
Mr. Michael Kerr
Administrator - Support Services
In association with Cardinal Consulting, Inc. (Chicago IL), Dak provided strategic output management services for Children's Memorial Hospital, Northwestern University Medical School's pediatric teaching facility. The healthcare provider organization needed to reduce printing, copying and fax costs over time, and it required a vision and plan for moving to a largely paperless environment. The catalyst for the consulting engagement was the 2001 expiration of a major contract for printers, photocopy equipment, and reproduction and mail room services. The project's analysis and recommendations were used in the subsequent development of Children's Request for Proposal and vendor / product selection for document services.
Medical Associates of
San Mateo County
San Mateo CA
Dirk Baumann, MD
The Medical Associates of San Mateo County (MASMC) was a not-for-profit, provider-of-care, membership organization. In 2000 and prior years MASMC contracted with California's San Mateo County to provide professional healthcare services for patients at the San Mateo County General Hospital and/or the clinics operated by the San Mateo County healthcare delivery system/network. Dak was retained to collect statistical data from the county's information systems to validate provider utilization and billed charges. Dak defined the requirements for a recommended MASMC compensation plan based on the relative values for services provided by MASMC's many members.
Doctors Medical Center
Tenet Health System
Ms. Debbie Fuller
Director - Health Information Systems and Services
Dak was retained to provide educational services for this flagship, Tenet Health System organization. The services included planning for the various types of data to be integrated in Doctors' computerized patient records. The data types included radiologic image and angiographic cine data with Doctors' existing, structured data from its healthcare information systems, unstructured, text data from its transcription systems, and document image data from its document management system. Dak's services prepared Doctors for its Picture Archiving and Communications System (PACS) to include video data from Doctors' catheterization laboratories, digital camera data from pathology, and computed radiography and output data from radiology's digital modalities.
UT Southwestern Medical Center at Dallas
Mr. Kirk Kirksey
Associate Vice President - Information Resources
Ms. Andrea Marshall
Director - Clinical Information Systems
The University of Texas Southwestern Medical Center at Dallas is a public, not-for-profit, multi-institutional, integrated healthcare delivery network. In 1998, its Ambulatory Services institution began planning for the potential acquisition and implementation of a Clinical Documentation System (CDS) and Document Management System (DMS) for its clinics and a DMS for its administrative offices. Dak was retained to assist UT Southwestern with the development of a CDS and DMS Business and Workflow Analysis. Dak provided UT Southwestern with a complex Requirements Definition (including data collection and flowcharts), Return on Investment Analysis, and architectural systems designs for strategic planning and information system decision-making purposes.
Stratum Med, Inc.
Mr. Gerald Tresslar
President and Chief Executive Officer
Ms. Martha Baddour
Executive Director of Medical Enterprises
Stratum Med is a physician-owned and governed practice management company, at the time serving approximately 1300 physicians in 15 medical groups located throughout Illinois, Indiana, Iowa and Michigan. Stratum Med retained Dak to assist the organization with the development of a Document Management System (DMS) Requirements Definition, a Return on Investment Analysis, and DMS Operating Alternatives. The deliverables were presented to the company's Board of Directors.
Kaweah Delta Health Care District
Mr. Lindsay Mann, FACHE
Chief Executive Officer
Mr. Dave Gravender
(formerly) Chief Information Officer
(currently) Chief Information Officer
Alameda Health System, Oakland CA
Kaweah Delta Health Care District (KDHCD) is a not-for-profit, community-owned, integrated healthcare delivery network (IDN) consisting of two acute care facilities, a rehabilitation facility, a transition care unit, a senior care unit, an urgent care unit, and a variety of related services. Dak assisted Kaweah Delta in their search for an information technology (IT) partner - one company that could provide the IDN with a suite of IT products, systems, and services best serving the interests of its diverse customers. Specifically, KDHCD was no longer looking to employ an IT strategy based on the "Best of Systems Solution" (aka "Best of Breed Solution") or the "In-House Developed Systems Solution" (aka "Home-Grown Systems Solution"). Nor was KDHCD looking to employ an IT strategy based on the "Single System Solution". Dak successfully coordinated the KDHCD process of evaluating several potential "partners" who could provide all the required products and services and consulted in the selection of KDHCD's "primary" partner.
Mr. Bertram Reese
Vice President & Chief Information Officer
Sentara is a regional, not-for-profit, integrated healthcare delivery network. It is the dominant healthcare force in southeastern Virginia's Hampton Road region. It operates six acute care facilities, several skilled nursing, assisted living, ambulatory Healthcare, and diagnostic and IV therapy centers, for-profit entities including home health and hospice services, two health maintenance organizations and other, related services offering a lifetime continuum of care. Dak was jointly hired by Sentara and one of its acute care facilities, Williamsburg Community Hospital (Williamsburg VA), to help determine what off-the-shelf Physician Information Network (PIN) products (aka Internet-based transaction processing systems), similar to Sentara's in-house developed SPIN Classic/SpinWeb products, existed in the Healthcare IT marketplace. This decision was used to help Williamsburg determine if it should invest in the SPIN Classic/SpinWeb products and to help Sentara determine if it should continue to invest more time and money into the long term development and maintenance of the products. Dak reviewed existing PIN products, compared the products to Sentara's, assessed existing network infrastructures and physician and document management information requirements, and presented findings/recommendations to Sentara's senior leaders. All of Dak's recommendations were adopted.
Mr. Wayne Mugrauer
(formerly) Chief Executive Officer
Dak was retained to assist this not-for-profit, freestanding, mental healthcare delivery network, founded by the Quakers in 1813, with a high-level assessment of Friends' existing, enterprise-wide information management standards and needs. Approximately sixty individuals representing all of the enterprise's functional areas were surveyed. The findings and recommendations contained in Dak's Information Management Needs Assessment were used as the foundation for Friends' strategic Information Management Plan.
Mount Carmel Health System
Mr. George Chessum
Senior Vice President and Chief Information Officer - MCHS
Vice President, Information Systems and Chief Information Officer - Resurrection Health Care, Elk Grove Village IL
Ms. Cindy Sheets
Vice President, Strategic Development - MCHS
Chief Information Officer - MCHS
At the time of the project, Mount Carmel Health System (MCHS) operated three acute care facilities, a plethora of outpatient service organizations, two home care organizations, a hospice, a skilled nursing care unit and facility, a broad network of community-based primary and wellness care programs, and a Health Maintenance Organization (HMO) for some of its Medicare patients. Dak conducted an assessment of MCHS' enterprise-wide patient medical, financial, and administrative record, document and information management practices. A high-level, prospective, quantitative cost/benefit analysis was prepared to project the economic outcome of an investment by MCHS in document technologies.
Hennepin County Medical Center
Ms. Mary Koepke, RHIA
Director - Electronic Health Record Revenue Cycle
Dak conducted a thorough Needs Assessment, including a Report of Findings and Recommendations, for this large, publicly-owned, teaching healthcare delivery system, located in the heavily managed care upper midwest. Dak examined Hennepin County Medical Center's (HCMC) existing patient medical record document processing and management practices to determine if and how to best apply a Document Management System (DMS). Dak demonstrated how the DMS would co-exist with and complement HCMC's existing and evolving Automated Medical Record system project. The areas within HCMC that were studied included several on-site and remote ambulatory care clinics, the Emergency Department, the Health Information Management Department, the Hennepin Faculty Associates, Information Services Department, and various Inpatient Services.
Christiana Care Health System
(formerly) Medical Center of Delaware
Mr. G. Ward Keever
Senior Vice President and Chief Information Officer - MCD
CTG Healthcare Solutions, Inc.
At the time of the project, Medical Center of Delaware (MCD) was a large, privately owned, tax-exempt community healthcare corporation operating three acute care facilities, a long-term care facility, and a network of primary care practices. Dak was retained to gain insight and provide suggestions for proceeding with MCD's Electronic Medical Record "topic", one of eleven topics contained in MCD's (then) five year Strategic Information Services Plan. Additionally, Dak was asked to assist MCD with the development of an Information Management strategy that would address the future implementation of the enterprise's Computer-based Patient Record system and related information systems. A formal presentation of Dak's findings and recommendations was delivered to MCD's senior executives, and a report documenting Dak's findings was used for planning purposes.
Lehigh Valley Hospital and Health Network
(formerly) Lehigh Valley Hospital
Mr. Harry Lukens
Senior Vice President and Chief Information Officer
Dak analyzed this major integrated delivery network and, at the time, member of the PennCare group of healthcare organizations to determine how to best implement a Patient Data Repository and Warehouse for Computer-based Patient Records. The project included determining how Lehigh Valley's (then) existing prime Healthcare Information System hardware platform, Tandem, could be maximized and tweaked to provide Lehigh Valley with a Decision Support System and a data repository housing discrete, structured data elements. Additionally, Dak incorporated in the design a Document Management System (DMS) that would "image-enable" the repository. A DMS was ultimately selected and implemented. The plan for the Decision Support System and repository continued to be developed.
(formerly) Memorial Mission Medical Center
Mr. Arlo Jennings, PhD (retired)
(formerly) Vice President
Dak prepared a Strategic Information Management Plan for the Memorial Mission Medical Center's eventual Computerized Patient Record (CPR) system. The project included analyzing the requirements for and needs of over thirty functional areas at the integrated delivery network (IDN). Also, it involved analyzing the data from the functional areas and preparing CPR recommendations. A formal presentation of Dak's findings and recommendations as well as a detailed report were delivered to the IDN's senior executives. The deliverables served as communication vehicles to all the appropriate staff to gain organizational support for a future project.
University of Pittsburgh Medical Center
Ms. Julie Truver
(formerly) Administrative Director - UPMC
(formerly) Vice President - Product Management
At the time of the project, this large, university-based teaching facility consisted of four acute care facilities and three large ambulatory care clinics. Also, the University of Pittsburgh Medical Center (UPMC) had an in-house developed, Unix-based, medical-surgical data repository consisting of over four million online records. The repository was UPMC's foundation platform for its Computer-based Patient Record system. The goal of the project was to integrate other data types (e.g., diagnostic images and document images) and patient types (e.g., mental health patients and corresponding data) into the UPMC repository and to establish a workflow design that would benefit UPMC's Health Record Services and Patient Financial Services Divisions. A Needs Assessment and system design specification were completed, a Request for Proposal was issued, and a contract with a vendor was executed with the assistance of Dak Systems Consulting.
Albert Einstein Healthcare Network
Mr. Hal Augustine
(formerly) Vice President and Chief Information Officer - AEHN
(currently) Vice President and Chief Information Officer
Dak guided this integrated delivery network through the process required to complete a successful evaluation of a Document Management System (DMS) and vendor for the Network's acute care facility's medical record documents. The process began with a detailed Needs Assessment, followed by a physician survey. Also, the process included establishing several internal committees for the planning of the DMS and preparing and issuing a Request for Proposal. The process ended with the detailed evaluation of systems and vendors, including on-site demonstrations, meetings, reviews of the proposals, telephone reference checks, site visits and other criteria. A contract was executed, and, currently, the system remains "up and running".
St. Vincent Hospitals and Health Services
Mr. Cliff Jaebker
(formerly) Vice President - Finance
Dak helped this large, multi-hospital, multi-clinic organization and member of the (then) national Daughters of Charity Health Care System in the planning and acquisition phases for a Document Management System for the organization's medical and financial record documents. The system planning and acquisition processes and the vendor selected with Dak's assistance were ultimately recommended to the regional and national (formerly) Daughters of Charity / (currently) Ascension Health corporations.
The Penrose-St. Francis Healthcare System
Colorado Springs CO
Mr. John Tanner
(formerly) Director - Information Systems Group
At the time of the project, this large, progressive healthcare network consisted of three acute care facilities and related healthcare facilities. The network was developing a Management Services Organization (MSO) model by which network participants would form a separate entity providing administrative services to physician practices. The integrated delivery network (IDN) was running the (then) Alltel/TDS 7000 and the (then) HBOC MediPac Healthcare Information Systems on an IBM mainframe. Dak provided consultative/advisory services to the IDN regarding the Alltel/TDS "clinical" data repository, the (then) Integrated Management Systems' MEDACOM product, and other data types and systems, such as document management for the IDN's Medical Record Services Department.
University of Washington/
Harborview Medical Centers
Mr. Walt Tossey (retired)
(formerly) Project Manager - Medical Centers Information Systems
Dak assisted these university-based, state-owned, teaching hospitals of Washington in preparing a complex Request for Proposal (RFP) for a Document Management System for the hospitals' medical record documents. A well known, for-profit company that subsequently purchased and resold the "public" RFP through the Freedom of Information Act labeled Dak's and the UW/H Medical Centers' work "The Ultimate RFP".
Tenet Healthcare Corporation
(formerly) National Medical Enterprises
Santa Barbara CA
Ms. Cheryl Servais (retired)
(formerly) Corporate Manager - Tenet Healthcare Corporation
(formerly) Vice President - Compliance and Privacy Officer
Dak performed a multi-hospital corporation analysis for the installation of a Document Management System (DMS) for the corporation's record documents. At the time of the project, Tenet's "Information Access and Delivery" systems, such as a DMS, coupled with Tenet's existing healthcare computer systems and repositories were viewed as one approach and/or step among many in achieving a corporate-wide Computer-based Patient Record system. Consequently, Dak analyzed several corporate departments and two of Tenet's (then) thirty-five acute care facilities for this project. The design configured and the vendor chosen with Dak's assistance continue to be used for all DMS installations in the corporation.
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