CIO Connect Brief - December 2023

CIO Connect December 2023 | I ssue #03

brief

Featured in this edition

A special message from CIO Deanna Wise

Nursing integration updates

Making health care easier

December 2023 – CIO Connect Brief

From the Desk of Deanna Wise SVP/Chief Information Officer Reaching new heights

Each quarter, we deliver the CIO Connect Brief to facility leadership and their assistants to keep you informed on technical and operational updates critical to your entities. The feedback we receive from the IT Insight Survey allows us to make adjustments to our promise of service delivery and customer engagement. Our survey scores have improved over the past four years thanks to your comments and transparent evaluation in five key areas. In 2023, our IT teams helped achieve maximum performance on our three-year, long-term initiative that improved our overall patient experience, specifically in improving the following key areas: Consumer Access, Integrated Patient Portal and Physician Mobile Experience. We successfully delivered on our 2023 financial results systemwide. With your collaboration and financial focus, we exceeded expectations and will finish the year $25 million under budget. We continue to build our IT leadership, operations, service and culture dedicated to serving Sofia, customers and our IT team members. We’re also proud to announce that we earned Computerworld’s Best Places to Work in

IT for a fourth consecutive year. Thank you for your partnership, Deanna

“You don’t take a photograph, you make it.” - Ansel Adams American photographer, 1902-1984

1 CIO Connect Brief

CIO Connect Brief 2

December 2023 – CIO Connect Brief Activation and implementation PharmNet and Barcode Medication Administration (BCMA) go live across Banner Ambulatory

Throughout 2023, PharmNet has been successfully implemented at the following locations: • Feb. 16: BHC Mercy Pediatrics • March 9: BHC Gilbert Health Center • March 23: BHC Gateway General Surgery & Bariatric, Orthopedics & Sports Medicine, Podiatry as well as BHC Higley Pediatrics

Banner IT is implementing both PharmNet and Barcode Medication Administration (BCMA) across Ambulatory. This project’s first activation began with Chandler Cardiology in August 2022. These project efforts will go through the 2024 calendar year as this project team implements PharmNet and BCMA across all Ambulatory and Urgent Care clinics within the Banner network. Activating PharmNet lays the groundwork for the implementation of BCMA. PharmNet utilizes Auto-Product Assignment (APA) and Auto-Verification (AV) in the background logic of the Cerner Millennium database to match a fitting product (technical representation of a physical medication) to an orderable medication on the patient’s profile. Once PharmNet is in place, BCMA will be implemented, which allows for the scanning of the matched product to the orderable on the patient profile. The benefits of implementing PharmNet and BCMA: • In the acute setting, we’ve been utilizing scanning technology to ensure patient safety for decades to reduce medication errors and meet the rights of medication administration. We’re now making strides to bring those safety practices into the ambulatory setting to service and give the same quality treatment in all aspects and settings in which Sofia receives care • Improved accuracy for reporting and billing as the National Drug Code (NDC) scanned will now be captured instead of the current state where the primary NDC is submitted for billing • Aids in inventory and formulary management of the products purchased and stocked at the clinics • Future state after CIRRC (Cerner Integrated Registration and Revenue Cycle is implemented). When a product is scanned, several of the required documentation fields will be filled based on the information attached to the barcode (reducing documentation burden) Impact to clinician’s workflow: • Scanning of inventory coming into the clinic upon arrival to ensure the product is built and available to the facility to scan • Administering clinician will need to take a scanner and laptop with them (if there’s no computer in the administration room) to document and complete the scanning process

• July 25: East Mesa, Queen Creek, Chandler and Maricopa • Oct. 24: A total of 56 clinics across the West Valley Region BCMA implementations: • Aug. 15, 2022: Chandler Cardiology Clinic • Aug. 8, 2023: Higley Pediatrics • Oct. 31, 2023: Goodyear Estrella Pediatrics and Family Medicine clinics

.Feedback from ambulatory clinicians who have already adopted this workflow has been great in stating this has sped up their administration process, adds additional safeguards and has been easy to adjust to. For example, Higley Pediatrics, who went live in March 2023, has done a remarkable job of scanning patients and medications so far. In the second week of adoption, scanning patient identifiers are at rate of over 98% and medications over 99%. Clinicians at the site have been reporting the ease of workflow and that BCMA is increasing their efficiency. We expect to keep hearing more positive feedback as rollouts continue as ambulatory clinics have been asking for scanning for some time, and those requests are now becoming a reality.

3 CIO Connect Brief

CIO Connect Brief 4

December 2023 – CIO Connect Brief Enhanced provider on-call scheduling Banner is undertaking a significant project to enhance its Provider on-call scheduling capabilities by utilizing QGenda systemwide. The goals of this project include standardizing processes, improving efficiency and integrating On-Call scheduling with the Provider Mobile application. Central Logic is currently utilized for On-Call scheduling while QGenda is the current vendor for Advanced Scheduling at most facilities. The upcoming project aims to implement On-Call scheduling functionality systemwide and take the place of Central Logic. The exception being Transfer Services, who will continue to use Central Logic. Anticipated benefits: • Standardized processes and improved efficiency for those accessing on-call schedules • Simplified scheduling for those responsible for building schedules, moving from multiple systems to one • Enhanced accessibility for clinical staff through integration with the Provider Mobile application • Standardized processes for building schedules, reducing the use of multiple systems to one Project goals: • Implement On-Call scheduling functionality systemwide (except for Transfer Services) • Integration of On-Call scheduling with the Provider Mobile application is imperative and a long-term goal of the project effort. This integration aims to make it easier for clinical staff to access on-call schedules and connect with providers without navigating to . a website We look forward to initiating this project effort in Q1 of 2024 and thank those who will be a part of the project effort. Coming soon: QGenda will be utilized systemwide

BabySteps and Cerner application integration Pediatrix Medical Group (PMG) provides multidisciplinary services systemwide. PMG and other Banner provider groups utilize the BabySteps Cloud application, which is a clinical documentation tool designed exclusively for neonatal intensive care unit (NICU) patients to capture specific granular data at point of care. On Dec. 18, 2023, Banner will implement a new interface feature to streamline the provider workflow of transferring their notes from BabySteps to Cerner Powerchart with an automatic export of the completed note once approved for billing. The provider will then finalize the note with a signature in Powerchart. This new systemwide demographics interface will also capture patient admissions into BabySteps, as well as professional billing fees. This implementation will occur at the 10 facilities utilizing the BabySteps Cloud application: Banner Ocotillo Medical Center, Banner Desert Medical Center, Banner Gateway Medical Center, Banner Ironwood Medical Center, Banner Casa Grande Medical Center & Hospital, Banner - University Medical Center Phoenix, Banner - University Medical Center Tucson, Banner North Colorado Medical Center, Banner Fort Collins Medical Center and Community Hospital Torrington. Brings streamlined workflow for providers

5 CIO Connect Brief

CIO Connect Brief 6

December 2023 – CIO Connect Brief

Banner IT is enhancing the patient meal ordering process by improving ease of access to the CBORD patient app and also creating a quick mechanism for our patient care team members to assist Sofia with ordering via a link in Cerner. Eligible Sofias now get a daily text message with a link to place their meal orders online and this streamlines the authentication process. We also added a “Meals” link within Cerner that can be used by our care team members for patients that are unable to order for themselves. CBORD patient app updates Improving the patient meal ordering process This project is improving adoption of our digital meal ordering, decreasing the call volume to the call center and making it easier for clinicians to assist their patients. These enhancements are currently available at Banner Del E. Webb Medical Center, Banner Thunderbird Medical Center, BEM, Banner Gateway Medical Center, Banner Ironwood Medical Center, Banner Ocotillo Medical Center and Banner Desert Medical Center.

On Jan. 9, 2024, additional facilities will go live: B - University Medical Center Tucson, Banner Wyoming Medical Center, Banner North Colorado Medical Center, Banner McKee Medical Center and Banner Fort Collins Medical Center. Discussions are currently underway related to all other facilities not currently using the CBORD Patient app. The adoption of digital meal ordering varies daily and by facility, but on average, these new

enhancements have increased the utilization by 10-15%, which brings most sites to about 25% total. BGMC already had very high utilization and is currently at about 35% total utilization. All sites can see utilization rates via a dashboard: Digital Meal Ordering Dashboard - Power BI.

7 CIO Connect Brief

CIO Connect Brief 8

December 2023 – CIO Connect Brief EKG workflow improvements

Artificial Intelligence tool to review clinical data ”Regard,” formally known as Health Tensor, was piloted at Banner Thunderbird Medical Center and has been well received by hospitalist providers. Due to the wide acceptance and favoring of this vendor and the Artificial Intelligence (AI) functionality, Regard will be implemented in 2024 systemwide for all hospitalists. Regard is an AI tool that reviews clinical patient data to recommend diagnoses (not already in the chart) and then generates relevant language and data to enhance a hospitalist progress note. The AI tool also generates relevant evidence bullets for any covered diagnosis, alerts providers to recently updated evidence since a previous note and suggests diagnosis title modifiers in compliance with CDI (Clinical Documentation Improvement) guidelines. Associated benefits and workflow impacts include: • Potential reduction of documentation time for hospitalists utilizing this functionality and the AI logic recommendations in the note • Consistency across various locations by using the same note type and adoption of best practices • Potential increase in billing accuracy due to increased specificity of a diagnosis generated by Regard’s AI The AI offered through Regard offers the following features: • Suggests diagnoses (from prior notes and ability to identify a new diagnosis) “Regard” to be implemented systemwide in 2024

at EKG Ambulatory clinics

Banner IT recently kicked off an effort to improve the EKG workflow within our ambulatory clinics. We’ll be implementing the Philips iECG application and refreshing EKG machines for clinics that don’t already have compatible devices for this system. Currently, in the ambulatory clinics, all EKGs must be printed and scanned into Cerner and the provider must then go into Cerner to do the “reading” in the system. iECG will allow EKGs to automatically integrate into Cerner and the provider can read from within the iECG system. Implementation benefits include: • Allows EKG results to be integrated into Cerner • Optimizes physician EKG reading workflow • Ensures appropriate charge capture iECG will be implemented at all clinics that currently have an EKG machine, which includes approximately 160 devices, and is estimated to be completed by October 2024.

• Adds specificity • Stacks diagnoses • Supportive evidence (both previously identified evidence and newly identified evidence by logic) • Diagnosis details (sees more information about a condition)

• Resource and support center, including ability to provide direct feedback to Regard team from the documentation window

9 CIO Connect Brief

CIO Connect Brief 10

December 2023 – CIO Connect Brief

Vishing and Smishing

Nursing Integration Project

Email is the more popular tool among phishers, however there are other ways a cyber criminal may try to lure you to gain access to personal or confidential information.

The Nursing Integration Project (NIP) is focused on reducing and improving nursing workload by eliminating manual data entry with Medical Device Integration allowing data and information to flow freely from medical devices to our electronic health record. Phase 1 of this project includes integrations at Banner Estrella Medical Center (BEMC), Banner Gateway Medical Center (BGMC) and Banner Thunderbird Medical Center (BTMC). With a focus on quality, integrating these products will allow redirecting nursing hours from data input to quality indicators, including reducing the length of stay (LOS).

Vishing

Short for voice-phishing, the cyber criminal calls you directly in an attempt to steal sensitive information or funds. The cyber criminal can either contact you from an unknown number or set up a Voice over Internet Protocol (VoIP) server to mimic a known entity or individual, like Chief Executive Officer Peter Fine or President and Chief Operating Officer Amy Perry.

Breast Milk Bridge went live at BEMC on Oct. 3 , which now rounds all three sites with this new functionality. This integration allows nurses to verify breastmilk by scanning bottle labels to ensure the correct milk is going to the correct patient safely with positive patient identification (PPID). Upcoming integrations and timelines: Ventilator Integration Decreased documentation burden and transcription errors allowing consistent documentation between nursing and respiratory teams

On Dec. 5, Telemetry ADT and PDF Integration went live at BEMC. This allows cardiac monitoring strips printed from the Philips cardiac monitors to flow directly into Cerner, decreasing the burden of clinical documentation on nursing and monitoring technician team members, resource burden on HIMS staff with scanning and printing supply costs.

Ventilator Integration went live at BGMC on Dec. 12 allowing ventilator settings and corresponding patient data to flow directly into the patient record within Cerner. This helps to decrease documentation burden on nursing and respiratory team members along with decreasing transcription errors. Bridge Blood Transfusion Patient safety through scanning of blood products and patient armbands BEMC - Q2 2024 BGMC - Q2 2024 BTMC - Feb. 13, 2024 CareAware Faster alerting to all clinical team members for ordering execution, treatments and results, received through a handheld device

Smishing

Smishing (SMS-phishing) is when a cyber criminal attempts to contact you via text message. The same rules for phishing emails apply to smishing attempts. If it seems too good to be true, it probably is and never click on suspicious links. With smishing attempts, the cyber criminal will pretend to be a known individual or entity and usually ask you to click on a link or provide sensitive information.

6 tips to stay safe from these attacks 1. Avoid answering calls from unknown numbers. If it’s legitimate or important, the individual will leave a voice message. 2. If you do happen to answer the call, don’t provide any personal information over the phone. 3. When in doubt, hang up the phone and call the entity back on a published known number.

Telemetry PDF Integration Decreased manual printing, scanning time delays and transcription errors

4. If you receive a suspicious text message, contact the individual or entity directly on a known number to validate the information being requested. 5. Block the unknown number on your phone to avoid future contact. 6. Keep your phone updated with the latest software updates to help with the security of your device.

Smart Bed Integration Decreased documentation burden and reduction of transcription errors BEMC - Jan. 16, 2024 BTMC - Feb. 6, 2024

BGMC - Jan. 16, 2024 BTMC - Feb. 6, 2024

Nurse Call Single system throughout facilities as a requirement for Smart Bed Integration and CareAware BEMC - Upgrade Feb. 6, 2024 BGMC - Q2 2024 BTMC - Q4 2024

For more information, please contact ISPTA@bannerhealth.com

BEMC - Q2 2024 BGMC - Q3 2024 BTMC - Q4 2024

BTMC - March 5, 2024

Updated Oct. 25, 2023

11 CIO Connect Brief

CIO Connect Brief 12

December 2023 – CIO Connect Brief Real Time Location Services pilot at Banner Wyoming Medical Center (WYMC)

adhere to hand hygiene protocols, RTLS can significantly reduce the spread of infections within the facility. This not only improves patient safety, but also enhances the hospital’s compliance with health standards, potentially leading to better scores in health care quality assessments like Leapfrog IT benefits of RTLS: Asset management: RTLS provides precise information on the location and utilization of medical equipment, helping in efficient asset management and reducing the incidences of lost or misplaced items Data analytics: The data collected through RTLS can be analyzed to identify patterns, predict needs and make informed decisions about resource allocation and facility management Network efficiency: Integrating RTLS with existing IT infrastructure, like Cisco spaces and Cox ProSight, can enhance network efficiency and provide a seamless experience for both health care providers and patients Implementation and future prospects: The pilot at Banner WYMC will serve as a testbed for assessing the effectiveness of RTLS in a real-world health care environment. The success of the pilot could pave the way for a broader implementation across Banner’s network, leading to more efficient health care delivery and improved patient experiences

Banner’s decision to pilot Real Time Location Services (RTLS) at Banner WYMC, leveraging Cisco spaces and Cox ProSight, represents a significant step toward enhancing operational efficiency and patient care. RTLS technology is designed to provide real-time tracking of equipment, staff and patients within the health care facility. Clinical benefits of RTLS: Improved patient care: RTLS enables health care providers to quickly locate necessary equipment and staff, reducing response times in critical situations. This can lead to improved patient outcomes and increased patient satisfaction Enhanced workflow management: By tracking the movement of staff and patients, RTLS helps in optimizing workflows, reducing wait times and ensuring that patients receive timely care Safety and security: RTLS can be used to monitor the location of patients, especially those with cognitive impairments, reducing the risk of patient elopement or loss within the facility Hand sanitation tracking: An essential clinical benefit of RTLS in a health care environment is its ability to track hand sanitation compliance. By monitoring and ensuring that health care providers

13 CIO Connect Brief

CIO Connect Brief 14

December 2023 – CIO Connect Brief

Social Determinants of Health (SDOH) - Unite Us Supporting Sofia with electronic referrals

A new electronic process to facilitate referrals for Social Determinants of Health (SDOH) went live on Tuesday, Nov. 14. This process leverages the Unite Us platform and will support electronic referrals for Sofia for a wide range of services including housing, food insecurity, transportation and other needs that affect whole-person care. The solution is initially being rolled out in Arizona and is primarily funded through Arizona Health Care Cost Containment System (AHCCCS), which is Arizona’s Medicaid program, as a statewide solution to address SDOH barriers. AHCCCS, in collaboration with Contexture (Arizona’s statewide Health Information Exchange), have branded this program “ CommunityCares”. Contexture, in collaboration with 2-1-1 Arizona and Solari Crisis & Human Services, is taking the lead to onboard Community Based Organizations (CBOs) to the Unite Us solution to provide a wide range of service options for Sofia. The Unite Us solution is embedded directly within Cerner to keep our users in workflow and to make access as easy as possible. We also imple mented single sign-on to the platform via web browser for some users that don’t operate directly within Cerner. Approximately 11,000 providers and staff have been provisioned with access to Unite Us for the initial go live. Dashboards and reporting have been built and will continue to be enhanced by the Data & Analytics team to support the operational needs of the program as well as to provide insights into Sofia’s journey within the CommunityCares network. In addition to the platform providing these necessary services for Sofia, the implementation and usage of the Unite Us platform ensures Banner’s compliance with key requirements across various program initiatives and puts Banner in a great position to meet future requirements. Expansion of the Unite Us platform beyond Arizona will be considered at a later phase.

15 CIO Connect Brief

CIO Connect Brief 16

December 2023 – CIO Connect Brief Provider Lifecycle Management tool CredentialStream selected as credentialing and privileging system

We migrated the data from our existing Morrissey application, including: • 92,137 practitioners • 124 facilities and 5200 Offices • All our practitioner’s privileges information We rebuilt integrations to all our dependent downstream systems including HL7 integrations to Cerner, MS4 and Optum, as well as feeds going to SailPoint, HR Datamart,

Over the last year IT has partnered with our Central Verification Office (CVO) and Medical Staff Services departments to build out new Credentialing and Privileging system called CredentialStream. CredentialStream is a comprehensive provider lifecycle management solution that offers a range of features to request, gather, and validate information about a provider to create a Source of Truth to serve downstream processes. CredentialStream is designed to work together with additional modules such as Enroll, Onboard, Privilege, Evaluate, and Network, to serve the complete provider lifecycle. CredentialStream benefits: • Paperless application process for initial appointment and re-credentialing, which includes an online application for physicians, allied health professionals, and nurse practitioners via the Hub • Provides a library of state applications, additional documents, supplements, and disclosures • Automates the validation and monitoring of provider data, including licenses and certifications, exclusions, sanctions, disciplinary actions, education, and hospital affiliations • Offers OneClick CVO, a quick and easy way to request assistance with the credentialing verification process • Eliminates facility credentialing inefficiencies and expedites payer reimbursement • Helps develop and maintain evidence-based privileging criteria, validate, identify, and match data via a proprietary algorithm • Provides a single system built around the best content, data, and practices to ensure excellence in care by offering the industry-leading software for enrolling, onboarding, and privileging to continuously evaluate providers

Verge, ServiceNow, EDW, and PDM Tools. Below is a Banner landing page example:

17 CIO Connect Brief

CIO Connect Brief 18

Banner Health Information Technology We are dedicated to the Mission of Banner Health to make health care easier, so life can be better. We are focused on hiring and retaining the best IT talent, driving innovation, providing legendary service and delivering successful outcomes.