UCSF Medical CenterCTG – February 6, 2014

Project: e-Form/e-Signature (Proof of Concept)

BCD Project Manager: Sheryl Shah

UCSF Medical Center

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The presenter(s):

The ask:

Sheryl Shah, PMO Project Manager, Pamela Hudson, Executive Director. Irene Brezman, Director

Request CTG approval to move forward with a “technical proof of concept” to confirm maturity/functionality of e-Form/e-Signature vendor solution prior to developing a full business case.

Scope: Proof of Concept

Create digital form with discreet data fields (patient demographics) with integration from APeX

Dual e-signature & workflow (Patient and Provider) of a surgical consent inside and outside of the organization

Integration of Consent Status in Apex so provider/staff easily know that the consent has been signed.

Prove of Concept Proposed Timeline: February to end of March 2014. Proof of Concept Cost : $29,920 (to vendor) but will be credited back

against license/subscription fee if we move forward with implementation Proof of Concept Funding: CS operating budget

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Background: Its been a journey . . . . .

Missing consent forms = delay patient care and waste (muda) : Inappropriate/Over Processing Unnecessary Motion Wait Time

Solution must integrate with Apex and ImageNow (ECM).

Various vendor solutions reviewed, including: BottomLine EPIC Docu-Sign/Kryptiq

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Recommended Vendor:

Benefits of the DocuSign for Patient include:

DSP is optimized for healthcare organizations by utilizing: DocuSign platform for:

Creation/Management of document templates e-signature/authentication Virtual distribution of e-form

Kryptic for workflow management and EMR integration : Centricity, Allscripts, NextGen and Greenway Device management at point-of-care (PC, Tablet)

Partnership Approach: In recognition of opportunity to partner with UCSF to:

Integrate with APeX (Epic) and ImageNow Extend workflow solution to Inpatient/Procedural areas

Kryptiq is offering UCSF a significant discount on an enterprise license

Electronic Signature Platform

Healthcare Workflow Integration

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Proof of Concept Use Case: Surgical Consent Form

Develop e-Form with discreet patient demographic fields from APeX. Validate Dual E-Signature workflow: Patient and Physician Integration of Consent Form “status” into Apex to inform consent was signed Storage of signed e-form in BLOB server and long-term into ImageNow

Impacted Application Resources (*Sunny Bang, Andrew Robinson, Khiang Seow)

Need Business Partners Participation for requirements/validation Dr. Robinowitz, Others: Nursing, Prepare Clinic

Target Completion Date: March 31, 2014

Interface Appl Soln Arch* OpThesia

Product Costs:

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DocuSign/Kryptiq has provided a reduced pricing quote One-time Perpetual License of $149,601 (-20% from Proof of Concept) Yearly maintenance fee of $29,920.

Includes: Enterprise wide software license Initial package of standard forms Kryptiq development for integration points with ImageNow and Apex. Client training on best practices for developing forms No restriction on amount of forms that can be built

Further Costs: (Total Cost Ownership TBD - - pending successful completion of Proof of Concept)

Hardware: Server Cost for installing DSP software onto Server Tablets Labor for UCSF staff

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Next Steps: Based on successfully completing a “technical” proof of

concept

Determine future roadmap for e-Form/e-Signature initiative Based on ImageNow (ECM) project research, UCSF has

approximately 2000 forms. Identify business representatives to participate in planning efforts

Prioritization of impacted areas: ROI, High Risk Areas Focus on specific use cases: Operational workflows to guide

technical development needs Determine opportunities to lean processes and drive to

standardization

Determine full cost estimates for further development and implementation

Present back to CTG in May or June

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Appendix

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