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Clinical Systems Applications and Related Technology: Today and into the Future . Prof. Steven H. Shaha, PhD, DBA Centre for Public Policy & Administration KLAS Research. For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com , 801-879-5543.

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clinical systems applications and related technology today and into the future

Clinical Systems Applications and Related Technology: Today and into the Future 

Prof. Steven H. Shaha, PhD, DBA

Centre for Public Policy & Administration

KLAS Research

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

slide2

Disclosures & Bio

Prof. Steven H. Shaha, PhD, DBAProfessor, Center for Public Policy & AdministrationDirector, KLAS Performance Insights, KLAS Research

100+ peer-reviewed publications, 200+ peer-reviewed presentations, 2 books

Advisory and consulting work for 10 governments in Asia, Australia and Europe including France, Spain, Switzerland, Netherlands, Singapore and Malaysia

Advisory and consulting to over 50 non-healthcare organizations, including Disney,

Ritz-Carlton, Coca-Cola, New Line Cinema, IBM, AT&T, Time Warner, Kodak, Johnson & Johnson, Marriott, U.S. Dept of Defense

Employment history includes: Coca-Cola, RAND Corporation, UCLA Medical Center, Intermountain Health Care, Gartner Group, Inst Integrated Outcomes, Allscripts

Professor or Lecturer or at 14 professional academies and graduate schools, e.g. Harvard, Columbia, Cornell, UCLA, MIT, UMass

Academic Appointments (current): Center for Public Policy and Admin, Harvard (lecturer), Zayed Univ (UAE), University of Utah

Education:

PhD, Research Methods & Applied Statistics

DBA, Business Administration (PhD)

MA, MEd, BS

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

the epr enabled possibilities
The EPR-Enabled Possibilities

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

slide4

Improved Stroke Outcomes

Impact of Stroke Outcomes Toolkit:

Comparative Quality with versus without

Impact of EMR/EHR

with Intelligent Order Sets and Advanced CDS

Stroke Care Best Practices

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

slide5

Improved Stroke Outcomes

CPOE w/ alerts alone

Impact of EMR/EHR

with Intelligent Order Sets and Advanced CDS

Stroke Care Best Practices

http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

slide6

Improved Stroke Outcomes

With CDS-rich Order Set

CPOE w/ alerts alone

Impact of EMR/EHR

with Intelligent Order Sets and Advanced CDS

With CDS-rich

Order Set

40.5% Greater Clinical Excellence

Without

Stroke Care Best Practices

http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

slide7

Improved Stroke Outcomes

With CDS-rich Order Set

Readmissions in 31 Days

CPOE w/ alerts alone

Discharge Patterns

9.4% more (p<.001)

35.7 % fewer (p<.001)

16.0% fewer (p<.001)

21.4% fewer (p<.001)

Length of Stay

Financial Impact

11.4% lower (p<.05)

12.7% lower (p<.05)

7.5% lower

0.35 fewer days avg.(p<.001)

Estimated savings of £140k-340k annualized

http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

slide8

Improved Stroke Outcomes Continue after Discharged

With CDS-rich Order Set

CPOE w/ alerts alone

Discharge Patterns

9.4% more (p<.001)

16.0% fewer (p<.001)

21.4% fewer (p<.001)

http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

slide9

Better Outcomes after Discharge

Admissions to Skilled Nursing Facilities

With CDS-rich Order Set

CPOE w/ alerts alone

Readmissions in 31 Days

Length of Stay

4.1 % shorter (p<.001)

7.7 % fewer (p<.001)

  • Additional Efficiencies
  • Capacity for 130 additional admissions
  • with NO staffing increases

http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

epr realities not everyone can
EPR Realities: “Not everyone can…”

Challenges

  • Quest for Interoperability and Integration
  • Implementation Challenges
  • Local Uniquenesses
  • Conflicting Priorities

Good News

Quest for Interoperability and Integration

Focus on Implementation Excellence

Importance of Local Uniquenesses

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

research model
Research Model

3,000+ Provider surveys and calls annually

Scores on 25-item Survey

Provider Narratives and Quotes

Comparatives by Vendor, Market, Product Type

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

coverage list
Coverage List

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

comparative vendor performance
Comparative Vendor Performance

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

comparative vendor performance1
Comparative Vendor Performance

Vendor A

EMR Product Name A

Vendor B

EMR Product Name B

Vendor C

EMR Product Name C

Vendor D

EMR Product Name D

Vendor E

EMR Product Name E

Vendor F

EMR Product Name F

Vendor G

EMR Product Name G

Vendor H

EMR Product Name H

Vendor I

EMR Product Name I

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

europe
Europe …

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

slide16

Vendor A

Vendor B

Vendor C

Vendor A

Vendor B

Vendor C

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

an intriguing pattern
An Intriguing Pattern …

Variability in scores among top vendors?

Variability between economies?

Deeper search led to ….

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

satisfaction it vs clinicians
Satisfaction: IT vs. Clinicians

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

where are the differences
Where are the differences?

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

mean ratings for emergency systems
Mean Ratings for Emergency Systems

Niche

53.4% Higher

Enterprise

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

usability study
Usability Study

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

slide22

Vendor A

Vendor B

Vendor C

Vendor D

Vendor E

Vendor F

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

two approaches
Two Approaches
  • Model B
    • More Prescriptive versus Adaptability & Customizability
    • Implement & Minimally Adjust
    • Application versus User that adapts
  • Model A
    • Less Prescriptive with Adaptability & Customizability
    • Implement & Adjust
    • Users versus Application that adapts

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

comparative usability
Comparative Usability

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

comparative time to clinician as expert
Comparative Time to Clinician as Expert

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

comparative time to clinician as expert1
Comparative Time to Clinician as Expert

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

prescriptive vs adaptive
Prescriptive vs. Adaptive?

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

prescriptive vs adaptive1
Prescriptive vs. Adaptive?

Still 45% Customization

Nearly 70% Customization

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

it vs clinicians avoidable
IT vs. Clinicians: Avoidable?

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

shared needs
CliniciansShared Needs

IT

  • Quick, Impactful Implementation
  • System Stability & Reliability
  • Efficiency
    • Hassles
    • Waste
  • Quality of Care
    • Benefits of Outcomes
    • Error Avoidance
  • Go home
    • Sooner
    • More worry-free
  • Quick, Impactful Implementation
  • System Stability & Reliability
  • Efficiency
    • Hassles
    • Waste
  • Quality of Care
    • Benefits of Outcomes
    • Error Avoidance
  • Go home
    • Sooner
    • More worry-free

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

contrasting needs
CliniciansContrasting Needs

IT

  • TCO
    • Maintenance & Upkeep
    • Interface requirements
    • Staff requirements
    • Vendor relationships
  • Coding accuracy
    • Financial repercussions
    • Administration's needs
    • Integrated across settings
  • Infinite customers
    • Needs and expectation
    • Evolving requirements
  • Specialty-specifics
    • Workflows
    • Diagnostics
    • Documentation
    • Information access
  • Population Management
  • Ease of Use
    • Quick uptake
    • Intuitiveness
  • Productivity
  • Clinical decision support
    • Error avoidance
    • Patient outcomes
  • Across Settings …

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

can both sets of urgencies be met
Can Both Sets of Urgencies be Met?
  • YES
    • System
      • Interoperability and Integration
      • Adaptability to Evolving Requirements
        • Coding
        • Reporting
        • Clinical Models
    • Culture
      • Balance of Stability with Adaptability
      • Silos versus Team Work
      • Micro versus Macro Perspectives
    • Vision
      • Population Health balanced with Individual Patient Needs
      • Exceptional Coding balanced with Information Value
      • Efficiency balanced with Quality

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

what matters most
What Matters Most …

Commodities

Anchors

Customer Ratings

Nuisances

Fires

Predictive Importance

(Correlation with Overall Satisfaction)

what matters most1
What Matters Most?

*Statistically Significant p<.01

Predictive Correlation to ‘Overall Satisfaction’ in Time Series

keys to sustainable impacts from vendor
Keys to Sustainable Impacts from Vendor
  • Delivery of “New Technology”
  • Supports Integration Goals
  • Relationship / Partnership
  • Usability
    • Strong, focused implementation
    • Internal relationships
    • Mission-focused culture

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

keys to sustainable impacts from provider organization
Keys to Sustainable Impacts from Provider Organization
  • Incorporation of “New Technology”
  • Quest for Integration Goals
  • Relationship / Partnership
  • Clinician Usability
    • Strong, focused implementation
    • Internal relationships
    • Mission-focused culture

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

clinical systems applications and related technology today and into the future1

Clinical Systems Applications and Related Technology: Today and into the Future 

Prof. Steven H. Shaha, PhD, DBA

Centre for Public Policy & Administration

KLAS Research

For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543