Enhancing EHR Quality: Expectations and Certifications

1. Expectations from the Process of EHRs Quality Labelling and Certification John O’Brien National Director Hospitals Office

2. Index • Context • Key Expectations for EHR Quality labelling/certification • Some associated considerations/issues

3. Context • Purchaser/Payor • Healthcare Authority • Certification/Accreditation background • EHR – central factor of production • Increasing complexity of Health care delivery • Multi-episode • Multi-diagnosis • Multi-location • Multi-professional

4. Context • Purchaser/Payor • Healthcare Authority • Certification/Accreditation background • EHR – central factor of production • Increasing complexity of Health care delivery • Multi-episode • Multi-diagnosis • Multi-location • Multi-professional EHR - Key Component of Healthcare Production Process

5. Context • Cost • Historic success limitations • Investors in EHR’s expect: • Efficient procurement/deployment • Effective/quality outcomes • Riskdiminution • Demonstrable RoI • Improved patient experience and diagnosis/treatment/care outcomes • Improved education/training/research outcomes • Improved workforce productivity • Improved business performance

6. Context • Cost • Historic success limitations • Investors in EHR’s expect: • Efficient procurement/deployment • Effective/quality outcomes • Riskdiminution • Demonstrable RoI • Improved patient experience and diagnosis/treatment/care outcomes • Improved education/training/research outcomes • Improved workforce productivity • Improved business performance QUALITY LABELLING AND CERTIFICATION OF EHR's HAS THE POTENTIAL TO SUPPORT MANY OR ALL OF THESE IMPERATIVES

7. Key Expectations for EHR Quality Labelling/Certification • More efficient procurement • Potential time reduction: • Standard Criteria & Certified Product/Vendors leads to: • Speedier short listing • Speedier evaluation • Resource/time savings for Vendors & procurers • Potential cost reductions • Vendors • Procurers • More efficient deployment • Suggest incorporation of deployment standards/criteria into the certification scheme • Quality labelling/certification has potential to assure certified EHR vendors optimise deployment timeframes • Potential cost reductions • Speedier procure-to-use timelines

8. Key Expectations For EHR Quality Labelling/Certification • Effective Quality Outcomes • A key requirement is that an EHR functions as specified • Availability of quality assured products improve prospects in this area • Risk Reduction • Record of successful EHR acquisition/implementationnot impressive • Quality labelling/certification of EHR’s has potential to significantly reduce associated risk by: • Specifying expectations/content of EHR'’s • Specifying interoperability requirements of EHR • Specifying deployment standards • Educating vendors/users on requirements of successful EHR’s • Driving performance standards convergence • Certifying compliance with expectations, content, interoperability, deployment and standards requirements for specific EHR’s

9. Key Expectations For EHR Quality Labelling/Certification • RoI Assurance • Potential to provide improved confidence that purpose/objectives of investment will be realised where products and vendors are quality assured • Improved contribution of EHR’s to Service, Academic, Business Performance • Thestandards/criteria structure for quality labelling/certification scheme must be constructed around service, academic, business performance excellence • Scheme likely to guide/push vendor community to match product to service excellence standards

10. Key Expectations For EHR Quality Labelling/Certification • RoI Assurance • Potential to provide improved confidence that purpose/objectives of investment will be realised where products are quality assured • Improved contribution of EHR’s to Service, Academic, Business Performance • Thestandards/criteria structure for quality labelling/certification scheme must be constructed around service, academic, business performance excellence • Scheme likely to guide/push vendor community to match product to service excellence standards QUALITY LABELLING/CERTIFICATION HAS EXTENSIVE POTENTIAL TO SIGNIFICANTLY IMPROVE SUCCESS AND PERFORMANCE POSSIBILITIES FOR EHR’S AT SEVERAL LEVELS FOR PURCHASERS/ FUNDERS/HEALTH AUTHORITIES. IT IS TO BE WELCOMED/SUPPORTED

11. Some Associated Considerations/issues • Capacity/capabilities of receptor entities: • Procurement capability/capacity • Implementation capability/capacity

12. Some Associated Considerations/issues • Capacity/capabilities of receptor entities: • Procurement capability/capacity • Implementation capability/capacity QUALITY LABELLING/CERTIFICATION OF EHRs AND VENDORS NOT SUFFICIENTTO ASSURE SUCCESS. NEED TO SPECIFY AND ASSURE RECEPTOR CAPACITY/ CAPABILITY THROUGH REQUIREMENT SET

13. Some Associated Considerations/issues • Standards/criteria must be • Demonstrably excellence / best-in-class based • Continuously updated/redeveloped • Currency relevance assured • Process of quality labelling/certification scheme as important as structure (standards/criteria) • Surveyors • Capabilities/Selection/Training/Credibility • Mandatory / voluntary • Evaluation approach (audit vs SA / PR etc.) • Certification award (pass/fail vs graded etc.) • QA/QI focus • Continuously evaluated

14. Some Associated Considerations/issues • Objectivity of scheme • Notified Body Government vs non-Government • Anti-competitiveness avoidance

15. Some Associated Considerations/issues • Objectivity of scheme • Notified Body Government vs non-Government • Anti-competitiveness avoidance CRITICAL ISSUESNOT PREDETERMINED. CORE PHILOSOPHYFREQUENTLY NOT SUFFICIENTLY PROVIDED FOR