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Kansas City HIMSS April 2019

Kansas City HIMSS April 2019. Better health through information and technology. Healthcare Information and Management Systems Society (HIMSS )

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Kansas City HIMSS April 2019

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  1. Kansas CityHIMSSApril 2019

  2. Better health through information and technology.

  3. Healthcare Information and Management Systems Society (HIMSS) HIMSS is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology. HIMSS Global Conference, Corp Membership, Thought Leadership, etc. Maturity Models Marketing Arm, Healthcare IT News, Local Forums, Content Creation & Syndication, etc.

  4. Five Key Strategies Member Value Thought Leadership Maturity Model Reach Diversify Revenue Expand Internationally Hal Wolf, President & CEO, HIMSS

  5. Key Features Healthcare specific Capability oriented Prescriptive, clear, and informative Simply stated compliance requirements Industry standard terminology and detailed references Maturity Models are… • Aspirational and drive the market • Roadmap • Learn from others experiences • Convey a vision of desired target state • Encourages everyone to work collectively • Global benchmarking • Vendor agnostic

  6. Model Development Process Healthcare Delivery Organizations Health IT Vendor Solutions Peer Review Pilot Group

  7. Global Progress

  8. Maturity Models Expand Global Reach

  9. Benefits at Stage 7 6% 36% 58% The U.S. Market

  10. Maturity Models Expand Local Reach Average 4.9 Lowest 0.1 Highest 7.0 Stage 7 2 Average 5.4 Lowest 1.6 Highest 7.0 Stage 7 10 Average 4.9 Lowest 0.1 Highest 7.0 Stage 7 2 Average 4.9 Lowest 0.0 Highest 6.0 Stage 7 0 Average 4.6 Lowest 0.1 Highest 6.0 Stage 7 0

  11. Maturity Models Expand Local Reach Avg 3.2 Min 0.0 Stage 7 Organizations 2

  12. Technology Innovation PERFORMANCE IMPORTANCE 59% 1. Drive operational, financial and process efficiencies 35% 61% 56% 2. Enhance the patient experience, drive patient engagement 38% 3. Gain market share/attract customers 52% 37% 4. Enable new models of care 50% 31% 5. Inform new treatment approaches, accelerate clinical imperatives 44% 31% 6. Improve the clinician experience, alleviate physician burnout 20% (N=180) HIMSS Media, Technology Innovation in Healthcare research, 2018.

  13. Maturity Model Overview

  14. Electronic Medical Record Adoption Model Measuring EMR capabilities and impact on systems, and patients. Outpatient Electronic Medical Record Adoption Model Scoring healthcare clinics on the maturity of their EMR environments. Adoption Model for Analytics Maturity Determining how to leverage data for better care and process optimization. Healthcare Supply Information Maturity Model Transforming clinical environments to support quality, safety and sustainability. Continuity of Care Maturity Model Assessing levels of care coordination, systems integration, and patient engagement. Infrastructure Adoption Model Improve care delivery, reduce risk, and create a pathway for infrastructure development. Digital Imaging Adoption Model Evaluating maturity of IT supported processes in medical imaging in hospitals and diagnostic centers.

  15. Electronic Medical Record Adoption Model Measuring EMR capabilities and impact on systems, and patients.

  16. Outpatient Electronic Medical Record Adoption Model Scoring healthcare clinics on the maturity of their EMR environments.

  17. Foundational HIT Investments Electronic Medical Records (EMR), pervasive, discreet data Computerized Practitioner Order Entry (CPOE) > 90% Driving paperless care, medically relevant info scanned in < 24 hours Closed loop admin of blood, medications, and human milk (CLMA) > 95% Disaster Recovery & Business Continuity (DR & BC) Governance Basic Clinical & Business Intelligence (C&BI) Health Information exchange (HIE) Etc…

  18. Governance • It relates to "the processes of interaction and decision-making among the actors involved in a collective problem that lead to the creation, reinforcement, or reproduction of social norms and institutions." • Characteristics of “good” governance? • Senior leadership commitment • Quality & performance focused • Focused on usability, reduce burn-out • Clinicians driving the content, workflow and level of alerting • Not IT Change Control!

  19. Adoption Model for Analytics Maturity Determining how to leverage data for better care and process optimization.

  20. Key Focus Areas Data Content Growth Basic data to advanced data Aligned with clinical, financial, and operational analytics activities Analytics Competency Growth Start simple and work to master specific competencies Enhance performance tracking / clinical decision support Appropriate analytics maturation for individual parts of the organization Infrastructure Growth Flexible approaches to accommodate a wide variety of situations Vendor neutral Timely data, centrally accessible Data Governance Growth Quality data and resource management Executive suite and strategic alignment

  21. Continuity of Care Maturity Model Assessing levels of care coordination, systems integration, and patient engagement.

  22. Continuity of Care Maturity Model Focus Areas • Health Information Exchange • Coordinated Patient Care • Advanced Analytics • Patient Engagement Stakeholders

  23. Digital Imaging Adoption Model Evaluating maturity of IT supported processes in medical imaging in hospitals and diagnostic centers.

  24. Source: Roth CJ, Lannum LM, Persons KR. A Foundation for Enterprise Imaging: HIMSS-SIIM collaborative whitepaper. J Digit Imag 2016)

  25. Infrastructure Adoption Model Gauging care delivery, risk reduction, and infrastructure development.

  26. Key Focus Areas Collaboration Messaging & Presence Conferencing Contact Center Transport Connectivity Tolerance and High Availability Management Data Center Storage Virtualization Cloud Wireless Access BYOD Location Security Identity and Device Management Threat Detection & Response Firewall Segmentation Policy Encryption

  27. What’s the Process?

  28. Stages 0 - 5 Survey (varies: phone, worksheet, web) Self-reported assessment Stage 6 on-site Validation (except in North America for EMRAM & O-EMRAM) Focus on model fundamentals Preparatory guide provided with clear requirements Stage 7 on-site Validation Focus on advanced capabilities, strong case studies, strategic alignment Preparatory guide provided with clear requirements Validation good for 3 years

  29. All of our models • Progress from Stage 0 – 7 (8 stages) • Have a survey • Actionable findings report* Example 2 basic results * EMRAM & O-EMRAM reporting online, Others via PDF

  30. Example 2 expanded results * EMRAM & O-EMRAM reporting online, Others via PDF

  31. What’s the Value?

  32. Benefits at Stage 7 The Danger Zone WHY?

  33. Benefits at Stage 7 At Stage 4 & 5 MDs are introduced to CPOE and Documentation. At these stages the medical record is a hybrid mix of online and paper. It can only provide rudimentary clinical decision support to the MD. The Danger Zone

  34. Digital Profile – Baseline Use the self-assessment tools to determine the current status of an organizations maturity within each model.

  35. Digital Profile – Goal Interview physician and executive leadership to understand where they want to be. A map of an organizations interest and ability to move up within each maturity model. EMRAM & O-EMRAM are base models and expected to be Stage 7

  36. Digital Profile – Opportunity The grey area represents the project scope and business opportunity. Not about reaching Stage 7 but improving capabilities and maximizing technology investments and resources available.

  37. Benefits at Stage 7 – Primary Care Childhood Immunizations: 70% to 89.7% Colorectal screening: 72% to 78% Tobacco cessation reminders: 54% to 97.4% Diabetes Nephropathy testing: 78% to 92.6% Asthma Protocol Compliance: 7% to 78% A1C testing: 50% to 83% Admissions for diabetic patients down 44% CHF patients supplied Blue-tooth enabled weight down 42% Source: HIMSS Analytics Stage 7 Case Study

  38. Benefits at Stage 7 – Population Health

  39. Benefits at Stage 7 – Acute Care Stage 6 hospital could be missing more than $1,006,000 annually in reimbursements from just these 8 DRGs Stage 6 and 7 organizations have similar discharge volumes, but the Average Total Payment for Stage 7 hospitals is 8.3% higher than the Stage 6 average for these 8 DRGs Data from Medicare Provider Utilization and Payment Data , data.cms.gov10/24/2017 n=965

  40. Benefits at Stage 7 – Acute Care 2016 Operating Margin Data from Moody’s Municipal Financial Ratio Analysis (MFRA) applied to 2016 EMRAM Analytics Stage data, bot as of February 2018. As of January 2019, Epic analysis of 2018 Leapfrog Grade data against HIMSS Analytics EMRAM Stage data.

  41. Benefits at Stage 7

  42. Benefits at Stage 7

  43. Benefits at Stage 7

  44. Benefits at Stage 7

  45. Estimated savings: Up to $60 Million Ongoing • “No one asks what’s the ROI for the elevators in • a hospital, the organization simply can’t operate without them. That is where we are now with • the EMR.” • Allen L Hsiao, MD, FAAP • Vice President & CMIO • Yale New Haven Medical

  46. Benefits at Stage 7 – Acute Care

  47. Benefits at Stage 7 – Acute Care

  48. Benefits at Stage 7 – Acute Care Physicians were asked: “What Contributes Most to Your Burnout?” Medscape National Physician Burnout, Depression & Suicide Report 2019 CIO CMIO to CEO CMO & Board https://www.medscape.com/2019-lifestyle-burnout

  49. Incredible Variation Overall Collaborative Trends 88% Satisfied! What are these organizations doing . . . 68% Dissatisfied! . . . different from these organizations? Organization Net EMR Experience Score (EMR Satisfaction)

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