Mastering the Key Challenges in EMR Adoption - From Patient Administration to Clinical Decision Support

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1 Mastering the Key Challenges in EMR Adoption - From Patient Administration to Clinical Decision Support Copyright by HIMSS Analytics Europe Benchmarking HIT Adoption in European Healthcare Organisations

2 Agenda An introduction to the European EMR Adoption Model a generic step-by-step roadmap to a paperless EMR environment Key challenges in EMR Adoption the essential elements of Clinical Decision Support Systems and achieving highest medication administration safety (Closed Loop Medication Administration) Preliminary findings on EMR adoption in Norway 11/22/2011 2

3 The European EMR Adoption Model by HIMSS Analytics Europe 11/22/2011 3

4 European EMR Adoption Model in 7 Stages to Highest Quality in Patient Care Paperless patient record environment and data continuity for highest quality of care Automated clinical decision support; closed loop medication administration Completely electronic image management Filled by electronic order entry with decision support and result reporting Complemented by other clinical documentation Compiled in a patient-centered electronic record repository Electronic diagnostic and pharmacy department information 11/22/2011 4

5 Clinical Decision Support 3 levels from error checking to pathway optimisation Level Level 1: conflict checking during order entry Level 2: rules engine firing during order entry Level 3: rules engine triggered by physician / clinical documentation proposes pathways Requirements System: low - OrderComm checks for duplicate orders, and order components within group orders User: low if no alternative orders are accepted System: medium - CPOE with rules engine populated with purchased or user developed clinical rules for prescriptions, appropriate sequencing, etc. User: medium user friendliness (one GUI no switching between systems); avoid alert fatigue System: high CPOE supports single and multiple clinical pathways pathways generate workflow through inter-disciplinary orders; Physician documentation in structured templates provides clinical guidance such as suggested orders and discrete data elements from medical devices feeds rules engine to generate possible predictive alerts User: high trust based on involvement and clinical evidence; IT follows process not vice versa 11/22/2011 5

6 Closed Loop Medication key components and challenges CPOE and/or e-prescribing Medication orders pass CDS and flow to Pharmacy and/or Ward emar Update and availability for review, override management and future CDSS interactions POC Administration Secure identification of nurse, patient and medication at POC by bar code scanning or RFID POC registration in emar dual signature for critical meds Pharmacy / Nurse Validation of order and dispensing of Unit Doses (e.g. by ADM) with bar code or complete prescription information NB: compounded vs. packaged med. ADM optional 11/22/2011 6

7 Economic Impact of EMR Adoption What are the main ROI points? Reduction in hard costs of Duplicate medical orders Length of stay Adverse Drug Events (ADEs) Paper-based processing Transcription Scanning Storage Soft costs and benefits Reduction of cost of medical errors Workflow improvements Increase in medical staff satisfaction Increase in family and patient satisfaction Copyright by HIMSS Analytics Europe Benchmarking HIT Adoption in European Healthcare Organisations 11/22/2011 7

8 EMR Adoption in Norway 11/22/2011 8

9 Gap Analysis EMRAM-critical Systems Key gaps and recommended order of deployment: Software Application Relevant for Stage Missing in x of 11 hospitals Pharmacy Management System 1 3 Order Communication 3 3 Electronic Medication Administration Record (EMAR) Computerized Practitioner Order Entry (CPOE) eprescribing 4 6 Clinical Decision Support (CDSS) 6 6 Clinical Workflow Management System /22/2011 9

10 Contact at Helse Sør-Øst RHF For more information on our collaboration please get in touch: Terje Wistner Leder, programområder og leverandørstyring Chief Program Officer Helse Sør-Øst RHF Mobil: Epost: 11/22/

11 Questions & Answers For anything else please get in touch: Uwe Buddrus Managing Director HIMSS Analytics Europe Schwägrichenstraße Leipzig, GERMANY phone: For further information please visit: 11/22/

12 HIMSS Europe Events Join HIMSS Europe at: November, 2011 I Geneva, Switzerland 7 9 May, 2011 I Copenhagen, Denmark 11/22/

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