Jan Duffy, Research Manager, Health Industry Insights EMEA

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1 Healthcare Transformation: The Role of IT Healthcare Transformation: The Role of IT Jan Duffy, Research Manager, Health Industry Insights EMEA

2 Agenda Western Europe: Healthcare IT Investment Western Europe: Healthcare and IT Trends Western Europe: Drivers of IT and EHR Adoption Proposed 3-Dimensional Framework for Measuring HIT Maturity Western Europe: HIT Maturity Key Messages Recent Research Q & A

3 Western Europe: Healthcare IT Investment

4 Key IT Investments in Priorities 1 11 of 22 EMEA Hospitals: HIT Investment Priorities #1-11 # 1 EMR/EHR 37.6% # 2 Patient Accounting Systems # 3 ADT #4 CPOE #5Ph Pharmacy # 6 ERP # 7 ebooking # 8 Lab Information Systems # 9 RIS #10 PACS # 11 eprescribing 24.4% 24.1% 24.0% 22.9% 22.0% 21.5% 21.3% 20.7% 19.4% 19.2% %of Hospitals Currently Investing 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% n=144 Source: IDC-HII October 2007

5 Key IT Investments in Priorities of 22 EMEA Hospitals: HIT Investment Priorities #12-22 #12 ereimbursement 18.2% #13 CRM 16.0% #14 Portals 15.7% #15 Telemedicine and disease management 15.5% # 16 Other ancillary a dept. systems s (Cardiology) ogy) 15.4% #17 Business Performance Management 15.0% % of Hospitals Currently Investing #18 Supply Chain Management 13.0% #19 Data Warehouses and Data Marts 13.0% #20 Content and Document Management 13.0% #21 IT Security Technology 12.3% #22 Collaborative Technologies 10.1% 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0% 20.0% n=144 Source: IDC-HII October 2007

6 IT Investment Deterrents Total project costs Competition for limited funding Product limitations Shortage of skilled resources Cultural/organizational resistance Perceived high acquisition and maintenance cost Misaligned financial incentives Lack of demonstrable ROI Lack of critical mass Lack of standards (content, clinical relevancy, terminology, code sets, interoperability, clinical practice) Immature technology and EHR applications Disruption of operations during implementation Concerns over ongoing support Concerns over privacy, security and confidentiality No credible base of benchmarks for IT use and maturity

7 Western Europe: Healthcare and IT Trends

8 Hospital Numbers Are Shrinking All Across Europe Hospital counts in every country surveyed are shrinking hospitals) (Number of 4,000 3, ,000 1,000 0 Austria Belgium Denmark Finland France Italy Netherlands Portugal Spain Sweden Switzerland Hospital alliances and systems will be the future; a formal, tiered approach to care is evolving Reimbursement and social policy changes will lead to a de-emphasis of hospital-based care in favor of daycare, office care and home care Diagnosis related group (DRG) based reimbursement systems are becoming the norm in Europe

9 Healthcare is rapidly becoming an inter-connected ecosystem, with IT as its circulatory system Consumers Healthcare Payers and Governments Enabling consumers to get involved in managing their health Understanding increasing patient liability Improving quality of care (and of life) through remote home health monitoring Healthcare Providers Reimbursing for outcomes (P4P) Reimbursing for remote home health monitoring Pharma Clinical Research Organisations (CRO) Exploring pharmacogenomics combining genes + drugs to improve results More powerful drugs Advanced screening for disease Drug safety and tracking Personalized Health Information connectivity Translational medicine research driven clinical practice Reducing costs and improving patient outcomes Identifying patients for clinical trials Utilizing EMRs to supplement electronic data capture (EDC) systems

10 IT is the Key to This Transformation TREND Hospital systematization and affiliation Deployment of consolidated, national, patient ehealth records DRG-based reimbursement Shift in care setting Challenges to: Reduce costs improve quality of care improve process efficiencies Telemedicine Remote patient monitoring NEED Enhanced public network infrastructure Enhanced hospital infrastructure Expanded wireless infrastructure Adoption of data exchange standards EMRs Clinical and business intelligence SOA Enhanced security Improved backup and recovery

11 Increasing appreciation for IT s role IT has proven to play a significant role in: Improving coordination of care within the healthcare delivery system through increased sharing of health information among authorized individuals, elevating the standard of care for everyone Providing individuals with electronic access to their own health and wellness information, engaging them in opportunities for improving their health and well-being Improving the health of the community through the use of aggregated health data for research, public health, emergency preparedness and quality improvement efforts

12 but there is a need for an underlying infrastructure that can support the use of patient-focused electronic health information The building blocks associated with this infrastructure are: Electronic medical record (EMR) Electronic health record (EHR) Personal health record (PHR) Health information exchange (HIE) Health information organization/regional health information organization (HIO/RHIO) the challenge is to develop a common understanding of what these building blocks are and how they fit together in a cohesive model

13 Western Europe: Drivers of Increased IT/EHR Adoption Improve access to health information Anytime Anyplace Anywhere But not by anyone! Improve quality of care Clinicians can make informed decisions about treating patients Incorporation of evidence-based medicine tools Improve patient safety More extensive medication history and allergy information Advanced clinical decision support and alerts Reduces adverse clinical events Reduce costs Eliminates or reduces redundant tests and procedures Reduces costs associated with adverse clinical events Eliminates costs associated with transcription and storage of paper records

14 Electronic Records: The Terminology Electronic medical record (EMR) An electronic record of health-related information n an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one healthcare organization Electronic health record (EHR) An electronic record of health-related information on an individual that conforms to national recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization Personal health record (PHR) An electronic record of health-related information on an individual that conforms to national recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual Source: National Alliance for health Information Technology (US April 2008)

15 A Proposed 3-Dimensional Framework for Measuring HIT Maturity in Europe

16 A Proposed 3 Dimensional Framework for Assessing HIT Maturity in EMEA Care Setting/Institution (Scope of deployment) Application/Technology (Breadth) Feature/Function (Depth)

17 IDC-HII Hospital IT Applications Maturity Model Stage 1 Basic HIS Stage 2 Advanced HIS Stage 3 Advanced HIS Core Clinicals Stage 4 Digital Hospital Stage 5 Digital Virtual Enterprise Patient Registration / Inpatient Admission Discharge & Transfer Patient Billing and Accounts Receivable HRIS / Payroll General Ledger / Financial Reporting Purchasing / Accounts Payable Electronic Claims Submission Electronic Payment Processing Inventory, Supply Requisitioning and Distribution Basic Order Communications Internet Access Intranet Laboratory Information System RIS/Radiology Results Reporting PACS Pharmacy Operating Room Scheduling and Management Patient Appointment Scheduling Computerized Physician Order Entry Nursing Documentation Emergency Department Management Physician Portal Patient Portal Wireless Infrastructure Inpatient Electronic Medical Record (EMR) Ambulatory EMR Enterprise Master Patient Index Location-based services Secure (Provider-Provider/ Provider-Patient) Clinical Data Repository/ Data Warehouse Participation in Regionalized Patient CDR Home Health Case Management Remote Patient Monitoring/ Telemedicine IDC Health Industry Insights 2007 All Rights Reserved Reproduction or redistribution without permission prohibited

18 IDC-HII Hospital IT Applications Maturity Model Stage 1 Basic HIS Patient Registration / Inpatient Admission Discharge & Transfer Patient Billing and Accounts Receivable HRIS / Payroll General Ledger / Financial Reporting Purchasing / Accounts Payable Stage 2 Advanced HIS Electronic Claims Submission (Discharge Summaries, Coding and Abstracting) Electronic Payment Processing Inventory, Supply Requisitioning and Distribution Basic Order Communications Internet Access Intranet The key prerequisites for an EMR IDC Health Industry Insights 2007 All Rights Reserved Reproduction or redistribution without permission prohibited Stage 3 Advanced HIS Core Clinicals Laboratory Information System RIS/Radiology Results Reporting PACS Pharmacy Operating Room Scheduling and Management Stage 4 Digital Hospital Patient Appointment Scheduling Computerized Physician Order Entry Nursing Documentation Emergency Department Management Physician Portal Patient Portal Wireless Infrastructure Inpatient Electronic Medical Record (EMR) Ambulatory EMR Enterprise Master Patient Index Location-based services Stage 5 Digital Virtual Enterprise Secure (Provider-Provider/ Provider-Patient) Clinical Data Repository/ Data Warehouse Participation in Regionalized Patient CDR Home Health Case Management Remote Patient Monitoring/ Telemedicine

19 Healthcare IT Applications Maturity in Western Europe Stage 1 Basic HIS Stage 2 Advanced HIS Stage 3 Advanced HIS Core Clinicals Stage 4 Digital Hospital Stage 5 Digital Virtual Enterprise Switzerland UK Greece Portugal Germany France Italy Spain Austria Norway Denmark Sweden Ireland Belgium Netherlands Finland Source: Health Industry Insights, 2007

20 Western Europe: % of Healthcare Expenditure Spent on IT Stage 1 Basic HIS Greece 0.2% Portugal 0.3% Switzerland Stage 2 Advanced HIS Stage 3 Advanced HIS Core Clinicals 0.6% 0.8% UK Stage 4 Digital Hospital 1.0% Germany 1.48% France Norway Italy Ireland 1.1% 0.4% Spain 0.4% Belgium 1.1% Austria 0.4% Finland 0.80% Denmark 1.51% Netherlands Sweden 1.57% 0.65% Stage 5 Digital Virtual Enterprise Source: Health Industry Insights, %

21 Key Messages An EMR/EHR is a journey, not a destination A solid business case is necessary for IT investment Learn from the leaders in your home country, across Europe and elsewhere Partner with your vendors Partner with your clinical leadership; you cannot succeed without their commitment Ask questions, lots of questions; share your experiences

22 Recent Relevant Research Healthcare IT Maturity Model: Western European Hospitals The Laggards (Health Industry Insights # HI211357, March 2008) Healthcare IT Maturity Model: Western European Hospitals The Followers (Health Industry Insights # HI211356, March 2008) Healthcare IT Maturity Model: Western European Hospitals The Leading Countries (Health Industry Insights # HI210231, March 2008) Healthcare IT Maturity Model: Western European Hospital Overview (Health Industry Insights # HI210230, February 2008) EMRs, Their Current State and Future Direction, Part 2: Ambulatory Care (Health Industry Insights # HI210696, February 2008) Regional Electronic Health Records: An Example of an Integrated Information System from Ib-Salut (Health Industry Insights # HIOH07P, December 2007) EMRs, Their Current State and Future Direction, Part 1: Hospitals (Health Industry Insights # HI208878, October 2007)

23 Questions? Jan Duffy Research Manager Health Industry Insights EMEA Please feel free to me at

24 Terms of Use Policy The information enclosed is the intellectual property of Health Industry Insights, an IDC company. Copyright Reproduction is forbidden unless authorized. All rights reserved. Please refer to Health Industry Insights Terms of Use policy at for more information about our terms and conditions. If you have any questions regarding permissions and restrictions regarding our brand and content, please contact Cinzia Rinelli

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