le KWS le gps de de l UZBrussel Rudi Van Velde UZBrussel

Transcription

1 KWS le le gps le gps de l UZBrussel de l UZBrussel Rudi Van de Velde Rudi Van de Velde UZBrussel

2 Setting the Scene What s Needed for the Electronic Medical Record of the Future? 2

3 The dangerous decade for builders of Health Information Systems Over the next 10 years we will build and deploy more ICT into the health system than in the entire previous history of our discipline. These systems are going to be larger in scope, more complex, and move from regional to national, and possibly supranational scale. Most remarkable feature of this 21 th century: hold it together with 9 th century paperwork There is still a long road to be traveled before we can construct information systems that we know are certifiably safe in the clinical workplace; 3 R. Van de Velde

4 EHR Adoption in US hospitals Level of EHR Function Percentag ge 15 Basic System 10 7,6% Fully Functional Fully Functional 5 1,5% 0 (*) G. Campbell, N Eng J. Medicine, 2009, 360: , 16 4

5 Old Vision New Vision Medical record as history Medical record as organizer Static : a replacement of paper record Dynamic : coordination of caregivers {workflow ; CDSS} Financial oriented Medical Driven Repository

6 What is an ideal EMR? The Importance of an Architecture Reach and cost of IT are enabling new forms of EMR New bridges between een providers and patients From Global connection to global orchestration Creating and using insight di drive quality & performance

7 Clinical Care 1-Collect Medical research Store Content View clinical data clinical data 4-Do Workflow Collaborate Clinical Activity Reasoning engine Intelligence 2-Learn Search Deduce 3-Think - Plan Knowledge Query Reduce

8 Get Ready EMRs : Here Comes One Billion Clinical Documents!!!!

9 The Internet of Things Conventional computers have computers have become only marginally powerfull in recent years y Mobile devices have increased their capabilities 10 fold Any device can deliver any content Amount of content of content grows f grows exponentially g p y 9

10 Medical documentation A rule to remember: Drs LOVE getting data They HATE to give data Modes Dictation Hand entry Structured entry Structured dictation Voice recognition Partial structure

11 Medical documentation

12 The Dynamic Nature of a EMR Dynamic Domain (Workflow) EMR Static Domain (Integration) Order Entry & Workflows Mj Major demand dfor intelligent t systems based on good practices and economic constraints Threat :Performance EMR = Workflow + Data Opportunity: enhance clinical data to become a management tool would lead to predictive workflows 12 EMR By Product Productof of Workflow Automation Fluid Collaboration

13 UZBrussel: Evolution over Time 13

14 What is Clinical Decision Support? To provide the right ihinformation, i in the right ih format, to the right person, at the right place, and at the right time to improve health care decisions and outcomes To facilitate decisions about risk, diagnosis, therapy, and follow up in patient care Clinical practice is clinical decision making! Data + Decisions = Differentiation 9 November 2007 CDS: Current Trends, Emerging Paradigms 14

15 Steps to True Meaningful Use True Meaningful Use Understand d Aggregate R. Van de Velde 15

16 Continuously seek greater insight Lab Data mining & cleaning Encounter ereferral / Consult. Note Create insight from data Medication Reports Put the insight to work Alert

17 UZBrussel Application pp Portfolio

18 Take Home Words People love innovation, but they hate change If Fundamentals remain unchanged, money goes away Value doesnot automatically result from implemention of an IT system Conduct post implementation audits: rarely organsisations revisit their IT increments Enormeous number of proces changes affect many people Adopt incremental Approach. Big bang implementations are risky and tricky Shorten the cycle of deliverables CelebrateValue achievement

19 From Informational to transformational HC Adopt a more hollistic view Boost education training Do More with less Adopt Incremental Approach: Big Bang=Risky&Tricky If fundamentals remain unchanged, money goes away Insufficient i IT workforce From supply driven to demand driven Informed and Empowered Pts & Family Interaction Prepared proactive Care Team

20 Radar View of Health Applications CDSS EMR E Health ADT PACS Tracing CPOE ERP Lab Nursing Proven 2000 Terminology Server Hot 2010 Emerging 2015

21 Questions div V lb 21