Eurpean Hspitals EMRAM Maturity Overview CIO Summit 2015 Sessin 1
HIMSS WORLDWIDE AT A GLANCE Missin: Thught leadership fr better health engagements and care utcmes thrugh infrmatin technlgy Nt-fr-prfit rganizatin funded in 1961, headquartered in Chicag Prviding glbal leadership fr the use f infrmatin technlgy (IT) t ptimize health and care utcmes Represents 56,000 individual and 600 crprate members, plus 250 nt-fr-prfit partner rganizatins with a presence in 200+ cuntries all ver the wrld
ABOUT HIMSS ANALYTICS Whlly-wned, nt-fr-prfit subsidiary f the Healthcare Infrmatin and Management Systems Sciety (HIMSS) Cllects and analyzes healthcare infrmatin related t IT adptin and envirnments in numerus cuntries Delivers thught leadership, services, and analytical expertise t the Healthcare IT Cmmunity Prviders Gvernment Vendrs Cnsultancies
THE EMR ADOPTION MODEL, EMRAM
HISTORY OF THE ACUTE CARE EMRAM The acute care EMRAM was develped in 2005 Why the structure? It is the typical manner by which hspitals rllut enterprise clinical systems The first Stage 7 validatin ccurred in Q1 2009 Three years+ after EMRAM intrductin At the time the acute care EMRAM was intrduced, all the sftware required was available, smewhere
WHY DO WE DO IT? Prvide infrmatin n EMR adptin in acute care hspitals What is the status qu? T infrm gvernment plicy Numerus cuntries and regins use HIMSS and EMRAM t gather data fr their plicy frmulatin T drive the market T push the adptin f EMRs (fr quality, safety, efficiency reasns) T benchmark the prgress f digitizatin and identify best practice hspitals Hw des my hspital, regin, cuntry etc. cmpare with thers? Where is the market heading, which trends can be seen? Frm which institutins can I learn smething? T identify cnditins and/r circumstances that are supprting and stimulating EMR adptin
EMRAM EVALUATIONS ACROSS THE GLOBE Since 2005 the EMRAM has been used in mre and mre cuntries US + CN: >6.000 hspitals 2005 2010 Eurpe: >2.000 hspitals 2013 TR: >320 2011 ASPAC: >800 Cre EMRAM cuntry (strng fcus by HIMSS) EMRAM used by many healthcare prviders (medium fcus by HIMSS currently) EMRAM used by few healthcare prviders (sme fcus by HIMSS currently)
Cmplete EMR, Data Analytics t Imprve Care Physician dcumentatin (templates), full CDSS, Clsed lp medicatin administratin Full R-PACS CPOE, Clinical Decisin Supprt (clinical prtcls) Clinical dcumentatin, CDSS (errr checking) CDR, Cntrlled Medical Vcabulary, CDS, HIE capable Ancillaries - Lab, Rad, Pharmacy - All Installed All Three Ancillaries Nt Installed Paperless patient recrd envirnment fr highest quality f care, Full electrnic clinical decisin supprt, and highest medicatin safety Electrnic diagnstic image management Electrnic rder entry with CDS and result reprting Clinical dcumentatin especially nursing care A patient-centered electrnic data repsitry Electrnic diagnstic and pharmacy department infrmatin Data frm HIMSS Analytics Database 2013 HIMSS Analytics
Care Imprvement by EMR Adptin clinical value ptential f each EMR Adptin Mdel Stage Stage 7 Paperless envirnment enabling data cntinuity t deliver and manage patient care fr all hspital services and supprting crdinated care delivery Optimized quality f care and patient safety Optimized clinical peratinal and business prcess efficiency clinical value ptential f each stage Stage 6 Stage 5 Stage 4 Optimized diagnstic and care delivery efficiency by standard treatment prtcls; Further reductin / eliminatin f medical errrs imprved patient safety; Reduced / eliminated paper-based dcumentatin and dictatin and transcriptin csts; Imprved billing and cding Eliminatin f film reduces csts and need fr strage space, image sharing wrks faster and mre efficiently, redundant imaging can be avided Imprved care delivery efficiency and reduced medical errrs with CPOE Stage 3 Stage 2 Stage 1 Stage 0 Optimised cllectin f nursing and clinical infrmatin; Standardized care delivery first imprvements f care quality Optimised access t diagnstic results, sharing f patient-infrmatin Imprved key dept. peratins and access t diagnstic infrmatin Lw clinical value; mainly patient administratin and hspital management HIMSS Eurpe HIMSS Benefits Realizatin Prgram 9
WHERE ARE STAGE 6 HOSPITALS? US, Canada, Ireland, UK, Netherlands, France, Spain, Italy, Switzerland, Belgium, Finland, Sweden, Turkey, KSA, UAE, India, Malaysia, Brazil, Singapre, Australia, China
EMR ADOPTION MODEL AWARDS Stage 6 & 7 awarded hspitals in Eurpe (Summer 2015) 3 hspitals identified acrss Eurpe s far: Hspital de Dénia Marina Salud S.A., Spain University Hspital Hamburg Eppendrf, Germany Radbud University Medical Center, Netherlands 59 hspitals identified acrss Eurpe s far, f which: Spain Turkey Netherlands France Italy Switzerland United Kingdm Belgium Finland Ireland Sweden Eurpean Stage 6 Hspitals by Cuntry 1 1 1 1 2 3 5 9 11 10 15
Crss Cuntry EMRAM Scre Distributin# (2015 Q2) Stage United States* Canada* Austria Netherlands Germany* Italy* Spain* Stage 7 3.7% 0.2% 0.0% 0.0% 0.6% 0.0% 0.4% Stage 6 22.2% 0.8% 0.0% 9.5% 0.0% 1.4% 3.9% Stage 5 30.8% 0.9% 35.7% 38.1% 11.6% 19.4% 42.4% Stage 4 13.6% 3.3% 2.4% 3.2% 6.7% 0.9% 5.2% Stage 3 19.7% 31.4% 0.0% 1.6% 4.9% 4.7% 1.7% Stage 2 4.3% 30.6% 38.1% 46.0% 23.8% 40.3% 26.2% Stage 1 2.2% 14.2% 2.4% 1.6% 0.6% 22.3% 6.6% Stage 0 3.5% 18.7% 21.4% 0.0% 51.8% 10.9% 13.5% N = 5462 N = 641 N = 42 N= 63 N = 164 N = 211 N = 229 Surce: HIMSS Analytics Database
Crss Cuntry EMRAM Scre Distributin # (2015 Q2) Stage United States* Canada* Australia New Zealand Singapre Malaysia Thailand Philippines Stage 7 3.7% 0.2% 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% Stage 6 22.2% 0.8% 0.4% 0.0% 77.8% 0.4% 0.0% 0.0% Stage 5 30.8% 0.9% 6.3% 5.0% 0.0% 6.4% 14.9% 0.0% Stage 4 13.6% 3.3% 0.7% 0.0% 11.1% 2.6% 0.0% 0.0% Stage 3 19.7% 31.4% 0.7% 0.0% 0.0% 0.4% 1.1% 0.0% Stage 2 4.3% 30.6% 72.7% 92.5% 0.0% 2.6% 8.0% 1.4% Stage 1 2.2% 14.2% 2.2% 2.5% 0.0% 2.1% 24.1% 1.4% Stage 0 3.5% 18.7% 17.0% 0.0% 11.1% 85.4% 51.7% 97.2% N = 5462 N = 641 N = 271 N = 40 N = 9 N = 233 N = 87 N = 72 Surce: HIMSS Analytics Database
EMR ADOPTION IN EUROPE AND THE US... based n HIMSS Analytics EMR Adptin Mdel EMR Adptin Mdel Scres, Means per Cuntry Pland 2015 Being surveyed nw Pland 2012 (147) 0,4 Eurpe 2 (1,023) 3,0 Germany (220) 1,7 Denmark 1 (24) 5,3 Singapre(9) 5,3 USA 3 (5,467) EMRAM Scre (Means) 4,6 Surce: HIMSS Analytics Database (03/2015) 0,0 1,0 2,0 3,0 4,0 5,0 6,0 7,0 1) Only public hspitals 2) Excl. Pland; incl. Austria (45), Belgium (9), Denmark (24), Finland (2), France (14), Germany (220), Iceland (1), Ireland (1), Italy (276), Netherlands (62), Nrway (3), Pland (3), Prtugal (25), Slvenia (2), Spain (222), Switzerland (8), UK (106)
Hw Lng it Takes T Make Significant Prgress 2006 2007 2008 2009 2010 2011 2012 2013 2014 Stage 7 0.0% 0.0% 0.3% 0.7% 1.0% 1.2% 1.8% 2.9% 3.6% Stage 6 0.1% 0.8% 0.5% 1.6% 3.2% 5.2% 7.3% 12.5% 17.9% Stage 5 0.5% 1.4% 2.5% 3.8% 4.5% 8.4% 11.5% 22.0% 32.9% Stage 4 3.1% 2.2% 2.5% 7.4% 10.5% 13.2% 14.0% 15.5% 14.0% Stage 3 18.7% 25.1% 35.7% 50.9% 49.0% 44.9% 41.7% 30.3% 21.0% Stage 2 40.0% 37.2% 31.4% 16.9% 14.6% 12.4% 11.4% 7.6% 5.1% Stage 1 17.4% 14.0% 11.5% 7.2% 7.1% 5.7% 4.8% 3.3% 2.0% Stage 0 20.4% 19.3% 15.6% 11.5% 10.1% 9.0% 7.5% 5.8% 3.7% # f Hspitals N = 4,237 N = 5,073 N = 5,166 N = 5,235 N = 5,281 N=5,337 N=5,310 N= 5,458 N=5,467 Surce: HIMSS Analytics Database
COMPARE US & CANADA Fr an Imprtant Lessn in Rle f Gvernment Same majr vendrs Allscripts, Cerner, Epic, Meditech Very similar culture. Primarily f Eurpean decent But a cmpletely different financing mechanism Canada: NO federal funding, just federal mandates fr care Canada: NO federal funding fr acute healthcare IT Result: drastically different e-health investment levels Message: It takes gvernment leadership t drive adptin
Percent f Hspitals Percent f Hspitals Huge Shift in the U.S. in Seven Years: 2007-2014 50% 45% 40% 35% 30% 25% 20% 15% 37,2% 25,1% 19,3% 14,0% 50% 45% 40% 35% 30% 25% 20% 15% 32,7% 21,0% 17,9% 14,0% 10% 5% 2,2% 1,4% 0,8% 0,0% 10% 5% 3,8% 2,0% 5,1% 3,6% 0% 0 1 2 3 4 5 6 7 EMRAM Stage 0% 0 1 2 3 4 5 6 7 EMRAM Stage Surce: HIMSS Analytics Database
The Canadian hspital market reflects a decidedly different adptin trajectry Same vendrs Similar culture Different Financing
All Canadian. Hspitals All Canadian. Hspitals Essentially N Shift 2010 t 2014 50% 50,0% 45% 45,0% 40% 35% 30% 34,2% 30,0% 40,0% 35,0% 30,0% 31,7% 29,7% 25% 20% 15% 10% 5% 0% 11,4% 23,2% 1,1% 0,0% 0,2% 0,0% 0 1 2 3 4 5 6 7 EMRAM Stage 25,0% 20,0% 15,0% 10,0% 5,0% 0,0% 19,1% 14,1% 3,9% 0,6% 0,6% 0,0% 0 1 2 3 4 5 6 7 EMRAM Stage Surce: HIMSS Analytics Database