Subtitle BENCHMARKING EMR ADOPTION IN ITALY How Italian hospitals keep up with digitization. Lessons learned from the annual HIMSS survey PRESENTED BY: CLEMENTE CAPASSO, HIMSS ANALYTICS EUROPE, COUNTRY MANAGER ITALY FORUM HIMSS PA, ROME Analytics MAY Europe 29 TH 2013 Benchmarking EMR Adoption in Italy page 1
Subtitle INTRODUCTION TO HAE HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 2
HIMSS ANALYTICS EUROPE Subtitle for benchmarking and best practice in the adoption of Healthcare IT in Europe! >1,600 hospitals evaluated on Data from >1,900 EMRAM acute hospitals across 18 European countries Cooperation with Healthcare Providers, National and Regional Health Authorities, Associations, HIT Vendors and System Integrators, Consultancies HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 3
Subtitle THE EMR ADOPTION MODEL IN THE CONTEXT OF EHR HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 4
THE EUROPEAN EMR ADOPTION MODEL Subtitle in 7 Stages to Highest Quality in Patient Care Paperless patient record environment for highest quality of care, data continuity & full HIE Full electronic clinical decision support, and highest medication safety Completely electronic diagnostic image management Electronic order entry with decision support and result reporting Clinical ordering and documentation especially nursing care A patient-centered electronic data repository Electronic diagnostic and pharmacy department information HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 5
Subtitle STATUS OF EMR ADOPTION IN ITALY AND OTHER COUNTRIES HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 6
EMR ADOPTION IN EUROPE Subtitle... based on HIMSS Analytics European EMR Adoption Model Ø3 Ø1 Ø0 Ø1 Ø2 Ø3 Countries currently under review Source: HIMSS Analytics Europe ehospital Census 2012 HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 7
EMR ADOPTION IN ITALY Subtitle... based on HIMSS Analytics European EMR Adoption Model Stage Italy Europe* Short Description (HA Europe Model) Stage 7 0.0% 0.1% Stage 6 0.6% 1.4% Complete EMR; CCD transactions to share data; Data warehousing feeding outcomes reports, quality assurance, and business intelligence; Data continuity with ED, ambulatory, OP Physician documentation interaction with full CDSS (structured templates related to clinical protocols trigger variance & compliance alerts), AND Closed loop medication administration Stage 5 6.6% 14.9% Full complement of R-PACS displaces all film-based images Stage 4 1.8% 2.8% Stage 3 3.4% 4.0% Stage 2 26.7% 27.2% Stage 1 41.4% 18.8% Stage 0 19.5% 30.7% CPOE in at least one clinical service area and/or for medication (i.e. eprescribing); may have Clinical Decision Support based on clinical protocols Nursing/clinical documentation (flow sheets); may have Clinical Decision Support for error checking during order entry and/or PACS available outside Radiology Clinical Data Repository (CDR) / Electronic Patient Record; may have Controlled Medical Vocabulary, Clinical Decision Support (CDS) for rudimentary conflict checking, Document Imaging and health information exchange (HIE) capability Ancillaries Lab, Radiology, Pharmacy All Installed OR processing LIS, RIS, PHIS data output online from external service providers All Three Ancillaries (LIS, RIS, PHIS) Not Installed OR Not processing Lab, Radiology, Pharmacy data output online from external service providers N 498 1,354 Institutions w ith valid EMRAM score (data from last 24 months, status as of Q1/2013) Mean 1.6593 2.0096 Median 1.1250 2.0150 Source: HIMSS Analytics Europe Database HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 8
KEY PERFORMANCE INDICATORS Subtitle and basic demogrpahic data from small, medium and large hospitals in Italy Small (<200 beds) Medium (200 499 beds) Large (>=500 beds) Total Universe Demography Total # of Institutions, of which 814 314 109 1,237 Part of a group 68.8% 81.0% 53.8% 70.6% Size of Institution (# of Beds) 104 301 683 205 Annual Hospital Budget (Operating Expense) ( ) 26,236,758 100,686,328 193,937,344 59,912,206 Annual IT Budget (IT Op. Exp. in % of Hosp. Op. Exp.) 1.5% 1.1% 1.5% 1.4% Total # of FTE (Staff) 275 843 1,654 541 IT Infrastructure per Hospital Dedicated # of IT Staff 3 6 10 4 # of Workstations overall 217 531 869 354 % of Institutions with WLAN 26.0% 37.9% 50.0% 31.5% # of Software Applications (out of 49) 27 28 30 28 Key Performance Ratios Capital Availability - Budget per Bed ( ) 253,479 334,334 283,965 292,630 Clinical Service Level - Staff per Bed 2.7 2.8 2.4 2.6 Clinical IT Availability Level - W/s per Staff 0.8 0.6 0.5 0.7 Clinical IT Support Level - W/s per IT Staff 77 82 90 81 Clinical IT Support Level - FTE per IT Staff Source: HIMSS Analytics Europe, HIS Report Italy 2011 (n = 251) 97 130 172 124 HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 9
KEY EMR APPLICATIONS Subtitle based on the Market Potential Universe (MPU) of Italian acute care hospitals and mapped to EMRAM Stage (% of institutions) Source: HIMSS Analytics Europe, HIS Report Italy 2011 (n = 251) HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 10
KEY INVESTMENT AREAS Subtitle based on projected first time investments (FTI) into software applications that Italian hospitals are likely to realize between 2012-2016 Source: HIMSS Analytics Europe, HIS Report Italy 2011 (n = 251) HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 11
EMR ADOPTION AND FINANCIAL BENEFITS Subtitle a well-planned EMR adoption is profitable (and has positive clinical benefits) - Operating Margin by EMRAM Stage Data only available for United States Source: HIMSS Analytics US Database HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 12
ITALIAN SUCCESS STORIES Subtitle Stage 6 Award Recipients (May 2013) ISMETT, Palermo (Sicily) Azienda ULSS 18, ospedale Rovigo i Trecenta (Veneto) 3 out of currently 27 European Stage 6 hospitals are from Italy. In addition HAE has identified 2 Stage 7 hospitals, one in Germany, one in Spain. Italy is still waiting for its first Stage 7 hospital. HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 13
CONCLUSIONS Subtitle Why benchmark and take part of HIMSS Annual Survey? Continuity Comparability External: EMRAM Scores and KPIs from individually selectable peer groups (regional, pan-european, global) Internal: across time periods Availability, Awareness, Acceptance Ease of Use & Free of charge Support for decisions regarding budget, staff and strategic investments Groundwork for in-depth benchmarking focussed on IT usage, process maturity, benefits realization etc. Identification of best practice enables exchange with thought leaders / innovators Public recognition HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 14
Subtitle Clemente Capasso Country Manager Italy HIMSS Analytics Europe Schwägrichenstraße 9 04107 Leipzig, GERMANY e-mail: ccapasso@himssanalytics.eu phone: +49 341 333 95 322 For further information visit: www.himssanalytics.eu HIMSS Analytics Europe Benchmarking EMR Adoption in Italy page 15