Benchmarking EMR Adoption in Catalunya Presented by Uwe Buddrus, Managing Director HIMSS Analytics Europe Presented at Presentació Pla de Salut i Pla Estratègic SITIC 2012-2015 Torre Telefónica. Barcelona, divendres, 23 de març. Organitza: AIAQS, TicSalut Copyright by HIMSS Analytics Europe 1
Introduction HIMSS and HIMSS Analytics Europe The European EMR Adoption Model Copyright by HIMSS Analytics Europe 2
HIMSS Worldwide non-profit, member-based, mission-driven 1960 2010 2006 2004 2007 >44.000 individual members 565 corporate members 278 organization affiliates Databases of >5.000 US and >700 Canadian, >8.000 European, and >5.000 hospitals in ASPAC Copyright by HIMSS Analytics Europe 3
HIMSS Analytics Europe for benchmarking and best practice in the adoption of Healthcare IT in Europe! (Re-)Definition of Best Practice Data Collection Improvement Analysis and Reporting Successful HIT Adoption Evaluation Data Adopted ehospital Census Information Statistical analyses and reports Benchmarking tools: EMRAM Intelligence Conclusions Decisions Strategies Copyright by HIMSS Analytics Europe 4
European EMR Adoption Model in 7 Stages to Highest Quality in Patient Care Paperless patient record environment for highest quality of care, data continuity & full HIE 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 Electronic diagnostic and pharmacy department information Copyright by HIMSS Analytics Europe 5
Benchmarking EMR Adoption in Catalunya Preliminary Results Copyright by HIMSS Analytics Europe 6
EMRAM Score Comparison Catalunya Hospitals compared to Spain, Italy, U.S. EMRAM Scores, % of Institutions Stage 7 Stage 6 100% 90% 80% 5% 3% 2% 1% 9% 6% 41% 10% 1% 5% 8% 13% Stage 5 70% Stage 4 Stage 3 60% 50% 68% 5% 9% 24% 45% Stage 2 40% 11% Stage 1 Stage 0 30% 20% 10% 0% 7% 9% 48% 12% 7% 5% 24% 6% 7% 9% Catalunya Spain Italy USA N = 44 N = 145 N = 136 N = 5337 Copyright by HIMSS Analytics Europe 7
EMRAM Score Comparison Catalunya Hospital Scores by Size Segment (Beds) EMRAM Small Medium Large Total Stage 7 0 0 0 0 Stage 6 1 0 1 2 Stage 5 11 (1) 12 (3) 7 (2) 30 (6) Stage 4 3 1 0 4 Stage 3 0 0 0 0 Stage 2 3 0 0 3 Stage 1 1 0 1 2 Stage 0 3 0 0 3 Valid N 22 13 9 44 Definition < 200 beds 200 499 beds 〵 beds Copyright by HIMSS Analytics Europe 8
9 Mastering the Key Challenges Clinical Decision Support and Closed Loop Medication Administration
10 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 interdisciplinary 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 Closed Loop Medication key components and challenges 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 Medication orders pass CDS and flow to Pharmacy and/or Ward 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 CPOE and/or e-prescribing optional
12 Benchmarking & Best Practice Motivating hospital participation
Informes de pruebas de referencia Gratuito para hospitales participantes Informes de pruebas de referencia Compare su hospital con otros hospitales de Europa o América del Norte. Personalice los criterios utilizados para comparar los resultados del departamento informático de su organización con los de otras organizaciones similares. Utilice los datos del Departamento de TI (presupuesto, personal, estaciones de trabajo) y la puntuación EMRAM para realizar las comparaciones. Descargue informes para sus propias necesidades (p. ej., presentaciones, artículos técnicos, etc.). Selección de instituciones homólogas Selección de informes Benchmarking against peers is a key management ingredient to success. Copyright by HIMSS Analytics Europe 13
Informes de pruebas de referencia Ejemplo: Comparaciónes de la puntuación EMRAM Cómo se puede comparar la puntuación EMRAM de su hospital con la del resto de los hospitales que ha evaluado HIMSS Analytics Europe? Copyright by HIMSS Analytics Europe 14
Informes de pruebas de referencia Ejemplo: Comparaciones de gastos del Departamento de SI Es suficiente la inversión realizada como porcentaje del total de gastos? Copyright by HIMSS Analytics Europe 15
EMR Adoption Model Awards European Stage 6 & 7 Award Winners (November 2011) Stage 7: University Hospital Hamburg Eppendorf, Germany Stage 6: ISMETT, Italy HUG, Switzerland Odense, Denmark Hospital de Dénia, Spain Hospital de Badalona, Spain Kronoberg Lasarett, Sweden Spaarne Ziekenhuis, The Netherlands Onkologikoa, Spain Universitair Ziekenhuis Brussel, Belgium Clínica Universidad de Navarra, Spain Inselspital Bern (Bern University Hospital), Switzerland Azienda ULSS 18, Italy At least 5 Stage 6 validations pending in Catalunya! Copyright by HIMSS Analytics Europe 16 16
HAE Plans & Business Goals An Outlook Copyright by HIMSS Analytics Europe 17
HIMSS Europe Events learn more, meet Award Winners and be awarded 7 9 May, 2011 I Copenhagen, Denmark Copyright by HIMSS Analytics Europe 18
HIMSS Analytics Europe geographic and survey scope Expand regional collaboration in Spain Cover 13+ European countries Achieve 20%-100% acute hospital coverage Include Primary Care in selected countries (Ambulatory EMRAM) Include Healthcare Information Exchange Copyright by HIMSS Analytics Europe 19
20 Questions & Answers For anything else please get in touch: Uwe Buddrus Managing Director HIMSS Analytics Europe Schwägrichenstraße 9 04107 Leipzig, GERMANY e-mail: ubuddrus@himssanalytics.eu phone: +49 341 333 95 111 For further information please visit: www.himssanalytics.eu