EMR AND BIG DATA. September 2014 EMR

EMR AND BIG DATA

EMR AND BIG DATA September 2014 EMR

1. Spain: Healthcare model The Spanish Health System is characterized by the fragmentation of both the public (17 autonomous communities) and the private spheres being the public provision predominant (80% of the market share). NATIONAL LEVEL: Ministry of Health These services are provided both by public and private organizations. Public ones are delivered mainly by REGIONAL HEALTH ADMINISTRATIONS: Primary Care High level of accessibility. Focused on prevention and promotion of healthcare. Holistic view of health problems. Secondary Care Ready to deal with acute situations and more complex situations. Better diagnosis capabilities. Accessed via PC or ER. Emergency Room First point of contact for patients in an urgent situation. 97% of the population is covered by the services provided by the public administration. On top of that, 16% of the population have private insurances provided by the private sector. On the other hand, there are several types of public-private collaboration (outsourcing of particular services, hospital public concession agreements and others). Copyright 2014 Accenture All rights reserved. 3

2. EMR Functionalities HIGH LEVEL EMR CAPABILITIES GROUPS E- Prescribing Clinical Decision Support Prescription Dispensation Drug administration Clinical Workflow EMR-Clinical documentation Clinical dashboard and station Administrative management (ADT) Interoperability Inpatient Emergency Triage Outpatient Surgery Admission (admission, discharge, transfer) Appointments Medical Orders Inter-consultation Nursing care plans Rehabilitation ICU Waiting List Archive (physical medical records) Coding Integration with ancillaries, based on IHE and HL7 Data model Ancillaries (LIS, RIS, PACS) Most adopted in Spain Copyright 2014 Accenture All rights reserved. 4

3. Spain s EMR Solutions Market / AS IS All the Regions already have an EMR solution and current business is AO oriented. HP and Siemens owns most of the market share. SOLUTION VENDORS (Map shows the most extended solution by Region, but not all the hospitals in each Region use same solution) AO PROVIDERS Custom solution Hewlett Packard (HCIS) Siemens / SAP (i.s.h.med) Siemens (SELENE) Spain s Hospitals are highly advanced in deployment of EMR/EHR solutions, only UK/I and Nordics are more advanced. (source: HIMMS) Copyright 2014 Accenture All rights reserved. 5

4.A. The use of EMR throughout Spain With strong vision and leadership from national and regional governments and a pragmatic approach to systems development, Spain has achieved widespread adoption of electronic medical records (EMR) and a good level of health information exchange (HIE) across many of its regions. Copyright 2014 Accenture All rights reserved. Results obtained from Accenture Connected Health Study 7

4.D. National Interoperability THE CHALLENGE: make this good practice consistent across all regions and achieve interoperability at the national level. 56% physicians have electronic 36% access to clinical data about a patient who has been seen by a different Physicians are hospital/health electronically organization. notified of my patients interactions with other health organizations 59% physicians send or receive referrals to/from health professionals in other hospitals/health organizations. Note: chart shows the percentages of physicians across primary and secondary care who stated they share clinical data to a great extent or to some extent. Copyright 2014 Accenture All rights reserved. Results obtained from Accenture Connected Health Study 8

4.B. Decision Support Protocol Management Help healthcare organizations leading to a new way o working: more efficient, supported on innovation. Protocol definition module provides a simple and intuitive framework to implement protocols: BPM tool for normalized modeling of the clinical pathways previously defined by the healthcare organization. Simple and intuitive to use, low cost of implementation. Open Source tool. Guidance and decision support enduser interface allows clinicians check work lists for their patients based on which protocols they are enrolled: Monitoring patients. Integration in the corporate EHR user interface. Fully compatible user interface. Instant notification system. Access to patient's health data. Alerts and general indicators. BENEFITS FOR CLINICIANS Monitoring patients along the process of their pathology. Checking their worklist. Alerts, warnings and tasks generation. Instant notification system. Copyright 2014 Accenture All rights reserved. 10

5.B. Valencia La Fe: Predictive Analytics for Chronic Patients Around 70% of the Spanish Health Cost is generated by the 5% of chronic patients. Patient segmentation is the key to identify which patients are high consumers of health resources and to recognize the top 5% consumers. The solution provides a risk score model for patients with chronic diseases: Based on historical diagnoses, socio- demographic characteristics of the patients, comorbidity indexes, and historical unplanned admissions, the model assigns a probability score of high consumption of hospital resources due to unplanned admission; thank to that, it is possible to prioritize patients for preventive medicine depending on their score and reduce unplanned admissions. EXPECTED RESULTS 59% reduction of unplanned hospitalizations in chronic patients reduction of total stays 25% Analytical model: an analytical model was developed in SAS, in order to cover the first business requirement, i.e. ability to identify in advance which patients had the high probability to generate highest level of consumption of hospital resources. Technological platform: has been designed to provide on a schedule basis the right input for preventive medicine and, at the same time, to permit an easy update of the analytical model when required. Copyright 2014 Accenture All rights reserved. 12

VISC+: Predictive Health Intelligence The VISC+ project is an initiative from the Cataluña Health Department that has as objective the investigation, innovation, and evaluation through the reuse of related, anonymous and secure health information. The public Catalonian health system includes a great number of information sources of diverse typology, (assistance activity data, medical records, etc.),that are generated in a regulated way by several organization and entities. The management and advantage taking of this big data volume, may in some occasions entail a challenge of great organizational and technological complexity. The program will allow the supply of information to investigation centers and other agents in order to improve the investigation and evaluation in Cataluña, always in an anonymous and secure way, under the corresponding privacy, security and property limitations. Thanks to this project more value will be given to the medical information used in decision takings carried out by the Health Department. Transparency will be strengthened during the evaluation of results and identification of possible improvements. Copyright 2014 Accenture All rights reserved. 13

VISC+: Predictive Health Intelligence (cont.) Aggregate data from multiple parties Application of data science tools for analysis Services to help develop evidencedriven business models Copyright 2014 Accenture All rights reserved. 14

Solutions Hospitals SIEMENS HP SAP CERNER Competitive Landscape Spain- SELENE is the product with EPR. Product totally developed in Spain to Spanish market, curious detail having Soarian in the international market. Key installation: 7 new hospitals in Madrid. Madrid, Asturias, Castilla-La Mancha, Murcia, Canary Islands, La Rioja. HP-HCIS is the product with EPR. Product totally developed in Spain to Spanish market. Key installation: Hospital Central de La Defensa (Madrid) They have more than 40% of the public market with his old PAS solution HP-HIS. Implementation in Ciudad Real, Tarrasa, Parc Tauli & Andorra. Solid experience in the market (more than 15 years). ISH & ISH-MED are the products. International product. Totally focused to partnerships. Majors Partners: IBM, IECISA. Key Installation: Hospital Clinic (Barcelona). Catalonia, Extremadura Millenium is the product with a new EPR generation. Latest arrival to the market. (Son Espases Mallorca- and Oviedo-Asturias). Key Installation: Hospital de Denia (Alicante)

Regions with own development Basque Country: E-Osabide Andalucia: Diraya Galicia: IANUS Valencia: Orion Castilla-Leon