a measurement to support the ehealth regional strategy · gimme the numbers next stop? suggestions....
TRANSCRIPT
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A Measurement to Support the eHealth Regional StrategySession 170 - March 7, 2018
Claudio Saccavini, CINO
Giulia Pellizzon, Project Engineer
Consortium Arsenàl.IT
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Claudio Saccavini, Chief Innovation Officer
Giulia Pellizzon, Project Engineer
Have no real or apparent conflicts of interest to report
Conflict of Interest
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AgendaBackground
Our ecosystem
The Five Ws and one H
Handle with care: hints and suggestions
Gimme the numbers
Next stop?
Suggestions
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Learning Objectives
Describe the assessment model for the exchange of
EHRs in the Veneto Region (Italy)
Evaluate the assessment measure in use to support
the eHealth strategy
Analyze the Veneto case and its application to other
contexts
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Arsenàl.IT – Who we are
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Background – Where we are
Venice
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Background – Some features
One regional authority
Seven provinces (counties)
575 municipalities
One regional public health system
Nine local health authorities (LHAs)
Two hospital trusts (HTs)
One oncology research center
The Healthcare System
Administrative Framework
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Veneto US
Background – Some features
Health Expenditure and ComparisonPublicPrivate70%
30%
49% 51%
Based on OECD data 2016 and 12° Health report – Crea Sanità
The Veneto Regional
Health System
Universal health coverage
but…
30% funded by
households and...
86% of which is out-of-
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Our ecosystemOne Army
~ 8,000
Hospital Specialists
~ 70,000
Overall Health Workers
~ 4,000
GPs ~ 1,500
Pharmacies
~ 5,000,000
Citizens
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Our ecosystemOne Mission
Health Information
Exchange system (HIEs)
Starting point
Mission accomplished
LHAOrHT
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2013 2019
Our ecosystemOne Vision
TIME LINE
VALUE LINE
ICT adoption Structured
info
Exchangeinfo Data at
work
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We need a measure
Bees on the ground, but…
How do we track the progress?
How do we improve our action plans?
How does a solution solve actual conditions?
Our ecosystemThe deployment
?
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The five Ws and one HThe assessment program
Independent institution
Healthcare digitalization adoption
The entire Veneto Region
WHO?
WHERE?
WHAT?
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The five Ws and one HThe assessment program – When?
Get the initial status and track the progress
2013 2016
Survey I Survey II …
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First, identify the digitization level of each LHA and HT
Second, get the whole picture of the regional health system
The five Ws and one HThe assessment program – Why? (1 of 2)
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The five Ws and one HThe assessment program – Why? (2 of 2)
Third, measure the value of a new asset class: structured information
RAW DATAMEANINGFUL DATA
ICT deploymentstrategy…
… Measure the value of information
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The five Ws and one HThe assessment program – How?
Identified HIMSS and its EMRAM methodology
0 stage All three ancillaries not installed
1 stage Lab, Rad, Pharmacy installed
2 stage HIE capable
3 stage Clinical documentation
4 stage CPOE; CDS
5 stage Full R-PACS
6 stage Full CDSS, CLMA
7 stage Complete EMR, data analytics
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Handle with care – Coding and meaningHIMSS EMRAM – HIEs meaning
0 and 1st stage
There is no
exchange of
digital data
2nd stage
Presence of
different digital
data but
limited
exchange
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Handle with care – Coding and meaningHIMSS EMRAM – HIEs meaning
3rd stage
Some
documents are
structured and
exchanged
4th stage
Starting to
work in a
CDSS-mode
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Handle with care – Coding and meaningHIMSS EMRAM – HIEs meaning
5rd stage
EHRs enable
new delivery
models
6th stage
Data analytics
supports clinical
strategy and
programs
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Handle with care – Coding and meaningHIMSS EMRAM – HIEs meaning
7th stage
AI at work
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Gimme the numbers – main results
From CDSS to AI
1 2 3 5 6 70
No
exchange Limited
exchangeSome docs are
structured and
exchanged
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The Veneto Region EMRAM mean score
2013
2.9
2016
3.9
EMRAM score
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eReferral: ~ 20M/y
ePrescription: ~ 40M/y
Already available docs
~ 160M in 4 years
Gimme the numbers
STOCKSFLOWS
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Gimme the numbers – A map
Check & Maintain
Good practices
4°
HIMSS stages 2016
Varia
tio
n 2
01
6 -
20
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1 7°
6°
5°
2°
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45
0-1
1°
Pay attention
3°
From 0.3 to 5.2
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Next stop? - A new measurement?
How to complete the EMRAM score?
How to assess the ability to deliver the continuity of care?
2013 2016
EMRAMRegione Veneto
Survey I
EMRAMRegione Veneto
Survey II
CCMM
on testing
2017
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Next stop?From hospital to primary and social care
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Transferability
APPROCH
Bottom-up
Engagement & Collaboration
Strong commitment
VALUES Standard and acknowledged methodology not case specific Self-feeding process
One measure does not provide insight to the value
OBSTACLES
Lack of vision
Reduced credibility of strategy
Undefined goals
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Any questions?
mmm…
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Claudio Saccavini
Technical Director
Consorzio Arsenàl.IT
@Consorz_Arsenal
LinkedIn: Consorzio Arsenàl.IT - OFFICIAL
Giulia Pellizzon
Project Engineer
Consorzio Arsenàl.IT
@Consorz_Arsenal
LinkedIn: Consorzio Arsenàl.IT - OFFICIAL