quality health care: technology and data drive improvement by stephen lieber
TRANSCRIPT
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Quality Health Care: TechnologyAnd Data Drive Improvements
H. Stephen LieberPresident & CEOHIMSS
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HIMSS Introduction
• Who is HIMSS– Global-focused, not for profit organisation of professionals,
clinicians, companies, policy makers and other stakeholders sharing the vision of better health through IT
• How do we work– As a dominant voice, convener and thought leader of
health transformation through IT
• Who is HIMSS– 300.000+ engaged professionals, 65.000+ members, ~400
staff in Europe, Asia, Middle East and North America
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We work with:
• Governments and Ministries• Policy makers and strategists• Care providers• Suppliers and Vendors• Professional communities• Clinical experts & IT professionals
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What drives our mission
• Hundreds of thousands die in hospitals each year as the result of medical errors– Tens of thousands die from medication errors alone
• Hundreds of thousands die each year without access to appropriate health care
• In the EU, missed healthcare opportunities have a €70 billion cost to European society
• These measures can be improved and IT is a major driver for that improvement
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Common Issues for Global Health
• Reducing hospital admissions, mortality• Reducing hospital acquired infections• Reducing “never” events• Reducing length of stay• Ageing population with multiple complications• Expanding community based care delivery• Improving patient safety• Improving efficiency and productivity• Justifying the investment in technology
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High Correlation:
Advanced EMR Capabilities and
Quality
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EMRAM: Model to Drive IT-Influenced Better Care
• Research shows relationship between higher levels of IT adoption and patient outcomes, safety
• EMRAM established globally-recognised pathway for IT adoption
• Baseline study will identify gaps, inform strategy development
• Standardised measuring tool of improvement
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• Apollo Hospitals Aynambakkam• Apollo Hospitals Chennai • Apollo Health City, Jubilee Hills • Apollo Speciality Hospital, Nandanam
India
• Max Super Speciality Hospital, East Wing, Saket • Max Super Speciality Hospital, West Wing, Saket
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Hospital Mortality
QUESTION: What is the association between EMR capabilities and hospital mortality?
• Paired HIMSS Analytics EMR Adoption Model (EMRAM) scores with Healthgrades’ hospital quality/mortality data.
In General… the more advanced the hospital’s EMR capabilities… the more likely the hospital is to have better risk-adjusted mortality rates when treating conditions like Heart Attack, Heart Failure, Stroke, several types of GI surgeries, Pneumonia, Sepsis and Respiratory failure.
US Hospitals with an "A" Leapfrog Hospital Safety Grade by EMRAM Stage
Stage 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Stage 70.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
0.0% 5.9%12.8% 14.3%
20.1% 21.8%30.8%
62.6%
All
hosp
itals
with
in e
ach
EMR
AM
Sta
ge
Tipping Point
0 (2008 N = 392; 2011
N=225)
1 (2008 N = 354; 2011
N=171)
2 (2008 N = 850; 2011
N=400)
3 (2008 N = 1060; 2011
N=1303)
4 (2008 N = 88; 2011
N=369)
5 (2008 N = 55; 2011
N=202)
6 (2008 N = 48; 2011
N=144)
7 (2008
N = 0; 2011 N=13)
-2.00%
-1.00%
0.00%
1.00%
2.00%
3.00%
4.00%
5.00%
6.00%
1.62%
2.84%2.25% 2.35%
3.53%4.06% 3.91%
-1.52%
-0.58%
0.77% 1.79%1.47%
2.55%
2.20%
4.91%
In 2008 In 2011EMRAM Stage
Mea
n O
pera
ting
Mar
gin
… HIT can achieve ROI !
Operating Margin by EMRAM Stage
Quelle: HIMSS Analytics US Database
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Who’s Using This
Denmark – annual data collection from all Danish hospitals to monitor status quo & provide input to new national ehealth strategy to achieve nationwide fully integrated care
Finland – with the HIMSS continuity of care model, HIMSS will support Finland in their new organizational transition, providing a strategy for regional integrated care
UK – data collection from all hospitals; gap analysis & assessment Spain – annual data collection from 6 Spanish regions, gap analysis and investment strategy
recommendations; CPHIMS education/certification for healthcare professionals Turkey – annual data collection of 850 public hospitals to monitor investments, provide gap
analysis & investment recommendations. New! Standards development & training/certification of Healthcare professionals
Iceland – data collection, gap analysis, investment recommendation European Commission: co-organize largest annual European joint HIT event eHealth week
presenting future roadmap for eHealth in Europe
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IT Drives Care Delivery Transformation
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IT Allows Focus on Patient Not Episode
• Better care outcomes at lower consumption of resources
• Break down silos across care providers to achieve: – A dynamic interconnected community wide focus:
• Health Information Exchange• Coordinated patient care• Patient engagement • Advanced analytics
• HIMSS has developed global model to provide comparative framework, gap analysis, and directional guidance
Continuity of Care Maturity
Resolve ID issuesHIE focus
Internal first,then external
Pt engagement
Optimization
Copyright © HIMSS Analytics
Info Tech
Clinical
Gov
Continuity of Care Maturation Model
Model Overview • Improve care coordination over diverse care
settings• Engages 3 key stakeholder groups• Leverages an 7 stage maturity model, like EMR
Adoption• 4 key focus areas theme for each stage, across
entire model• Aspirational model drives value based care
approach• Simple assessment survey • Action oriented, strategically focused
deliverables
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Data and Analytics: Going Beyond IT Systems
Analytics Value Curve
Descriptive Analytics
Diagnostic Analytics
Predictive Analytics
Prescriptive Analytics
Hindsight Insight Foresight
What happened?
Why did it happen?
What will happen?
Can we make things happen?
Less Difficult
More Difficult
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Why a maturity model
• Learn from others experiences• Provides a roadmap• Helps convey a vision of target state• Encourages everyone to work collectively
Key Focus Areas Across All Stages• Data Content growth
– Basic data to advanced data– Aligned with clinical, financial, and operational analytics activities
• Analytics competency growth– Start simple and work to master specific competencies– Enhance performance tracking / clinical decision support– Appropriate analytics maturation for individual parts of the
organization• Infrastructure growth
– Flexible approaches to accommodate a wide variety of situations– Vendor neutral– Timely data, centrally accessible
• Data Governance growth– Quality data and resource management– Executive suite and strategic alignment
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Building Blocks to Quality
• Sophisticated IT Adoption
• Continuity of Care
• Data and Analytics