Trend of Digital Hospitals Driving Patient’s Safety and Quality of Care Through IT

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trend of digital hospitals Driving patients
safety and quality of care through itSteven
YeoGeneral Manager, HIMSS Analytics Asia
Pacific middle east

• 6th September 2013

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CONTENT

• Asia Pacific EMRAM Trend
• Key challenges for hospitals in adopting EMR
• Values
• Summary

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3 Fundamental Healthcare Issues

• Cost
• Quality of Care
• Access to care

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A common global problem

• Safety
• Privacy
• Engagement
• Clinicians
• Consumers
• Maturity
• Paper Management

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This looks familiar?
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Himss analytics Asia pacificEMR Adoption Modelsm
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EMR Adoption in the U.S. Market Trended
2006 2012 ( of U.S. Hospitals)
Tracking EMR adoption assists in the creation of
policies and strategies that drive EMR adoption
and improve patient care
Source HIMSS Analytics Database
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Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2)
Stage United States Canada Australia Malaysia Singapore United Arab Emirates Saudi Arabia Germany Italy Poland Portugal Spain Nether-lands
Stage 7 1.9 0.0 0.0 0.0 0.0 0.0 0.0 0.3 0.0 0.0 0.0 0.5 0.0
Stage 6 9.1 0.5 0.0 0.5 57.1 12.8 2.9 0.0 0.6 0.0 0.0 4.3 3.8
Stage 5 16.3 0.3 3.5 4.7 14.3 14.9 14.7 8.3 6.6 0.0 26.1 40.9 34.6
Stage 4 14.4 2.2 0.9 2.8 14.3 4.3 5.9 1.9 1.8 0.7 4.3 6.7 3.8
Stage 3 36.3 33.6 0.4 0.5 0.0 6.4 27.9 8.3 3.4 0.0 21.7 1.9 1.9
Stage 2 10.1 26.9 52.0 1.9 14.3 25.5 14.7 34.9 26.7 10.3 4.3 18.8 55.8
Stage 1 4.2 14.8 4.4 1.4 0.0 21.3 8.9 0.6 41.4 13.0 4.3 9.6 0.0
Stage 0 7.8 21.7 38.9 88.2 0.0 14.9 25.0 45.7 19.5 76.0 39.1 17.3 0.0
N 5,441 N 640 N 229 N 212 N 7 N 47 N 68 N 324 N 498 N 146 N 23 N 208 N 52
Data from HIMSS Analytics Database
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EMR Adoption Model Scores, of Hospitals, Q2 2013
Cross Regional EMRAM Score Distribution Cross Regional EMRAM Score Distribution Cross Regional EMRAM Score Distribution Cross Regional EMRAM Score Distribution Cross Regional EMRAM Score Distribution Cross Regional EMRAM Score Distribution
Stage Asia Pacific Middle East United States Canada Europe
Stage 7 0.2 0.0 1.9 0.0 0.1
Stage 6 2.3 7.0 9.1 0.5 1.4
Stage 5 4.5 14.8 16.3 0.3 14.9
Stage 4 2.5 5.2 14.4 2.2 2.8
Stage 3 0.5 19.1 36.3 33.6 4.0
Stage 2 28.0 19.1 10.1 26.9 27.2
Stage 1 6.2 13.9 4.2 14.8 18.8
Stage 0 55.8 20.9 7.8 21.7 30.7
N 600 N 115 N 5,441 N 640 N 1,354
Data from HIMSS Analytics Database
Data Retrieved Q1, 2013
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Asia Pacific EMR Adoption ModelSM
Stage Short Description 2012 Q4 2013 Q1 2013 Q2
Stage 7 Complete EMR CCD transactions to share data Data warehousing Data continuity with ED, ambulatory, OP 0.2 0.2 0.2
Stage 6 Physician documentation (structured templates), full CDSS (variance compliance), closed loop medication administration 2.6 2.2 2.3
Stage 5 Full complement of R-PACS displaces all film-based images 4.1 5.3 4.5
Stage 4 CPOE, Clinical Decision Support (clinical protocols) 3.0 3.0 2.5
Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 0.4 0.4 0.5
Stage 2 Clinical Data Repository (CDR), Controlled Medical Vocabulary, CDS, may have Document Imaging HIE capable 27.5 26.0 28.0
Stage 1 Ancillaries Lab, Radiology, Pharmacy All Installed 3.8 6.1 6.2
Stage 0 All Three Ancillaries (LIS, RIS, PHIS) Not Installed 58.4 56.9 55.8
N 469
N 508
N 600
Data from HIMSS Analytics Database 2013 HIMSS
Analytics
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Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2) Cross Country EMRAM Score Distribution (2013 Q2)
Stage Australia New Zealand Singapore Malaysia Thailand
Stage 7 0.0 0.0 0.0 0.0 0.0
Stage 6 0.0 0.0 57.1 0.5 0.0
Stage 5 3.5 5.6 14.3 4.7 6.2
Stage 4 0.9 0.0 14.3 2.8 0.0
Stage 3 0.4 0.0 0.0 0.5 1.5
Stage 2 52.0 91.7 14.3 1.9 9.2
Stage 1 4.4 2.8 0.0 1.4 32.3
Stage 0 38.9 0.0 0.0 88.2 50.8
N 229 N 36 N 7 N 212 N 65
Data from HIMSS Analytics Database Data
Retrieved 2013 Q2
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australia
KSA EMR Adoption ModelSM (2013 Q2)
Stage Short Description Small ( 100 beds) Medium (101-200 beds) Large (gt200 beds)
Stage 7 Complete EMR CCD transactions to share data Data warehousing Data continuity with ED, ambulatory, OP 0.0 0.0 0.0
Stage 6 Physician documentation (structured templates), full CDSS (variance compliance), closed loop medication administration 0.0 0.0 6.7
Stage 5 Full complement of R-PACS displaces all film-based images 7.1 12.5 20.0
Stage 4 CPOE, Clinical Decision Support (clinical protocols) 0.0 12.5 3.3
Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 28.6 20.8 33.3
Stage 2 Clinical Data Repository (CDR), Controlled Medical Vocabulary, CDS, may have Document Imaging HIE capable 7.1 16.7 16.7
Stage 1 Ancillaries Lab, Radiology, Pharmacy All Installed 0.0 8.3 13.3
Stage 0 All Three Ancillaries (LIS, RIS, PHIS) Not Installed 57.1 29.2 6.7
N14
N 24
N 30
Data from HIMSS Analytics Database 2013 HIMSS
Analytics
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CONTENT

• Asia Pacific EMRAM Trend
• Key challenges for hospitals in adopting EMR
• Values
• Summary

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Challenges for Adoption in Healthcare
Organizations

• Lack of financial resources
• Lack of basic IT infrastructure
• Use of open-source technology in developing
  countries
• Lack of professional healthcare IT Staff
• Lack of incentives for private hospitals to adopt
  EMR E.g. Raffles Hospital
• Nursing documentation not considered a priority
• Unable to justify the Returns of Investments
  (ROIs)
• Managing competing priorities to meet
  organisational budget and goals

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Key Issues in Achieving Stage 6 7

• Nursing functions not a priority unable to move
  past Stage 2 of the EMRAM
• No pre-packaged unit dose medications for closed
  loop medication administration

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CONTENT

• Asia Pacific EMRAM Trend
• Key challenges for hospitals in adopting EMR
• Values
• Summary

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Reasons for Adopting HIMSS EMRAM Benchmark
Stage Capabilities Benefit
Stage 7 Medical record Fully electronic, Able to contribute CCD as by product of EHR/EMR, Data Warehousing Paperless environment for better care medical outcomes . Clinical analytics derived from EMR data used to improve outcomes by inputs back to operational EMR. Rich analytics due to ability to capture data at every point.
Stage 6 Physician Documentation, Full CDSS Higher level of Patient Safety, Patient Care, Enhanced Effectiveness of Care
Stage 5 Closed Loop Medication Administration Patient Safety, 5 Rights
Stage 4 CPOE, CDSS Patient Safety
Stage 3 Clinical Documentation (Flow sheets), CDSS Allow Team-Based Care
Stage 2 Clinical Data Repository Force Standardisation. Single source of Truth
Stage 1 Ancillaries Automation of Departmental Workflow. Basis for Electronic Orders
Stage 0 -- --
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CONTENT

• Asia Pacific EMRAM Trend
• Key challenges for hospitals in adopting EMR
• Values
• Summary

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In Summary

• Government and hospitals are investing in IT to
  deliver better patient care safety, quality and
  access.
• HIMSS Analytics EMRAM (EMR Adoption Model)
  provide a good framework for government to
  baseline and track hospitals IT capability.
• Creation of policy and strategy
• Drive EMR adoption and patient care
• Hospitals can learn from other hospitals that had
  successfully achieved the stages and getting the
  ROI.
• Management needs to have clear strategy for
  building its EMR environment to meet its
  corporate objectives with its investment and
  outcome.

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In Summary

• Government and hospitals are investing in IT to
  deliver better patient care safety, quality and
  access.
• HIMSS Analytics EMRAM (EMR Adoption Model)
  provide a good framework for government to
  baseline and track hospitals IT capability.
• Creation of policy and strategy
• Drive EMR adoption and patient care
• Vendor needs to continue to invest in RD on
  capabilities in their solutions to meet
  customers needs.

Steven Yeo syeo_at_himss.org Tel [phone]