1

Quality Health Care: TechnologyAnd Data Drive Improvements

H. Stephen LieberPresident & CEOHIMSS

2

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

3

We work with:

• Governments and Ministries• Policy makers and strategists• Care providers• Suppliers and Vendors• Professional communities• Clinical experts & IT professionals

4

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

5

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

6

High Correlation:

Advanced EMR Capabilities and

Quality

7

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

8

• 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

10

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

13

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

14

IT Drives Care Delivery Transformation

15

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

18

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

20

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

23

Building Blocks to Quality

• Sophisticated IT Adoption

• Continuity of Care

• Data and Analytics

24

Thank you

H. Stephen Lieber

slieber@himss.org

www.himss.org