trend of digital hospitals Driving patient’s safety and quality of care through it
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Transcript of trend of digital hospitals Driving patient’s safety and quality of care through it
TREND OF DIGITAL HOSPITALS
DRIVING PATIENT’S SAFETY AND QUALITY OF CARE THROUGH IT
STEVEN YEOGENERAL MANAGER, HIMSS ANALYTICS ASIA PACIFIC & MIDDLE EAST
6th September 2013
CONTENT
• Asia Pacific EMRAM Trend
• Key challenges for hospitals in adopting EMR
• Values
• Summary
3 FUNDAMENTAL HEALTHCARE ISSUES
• Cost
• Quality of Care
• Access to care
A COMMON GLOBAL PROBLEM
• Safety• Privacy• Engagement
» Clinicians» “Consumers”
• Maturity• Paper
‘Management’
THIS LOOKS FAMILIAR?
HIMSS ANALYTICS ASIA PACIFICEMR ADOPTION MODELSM
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
Data from HIMSS Analytics® Database ©
Cross Country EMRAM Score Distribution (2013 Q2)
Stage United States*
Canada* Australia Malaysia SingaporeUnited 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 ©
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
EMR Adoption Model Scores, % of Hospitals, Q2 2013
* Data Retrieved: Q1, 2013
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= 600Data from HIMSS Analytics® Database © 2013 HIMSS Analytics
Asia Pacific EMR Adoption ModelSM
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
Stage Short DescriptionSmall
(≤ 100 beds)Medium
(101-200 beds)Large
(>200 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%
N=14 N= 24 N= 30Data from HIMSS Analytics® Database © 2013 HIMSS Analytics
australia KSA EMR Adoption ModelSM (2013 Q2)
CONTENT
• Asia Pacific EMRAM Trend
• Key challenges for hospitals in adopting EMR
• Values
• Summary
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
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
CONTENT
• Asia Pacific EMRAM Trend
• Key challenges for hospitals in adopting EMR
• Values
• Summary
04/10/2023
17©2011 Healthcare Information and Management Systems Society
Reasons for Adopting HIMSS EMRAM BenchmarkStage 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 -- --
CONTENT
• Asia Pacific EMRAM Trend
• Key challenges for hospitals in adopting EMR
• Values
• Summary
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 hospital’s 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.
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 hospital’s IT capability.» Creation of policy and strategy» Drive EMR adoption and patient care
• Vendor needs to continue to invest in R&D on capabilities in their solutions to meet customer’s needs.
Steven [email protected] : +65-98485259