Kansas City HIMSS April 2019 Better health through
Kansas City HIMSS April 2019
Better health through information and technology.
HIMSS Global Conference, Corp Membership, Thought Leadership, etc. Healthcare Information and Management Systems Society (HIMSS) Maturity Models Marketing Arm, Healthcare IT News, Local Forums, Content Creation & Syndication, etc. HIMSS is a global, cause-based, not-forprofit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology.
Five Key Strategies 1. Member Value 2. Thought Leadership 3. Maturity Model Reach 4. Diversify Revenue 5. Expand Internationally Hal Wolf, President & CEO, HIMSS
Maturity Models are… • Aspirational and drive the market • Roadmap • Learn from others experiences • Convey a vision of desired target state • Encourages everyone to work collectively • Global benchmarking • Vendor agnostic Key Features • Healthcare specific • Capability oriented • Prescriptive, clear, and informative – Simply stated compliance requirements – Industry standard terminology and detailed references
Model Development Process Healthcare Delivery Organizations Peer Review Pilot Group This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Health IT Vendor Solutions Certified Consultant Training 6
Global Progress
Maturity Models Expand Global Reach This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 8
Benefits at Stage 7 6% 36% 58% The U. S. Market
Maturity Models Expand Local Reach Average Lowest Highest Stage 7 4. 9 0. 1 7. 0 2 Average Lowest Highest Stage 7 4. 6 0. 1 6. 0 0 This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Average Lowest Highest Stage 7 5. 4 1. 6 7. 0 10 Average Lowest Highest Stage 7 4. 9 0. 0 6. 0 0 Certified Consultant Training 10
Maturity Models Expand Local Reach Avg 3. 2 Min 0. 0 Stage 7 Organizations 2 This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 11
Technology Innovation IMPORTANCE PERFORMANCE 61% 1. Drive operational, financial and process efficiencies 35% 59% 2. Enhance the patient experience, drive patient engagement 38% 56% 3. Gain market share/attract customers 37% 52% 4. Enable new models of care 31% 50% 5. Inform new treatment approaches, accelerate clinical imperatives 31% 44% 6. Improve the clinician experience, alleviate physician burnout 20% (N=180) HIMSS Media, Technology Innovation in Healthcare research, 2018. This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 12
Maturity Model Overview
Electronic Medical Record Adoption Model Outpatient Electronic Medical Record Adoption Model Measuring EMR capabilities and impact on systems, and patients. Scoring healthcare clinics on the maturity of their EMR environments. Adoption Model for Analytics Maturity Determining how to leverage data for better care and process optimization. Continuity of Care Maturity Model Infrastructure Adoption Model Digital Imaging Adoption Model Assessing levels of care coordination, systems integration, and patient engagement. Improve care delivery, reduce risk, and create a pathway for infrastructure development. Evaluating maturity of IT supported processes in medical imaging in hospitals and diagnostic centers. This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Healthcare Supply Information Maturity Model Transforming clinical environments to support quality, safety and sustainability. Certified Consultant Training 14
Electronic Medical Record Adoption Model Measuring EMR capabilities and impact on systems, and patients.
Outpatient Electronic Medical Record Adoption Model Scoring healthcare clinics on the maturity of their EMR environments.
Foundational HIT Investments Electronic Medical Records (EMR), pervasive, discreet data Computerized Practitioner Order Entry (CPOE) > 90% Driving paperless care, medically relevant info scanned in < 24 hours Closed loop admin of blood, medications, and human milk (CLMA) > 95% Disaster Recovery & Business Continuity (DR & BC) Governance Basic Clinical & Business Intelligence (C&BI) Health Information exchange (HIE) Etc… This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 17
Governance It relates to "the processes of interaction and decision-making among the actors involved in a collective problem that lead to the creation, reinforcement, or reproduction of social norms and institutions. " • Characteristics of “good” governance? • • Senior leadership commitment Quality & performance focused Focused on usability, reduce burn-out Clinicians driving the content, workflow and level of alerting • Not IT Change Control! This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 18
Adoption Model for Analytics Maturity Determining how to leverage data for better care and process optimization.
• Data Content Growth Key Focus Areas – 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 This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 20
Continuity of Care Maturity Model Assessing levels of care coordination, systems integration, and patient engagement.
Continuity of Care Maturity Model Governance Focus Areas • • Health Information Exchange Coordinated Patient Care Advanced Analytics Patient Engagement Clinical Information Technology Stakeholders
Digital Imaging Adoption Model Evaluating maturity of IT supported processes in medical imaging in hospitals and diagnostic centers.
Source: Roth CJ, Lannum LM, Persons KR. A Foundation for Enterprise Imaging: HIMSS-SIIM collaborative whitepaper. J Digit Imag 2016)
Infrastructure Adoption Model Gauging care delivery, risk reduction, and infrastructure development.
Key Focus Areas • Collaboration • Wireless – Messaging & Presence – Access – Conferencing – BYOD – Contact Center – Location • Transport • Security – Connectivity – Identity and Device Management – Tolerance and High Availability – Threat Detection & Response – Management – Firewall Segmentation – Policy – Encryption • Data Center – Storage – Virtualization – Cloud This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 26
What’s the Process?
q Stages 0 - 5 • Survey (varies: phone, worksheet, web) • Self-reported assessment q Stage 6 on-site Validation (except in North America for EMRAM & O-EMRAM) • Focus on model fundamentals • Preparatory guide provided with clear requirements q Stage 7 on-site Validation • Focus on advanced capabilities, strong case studies, strategic alignment • Preparatory guide provided with clear requirements • Validation good for 3 years This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 28
All of our models • Progress from Stage 0 – 7 (8 stages) • Have a survey • Actionable findings report* Example 2 basic results * EMRAM & O-EMRAM reporting online, Others via PDF This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 29
Example 2 expanded results * EMRAM & O-EMRAM reporting online, Others via PDF This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 30
What’s the Value?
Benefits at Stage 7 The Danger Zone This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. WHY? Certified Consultant Training 32
Benefits at Stage 7 The Danger Zone This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. At Stage 4 & 5 MDs are introduced to CPOE and Documentation. At these stages the medical record is a hybrid mix of online and paper. It can only provide rudimentary clinical decision support to the MD. Certified Consultant Training 33
Digital Profile – Baseline Use the self-assessment tools to determine the current status of an organizations maturity within each model. This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 34
Digital Profile – Goal Interview physician and executive leadership to understand where they want to be. A map of an organizations interest and ability to move up within each maturity model. EMRAM & O-EMRAM are base models and expected to be Stage 7 This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 35
Digital Profile – Opportunity The grey area represents the project scope and business opportunity. Not about reaching Stage 7 but improving capabilities and maximizing technology investments and resources available. This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 36
Benefits at Stage 7 – Primary Care Childhood Immunizations: 70% to 89. 7% Colorectal screening: 72% to 78% Tobacco cessation reminders: 54% to 97. 4% Diabetes Nephropathy testing: 78% to 92. 6% Asthma Protocol Compliance: 7% to 78% A 1 C testing: 50% to 83% Admissions for diabetic patients CHF patients supplied Blue-tooth enabled weight down 44% down 42% Source: HIMSS Analytics Stage 7 Case Study This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 37
Benefits at Stage 7 – Population Health This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 38
Benefits at Stage 7 – Acute Care Stage 6 hospital could be missing more than $1, 006, 000 annually in reimbursements from just these 8 DRGs Stage 6 and 7 organizations have similar discharge volumes, but the Average Total Payment for Stage 7 hospitals is 8. 3% higher than the Stage 6 average for these 8 DRGs Data from Medicare Provider Utilization and Payment Data , data. cms. gov 10/24/2017 This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training n=965 39
Benefits at Stage 7 – Acute Care Leapfrog "A" Patient Safety Grades by HIMSS EMRAM Stage Average Operating Margin by HIMSS EMRAM Stage 60% 4. 00% 49% 50% 3. 52% 3. 50% 3. 00% 37% 40% 2. 50% 30% 2. 00% 23% 1. 92% 1. 94% Stage 5 Stage 6 1. 50% 20% 1. 00% 10% 0. 50% 0% Stage 5 or Lower Stage 6 Stage 7 As of January 2019, Epic analysis of 2018 Leapfrog Grade data against HIMSS Analytics EMRAM Stage data. 0. 00% Stage 7 2016 Operating Margin Data from Moody’s Municipal Financial Ratio Analysis (MFRA) applied to 2016 EMRAM Analytics Stage data, bot as of February 2018. This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 40
Benefits at Stage 7 Cirrhotic Patient Care Children’s Sickle Cell • • Readmit rate ↓ 29% Patient days ↓ 39% Children’s PICU / RT Telemetry (BH) • • Overall LOS ↓ 25% PICU LOS ↓ 39% # pts on telemetry ↓ 24% Telemetry unit LOS ↓ 15% Sepsis Redesign Medicine TPN Utilization • • ICU LOS ↓ 11% ED LOS ↓ 14. 3% ED Mortality ↓ 23% % TPN started within 7 days of readmit ↓ 37% This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 41
Benefits at Stage 7 PEG Tube Feeding Hospitalist Routine Labs • Inpatient LOS ↓ 8% • BMP orders ↓ 6% Medicine Long Stay Patients Observation Unit (BH) • Patient days avoided = 1, 541 • Observation pt LOS ↓ 27% Surgical Pack Standardization ED Radiology Utilization • GYN pack costs ↓ 24% • PEDI pack costs ↓ 13% • Instruments in circulation ↓ 9, 480 • Total ED scan rate ↓ 15% This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 42
Benefits at Stage 7 Troponin Utilization (BH) ERAS LOS • Utilization ↓ 17% • • Virtual Hospice • Referrals up 25% • Inpatient CMO deaths ↓ 30% Behavioral Intervention (BH) • ALOS ↓ 10% GI/Colon (YNHH) ↓ 13% Total knee (BH) ↓ 19% Total hip (BH) ↓ 24% GYN (BH) ↓ 21% ID & Treatment Pts w Delirium • ALOS ↓ 10% This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 43
Benefits at Stage 7 Children’s Complex (YNHH) Observation Unit (BH) • Asthma visits ↓ 41% • BPA admitted LOS ↓ 15% COPD / PNA Care (LMH) SNF Utilization • PNA ICU Pt ALOS ↓ 43% • ↓ 5% Opioid Utilization MRSA Precautions (YNHH) • MME per day ↓ 17% • Multimodal analgesia administered ↓ 10% • 10, 400 pts taken off MRSA Precautions ↓ 61% This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 44
“No one asks what’s the ROI for the elevators in a hospital, the organization simply can’t operate without them. That is where we are now with the EMR. ” Estimated savings: Up to $60 Million Ongoing Allen L Hsiao, MD, FAAP Vice President & CMIO Yale New Haven Medical 45
This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 46
Benefits at Stage 7 – Acute Care This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 47
Benefits at Stage 7 – Acute Care This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 48
Benefits at Stage 7 – Acute Care Physicians were asked: “What Contributes Most to Your Burnout? ” Medscape National Physician Burnout, Depression & Suicide Report 2019 CIO CMIO to CEO CMO & Board https: //www. medscape. com/2019 -lifestyle-burnout This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 49
Incredible Variation Overall Collaborative Trends 88% Satisfied! What are these organizations doing. . . 68% Dissatisfied!. . . different from these organizations? Organization Net EMR Experience Score (EMR Satisfaction) This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 50
Benefits at Stage 7 “I see first hand during EMRAM and OEMRAM validations that there are organizations that are excited about their EMR and the benefits they are deriving from its use. ” - Philip Bradley, Regional Director HIMSS Analytics Is there a correlation between the Arch Collaborative MD satisfaction and the EMRAM Stages? This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 51
Percent of Hospitals with Count of Physicians Physician Net EHR Positive Physician Surveyed Experience Score Net EHR Experience Score HIMSS EMRAM Stage Count of Unique Hospitals US Hospitals Not on Stage 6/7 Validated List 63 3, 769 6. 6 67% Stage 6 Hospitals 145 14, 528 17. 5 74% Stage 7 Hospitals 65 5, 226 33. 8 95% Data Sources Used • • HIMSS Analytics publically available list of Stage 6 & 7 organizations (US Only) KLAS Arch Collaborative survey data (MDs responses only) Method • Matching organizations in the Arch Collaborative to HIMSS Stage 6 & 7 organizations This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 52
Benefits at Stage 7 100. 00 40 35 90. 00 30 25 80. 00 20 15 70. 00 10 5 60. 00 0 Not Validated Stage 6 Positive MD Responses “The jump in satisfaction is statistically significant (p<. 001) and very large. Especially meaningful is that of the 65 stage 7 hospitals, 95% of them had a positive Net EHR Experience Score—that is really amazing to us. ” Stage 7 Net EHR Exp Score Taylor Davis, KLAS VP of Innovation “Only included hospitals which had more than 15 physician responses, and we only included physician responses. ” This document contains proprietary information and intellectual property of HIMSS Analytics. Information contained herein may not be reproduced or disclosed under any circumstances without the express written permission of HIMSS Analytics. 2019 HIMSS Analytics. All rights reserved. Certified Consultant Training 53
Q & A Enabling better health through information technology. Thank you
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