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Electronic Medical Record Adoption Model (EMRAM)
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Electronic Medical Record Adoption Model (EMRAM)

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Gary Lakin

Gary Lakin
Regional Director
HIMSS Analytics Asia Pacific
(Friday, 7.15am, Forum Room)

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    Electronic Medical Record Adoption Model (EMRAM) Electronic Medical Record Adoption Model (EMRAM) Presentation Transcript

    • HIMSS ANALYTICS ASIA PACIFICElectronic Medical Record Adoption Model™ (EMRAM) Gary Lakin Regional Director HIMSS Analytics Asia Pacific PREPARED BY
    • Agenda Who is HIMSS Analytics? What is the EMR Adoption ModelSM (EMRAM) How is the Model used? How does New Zealand score? Where do we go from here? 2
    • About HIMSS Analytics  Formed in 2004 as the research arm of HIMSS  HIMSS Analytics Asia Pacific established in 2011  30 years of data collection and reporting  Collect and analyse data related to the use of information technology in the healthcare industry  Track technology implementations, trends, and identify opportunities for advancing and improving the quality, safety and efficiency of care  www.himssanalyticsasia.org and www.himssanalytics.org 3
    • THE EMR ADOPTION MODEL(EMRAM)A common understanding drives improved outcomes
    • Introduction to the EMRAM Acute Care Model created in 2005 for the North American market and then localized for both the Europe and Asia Pacific regions Creates a common framework and foundation for a dialog around IT adoption Intended to push the industry to increasingly sophisticated levels of IT adoption. 5
    • EMRAM StudyBenchmarking drives Performance Improvement Objective – to track and evaluate IT system utilization in relation to its impact on improved patient care and operational efficiencies within the acute care setting. EMRAM Score provides a roadmap for implementing technologies that enable a fully realized EMR that improves patient care. Gap Assessment allows hospitals to determine “what’s next”. Segment Comparison Reports compares EMR-readiness within geographical segments of interests. Benchmarking Tools - over 40 peer comparison reports provide intelligence for future planning and operational advancements. Custom Reporting for Government and Regional Organisations. 6
    • EMRAM Explained An EMR is an environment not one specific system 8 Stages (0-7) of increasingly sophisticated levels of adoption Drives improved outcomes through advanced clinical decision support To progress from one stage of adoption to another a hospital must have all technologies in a specific stage implemented in at least one acute care setting (thru Stage 6) An EMRAM Score has four decimal places Technologies implemented in higher level stages not yet achieved are reflected by the values following the decimal place EMRAM scores are confidential – De-identified in peer level benchmarking and analysed at an aggregate level 7
    • 8
    • HOW IS THE MODEL USED?Know What’s Next
    • How is the EMRAM Used?  Healthcare Providers • Benchmark IT efforts • Identifying opportunity for cost and resource efficiencies • Guidance for IT strategic planning • Justification for Investment  Vendors • Promote client successes • Partner with clients  Thought Leadership • Predict market trends • Inform government policy decisions • Identify intentional/unintentional consequences of EMRs 10
    • An Example: EMR Adoption in the U.S. Market Trended 2006 – 2011 (% of U.S. Hospitals) Stage 2006 2007 2008 2009 2010 2011 Stage 7 0.0% 0.0% 0.3% 0.7% 1.0% 1.2% Stage 6 0.1% 0.8% 0.5% 1.6% 3.2% 5.2% Stage 5 0.5% 1.4% 2.5% 3.8% 4.5% 8.4% Stage 4 3.1% 2.2% 2.5% 7.4% 10.5% 13.2% Stage 3 18.7% 25.1% 35.7% 50.9% 49.0% 44.9% Stage 2 40.0% 37.2% 31.4% 16.9% 14.6% 12.4% Stage 1 17.4% 14.0% 11.5% 7.2% 7.1% 5.7% Stage 0 20.4% 19.3% 15.6% 11.5% 10.1% 9.0% Number of Hospitals n = 4,237 n = 5,073 n = 5,166 n = 5,235 n = 5,281 n = 5,337 Tracking EMR adoption assists in the creation of policies and strategies that drive EMR adoption and improved patient careSource: HIMSS Analytics ® Database 11
    • EMR Adoption Comparisons Across RegionsEMRAM United Stage States Canada Germany Italy Spain Sweden UAE Singapore 7 1.20% 0.00% 0.87% 0.00% 0.00% 0.00% 0.00% 0.00% 6 5.20% 0.50% 0.00% 1.35% 4.59% 2.94% 0.00% 66.67% 5 8.40% 0.20% 11.30% 2.70% 32.11% 26.47% 16.67% 0.00% 4 13.20% 2.30% 6.96% 5.41% 14.68% 2.94% 2.78% 0.00% 3 44.90% 36.50% 7.83% 8.56% 6.42% 11.76% 2.78% 0.00% 2 12.40% 20.4% 12.17% 15.77% 12.84% 35.29% 33.33% 33.33% 1 5.70% 14.50% 1.74% 30.18% 9.17% 0.00% 30.56% 0.00% 0 9.00% 25.60% 59.13% 36.04% 20.18% 20.59% 13.89% 0.00% No. ofHospitals 5337 641 115 222 109 34 36 6 12
    • Trends: EMR Adoption Positively Associated to Operating MarginSource: HIMSS Analytics ® Database 13
    • EMR ADOPTION INNEW ZEALANDIdentifying opportunity for improved outcomes
    • Sample Scores for 4 New Zealand HospitalsSource: HIMSS Analytics ® Database 15
    • Mean and Median EMRAM Scores Across Countries* Not statistically significantSource: HIMSS Analytics ® Database 16
    • GETTING TO STAGE 6Strategic planning
    • Sample EMR Gap Assessment* Identifying Opportunities for a Fully Realized EMR Hospital A Hospital B Hospital C Hospital D Stage (2.2690) (2.2100) (2.1990) (2.1390) 1 Completed Completed Completed Completed 2 Completed Completed Completed Completed Electronic Medication Electronic Medication Electronic Medication Electronic Medication 3 Administration Record (EMAR) Administration Record (EMAR), Administration Record (EMAR), Administration Record (EMAR), Nursing Documentation, Order Entry Order Entry Nursing Documentation Computerized Practitioner Order Computerized Practitioner Order Computerized Practitioner Order Computerized Practitioner Order Entry (CPOE), Physician Type Use Entry (CPOE), Physician Type Use Entry (CPOE), Physician Type Use Entry (CPOE), Physician Type Use 4 CPOE, Physicians Use CPOE - CPOE, Physicians Use CPOE - CPOE, Physicians Use CPOE - CPOE, Physicians Use CPOE - Medical Orders Medical Orders Medical Orders Medical Orders PACS Radiology - DF (Digital 5 Completed Completed Fluoroscopy), PACS Radiology - Completed Nuclear Medicine, Closed Loop, Electronic Medication Closed Loop, Electronic Medication Closed Loop, Electronic Medication Closed Loop, Electronic Medication Administration Record (EMAR), Administration Record (EMAR), Administration Record (EMAR), Administration Record (EMAR), Medication Administration Bar- Medication Administration Bar- Medication Administration Bar- Medication Administration Bar- 6 coding, Patient And Medication Bar- coding, Patient And Medication Bar- coding, Patient And Medication Bar- coding, Patient And Medication Bar- coded or RFID, Physician coded or RFID, Physician coded or RFID, Physician coded or RFID, Pharmacy Bar- Documentation, Track Inventory Documentation Documentation coding, Physician Documentation Management in Pharmacy 7 Not Validated Not Validated Not Validated Not Validated *Detailed Gap Assessment provided in Excel formatSource: HIMSS Analytics ® Database 18
    • Identifying Investment Opportunity  The four sample hospitals have achieved Stage 2  There are three major gaps in technology needed to achieve Stage 6 1. Documentation • Stage 3 - For Nurses at 2 hospitals • Stage 3 - For medication -- Electronic Medication Administration Record (EMAR) at all hospitals • Stage 6 - For Physicians with structured templates at all 4 hospitals 1. CPOE with physician adoption (Stage 4) 2. Closed Loop Medication Administration (Stages 6)Source: HIMSS Analytics ® Database 19
    • WHERE DO WE GO FROMHERE?100% hospital engagement
    • Facilities Region District Health Board Facilities CompletedParticipation to Date Northland 4 0 Auckland 1 1 Northern Waitemata 2 2• 3 of 4 Regions Counties Manukau 1 0• 8 Facilities completed Waikato Bay of Plenty 5 3 1 1• 1 Facility in Progress Midland Lakes 2 1• 31 Remaining Tairawhiti 1 0 Taranaki 2 1 Capital and Coast 2 1 Hutt Valley 1 0 Wairarapa 1 0 Central Mid-Central 2 0 Whanganui 1 0 Hawkes Bay 1 0 Nelson Malborough 3 0 Canterbury 3 0 Southern West Coast 1 0 South Canterbury 1 0 Southern District 3 0 TOTAL 40 8
    • 100% Engagement Data collection strategies tailored to meet each hospital’s needs Strategies include: • online survey • phone interview • Excel spreadsheets, etc. Support provided by HIMSS Analytics Asia Pac research team 22
    • Benefits of Participation Creates a common language for discussing IT strategy at the facility, district, national and regional levels Identifies best practices and opportunities for improved clinical, financial, and operational outcomes Validates and informs IT Investment and strategy 23
    • THANK YOU! Gary Lakin, Regional Director HIMSS Analytics Asia Pacific glakin@himss.org
    • Appendix HIMSS Analytics Stage 7 Awards recipients: http://www.himssanalyticsasia.org/emram/stage7hospitals.asp HIMSS Analytics Stage 7 Case Studies: http://www.himssanalyticsasia.org/emram/stage7caseStudySNUBH.asp HIMSS Analytics Stage 6 Awards recipients: http://www.himssanalyticsasia.org/emram/stage6hospitals.asp HIMSS Analytics Benchmark Reports: http://www.himssanalyticsasia.org/market/benchmarkingReports.asp HIMSS Analytics FAQ: http://www.himssanalyticsasia.org/market/FAQ.asp Contact: Gary Lakin, Country Lead E: glakin@himss.org M: 0400 808 504 25