16072-EMC-HealthcareIDC-eBook-1.27

TRANSFORMING
HEALTH Enabling integrated Care
EMEA Market Study
Connect people, processes, and information
where it counts – at the point of need

2
EMC asked IDC Health Insights to analyze the
future of information sharing in the health sector.
The goal was to better understand the business drivers
influencing IT investments in hospitals, regional and national
government healthcare entities.
This eBook provides an overview of the findings, showing the
commonalities and differences of how the integrated care delivery
model is being adopted in Western Europe, the Middle East and Africa
find short, medium and long-term strategies to enable integrated care.
You can download the full report here.
International Data Corporation (IDC) is the premier
global provider of market intelligence, advisory
services, and events for the information technology,
telecommunications and consumer technology
markets. IDC helps IT professionals, business
executives, and the investment community make
fact-based decisions on technology purchases and
business strategy. More than 1000 IDC analysts
provide global, regional, and local expertise on
technology and industry opportunities and trends in
over 110 countries worldwide.
Learn more at www.idc.com
EMC is a global leader in enabling businesses and
service providers to transform their operations
and deliver information technology as a service
(ITaaS). Fundamental to this transformation is cloud
computing. Through innovative products and services,
EMC accelerates the journey to cloud computing,
helping IT departments to store, manage, protect and
analyze their most valuable asset — information — in a
more agile, trusted and cost-efficient way.
Learn more at www.emc.com

REPORT METHODOLOGY
3
12 Government interviews
with executives in charge of
eHealth programs at both
national & regional levels
188 Hospital executives
from a telephones survey
(IT & non-IT)
IDC’s Continuous
MONITORING
of the healthcare sector
IT trends in Europe,
Middle-East and Africa
25 United Kingdom
35 Turkey
28 Germany
35 Saudi Arabia
27 France
38 South Africa
WESTERN EUROPE
MIDDLE-EAST & AFRICA

INTEGRATED CARE
At The Nexus of the Health Value Chain
“A re-orientated healthcare system will ensure
the future sustainability of service delivery. ”

Integrated Care At The Nexus Of The Health Value Chain
THE HOSPITAL CENTRIC SYSTEM
5
Traditionally the
center of gravity of the
healthcare system is
the general hospital,
which still accounts for
This hospital-centric system deals efficiently and
effectively with acute episodes, such as serious infections,
or surgeries. These conditions require providing several
days of acute care for a relatively small number of very ill
patients.
40%+
of healthcare expenditure,
in many developed countries.
This system, however, does not deal efficiently and
effectively with noncomunicable diseases (NCDs) that
require continuous care for a large number of patients
whose conditions are less acute but are often associated
with long-term disabilities and premature deaths.

THE HOSPITAL CENTRIC SYSTEM
6
will have a significant impact on health
and social care and may require
Source: Lancet scientific magazine in 2012
In fact, the World Health Organization (WHO) estimates
that: “Nearly 80% of NCD deaths - 29 million - occur in low-and
middle-income countries” and “More than 90% of NCD
deaths that occur before the age of 60, happen in low-and
middle-income countries”. As a result, NCDs rose to the
top of the healthcare policy agenda in emerging countries,
because their impact on younger age people are a serious
drag on economic development. A trend that is confirmed by
this IDC-EMC study, as hospital executives in Turkey, Saudi
Arabia and South Africa indicated that prevention and control
of NCDs is as important, if not more important than other
broad healthcare policy goals, such as increasing access to
services. (See Figure 1)
World Health Organization
studies indicate that NCDs
are an: “invisible epidemic...“
and “The burden is growing - the number of people, families
and communities afflicted is increasing. Common, modifiable
risk factors underlie the major NCDs. They include tobacco,
harmful use of alcohol, unhealthy diet, insufficient physical
activity, overweight/obesity, raised blood pressure, raised
blood sugar and raised cholesterol.”
In the U.K.,
the number
of people
with three
or more
long-term
conditions
is predicted
to rise
1.9M
POLICY
OBJECTIVES IN
MIDDLE-EASTERN
AND AFRICAN
HOSPITALS
Source: IDC 2013
#.##
#.##
Prevention and control of non-communicable disease initiatives
Accreditation of programs and clinical patients
#.##
Increase access to healthcare services
Promotion of evidence-based clinical practice
#.##
Figure 1
2.9M
2008
2018
Large
Ageing
population
More
Long-term
conditions
additional
expenditure
by 2018. £5B
1 ----------------------------------------------------- IMPORTANCE --------------------------------------------------- 5

TRANSITIONING TO A SUSTAINABLE SERVICE DELIVERY MODEL
7
An integrated care
delivery model can
INCREASE PATIENT
SAFETY
HELP CONTROL
COSTS
Lessening
the impact of risk factors
through their mapping and
prevention campaigns
Strengthening
primary healthcare early-detection
and treatment capabilities to
reduce the risk of acute episodes
at later stages
Re-orienting
the overall health system to
address the needs of people affected
by NCDs
+

TRANSITIONING TO A SUSTAINABLE SERVICE DELIVERY MODEL
8
Hospitals Primary Care
Professional
The re-orientated healthcare system will ensure
the future sustainability of service delivery
by coordinating all actors across the value chain, including hospitals, primary
care, community care, private clinics, public health authorities, payers,
life-science organization and, last but not least, patients.
Community &
Social Care
Life Science Research
Organizations
Day Hospital
Clinics & Labs
Governments & Public Payers Patients
Education Institutions

INFORMATION
IS THE CONNECTIVE TISSUE
“Patient information needs to be reliable, complete,
and relevant to the context in which it will be used.”

10
Figure 2
#1
ENABLE INFORMATION SHARING
WITH INTEGRATED RECORDS
Information is the connective tissue for integrated care
that increases patient safety - The level of coordination
and collaboration required by integrated care delivery
across the health value chain is a step-change,
particularly for hospitals that have been at the center of
the delivery system for over a century.
The need to coordinate among hospitals and other stakeholders will spur some consolidation
but the vast majority of integrated care delivery will have to be enabled by cross-enterprise
information sharing, through the creation of integrated patient records.
When complemented by appropriate organizational processes and incentives, information
technologies provide healthcare decision makers the meaningful and timely insights to
make planning, management and service delivery decisions that improve patient safety and
satisfaction, while controlling costs, across the end-to-end patient experience.
In fact, patient care and satisfaction are the top business priorities for the hospital executives
interviewed as part of this study. Taking precedence over regulatory compliance, and sensitive
data protection. (See Figure 2)
Hospital executives also feel patient safety outweighs cost controls.
1 ------------------------ IMPORTANCE ---------------------- 5
Source: IDC, 2013
Information Is The Connective Tissue
Patient care and satisfaction
enchancement
4.1
4.4
Sensitive data protection 4.0
4.3
Regulatory compliance 3.9
4.3
Clinical performance
improvement
3.9
4.3
Organization contribution to
business goals
3.8
4.1
Increase staff satisfaction 3.8
4.0
Reducing operational costs 3.8
4.0
Communication and external
relations improvement
3.8
4.0
Procurement efficiency 3.8
3.9
Multi-channel strategies to
suport patient services
3.6
4.1
Organizational restructuring
and consolidation activities
3.7
3.8
EMEA HOSPITAL SECTOR
BUSINESS PRIORITIES
Organizational restructuring and M&A activities are not a business
priority while patient care and satisfaction are at the top of the list.
Western Europe Middle East & Africa

11
THE VALUE OF
INFORMATION INSIGHTS
Insights extracted from integrated patient records will
be precious in a wide-variety of use cases, from hospital
administrative processes, to clinical decision support,
to collaboration of university hospitals with life-science
research organization.
Administrative information sharing
can drive value for money in anti-fraud, and resource optimization.
Clinical information sharing
can help doctors apply the latest findings of medical research, thus
providing personalized and evidence based care services. This will
enable providing better care for patient current conditions and
efficiently preventing complications and new disease developments.
Life-science research organizations
can improve clinical trial design and results analysis, speeding up
research times, results accuracy and bench-to-bedside translation.

12
Figure 3
BIG DATA ADOPTION DRIVERS
3.45
3.91
3.55
3.68
3.60
3.83
Volume Variety Velocity
INTEGRATED CARE
INFORMATION MANAGEMENT CHALLENGES
Integrated care is not an entirely
new business model. And so
are the related information
technologies that support it, such
as telemedicine, electronic health
records and clinical decision
support systems. Pilot initiatives,
particularly in Western Europe,
North America and Australia have
been running, for the past ten
years; and in emerging countries,
for the past three or four years.
However, full-blown transformation
has been hindered by a number of
business and technical challenges.
Governance models
The transformation from traditional service delivery, to
integrated care implies profound change in the governance
of national healthcare systems and in the organization
of individual providers. The fact that “organizational
restructuring and consolidation” activities rank very low,
among top business priorities, confirms the difficulty of
driving change. (Link to Figure 2)
Big data
In many healthcare organizations, the BI/DW technology
stack cannot leverage clinical documentation that is by nature
unstructured. This has thwarted efforts by providers to
create highly structured data warehouses common to other
industries. Clinical data is also extensive, inconsistent and
multidimensional, creating issues for warehouse designers.
These BI architectures, and the scalability of the underlying
infrastructure, will be challenged further by the increase in
data volume, velocity and variety. (See Figure 3)
Regulatory compliance
In jurisdictions where cultural and religious considerations
are carefully considered, lack of data privacy legislation has
slowed down information integration. However, advances
in IT security tools and information assurance management
policies and practices permit further progress.
Cultural change
Within any given healthcare organization, the technical
rationality of IT professionals and suppliers often collides with
managerial rationality of hospital managers and the medical
rationality that puts clinical care at its center. Effective change
management during an implementation project becomes
essential to educate staff about the potential benefits and
risks to their daily routine, as well as their involvement in
ensuring patient safety.
5
--------------- IMPORTANCE ----------
1

INTEGRATED CARE: INFORMATION MANAGEMENT CHALLENGES
13
Figure 5
2014 ICT BUDGET OUTLOOK
7%
12%
17%
UK Germany France Turkey Saudi
Positive Outlook
Arabia
Increase Same Decrease
29%
South
Africa
12%
32%
56%
4%
43%
46%
48%
37%
14%
65%
46%
38%
66%
Figure 6
20%
Upgrade Innovate Compliance Maintain
Budget
National healthcare services are mostly seeing a positive
budget outlook from survey respondents. (See Figure 5)
However, a large share of hospital ICT budgets are committed
to maintaining and running legacy systems and infrastructure,
(See Figure 6) leaving a small share of funding to radically innovate
existing solutions.
Data quality
As care becomes patient centric, volume, speed, granularity,
and variety of patient data will become more susceptible
to risks of errors. Patient information needs to be reliable,
complete, and relevant to the context in which it will be used,
so that clinicians, administrators and patients can not only
trust it, but so that it positively increase quality and outcomes.
The time aspect, however, should not be neglected, as the
rate in which individuals are affected by chronic diseases will
change slowly as populations continue to grow.
Figure 4
Integrated and secure
access to data and
applications
1 ------------ IMPORTANCE ---------- 5
Maturity of ICT service delivery
Western European countries have achieved a relatively high
level of maturity of their ICT infrastructure and now must
free up resources from maintenance budgets to continuously
improve through consolidation, shared services and cloud
computing. Emerging countries, on the other hand, suffer
less from legacy maintenance issues, but rather have
experienced hindrances finding skilled workers. (See Figure 4)
Siloed legacy architectures
To build an integrated patient record, information currently
sitting in fragmented administrative and departmental
systems must be pulled together. A top priority to survey
respondents. (See Figure 4) This demand is expected to increase
as more patient histories are digitized and must be combined
with medical images, pathology tests and administrative
patient information in order to provide optimal clinical and
care management.
2014 ICT BUDGET BREAKDOWN
19%
12%
18%
23%
15%
39%
54%
IT ORGANIZATION PRIORITIES
4.18
4.39
Align IT projects and build
flexible IT systems to
support strategic business
4.06
4.23
Improve quality of IT skills
within the organization
4.01
4.28
Proven data privacy
protection
4.13
4.56
Speed and cost of regulatory
compliance adaptation
4.01
4.20
Improve IT governance
3.93
4.25
Lower costs of IT
3.90
3.57

DOCUMENT
LIFECYCLE MANAGEMENT
“IT solutions strongly contribute to building the
solutions needed for integrated patient records.”

Document LifeCycle Management
15
AN INFORMATION-CENTRIC INTEGRATED CARE MODEL
Coherent archiving, retention, and disposal and most importantly,
integrated access and interpretation of data can give administrative and
clinical decision makers valuable insights for effectively planning,
managing and operating business processes.
Solutions that support structured
and unstructured information
capture, archival and access
across multiple EMR, EHR, COPE
and departmental applications
by decoupling the data from the
business logic.
Big data & analytics
Document life cycle
Cloud computing
SOLUTIONS

16
Figure 9
CLOUD COMPUTING
INVESTMENT DRIVERS
Cost efficient
1 ------------ IMPORTANCE ---------- 5
3.62
4.05
Helps deploy
applications faster
3.60
4.00
Improves access
from various devices
and locations
3.86
4.19
Scalable
3.58
4.28
Helps establish
standard processes
3.62
4.14
Innovate and expand
the business
3.74
0.00
Figure 7
DOCUMENT LIFE-CYCLE MANAGEMENT
12 MONTH INVESTMENT PLANS
Invest in a
new solution
Arabia
Maintain or enchance
exisiting solution
16%
South
Africa
60% 57%
4%
89%
7%
23%
15%
94%
6%
11%
Figure 8
BI/ ANALYTICS
12 MONTH INVESTMENT PLANS
56%
Invest in a
new solution
Arabia
Maintain or enchance
exisiting solution
26%
South
Africa
61%
63%
7%
15%
11%
94%
18%
16%
7%
The overall adoption of big data solutions in the EMEA
healthcare market is still small due to limited market
maturity. However traditional BI solutions are increasingly
being used to run analysis beyond simple financial
data reporting, such as complications management,
readmission management and disease progression.
Further investments are expected.
Document life cycle solutions
support structured and unstructured information capture,
archival and access across multiple EMR, EHR, CPOE and
departmental applications by decoupling the data from the
business logic. See Figure 7
These solutions, such as the EMC Documentum Integrated
Patient Record solution suite, should rely on coherent
archiving infrastructure that can provide reliability,
redundancy and security, while orchestrating different tiers of
storage to reduce the cost of managing increasing volumes
of data.
Big data and analytics
beyond volume, variety and velocity—will enhance patient
safety and satisfaction. Big data will also enable better
coordination to manage population health, and support new
business models to make healthcare services more financially
sustainable. See Figure 8
Cloud computing solutions
help deploy applications faster, offer access from multiple
locations and devices and offer scalability to deal with
the increasing volume of information that needs to be
archived and retained for longer periods of time as part of
a coherent archiving strategy that relies on hybrid storage
infrastructures. See figure 9
AN INFORMATION-CENTRIC INTEGRATED CARE MODEL

INTEGRATED CARE DELIVERY:
A PATIENT INFORMATION MANAGEMENT STRATEGY FRAMEWORK
The adoption of technology alone
will not deliver the expected results.
With a consistent strategy and
implementation approach, the
ecosystem of healthcare providers
can overcome business and
technology challenges to share
patient information effectively and
efficiently.
It is important to note, that most hospital IT and non-IT
executives will not be able to define and control all variables.
Countries that launched eHealth strategies as early as 2004,
such as Turkey, or later adopting countries, such as Saudi
Arabia that launched its first national eHealth strategy in
2010, have to deal with legacy governance arrangements,
legacy business processes and technologies, changing
budget and political priorities.
17
Figure 10
PATIENT INFORMATION MANAGEGMENT STRATEGY FRAMEWORK
OUTCOMES/GOALS
OF INTEGRATED CARE
INTEGRATED CARE
GEOGRAPHICAL SCOPE
PATIENT DATA
OWNERSHIP &
MANAGEMENT
SCOPE OF PATIENT
DATA REPOSITORY
Patient saftey
and satisfaction
Cost effective allocation of
healthcare expenditure
Regulatory
compliance
SOFTWARE SOURCING
International National Regional Community of
providers
administrative data Patient pathologies Patient medical tests Patient treatments
and prescribed drugs
APPROACH Best-of-breed End-to-end suite Best-of-suite
INFORMATION
Point-to-point
Service oriented architecture
INTEGRATION
application integration
that updates a consolidated
APPROACH
dataset real time
Federated architecture, based on a
master-patient index, that updates
information from source systems
National/regional
department of health
Individual hospital/
healthcare provider Patient Third-party
PATIENT DATA MODEL Proprietary – application specific Open – Compliant with international standards
BUSINESS LOGIC/
FUNCTIONAL
CAPABILITIES
Data capture, archival, retention,
access, reporting and auditing Big data/analytics Clinical
workflows
Administrative
workflows
Patient
USER ACCESS
INTERFACE/ CHANNEL
Healthcare
provider portal
Desktop
application UI
Department of
health portal Third-party portal Native mobile
apps
BUSINESS STRATEGY
INFORMATION GOVERNANCE
ENTERPRISE ARCHITECTURE

OUTCOMES OF INTEGRATED CARE
The strategic business outcomes of integrated care
management and delivery are usually a combination of
patient safety, cost-effectiveness and regulatory compliance.
18
Figure 11
2014 BUDGET EXPECTED TO BE
ALLOCATED TO REGULATORY
COMPLIANCE
13.8%
28.1%
16.5% 16.6% 18.6%
16.2%
No plans to invest
in new solution
Maintain current
solution
Plans to invest or
upgrade in 12 mos
Patient safety
and satisfaction
The top priority for the vast majority
of hospital executives. In an
integrated care setting, outcomes are the result of effective
coordination, collaboration and communication among
multiple stakeholders. This helps prevent patient health
deteriorating, and in cases where it does, apply the most
appropriate treatment.
Cost-effective allocation
of healthcare expenditure
A top objective for national and regional
health policy-makers that want to free
up resources to broaden citizen access to health services.
A more cost effective allocation of resources can result
in a balanced flow of patients between hospitals and
other healthcare providers, and by proxy, reduces waiting
times and shortens hospital stays, which improves patient
experience.
Regulatory compliance
From an information management
perspective, it is interesting to notice
(See Figure 11) that the hospital executives that
have already adopted document life-cycle
management solutions and plan to maintain them in 2014
are also those that expect to allocate the largest share of ICT
budget to regulatory compliance initiatives. (Link Figure 4)
This is a clear indication that document life-cycle
management solutions have been deployed to make
sure that the increasingly complicated data privacy and
retention laws and policies are applied consistently and in an
automated manner across multiple business systems. In the
future, this strong basis of securely and coherently archived
patient data could be leveraged to generate higher business
value in terms of patient safety and cost effectiveness.

INTEGRATED CARE GEOGRAPHIC SCOPE
International eHealth initiatives
have been promoted over the years by the European
Commission to ensure the free and safe flow of workers
and tourists. However, beyond a standard European Health
Insurance Card for patient identification and access to A&E
services, EU member states have achieved little in terms of
cross-border information sharing so far.
National eHealth strategies,
which include building integrated patient records, have
been launched in countries such as the U.K., France and
Saudi Arabia. These initiatives, however, still face challenges
that need to be addressed, such as change management
requirements.
19
The challenges that
national programs
encounter in supporting
integrated care and
integrated patient records
indicates that a purely top-down
national approach
is not viable. As a result,
policy-makers are breaking
down national programs
into community-level pilots
and regional-level projects
that are more sustainable
in the long-term.
Region-wide integrated health
and eHealth programs
have been the prevalent model in countries like Germany,
Spain, Italy and the Nordics. In large regions with many
patients and hospitals, the governance challenges are
still big, but more manageable than at the national level.
Decisions regarding data standards, procurement and
program implementation can be managed through pilots and
escalation mechanisms, built to reconcile points of view at
the regional level, where the overall budget is held.
Community healthcare providers
revolve around one or a small group of hospitals that act as
a small ecosystem. This is also the geographic scope of most
patients’ mobility. The majority of patient interaction with
healthcare providers takes place in the area where they live.

20
Patient Data Model
The European Union and the United States government set
up a Cooperation Initiative to promote interoperability of
Electronic Health Records, so that:
• Individual patients can be empowered
• Clinical outcomes can be improved
• Individual patient safety and population health can be
improved
Historically, patient data have been tightly coupled with
application logic through proprietary data models, which
made integration difficult. To achieve more open data
models that ensure semantic interoperability, syntactic
interoperability and patient mediated data exchange requires
more than making software compliant with international
standards. It will requires reconciling approaches with more
loosely coupled architectures that combine structured and
unstructured data management tools. Something that is very
hard to deploy and manage at a national or regional level.
Patient Data Ownership & Governance
According to European Union legislations, the patient is the
legal owner of his clinical and administrative data. However,
national and regional departments of health, individual
hospitals, or GPs end up managing patient records and are
responsible for an integrated care ecosystem. The gap of
health and regulatory compliance literacy is still too wide to
expect patients take full ownership of an integrated patient
record.
However, more involvement from the patient will be
necessary to ensure full orchestration, as not even GPs have
a full view of clinical treatments, tests and prescriptions
particularly over a long-period of time. Patient participation is
also necessary because pieces of clinical and administrative
information are held by third-parties, such as private clinics,
employers and private health insurance companies.
Scope Of Patient Data Repository
When dealing with integrated patient information
management, the business objectives have an impact on the
scope of the patient repository. For instance, if the objective
is to ensure free access to A&E services, access to basic
administrative and clinical data is sufficient.
But the more comprehensive the business objectives, the
wider the set of data that should be archived and made
available for analysis. This covers health information such as:
• Patient administrative data: identity, address,
reimbursement entitlement, etc.
• Patient history of pathologies and acute episodes
• Patient history of medical tests
• Patient history of medical treatment and prescribed drugs

BUSINESS LOGIC &
FUNCTIONAL CAPABILITIES
The business objectives of integrated care management
and delivery programs influence the evolution of
business logic because initiatives that are purely focused
on regulatory compliance can be satisfied with solutions
that provide data capture, archival, retention, access,
reporting and auditing capabilities.
Big data and analytics enable integrated care ecosystems to extract value from integrated
patient records to apply optimal treatment and give the right incentives to providers that need
to collaborate through more granular measurement of outcomes.
21
In order to orchestrate clinical
pathways across the health value chain,
clinical and administrative workflow
capabilities are required.
Clinical
Workflow Capabilities
CPOE & Electronic
Prescribing
Administrative
Workflow Capabilities
PAS admission-discharge-transfer
functionalities
to track reimbursement patterns

USER ACCESS / INTERFACE
22
Access to patient information is
increasingly moving away from pure
desktop application specific UIs and
being made available through portals
and native mobile apps.
Increasingly, native mobile apps for
healthcare professionals and patients
provide the same granularity and
real-time consistency but with user-friendly
access to information than
legacy application UIs. The shift in usability enabled
by mobile apps could bridge some
of the patient information integration
gap, particularly in clinical data
consumption use cases.

SOFTWARE SOURCING APPROACH
Hospital clinical information system
architectures have historically
used best-of-breed applications
for electronic patient record,
departmental systems, CPOE,
medical imaging and laboratories.
These fragmented architectures
and proprietary data models have
typically focused on leading-edge
business capabilities for a small
group of administrative or clinical
users, which did not favor building
a consistently integrated patient
record, not even within individual
hospitals.
23
True end-to-end suites, including all administrative and clinical
processes could solve the patient data integration issue and
would ensure consistent management of the platform. But
at this stage of market maturity, there are no real end-to-end
suites that can satisfy all clinical and administrative users.
Rather, they are loosely coupled modules offered by the
same software provider. Sometimes they are running with
different UIs and on different database, application server,
and operating system versions that force users to customize
code and build add-ons that jeopardize the out-of-the-box
consistency.
A best-of- suite approach provides a more sustainable model
with core data and business capabilities that are sitting in one
suite of products with ancillary capabilities and data being
supported by other systems. It is in a best-of-suite scenario
that solutions like document life-cycle management and
vendor neutral archive can add value by not only automating
regulatory compliance, but stitching together structured and
unstructured data to create integrated patient records.
(See Figure 12)
Figure 12
WESTERN EUROPE HOSPITAL SECTOR
INTERDEPENDENCE BETWEEN INVESTMENTS
IN DOCUMENT LIFE-CYCLE AND OTHER SOLUTIONS
35% 44% 21%
39% 39% 21%
33% 17% 50%
No plans
to invest
Maintain current
solution
62% 12% 26%
41% 38% 21%
28% 39% 33%
Plans to invest in
next 12 months
No plans to invest
Maintain Current
Plans to invest in next 12 months
EHR
Hospital executives that plan to invest
in document life-cycle management
solutions in the next 12 months are also
more likely to invest in EHR, particularly
in Western Europe.
DOCUMENT LIFECYCLE
VNA
This investment forms the architectural
foundation for federated access across
the health value-chain and in vendor
neutral archives, which is a key piece
to complete the patient data repository
with medical images coming from
different PACS solutions.

INFORMATION
INTEGRATION APPROACH
24
Software sourcing approaches, the
relative openness of data models
and the scope of integration are
all factors that influence the way
patient data integration can be
addressed. Though, in a highly
fragmented environment, point-to-point
application connectors will be
necessary to make sense of data.
Alternatively, a community of providers,
each with a consistent set of data residing in
end-to-end suites, could build a service-oriented
architecture that can consolidate data.
With a set of best-of-suite environments, an HIE federated
architecture based on a master-patient index can be built to offer
access to information that is extracted from source systems.

ESSENTIAL GUIDANCE
“Hospital executives should collaborate on a roadmap that
includes more loosely integrated data architectures.”

Essential Guidance
INTEGRATING PATIENT INFORMATION: WHAT’S NEXT?
26
The integrated care
management and delivery
model will
INCREASE PATIENT
SAFETY & SATISFACTION
as demanded by hospital and other provider executives.
Integrating patient information in a secure manner
will provide the connective tissue for collaboration
across the health value chain, so that patients can be
attended more promptly, treatments applied more
KEEP COSTS
UNDER CONTROL
as mandated by policymakers and payers.
+
appropriately, and unnecessary and costly intervention
eliminated. To fully leverage information for improved
patient outcomes, while complying with patient data
regulation, federated architectures must be leveraged.

27
Hospital executives should
collaborate with other stakeholders across
the value chain on a roadmap that includes more loosely integrated data
architectures to combine clinical and administrative applications with:
Essential Guidance
Document life-cycle
solutions
to integrate structured and unstructured
information, while applying regulatory
requirements consistently.
Big data & analytics
solutions
to extract insights from data sets of
large volume, variety and velocity.
Cloud computing
solutions
to ensure flexibility and scalability.
INTEGRATING PATIENT INFORMATION: WHAT’S NEXT?

Essential Guidance
WHAT SHOULD HOSPITAL
EXECUTIVES DO?
28
The short-term.
Use the information management framework to
evaluate your assets (technologies, standards and
patient data), processes (clinical, administrative, and
governance, risk and compliance related) and skills
to discover untapped opportunities in patient data
integration and analysis. For instance, document
management tools applied only to automate patient
data retention compliance could be used to improve
safety of medical orders. Start to experiment with
document life-cycle management, big data and cloud
computing to build collaborative pilots that involve other
stakeholders along the health value-chain.
The medium-term.
Design a roadmap for integrated care service delivery
and integrated patient record initiatives, which identify
gaps relative to existing assets, processes and skills.
Combine the gap assessments with early evaluation of
pilot projects in terms of business model sustainability
to attract budget and scale them to include a larger
number of stakeholders, medical specialties and
patients.
The long-term.
Optimize clinical and administrative workflow by
leveraging an integrated patient record to improve
the appropriateness of care. Consolidate benefits by
clearly communicating changes and how they impact
the long-term goals. This allows new practices in patient
data archiving, retention, access and analysis to be
industrialized and new resources freed-up for new
programs.
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