Himss Overview, Madrid Cio Meeting

HIMSS Overview: Global Perspective/ Regional Emphasis February, 2010

History
1961: Founded as “HMSS” – a healthcare-focused management engineering professional society
1987: Added IT professionals
2001: Added corporate members/strengthened focus on improving healthcare through IT
2002: Enhanced focus on EHRs and Interoperability
2004: Added data services and market r esearch capabilities
2005: Established HIMSS Europe, AsiaPac & Middle East –
Global Perspective/Regional Emphasis
2006: Expanded to include focus on business and financial IT

Today
26,000+ Individual Members of which 73% work in the field (non-vendors, non-consultants)
420+ Corporate Members
90+ committees, task forces, & work groups
47 Chapters
Over 200 staff
Offices: Chicago, Washington DC, Ann Arbor, Brussels, Singapore
One of the 10 largest not-for-profit healthcare associations worldwide
Top 5 largest healthcare conference in US (27,000+)
Largest healthcare IT conferences in Europe, Asia and the Middle East

Strategic Subjects & Settings
Subjects
Interoperability
IT Adoption
Privacy & Security
Quality & P4P
Financial Systems
Clinical Informatics
Patient Safety
Management Systems
Standards & architecture
PHRs
Settings
Acute
Ambulatory
Life Sciences
Payer, Banking
Public Health
Long-Term Care
Home Health

HIMSS Strategic Direction
Vision
Better health care through information and management systems

Mission
Lead healthcare transformation through the effective use of health information technology

How
Engage all stakeholders: IT professionals, CEOs/administrators, physicians, nurses, other providers/clinicians, government, vendors, consultants, financial services
Develop tools and resources from real life experiences
Share, teach, learn: locally, regionally, globally

U.S.: Trends, Policy and Meaningful Use

Sound Familiar?
The situation and challenges are:
limited budgets
rising demand for healthcare services
increasing chronic diseases
quality below expectations
people in countryside with limited access to health care services
impact of changing demographic

Worldwide Themes
Cost: Europe, Asia, North America, Middle East, Africa all say the same: too high
Quality: Again, all say the same: too low
Access: patient access to care is uneven and at time unequal regardless of delivery or payment system

Trend: EMR Quality
HIMSS Analytics: Electronic Medical Record adoption progress correlates to the quality of care
Size not a requirement for IT adoption or improved quality
Quality solutions: coordination of care among providers and computerized test results

EMR Adoption Model Source: HIMSS Analytics TM Database N = 5,170/5,172 0.3% 1.0% 4.5% 3.6% 38.4% 31.4% 7.2% © 2009 HIMSS Analytics Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology Stage 4 CPOE, Clinical Decision Support (clinical protocols) Stage 5 Closed loop medication administration Stage 6 Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS Stage 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP Stage 1 Ancillaries – Lab, Rad, Pharmacy – All Installed Stage 0 All Three Ancillaries Not Installed 2008 Final 0.3% 0.5% 2.5% 2.5% 35.7% 31.5% 11.5% 15.6% 2009 Q3 13.4%

What’s Happening in the US
The Federal Government sees the problem
Costs, Quality, Access
Took First Action Last February
Signed ARRA (Stimulus Bill)
Established funding incentives
Issued Implementation Regulations in December
Will drive Health IT standards
Will link incentives to Health IT product certification and demonstrated use
Will establish minimum requirements for functionality, interoperability, and reporting

Meaningful Use Defined
Use certified EHR in a meaningful manner (ex. E-Prescribing)
Utilize certified EHR technology for the electronic exchange of health information to improve the quality of healthcare such as promoting care coordination
Submit information on clinical quality measures and other measures

5-Year, 3-Stage Process
Stage I (2011) – Electronic capture of health information in a coded format; tracking key clinical conditions for care coordinating; implementing clinical decision support tools; and reporting outcomes for public health purposes.
Stage II (2013) – Stage I + expanded computerized provider order entry; electronic transmission of diagnostic test results.
Stage III (2015) – Stage l + Stage II + focus on clinical decision support at a national level by encouraging patient access and involvement; and, improved population health data.

Stage I Requirements
Certified EHR technology that includes 25 measures
Requires Computerized Provider Order Entry (CPOE) for 10% of all hospital orders and 80% of all eligible providers’ orders
Delineates robust clinical quality measures
Requires patients be provided with an electronic copy of test results, problem lists, medication lists, and discharge summary upon request.
Implement five clinical decision support rules relevant to clinical quality measures.

Eligible Hospitals
Clinical Data Repository – store, retrieve, and manage laboratory and radiology results.
Clinical Documentation – nursing and physician in the areas of discharge, transfer, care coordination, problem list, demographic capture, vital signs and BMI, smoking status (for patients 13 years and older).
CPOE – in the areas of medications, laboratories, radiology/imaging, blood bank, physical therapy, occupational therapy, respiratory therapy, rehabilitation therapy, dialysis, provider consults, and discharge/transfer.

Eligible Hospitals
Medication Management - Medication administration for alerts at the point-of-care to accomplish real time drug-drug, drug-allergy, and drug-formulary checks.
Financial Information Systems – ability to check insurance eligibility and electronically submit claims.
Patient Communication – create and provide an electronic copy of a patient’s clinical information, discharge instructions and procedures upon request.
Clinical Decision Support – implement the five automated, clinical rules.

Standards Criteria
Relevant Themes
Creates a floor for standards, implementation specifications, and certification criteria for meaningful use.
Creates specific standards in 2011 in four areas:
Vocabulary
Content exchange
Transporting of information
Privacy and security

Real Message
Objective is not the installation or adoption of HIT
Objective is to change the cost curve and quality of care (change the way medicine is delivered and paid for)

What Does this Mean?
It does nothing to help multi-national collaboration
Certification and Standards: CCHIT, Q-Rec, IHE, ISO, etc differences will not be addressed
It will help multi-national learning from failure and success

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Himss Overview, Madrid Cio Meeting

by mcabrer on Feb 17, 2010

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