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eHealth Reality in North America
eHealth Reality in North America
eHealth Reality in North America
eHealth Reality in North America
eHealth Reality in North America
eHealth Reality in North America
eHealth Reality in North America
eHealth Reality in North America
eHealth Reality in North America
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eHealth Reality in North America

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eHealth Reality in North America. Garets D. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

eHealth Reality in North America. Garets D. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

Published in: Health & Medicine
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  • 1. eHealth Reality in North America David E. Garets, President & CEO, HIMSS Analytics Executive Vice President, HIMSS
  • 2. Expectations, Limits, and Barriers for EMRs in U.S. • Expectations: • Widespread adoption of acute care and ambulatory EMRs, and “meaningful use” – via first time ever financial incentives and requirements from the federal government, increasingly stringent over 3 phases starting this calendar year. • Interoperable exchange of summary patient data among acute care and ambulatory providers, payers, health registries, and patients via health information exchanges • Limits: • Perverse incentives – hospitals and physicians get paid for helping people once they’re sick as opposed to keeping people healthy • Hospitals compete against each other – medical arms wars – most health systems don’t have good economies of scale in IT
  • 3. Expectations, Limits, and Barriers for EMRs in U.S. • Barriers: • Clinician adoption – lack of change management strategies • Lack of pan-America standards adoption • Money is tight, in both operating and capital budgets • There’s a 40,000 – 60,000 person shortage of qualified, experienced health IT professionals • Potentially 35% of hospitals have “too far to go” to earn Phase 1 incentives.
  • 4. 2005-2009 US EMR Adoption Model Trends 2005 2009 Final Final Complete EMR; CCD transactions to share data; Data Stage 7 warehousing; Data continuity with ED, ambulatory, OP 0.0% 0.7% Physician documentation (structured templates), full Stage 6 CDSS (variance & compliance), full R-PACS 0.0% 1.6% Stage 5 Closed loop medication administration .001% 3.8% Stage 4 CPOE, Clinical Decision Support (clinical protocols) 2.5% 7.4% Nursing/clinical documentation (flow sheets), CDSS Stage 3 (error checking), PACS available outside Radiology 10.0% 50.9% CDR, Controlled Medical Vocabulary, Stage 2 CDS, may have Document Imaging; HIE capable 48.8% 16.9% Stage 1 Ancillaries – Lab, Rad, Pharmacy – All Installed 19.6% 7.2% Stage 0 All Three Ancillaries Not Installed 18.4% 11.5% Source: HIMSS AnalyticsTM Database N = 3,816/5,235
  • 5. Expectations, Limits, and Barriers for EMRs/EPRs in Canada • Expectations: • Widespread adoption of physician/primary care clinic EMRs • Obligation to make minimal data available to all patients – lab/radiology diagnostic results, drug history • Minimizing number of EMR platforms in most provinces • Limits: • Full acute care implementations at a few selected sites • Extensive rural environment precludes practicality of complete paperless EMRs in most population centers.
  • 6. Expectations, Limits, and Barriers for EMRs/EPRs in Canada • Barriers: • Clinician adoption remains a challenge • Canada has yet to adopt HL7 CCD standards • EMR strategies remain intra-provincial • Emphasis by Canada Health Infoway on pan-Canadian PHR • Economic restrictions due to large deficits
  • 7. 2009 Canadian/U.S. Comparison CDN US Final Final Complete EMR; CCD transactions to share data; Data Stage 7 warehousing; Data continuity with ED, ambulatory, OP 0.0% 0.7% Physician documentation (structured templates), full Stage 6 CDSS (variance & compliance), full R-PACS 0.2% 1.6% Stage 5 Closed loop medication administration 0.0% 3.8% Stage 4 CPOE, Clinical Decision Support (clinical protocols) 1.1% 7.4% Nursing/clinical documentation (flow sheets), CDSS Stage 3 (error checking), PACS available outside Radiology 28.8% 50.9% CDR, Controlled Medical Vocabulary, Stage 2 CDS, may have Document Imaging; HIE capable 22.7% 16.9% Stage 1 Ancillaries – Lab, Rad, Pharmacy – All Installed 11.7% 7.2% Stage 0 All Three Ancillaries Not Installed 35.6% 11.5% Source: HIMSS AnalyticsTM Database N = 660/5,235
  • 8. IT Spending in U.S. hospitals • Projected 2009 spending: • $27.5B - $30.41B • Actual 2009 spending: • $28.03B
  • 9. Thank you!

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