WHY AND HOW EMR SHOULD BE COORDINATED THE CHALLENGE OF COORDINATING EMR

Transcription

1 WHY AND HOW EMR SHOULD BE COORDINATED THE CHALLENGE OF COORDINATING EMR

2 WHY AND HOW EMR SHOULD BE COORDINATED 1) Why coordinated EMR 2) Complexity of Healthcare 3) Automatic exchanges HIE Platform 2

3 Quality of care : implication for patient s safety and continuity of care 1 (e.g.: avoid lapses in management of patients) Efficiency: avoid redundant exams and tests 2 HIT in the Healthcare system: primary care and hospitals Sharing of patients information between care providers Need to improve information exchanges 3 1. Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA 2007;297(8): Fontaine P, Ross SE, Zink T, Schilling LM. Systematic review of health information exchange in primary care practices. J Am Board Fam Med 2010;23(5): Échange et partage de données par voie électronique Analyse bibliographique réalisée entre octobre 2012 et février 2013 HAS juillet

4 FEATURES Useful and better than the current system User friendly, interoperability Adaptable to needs and evolution SOCIAL ASPECTS Technological knowledge Cost Users implication ORGANIZATIONAL FACTORS Local leaders Decreased workload Appropriate management and implementation («progressive or big bang») Échange et partage de données par voie électronique Analyse bibliographique réalisée entre octobre 2012 et février HAS juillet

5 care coordination average patient sees 7 clinicians in 4 different settings n engl j med 2007; 356:

6 transitions of care a primary care provider must coordinate care with 229 physicians and 117 different practices to care for an entire panel of patients. ann intern med feb 17;150(4):

7 healthcare data journey 7

8 HIE a fulcrum for change Real interest from care providers Lack of shared vision Need for HIE 8

9 resistance to electronic exchanges Lack of interoperability Safety and confidentiality Loss of income Reliability and data quality Complexity of processes and policies to protect personal data Loss of care provider s autonomy 9

10 often begins by connecting applications inside hospitals 10

11 & extends across the continuum of care other communities ehealth exchange (formerly nwhin) ehealth exchange (nwhin) gateway centers of health & education providers (with or without an electronic medical record) strategic interoperability, patient-centric record payor organizations federal agencies radiology facilities hospitals & health centers laboratories diagnostic systems pharmacies state agencies rehabilitation personal health records facilities 11

12 engaged communities citizens as patients & consumers clinicians & care managers services information managers 12

13 the complexity of healthcare rapid rate of change vast amounts of complex data extensive cross-organization activity increased pressure to measure & improve 13

14 coordination = 2 LEVELS AUTOMATIC EXCHANGE DSS = VISUAL RULES (TrakCare) PLATFORM HIE HealthShare 14

15 DSS = VISUAL RULES (TrakCare) Creating DSS 15

16 DSS = VISUAL RULES (TrakCare) Visual Rules Wizard 16

17 HIE Platform = HealthShare healthcare organization solutions product platform solutions partner solutions 17

18 HIE Platform = HealthShare who uses an informatics platform 18

19 HIE Platform = HealthShare New York ehealth Collaborative statewide information network serving 20m patients create comprehensive, current, credible patient-centric records across diverse systems and populations recognize a variety of workflows and needs 19

20 HIE Platform = HealthShare comprehensive, current, credible patient-centric records 20

21 Global keys to success create current patient-centric records deliver value immediately & continually embrace a platform mindset use data to improve outcomes 21

22 3 business areas 1 Advanced data technology 2 Electronic patient record 3 Health informatics platform 22

23 THANK YOU Dr Hervé RIVIERE Physician Executive Paris, FRANCE