Lessons in Health IT. John Paganini, MBA, CPHIMS, CIIP Sr. Manager Interoperability Initiatives

Transcription

1 Lessons in Health IT John Paganini, MBA, CPHIMS, CIIP Sr. Manager Interoperability Initiatives

2 HIMSS Innovation Center Health Care Initiatives Emerging Technologies

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4 HIMSS s Strength in Innovation 52 years of global health IT leadership Unmatched convening power Highly-credible and respected thought leadership, tools, resources, and publications to equip all in their transformational role The recognized international leader in interoperability, standards, and harmonization initiatives

5 Serves as an international Center of Excellence Enables innovation that improves the value of information technology in healthcare Convenes industry stakeholders to solve real-world clinical workflow and financial transactional challenges

6 Components of the HIMSS Innovation Center Welcome Center Immersion Theater Learning Center Technology Showcase Conference Center Bookstore/Resources

7 HIMSS Innovation Center Collaborators

8 Marketing Exposure and Product Visibility Interactive Health Journey HIMSS Mobile Application HIMSS Websites HIMSS Marketing and Ad Campaigns

9 Technology Showcase Connects Technology Innovations with Healthcare Industry Designed to Enhance Discussion and Extend Education Establish Awareness and Visitor Connections Collaborator Demonstrations Year Round Attended or Unattended Exhibition Environment Collaborator Exposure and Visibility Beacon Technology Facilitates Lead Management

10 Conference Center Host meetings of up to 150 people in the epicenter of innovation Fully wired audio/visual environment. Splits into 3 separate rooms.

11 Immersion Theater Describes the Importance of Health IT Highlights Collaborator Products and Services Theater messaging can be customized for Events and Meetings

12 Learning Center Visitors learn about healthcare initiatives from their point of view

13 LEFT SCREEN CENTER SCREEN RIGHT SCREEN Healthcare Professional/Provider Looping picture CONSOLE SCREEN Healthcare Professional story What s your point-of-view? Make a choice to start. Healthcare Consumer Healthcare Professional/Provider Health IT Vendor Academic Government Looping picture

14 LEFT SCREEN CENTER SCREEN RIGHT SCREEN Healthcare Professional/Provider Interoperability & Standards Looping picture CONSOLE SCREEN Interoperability & Standards story Select a HOT TOPIC and learn how it effects your point-of-view. Interoperability & Standards Health Business Solutions Privacy & Security Patient Engagement Analytics Looping picture

15 Events Over 6000 Attendees Over 130 EVENTS

16 Visitors

17 HIMSS Innovation Center infrastructure and services to advance interoperability Technical Demos HIMSS Interoperability Showcase TM Technical Support HIMSS Interoperability Services IHE USA Certification Patient Care Devices Vendors (Infusion Pumps) EMR, HIE and HISP vendors Special Projects Host Toolsets for Custom testing projects Plugfests, and hack-a-thons

18 HIMSS Interoperability Services Program Neutral Environment for Testing and Certification IHE USA Certification Program Newly Branded Interoperability Certification Program (IWG) launching at HIMSS15 Gazelle and other Open Source Tools (e.g. EMR)

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20 HIMSS Innovation Center Health Care Initiatives Emerging Technologies

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25 Privacy and Security Information security and patient privacy are fundamental components of a wellfunctioning healthcare environment. HIMSS provides resources to assist healthcare organizations and business associates with their privacy and security initiatives.

26 Privacy and Security Privacy and Security is one of the first and most crucial steps in expediting care in Sara s health journey. When the ambulance arrives at the scene, EMTs quickly access Sara s condition and call ahead to the Emergency Department to let them know that Sara Brown, a 45-year old woman, was coming in with stroke symptoms. A consent form, signed by Sara, allows hospital admissions to use a Health Information exchange (HIE) to request Sara Brown s medical information. Now, with Sara s consent, all of her correct vital information and patient records are present in the Emergency Department Electronic Medical Record before she even arrives. Since Sara s vital information is only entered once the results is: reduced errors, increased patient safety and improved quality of care.

27 What does Cyber look like now? Hacktivists Nation state actors (e.g., N. Korea, China, Iran, Russia, etc.) Malicious & negligent insiders (a complex problem) Destructive malware (not just adware) Mainstream media & trade press reports Hollywood Movies & TV

28 The Evolving Threat Space Threats - Multi-dimensional - The equation to be solved is complex Malicious insiders + phishing attacks + nation state activity

29 Occam's Razor The scientific principle that, all things being equal, the simplest answer is usually the right one. When trying to explain or prove something, we should refrain from making more assumptions than are necessary.

30 The Evolving Threat Space Occam s razor Unencrypted data Very weak passwords Unsecured wireless connections Significant, well-known vulnerabilities + effective exploits Phishing (exploit the human) Elicitation (befriend the human) Aging IT infrastructure (exploit the tech)

31 Pathways to Solutions Public-private partnerships Secure the human & technology Know & predict the threats Cross-sector engagement Work with the government Innovation Stay ahead of the threat with automation/ai Current threats, predicted threats Train & prepare for the event (even if it never happens)

32 Cyber Threat Intelligence in Health Care As a result of these sophisticated cyber threats, health care organizations are realizing that their current cybersecurity programs are not sufficient to prevent, detect, respond and recover from the current level of cyber attacks. Healthcare organizations are working hard to make needed improvements. One resource healthcare organizations should make use of is cyber threat intelligence (CTI). Lee Kim JD, FHIMSS

33 Cyber Threat Intelligence in Health Care Specific, detailed, actionable data about cyber threats, cyber threat actors, malware, vulnerabilities, and indicators of compromise (IOC). Simply put, cyber threat intelligence is all about helping the healthcare organization improve its security posture based on accurate, detailed information on the current cybersecurity threats. Lee Kim JD, FHIMSS

34 Cyber Threat Intelligence in Health Care In light of increasingly sophisticated cyber threats, healthcare organizations should evaluate the effectiveness of their cybersecurity program and make improvements where appropriate. Consider how cyber threat intelligence can help your healthcare organization to improve the ability to prevent, detect, respond and recover from cyber attacks. Lee Kim JD, FHIMSS

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36 Health Business Solutions Identifies and promotes the effective use of financial and administrative systems for healthcare organizations.

37 Health Business Solutions Financial management of healthcare is an important concern for Sara and her family. In addition to worrying about Sara s care, Mike wanted to ensure they could manage the financial costs. Through Health Business Solutions the hospital was able support Mike and Sara by getting them real time financial information on the costs of the care she was receiving. Helping the family finding financial solutions allowed them to focus on Sara s healthcare and not the cost.

38 Health Business Solutions Committee Purpose Statement Health Business Solutions Committee identifies and promotes the effective use of financial and administrative systems for healthcare organizations. Building on the historical work of the Medical Banking and Financial Systems Committee, the Committee will work collaboratively with others to understand and define the points of intersection of finance and administrative systems across the healthcare continuum.

39 Health Business Solutions Areas of Focus ICD-10: Concentrates on the development of tools and resources (ICD-10 Playbook) that will equip HIMSS membership with preparation for and implementation of ICD-10. The targeted HIMSS audience for these tools may include but is not limited to ambulatory providers, hospital/enterprise providers, payers, software vendors and clearinghouses.. Financial Privacy and Security: Examines the current deployment of risk management and security controls within the financial services industry and analyzes how these could be leveraged to facilitate the nation s goals for ehealth. Revenue Cycle Improvement: Create a vision for the next generation of revenue cycle management business processes and tools that will keep administrative cost containment, interoperability and consumer engagement front and center. Task Force members include a cross-section of representatives from provider organizations, payer organizations, financial institutions, retail clinics, and a variety of revenue cycle vendors and consultants.

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41 Patient Engagement Patients can take control of their health and health information by leveraging capabilities and connectivity of a personal health record and utilize the work of an alliance of health device manufacturers.

42 Patient Engagement Understanding her medical care and treatments was an important step in making the right healthcare decisions for Sara and Mike. While Sara was recovering in the hospital Mike, with Sara s permission, was following her care through an app on his ipad. Through a private and secure patient portal, Mike was able to see her labs, tests, and plans of care through the hospital stay. When it was documented that Sara was allergic to a medication, Mike was able to correct it quickly, which helped keep the record accurate. When Sarah went home, they shared the patient portal with their primary care provider to collaborate on Sara s recovery path. Healthcare providers working together with Sara and Mike contributed to a quicker recovery time and a better outcome for all.

43 Frost & Sullivan estimates that patient portals will grow 221% through 2017.

44 Consumers are Demanding a LOT from Health IT Cloud access to their detailed patient records accessibility to their providers and staff Ability to use their personal health record (PHR) Control access Maintain records Import data from pharmacy and labs Pay bills

45 This is our goal, is it happening now? Friend is being treated at two health systems, both have the same EHR, PHR When he logged into the second PHR, it prompted him, asking if he agreed to integrate his two medical records. He agreed. The next time he saw his specialist at the first facility, she noticed that his records from the other system had been integrated into his record Lessons: Health information exchange (HIE) works Should be driven by the patient s consent Leads to a more engaged patient This is what Meaningful Use is about

46 Patient Engagement Further Defined We define engagement as actions individuals must take to obtain the greatest benefit from the healthcare services available to them This definition focuses on behaviors of individuals Relative to their healthcare That are critical and proximal to health outcomes Rather than the actions of professionals or policies of institutions

47 Meaningful Use Stage 2 Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP (for EPs only) More than 50% of all unique patients seen by the EP are provided timely online access to their health information Provide patients the ability to view online, download and transmit their health information within 36 hours after discharge from the hospital (for Eligible Hospitals/CAHs only) Use secure electronic messaging to communicate with patients on relevant health information (for EPs only) More than 5% of all unique patients seen

48 Patient Engagement fit with Strategy New Payment Models Patient Centered Medical Home Accountable Care Organizations To achieve these successfully, patient engagement essential

49 The Future of Patient Engagement

50 The Future of Patient Engagement

51 Patient Engagement is key to Meaningful Use Stage 2 Reaching the 5% participation threshold is a challenge Integration of patient engagement into a strategic initiative is the key There is growing evidence that patient engagement impacts medical outcomes

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53 Interoperability HIMSS is continually working to provide crucial tools for achieving interoperability and implementing standards in all areas of Health IT integration, including clinical and nonclinical information.

54 Interoperability Health information exchange was an important factor in ensuring the right information was available to all providers working on Sara s care. The hospital Sara was admitted to had implemented standards in all areas of Health IT integration, including clinical and non-clinical information. This infrastructure allowed for a seamless flow of information between physicians, hospital systems and Sara s own electronic medial record. Health IT interoperability help Sara and her doctors achieve crucial health information exchange.

55 Interoperability

56 The Connected Healthcare System

57 Interoperability Defined In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user. Data exchange schema and standards should permit data to be shared across clinicians, lab, hospital, pharmacy, and patient regardless of the application or application vendor.

58 Foundational interoperability allows data exchange from one information technology system to be received by another and does not require the ability for the receiving information technology system to interpret the data. Structural interoperability is an intermediate level that defines the structure or format of data exchange (i.e., the message format standards) where there is uniform movement of healthcare data from one system to another such that the clinical or operational purpose and meaning of the data is preserved and unaltered. Semantic interoperability provides interoperability at the highest level, which is the ability of two or more systems or elements to exchange information and to use the information that has been exchanged.

59 CONSUMER PROVIDER VENDOR Interoperability and standards ensures that your health information moves seamlessly and in a standardized manner between all of your healthcare providers. Your information follows you wherever you go, allowing your provider to have the right information at the right time to make informed clinical decisions. Interoperability aims to create a common framework for information sharing designed to optimize clinical workflow and improve patient care. Electronic health record systems implemented using interoperable technology and standards can streamline your flow of clinical information, reduce errors and improve efficiency. Interoperability product testing and certification programs will enable you to achieve optimal levels of interoperability, accelerating the alignment of healthcare provider needs with regulatory requirements.

60 Over $30 Billion to be saved by achieving Medical Device Interoperability

61 The Connectathon An IHE Connectathon is a crossvendor, live, supervised, and structured testing event with over 100 participating vendors and 600+ engineers and IT architects. All these organizations and IT experts converge on-site in Cleveland, OH, for one full week of interoperability testing and problem resolution. Participants test their products against multiple vendors using real-world clinical scenarios contained in IHE's Integration Profiles. Source: Source:

62 IHE NA Connectathon Moves to Cleveland, OH /01/clevelands_first_connectathon.html# incart_related_stories news/db_330498/contentdetail.htm? contentguid=blrlfhkj

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65 Analytics HIMSS Analytics supports improved decision making for healthcare organizations, healthcare IT companies and consulting firms by delivering high quality data and analytical expertise.

66 Analytics Having the right information, at the right time, available to Sara s doctors helped improve decision making in her overall care. There were many treatments for Sara s stroke. The physicians used the information available to them through analytics to see what would be the best care for her by comparing her demographics to large databases of patient information, or population health. Using analytics to help support Sara s doctor make informed medical decisions, improved the quality of care she received.

67 The HIT industry has enjoyed a positive history during the past few years.

68 All U.S. Hospitals The percentage of U.S. hospitals acquiring and/or installing HIT applications each year is back to 2008 levels Percent of US Hospitals Acquiring/Installing at least one HIT application 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 54.7% 57.7% 61.4% 64.6% 65.4% 62.3% 54.8% Acquired/Installed at least one HIT application

69 All U.S. Hospitals with the level of activity (number of applications acquired) in 2014 are lower than in Percent of US Hospitals Acquiring/Installing HIT applications 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 13.0% 14.5% 27.2% 10.0% 14.4% 9.8% 12.3% 13.1% 9.5% 15.6% 16.0% 13.2% 12.7% 8.6% 9.3% 33.3% 36.0% 36.3% 39.1% 40.1% 36.9% Applications 4-9 Applications 10+ Applications

70 The market seems to be shifting in significant ways.

71 The market continues to be focused on EMR applications with their buying patterns shifting in a predictable way. Top Five Most Frequently Acquired/Implemented HIT Applications Application Physician Documentation Computerized Practitioner Order Entry (CPOE) Patient Portal Electronic Medication Administration Record (emar) Clinical Decision Support System (CDSS) Higher market demand Lower market demand

72 In $Billions Leading us to conclude that the hospital HIT market will continue to constrict Projected Total U.S. Hospital HIT Application Spend ( ) $8.00 $7.80 $7.60 $7.40 $7.20 $7.00 $6.80 $6.60 $7.27 $6.40 $7.14 $7.05 $6.99 $6.96 $6.95 $6.20 $

73 Five Year CAGR reflecting both a notable shift in buyer interests... Projected Five Year CAGR of HIT Application Categories ( ) 7.0% 6.0% 5.0% 4.0% 3.0% 2.0% 1.0% 0.0% -1.0% -2.0% -3.0% 6.3% Hospital Tethered Applications 1.5% -1.2% -2.5% Other Clinical Applications EMR Applications Operational Applications

74 % of Total Hospital HIT Spend and buyer motivations. Projected Hospital HIT Application Spend ( ) 100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% 39.7% 41.0% 43.3% 46.0% 49.1% 51.0% 60.3% 59.0% 56.7% 54.0% 50.9% 49.0% First Time Buyers Replacement Buyers

75 The growth in this market has led to advanced EMR capabilities in the US hospital market.

76 HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) incorporates methodology and algorithms to automatically score the more than 5,400 U.S. and approximately 650 Canadian hospitals in the HIMSS Analytics database relative to their EMR capabilities. Ranging from limited ancillary department systems through a paperless EMR environment, EMRAM scores provide peer comparisons for hospital organizations as they strategize their path to implementing a complete EMR and participation in an electronic health record (EHR).

77 Percent of Hospitals EMRAM Distribution: All US Hospitals Q % 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 37.2% 25.1% 19.3% 14.0% 2.2% 1.4% 0.8% 0.0% EMRAM Stage

78 Percent of Hospitals EMRAM Distribution: All US Hospitals Q % 45.0% 40.0% 35.0% 30.0% 25.0% 20.0% 15.0% 10.0% 5.0% 0.0% 32.7% 21.0% 17.9% 14.0% 3.8% 5.1% 3.6% 2.0% EMRAM Stage

79 The advanced EMR capabilities of hospitals has notable implications for providers.

80 Operating Profit Margin Hospitals with advanced EMR capabilities tend to be more profitable Average Operating Margin : U.S. Hospitals (2014) 7.0% 6.4% 6.0% 5.5% 5.0% 4.0% 3.8% 3.5% 4.4% 3.0% 2.0% 2.3% 2.5% 2.3% 1.0% 0.0% EMRAM Stage

81 Number of FTE IS Staff The number of information system employees increases as the hospital s EMR capabilities advance Average IS FTEs: U.S. Hospitals (2014) EMRAM Stage

82 How do we know Health IT works? How does Health IT improve patient care? Can we duplicate the type of value others have achieved?

83 Better healthcare Improving patients experience of care within the Institute of Medicine s 6 domains of quality: Safety, Effectiveness, Patient- Centeredness, Timeliness, Efficiency, and Equity. Better health Keeping patients well so they can do what they want to do. Increasing the overall health of populations: address behavioral risk factors; focus on preventive care. Reduced costs $ Lowering the total cost of care while improving quality, resulting in reduced monthly expenditures for Medicare, Medicaid, and CHIP beneficiaries. Health Information Technology Source:

84 HIMSS Innovation Center Health Care Initiatives Emerging Technologies

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88 - Advanced Medical Imaging - Computer-Aided Diagnostics - Wireless Telemedicine - Noninvasive Health Monitoring - Teleradiology - Personal Medical Devices - Implantable Sensors - Medication Adherence - Asset Tracking and Monitoring - Mobile Diagnostics - Implantable Prosthetics

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