GARTNER TELECONFERENCE Healthcare The Updated Gartner CPR Generation Criteria Tom Handler, M.D. Barry Hieb, M.D. 13 June 2007 Notes accompany this presentation. Please select Notes Page view. These materials can be reproduced only with Gartner's official approval. Such approvals may be requested via e-mail vendor.relations@gartner.com.
Digital Record Scope Patients/ Members of Multiple Independent Organizations Patients/ Members of an Organization CPR = computer-based patient record EHR = electronic health record EMR = electronic medical record PHR = personal health record CDW Information Analysis LMR EHR PHR Information Exchange Purpose 1 PHMT Personal Health Management CPR Care Mgmt. EMR Enterprise Ambulatory Direct Care Giving Definitive Usage Likely Additional Usage
The Pendulum Is Swinging to Best of Suite Best of Breed Best of Suite 2
Defining Advanced Clinical PHR QIO or Payer Pay for Performance Italicized entries are the most speculative Regional Health Information Organization ADT = admission, discharge and transfer EMPI = enterprise master person index PBM = pharmacy benefit management QIO = quality improvement organization RIS = radiology information system External Knowledge Source Registration and ADT Managed Care Context EMPI Extraenterprise PBM Cooperating Scheduling Pharmacy Laboratory Pathology CPR Subscriber Data Warehouse Patient Billing Claims Support 3 PACS/ RIS NHIN Clinical Trial Data Manager E-prescribing Network Reference Labs External CPR/EMR
Core Capabilities of a CPR System Doc. and Data Capture Clinical Workflow POE & Order Management Clinical Decision Support CMV/VOSER Display/ Dashboard Clinical Data Repository Interoperability CPR System Management 4 Doc. and Data Capture Clinical Workflow POE and Order Management Clinical Knowledge Management Clinical Decision Support CMV/VOSER Display/ Dashboard Clinical Data Repository Interoperability CPR System Management CMV = controlled medical vocabulary POE = physician order entry VOSER = vocabulary server
CPR Generations: Available Today Generation 1: The Collector Generation 2: The Documentor Generation 3: The Helper (Only a few are currently available) These are simple systems that provide a site-specific, encounter-based solution to accessing clinical data. Basic systems that clinicians begin to use at the point of care for somewhat more than merely accessing clinical data. More-advanced systems that support clinical episodes and encounters clinicians. These systems must include integrated pharmacy functionality and cover both ambulatory and acute-care settings. For the first time, the technology can permit a CDO to bring EBM to the point of care CDO = care delivery organization EBM = evidence-based medicine 5
CPR Generations: Available in the Future Generation 4: The Colleague (Available 2010?) Advanced systems that provide substantial functionality for nurses, physicians and pharmacists. These systems have more decision support and workflow capabilities along with tools that permit CDOs to more easily bring EBM to the point of care. Generation 5: The Mentor (Available sometime after 2015?) Complex, sophisticated and fully integrated context-aware systems that cover the full continuum of care and care givers, and that can actually guide clinicians when appropriate. 6
CPR Generation Impact on Medical Errors Reduction in Preventable Errors 100% 80% 60% Generation 5: The Mentor Generation 4: The Colleague Generation 3: The Helper 40% Generation 2: The Documentor 20% Generation 1: The Collector 0% 1993 1998 2004 Year 2008 2012+ 7
Generation 3 CPR Component Synergy Generation 3 CPRs enable EBM through the provision of six key synergistic capabilities Conflicts Order Sets CPOE Evidence Data Access Integration CDR Processes Protocols Literature KM EBM WF Role Mgmt. CDR = clinical data repository CDS = clinical decision support CMV = controlled medical vocabulary CPOE = computer-based physician order entry KM = knowledge management WF = workflow framework Error CDS Checking Clinical Decisions 8 CMV Semantic Links Synonyms