HIMSS Overview:Global Perspective/Regional Emphasis

HIMSS Overview:Global Perspective/Regional Emphasis

February, 2010

HistoryHistory1961: 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 research capabilities

2005: Established HIMSS Europe, AsiaPac & Middle East – Global Perspective/Regional Emphasis

2006: Expanded to include focus on business and financial IT

TodayToday

• 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 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 DirectionHIMSS Strategic Direction

VisionBetter health care through information and management systems MissionLead healthcare transformation through the effective use of health information technology

HowHow

• 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

U.S.: Trends, Policy and Meaningful Use

Sound Familiar?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 ThemesWorldwide 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 QualityTrend: 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

Source: HIMSS AnalyticsTM Database N = 5,170/5,172

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

2008Final

0.3%

0.5%

2.5%

2.5%

35.7%

31.5%

11.5%

15.6%

0.3%

1.0%

4.5%

3.6%

38.4%

31.4%

7.2%

2009Q3

13.4%

© 2009 HIMSS Analytics

EMR Adoption ModelEMR Adoption Model

What’s Happening in the US 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 DefinedMeaningful 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 Process5-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 RequirementsStage 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 HospitalsEligible 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 HospitalsEligible 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 CriteriaStandards Criteria

Relevant Themes • Creates a floor for standards, implementation

specifications, and certification criteria for meaningful use.

• Creates specific standards in 2011 in four areas:

1. Vocabulary

2. Content exchange

3. Transporting of information

4. Privacy and security

Real MessageReal 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?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