Daniels全球医疗保健转型

GlobalHealthcareTransformationBetterhealththroughInformationTechnologyrGlobalHealth•Doingmorewithless•Reducinghospital•Reducinghospitalmortality•Reducinghospitalacquired•Reducing‘never’events•ReducingLOS•Growingagingpopulation•ImprovingpatientsafetyImprovingefficiencyandImprovingstaffsatisfactionn•Reducinginequality•Justifyingtheinvestmentin•Protectingthosemostatrisk•Andmanyothers……Whatisdrivingthevision?•In1999,IOMreportedmorethan98,000Americansdieinhospitalseachyearasaresultofmedicalerrors•7,000areestimatedtodiefrommedicationerrorsalone•57,000dieeachyearwithoutappropriatehealthcare•InEurope,missedhealthcareopportunitiescostEuropeansociety€70billionThesechallengesaresharedWorldwideProblemhasworsened–2016Why?LackLackofRelevantInformationatthePointofCareHowcanwetransformhealthcareInvestmentininformationtechnologyisneededtohelpmakehealthcare…Crossingthequalitychasm:Anewhealthsystemforthe21stmyPressthcareInformationTechnologythcareInformationTechnologylthcareInformationTechnologyQuickCaseStudy–UnitedStatesGlobalHIMSSAnalyticsEMRAdoptionModelSMGlobalHIMSSAnalyticsEMRAdoptionModelSM2011Q22014Q3CompleteEMR,DataAnalytics2011Q22014Q3Physiciandocumentation(templates),fullCDSS,loopmedicationadministrationAprogressivelysophisticatedroadmapAprogressivelysophisticatedroadmap…thatenables0%CPOE,ClinicalDecisionSupport(clinicalprotocols)Clinicaldocumentation,CDSS(errorQuality,Safety,&6.3%OperationsEfficienciesCDR,ControlledMedicalVocabulary,6.3%OperationsEfficienciesAncillaries-Lab,Rad,Pharmacy-AllAllThreeAncillariesNot4%4%2009–AmericanRecoveryandReinvestmentActWhatisARRA?WhatisMeaningfulUse?unched•USD$250Minvestedto…•Build/strengthenITinfrastructure&exchangecapabilities•Improvecost,quality,andpopulationhealth•Develop/accelerateinnovativeapproachestoperformancemeasurement,technology,andcaredeliveryunched•Conclusions•EHRadoptionincreased•HIEparticipationincreased•However…•Needmoretimetodevelopanddemonstrate•Alignmentbetweenregionalandgovernmentinitiativesiscritical•Needmoreanalysestodetermineneedandreturnoninvestment•Privatesectorstillunabletoachieveinteroperability18.7%17.4%3.1%0.5%0.1%0.0%20.4%18.7%17.4%3.1%0.5%0.1%0.0%20.4%40.0%01234567EMRAMStage19.3%14.0%2.2%0.8%0.0%25.1%19.3%14.0%2.2%0.8%0.0%25.1%37.2%01234567EMRAMStage35.7%31.4%15.6%2.5%22.5%0.5%0.3%0.5%01234567EMRAMStage16.9%7.4%7.27.4%3.8%0.7%01234567EMRAMStagenCommunitieslaunched14.6%10.5%10.10.5%7.1%3.2%4.53.2%01234567EMRAMStage•••tsstart44.9%112.4%9.0%5.2%13.2%8.4%5.7%01234567EMRAMStage•••e38.3%44.3%14.2%14.0%8.4%8.2%10.7%01234567EMRAMStage•••e30.3%222.0%5.8%2.9%3.3%12.5%7.6%15.5%01234567EMRAMStage•••e32.7%117.9%3.8%2.0%5.1%14.0%3.6%21.0%01234567EMRAMStageCommunitiesevaluationrnmentpaymentscontinue35.9%27.1%27.1%16.4%10.1%4.2%2.1%1.7%2.6%01234567EMRAMStagelsarelsare 2011lsarelsare 2011|MUPaymentslsare2009|2005|EMRAMLaunchedlsare20142010|BeaconCommunitiesARRAPassedlsare|MU2AdoptionModelSMke“significant”nationalprogressStage3%%4.2%0.1%.5%%.1%ge.5%4.5%.1%e.1%e%Stage1.1%N=4,237N=5,073N=5,166N=5,281N=5,337N=5,458N=5,458N=5,449N=5,467N=5,460DatafromHIMSSAnalytics®Database©nalEMRAMScoreDistributionacifice.5%4.2%2%0.1%e.1%4.6%tage.1%ge6%geStage148.2%.1%.1%N=770N=142N=5,460N=641N=2,395DatafromHIMSSAnalytics®Database©Canada,China,Germany,SouthKorea,Spain,SaudiArabia,TheNetherlands,Turkey,USAArgentina,Australia,Belgium,Brazil,Canada,Chile,China,Denmark,Finland,France,India,Ireland,Italy,Malaysia,SaudiArabia,Singapore,Switzerland,Taiwan,Thailand,TheNetherlands,Turkey,UAE,UK,USAProfileofaStage&7Organization•Usedatatodriveimprovedoutcomesrelatedto…–Process,Financial,Clinical,Quality&Safety•Arepaperless,ornearpaperless(createnopaper)–AllclinicallyrelevantdataisintheEMR•Arefullycommittedtocontinuousprocessimprovementthroughcollaboration–StrongITleadershipandexecutivechampions–Clinician/end-userchampionslDecisionSupportandClosedLoopMedicationAdministrationareKeyElementsofPatientSafety18.0%16.0%14.0%12.0%10.0%8.0%6.0%4.0%2.0%0.0%eMARManualTimingrelatederrorscriptionerrorsinceceEffectofBarCodeTechnologyontheSafetyofMedicationAdministrationPoonKeohaneBatesLipsitzetalNewEnglandJournalofMedicineMay6,2010PtScanPtScan:96%PtScanPtScan:96%19107CMI-AdjustedPatientDays0Jan2011Jan2013Jun2013TopPerformingHospitalsbyNumberMetricsExcellingInbyEMRAMStage.7%30.1%16.3%6.5%eSourceSource:HIMSSAnalytics®Logicm40intint49.045.544.638.945.945.9Stage0Stage1Stage2Stage3Stage4Stage5Stage6Stage7Sourc