-
Going Beyond EMRAM-The Value ScorePat Wise
VP, Health Information Systems
HIMSS North America
June 24, 2015
-
EMRAM
-
Data from HIMSS Analytics Database 2015 HIMSS Analytics
0.7% 3.7%
22.2%
30.8%
13.6%
19.7%
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1.8%
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7.7%
50.0%
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11.4%
2010 Q1 2015 Q1
N = 5223 N = 5462
Complete EMR, CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP
Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS
Closed loop medication administration
CPOE, Clinical Decision Support (clinical protocols)
Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology
CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable
Ancillaries - Lab, Rad, Pharmacy - All Installed
All Three Ancillaries Not Installed
-
Data from HIMSS Analytics Database 2015 HIMSS Analytics
3.6% 3.7%
22.2%
30.8%
13.6%
19.7%
4.3%
2.2%
3.5%
17.9%
32.8%
14.0%
21.0%
5.1%
2.0%
3.7%
2014 Q4 2015 Q1
N = 5467 N = 5462
Complete EMR, CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP
Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS
Closed loop medication administration
CPOE, Clinical Decision Support (clinical protocols)
Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology
CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable
Ancillaries - Lab, Rad, Pharmacy - All Installed
All Three Ancillaries Not Installed
-
Data from HIMSS Analytics Database 2015 HIMSS Analytics
3.6% 3.7%
22.2%
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13.6%
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4.3%
2.2%
3.5%
17.9%
32.8%
14.0%
21.0%
5.1%
2.0%
3.7%
2014 Q4 2015 Q1
N = 5467 N = 5462
Complete EMR, CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP
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CPOE, Clinical Decision Support (clinical protocols)
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CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable
Ancillaries - Lab, Rad, Pharmacy - All Installed
All Three Ancillaries Not Installed
MU Stage 1
MU Stage 2
MU Stage 3
-
Value Suite
-
Initiated 2 years ago resulting in a collection, a framework and a value score
International; 2,000 of 11,000 examples from other than US Value Vocabulary
STEPS = framework for discussing, attributing value Value Suite = collection of 11,000+ statements of derived
value sorted into the STEPS framework Organized by Level of Evidence (1-4) (Peer Review->
Vendor Submission) Value Score = numeric score from 0-10
Value Suite
-
Value STEPS
Value Suite Collection
Organized into STEPS Framework
-
Value Vocabulary
STEPS = framework for discussing, attributing value Value Suite = collection of 11,000+ statements of
derived value sorted into the STEPS framework
Value Realization Model = model based on value attainment; basis for advisory services
Value Score = numeric score from 0-10 (score can be calculated to hundredths (4.35, 5.60)
Value Score
-
Value Score by S-T-E-P-S
2,940
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2,072
4,719
647
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S T E P S
-
11|
Count of Value Statements by STEPS subtype
SOURCE: HIMSS VS database as of April 2, 2015
Total = 11,078
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12|
Value Statements by provider type
SOURCE: HIMSS VS database as of April 2, 2015
Total = 13,143 (some statements fall in multiple buckets)
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STEPS: Electronic info/Data
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u
s
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o
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e
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e
n
c
e
b
a
s
e
d
m
e
d
i
c
i
n
e
g
u
i
d
e
l
I
n
c
r
e
a
s
e
d
i
n
f
o
r
m
a
t
i
o
n
s
h
a
r
i
n
g
a
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o
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g
p
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r
s
I
n
c
r
e
a
s
e
d
c
l
i
n
i
c
a
l
t
r
e
n
d
s
t
r
a
c
k
i
n
g
/
p
o
p
u
l
a
t
i
o
n
h
e
a
l
t
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o
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o
r
d
s
Total = 2,072
-
16|
STEPS: Patient education/Prevention
19
536044
7080
4850
22
177
51
4I
n
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a
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(
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f
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Total = 678
-
17|
STEPS: Savings
131
9
8295
152128
353361386
285
83131
103
391
89
142
O
v
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r
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O
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R
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R
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p
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R
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r
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s
I
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r
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u
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n
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k
f
l
o
w
/
p
r
a
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t
i
c
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e
f
f
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c
y
I
m
p
r
o
v
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d
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o
f
s
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m
p
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v
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d
c
l
a
i
m
s
m
a
n
a
g
e
m
e
n
t
Total = 2,921
-
Review of the Value Suite Collection led to the concept of a Value Score
Value Score + Analysis
Value Score + Analysis+ Advisory Services
Value Score
-
SATISFACTIONSatisfaction Score: Sample Areas
Provider Satisfaction Do you have a formalized program for getting
feedback from your physicians re: your EHR?
Does this measurement program allow you to benchmark your performance against other provider organizations?
How does physician satisfaction with the EHR at your organization compare to other organizations?
Staff Satisfaction Do you have a formalized program for getting
feedback from your staff re: your HIT?
Does this measurement program allow you to benchmark your performance against other provider organizations?
How does staff satisfaction with the HIT at your organization compare to other organizations?
-
Treatment/Clinical Score: Sample Areas
Efficiencies Have you formally evaluated the impact of health
information technology on the productivity of your clinical staff?
What was the outcome of the evaluation?
Quality of Care Have you formally evaluated the impact of health
information technology against externally established quality metrics (e.g. The Joint Commission; Leapfrog)?
What was the outcome of the evaluation?
Have you formally evaluated the impact of health information technology against internally established measures of care?
What was the outcome of the evaluation?
TREATMENT/CLINICAL
-
ELECTRONIC SECURE DATAElectronic Secure Data Score: Sample Areas
Security Does your organization have a formal documented risk
analysis program designed to mitigate the threats and vulnerabilities to your electronic personal health information (ePHI)?
Does this risk analysis program specifically include networked medical devices?
Does this risk analysis program specifically include mobile health (mHealth) technologies?
Data Sharing and Reporting Is your organization able to securely transfer electronic personal
health information (ePHI) to providers outside of your organization?
Analytics The extent to which predictive analytics are used on an ongoing
basis to drive patient care processes.
EMRAM Score What is your HIMSS Analytics EMR Adoption Score?
-
Patient Engagement & Population Health PATIEEDUCATIONPrevention & Patient Education Score: Sample Areas
Patient Engagement Does your organization have a formal
documented patient engagement strategy?
Do you have a patient portal or API?
Have you formally evaluated the impact of your patient portal on patient compliance?
What was the outcome of the evaluation?
Population Health Does your organization have a formal
documented population health strategy?
What impact is health information technology having on managing your defined population?
-
SAVINGSSavings Score: Sample Areas
Efficiency Savings Have you formally evaluated the financial impact of health
information technology on the productivity of your clinical staff?
What was the outcome of the evaluation?
What savings have you realized through process improvement enabled by HIT?
Financial/Business Have you formally evaluated the impact of health
information technology on coding accuracy?
What was the outcome of the evaluation?
Operational Savings Have you formally evaluated the impact of health
information technology on your inventory control?
What was the outcome of the evaluation?
-
24|
Value Score
Completeness Hospitals can get credit for a large range of activities that lead to better value
Incremental opportunities
Additional activities can lead to higher scores in a large variety of ways Achieving the highest score possible in any domain should mean that a
hospital has done all it can do to achieve value in that domain
Score can be broken down into segments, with a potential gap analysis possible in each segment
Temporal comparability
Rating system should allow for hospitals to track their progress over time Components would be added and adjusted over time Existing components would have limited ability to be changed over time,
similar to how EMRAM changes in very minor ways
Organizational comparability
Over time should allow use of the rating to benchmark hospitals and systems against each other, allowing it to become a method that consumers and payors use to do better "shopping"
Confidential algorithm
Scoring algorithm should be held privately within HIMSS and be sufficiently complex that external parties cannot re-engineer it
-
Value Score/Timeline
Quarter /Year Task
Solicit from Stage7/Davies - Pilots FY 15 4th quarter/ FY 16 1st quarter
Conduct Pilots FY 16 1st quarter
Reevaluate Scoring Based on Pilot Input
FY 16 2nd quarter
Soft Launch National HIT Week
Launch HIMSS16
-
Questions?
Value Score
