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Beyond the EHR: The Next Steps for Healthcare. J. Bryan Bennett, Adjunct Professor and Predictive Analytics SME, Northwestern University BDPA Technology Conference August 7, 2014. Agenda. State of Healthcare Technology Healthcare Transformation Model Why is it so important? - PowerPoint PPT Presentation
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Beyond the EHR: The Next Steps for Healthcare
J. Bryan Bennett, Adjunct Professor and Predictive Analytics SME, Northwestern University
BDPA Technology Conference
August 7, 2014
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Agenda State of Healthcare Technology Healthcare Transformation Model
Why is it so important? Opportunities in Healthcare
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The State of Healthcare Technology
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Healthcare Technology Mandate The Health Information Technology for Economic
and Clinical Health (HITECH) Act, was enacted in February of 2009 with $19 billion in funding Part of the American Recovery and Reinvestment Act
of 2009 It promotes the adoption and meaningful use of health
information technology Healthcare providers will be offered financial
incentives for demonstrating meaningful use of electronic health records (EHRs) Incentives will be offered until 2015
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Healthcare Technology Mandate Healthcare providers will be offered
financial incentives for demonstrating meaningful use of electronic health records (EHRs) Incentives will be offered until 2015.
Not related to the Affordable Care ActSometimes called ObamacareCompletely separate funding
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EHR Adoption
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EHR Usage By State
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Who’s Using An EHR?
Hospital-Based, 56%Ind. Practice, 39%
Ind Using Hospital, 6%
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Type of EHR by Practice Size
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E-Prescription Use
2008 2011 20140%
10%
20%
30%
40%
50%
60%
70%
7%
24%
70%
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The Current Situation Healthcare organizations are faced with
the challenges of transitioning from a paper-based system to one that is data-enabled
Most organizations are primarily focused on the technology and dataNeglecting key components that will
significantly improve their chances for success and improved effectiveness
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Healthcare Transformation Model
The continuums and steps required for a healthcare organization to transform from a paper-based organization to one that is data-enabled.
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Healthcare Transformation Change Model
Paper-BasedHealthcare
Organization
Data-EnabledHealthcare
OrganizationDATA / TECHNOLOGY
ORGANIZATIONAL / PEOPLE
PROCESS / WORKFLOWS
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Data-Enabled vs Data-Driven Data-Driven: letting the data dictate how
we treat and manage customers with as much automated decisions as possible
Data-Enabled: providers are provided real-time information to enable them to make better final decisions and diagnoses based on hundreds or thousands of patients with similar symptoms
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Data-Enabled Healthcare Organization
A DEHO will also be able to better manage their “patient portfolio” or community to provide more consistency and an improved overall quality of care*
* “Big Data Needs the Big Three to Succeed”, August 8, 2013, www.himssfuturecare.com
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Healthcare Transformation Change Model
Paper-BasedHealthcare
Organization
Data-EnabledHealthcare
Organization
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Paper-BasedHealthcare
Organization
Data-EnabledHealthcare
OrganizationDATA / TECHNOLOGY
ORGANIZATIONAL / PEOPLE
PROCESS / WORKFLOWS
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Healthcare Transformation Change Model
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Paper-BasedHealthcare
Organization
Data-EnabledHealthcare
OrganizationDATA / TECHNOLOGY
ORGANIZATIONAL / PEOPLE
PROCESS / WORKFLOWS
Integration of Clinical& Non-ClinicalData Sources
Real-TimeDecisionSupport
EHRImplementation
Analysis &Modeling
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Healthcare Transformation Change Model
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Paper-BasedHealthcare
Organization
Data-EnabledHealthcare
Organization
ResistanceTo Change
Step 2 Step 3
Step 4
DATA / TECHNOLOGY
ORGANIZATIONAL / PEOPLE
PROCESS / WORKFLOWS
Real-TimeDecisionSupport
EHRImplementation
Analysis &Modeling
MinimalData
CaptureStep 2
Step 3
Step 4
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Integration of Clinical& Non-ClinicalData Sources
Healthcare Transformation Change Model
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Continuum Alignment Continuums must be aligned to make sure
organization doesn’t get too far out front on any particular continuumGreat processes with no capture commitment
or poor data will negate impact of process change
Allows for possibility of lower morale and/or project management
Multi-stage project
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Paper-BasedHealthcare
Organization
Data-EnabledHealthcare
Organization
ResistanceTo Change
Step 2 Step 3
Step 4
DATA / TECHNOLOGY
ORGANIZATIONAL / PEOPLE
PROCESS / WORKFLOWS
Real-TimeDecisionSupport
EHRImplementation
Analysis &Modeling
MinimalData
CaptureStep 2
Step 3
Step 4
Stage 1 Stage 2 Stage 3 Stage 4
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Integration of Clinical& Non-ClinicalData Sources
Healthcare Transformation Change Model
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Process is Least Addressed Continuum We performed an ethnographic study of a
sample of over 1,000 physicians during the implementation of a computerized provider order entry system we observed that:Comments and behaviors related to the
process represented 62% of the issues Positive and negative
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Comments & Observations Negative Comments Included:
I don’t have time for this; I will call from my phone to place orders
I did not know I went to med school to become a secretary.
This is ridiculous!! All it does is take time away from my patients. I am with the patient now 5 minutes and with the computer 15 – 20 minutes.
I have not put orders in the computer for over 20 years and I am not starting now. I will retire before I start with this crap.
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Comments & Observations Negative Observations included:
Many would not ask questions because it seemed they would feel diminished.
Some doctors kept complaining about how this is a “waste of my time”
A few doctors left the floor and then proceeded to call in the orders because they refused to place the orders themselves.
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Process Rules!
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Process, Solution & Hardware
Solution & Hardware
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Implementation Problems Summary
Automating or adding technology to a bad process or not giving the process enough attention just results in a bad automated process. Personnel Buy-In Delayed training
CategoryObservations & Comments
Process Only 47%
Process & Solution 13%
Process, Solution & Technology 2%
Total 62%
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Healthcare TransformationNext Major Step - Analytics
Most organizations can do some form of Description Analytics from their current legacy or EHR systems
With some additional data management, many are capable of performing some Diagnostic Analytics
Predictive Analytics are being implemented by many advanced healthcare organizations
Prescriptive Analytics is only being implemented by the most elite organizations
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Opportunities in Healthcare Technology
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Technology Continuum EHR
Implementation Data Warehouse
Development Predictive and
Advanced Analytics Implementation
Real-time Decision Support
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Opportunities – Current Needs EHR Implementation Change Management
Specialist Project Management Consumer Behavior
Physician Engagement
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Opportunities – Future Needs Data analyst Statisticians / Modelers Transformation
Consultants
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Questions and Answers Contact Information:
J. Bryan Bennett, “The Professor” Healthcare Transformation Specialist, Data Scientist
and Predictive Analytics Professor E-mail
[email protected] Website / Blogs
www.dataenabledhealth.com www.himssfuturecare/blog/1266
Twitter @enabledhealth