beyond the ehr: the next steps for healthcare

www.dataenabledhealth.com

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


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


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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Organization


Organization

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Organization




PROCESS / WORKFLOWS

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Organization




PROCESS / WORKFLOWS

Integration of Clinical& Non-ClinicalData Sources

Real-TimeDecisionSupport

EHRImplementation

Analysis &Modeling

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Organization


Organization

ResistanceTo Change

Step 2 Step 3

Step 4

DATA / TECHNOLOGY


PROCESS / WORKFLOWS


EHRImplementation

Analysis &Modeling

MinimalData

CaptureStep 2

Step 3

Step 4

19



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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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Organization


Organization

ResistanceTo Change

Step 2 Step 3

Step 4

DATA / TECHNOLOGY


PROCESS / WORKFLOWS


EHRImplementation

Analysis &Modeling

MinimalData

CaptureStep 2

Step 3

Step 4

Stage 1 Stage 2 Stage 3 Stage 4

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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


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

http://www.himssfuturecare.com/

beyond the ehr: the next steps for healthcare

Documents

ehr system

ehr adoption

ehr usage

institutions ehr

type of ehr

meaningful use of ehrs

health system network

health record system