community meetings3.amazonaws.com/rdcms-himss/files/production/... · davies 101 the davies awards...
TRANSCRIPT
Innovation Community Mission Statement
The HIMSS Innovation Community mission is to foster a collaborative community which aggregates and
disseminates evidence-based strategies to bend the cost curve and improve health outcomes and system value.
Our Community Is Growing!
Community members as of December 12:
3,635
Community Meetings
• Future meetings to be held monthly on the 2nd Friday of each month at 3:00 – 4:30 PM EST.
• Will include: • Updates from Community workgroups and
related HIMSS Initiatives • Spotlight on healthcare innovators, including a
“backstage pass” Q&A session for 30 minutes at conclusion of presentation.
Agenda • HIMSS Innovation Initiative Updates
– Davies Committee: Jonathan French, Director, HIMSS
– HIT X.0: Kerry Amato, Manager, Specialty Education, HIMSS
– Innovation Symposium: Kerry Amato, Manager, Specialty Education, HIMSS
• Innovation Community Workgroup Updates – Website: Jessica Jacobs, ORISE Fellow, FDA, MHSA, CPHIMS
– HIMSS13 Community Event: Greg Wolverton, CIO, Arcare, FHIMSS
– Book: Craig Miller, Vice President, Health Strategy and Innovation, GDIT
– Community Survey: Craig Miller, Vice President, Health Strategy and Innovation, GDIT
• “Grassroots” Healthcare Innovation: Judi Painter, Quality Improvement Specialist-Physician Offices at Healthcare Quality Strategies, Inc., MBA
• Featured Speaker: Lyle Berkowitz, Associate Chief Medical Officer of Innovation, Northwestern Memorial Hospital, MD, FACP, FHIMSS
– Backstage Pass (Q&A)
HIMSS Awards of Excellence: Alignment of Davies and Stage 7 Recognition
Jonathan French, Director, HIS
Davies 101
The Davies Awards of Excellence case studies require that staff in the healthcare system applying for the award to assess and document their progress and accomplishments against a framework for thinking about the process of implementing an EHR. The Davies Award not only is recognition of excellence, but the case studies also serve as best practice guidance for other hospitals, clinics, providers, and community health centers struggling to incorporate EHR into their work flow.
Board-Approved Goals • Recognize excellence in IT and management systems that
demonstrably improve quality of care, process performance, and patient safety
• Identify and honor healthcare settings that can demonstrate documented, meaningful positive return on financial investment
• Significantly broaden the HIMSS portfolio of concise, real-world examples of excellence in meaningful use that can be adopted by others
• Ensure ongoing relevance through year-round release of new case studies, publications, education, and other vehicles
• Positively impacts the HIMSS brand as a credible, relevant voice of authority and guidance
Overview of Realigned Davies Awards
1. Applications accepted on a rolling basis
2. Submission Process: No applications to complete – Case Study format
3. Davies Enterprise applicants must have achieved Stage 6 or 7 on the HA EMR Adoption Model
4. Two Award Categories vs Four Awards
A. Davies Enterprise – formerly Davies Organizational Award
B. Davies Ambulatory – includes Ambulatory Clinics, Enterprise Clinics, Community Health Organizations (CHOs)
5. Successful Stories of Success case studies eligible for inclusion as menu case studies if applicable
Pre-requisites for Applying
Enterprise • To be considered for the Davies
Enterprise Award, the organization must be either an EMR Adoption Model (EMRAM) Stage 6 or Stage 7 status as designated by HIMSS Analytics. This designation cannot be self-determined.
• A component of a hospital, such as an enterprise clinic owned by a hospital, cannot apply on its own.
Ambulatory 100% of providers in Ambulatory facilities must:
• Enter all patient encounters at the point of care and any patient requests for data
• Generate prescriptions (ideally, the successful use of e-prescribing).
• Where possible, place electronic orders out and/or receive electronic results.
• Using an EHR in a meaningful way should result in improvement in patient care metrics—not just monitoring.
• Stand alone ambulatory clinics submit “Critical Qualifying Questions” found in Appendix 1 of the Ambulatory “How to Apply”
• Enterprise Clinics submit “Critical Qualifying Questions” found in Appendix 2 of the Ambulatory “How to Apply”
• Community Health Organizations submit “Critical Qualifying Questions” found in Appendix 3 of the Ambulatory “How to Apply”
Past Timeline
• Organizational Award: March 31
• Ambulatory Award: April 30
• Public Health Award: March 13
• Community Health Organization (CHO) Award: May 15
• Intent to Apply Must Be Received by June 1, 2013 for winner to present at HIMSS14
• Enterprise
– 30 day intent to apply
– 45 day turnaround
• Ambulatory
– 30 day intent to apply
– 45 day turnaround
New Timeline
Application Timeline
How to Apply Enterprise Step 1: Intent to Apply
Intent to apply is expected from all potential applicants 30-days prior to submission. Intent to apply includes: (1) the name of your organization; (2) what facilities you plan to submit for the Davies Award consideration;(3) primary & secondary points of contact; and (4) EMRAM score provided from HIMSS Analytics
Step 2a: Core Case Studies
Applicants complete two case studies: 1) a hard dollars ROI; and (2) clinical value. Submit within 60-days of the intent to apply.
Step2b: Menu Case Studies
Applicants select three menu case study topics among the 20+ options listed in Table 2 of Enterprise How to Apply document. Submit within 60-days of the intent to apply
Step 3: Site Visit
Finalists are selected by a peer-reviewed process within 30 days after submission. Stage 7 EMRAM finalists will receive a virtual site visit. Stage 6 finalists will receive an in-person site visit.
Step 4: Submission of final case studies to HIMSS website & educational offerings.
Ambulatory Step 1: Intent to Apply
Intent to apply is expected from all potential applicants 30-days prior to submission. Intent to apply notification includes: (1) the name of your organization; (2) what facilities you plan to submit for the Davies consideration;(3) primary & secondary points of contact; and (4) pre-requisites
Step 2a: Core Case Studies
Applicants complete the following two case studies: 1) a hard dollars ROI and; (2) clinical value. Submit within 60-days of the intent to apply
Step2b: Menu Case Studies
Applicants select two menu case study topics among the 20+ options listed in Table 2 of Ambulatory How to Apply document. Submit within 60-days of the intent to apply
Step 3: Site Visit
“Finalist” candidates are selected by a peer-reviewed process within 30 days after case study submission. Each finalist will receive a site visit.
Step 4: Submission of final case studies to HIMSS web site & educational offerings.
Case Study Process & Format • Rolling Basis – Applications submitted on a rolling basis
– Each Award can submit each month
– Provide 30-day notice of intent to apply prior to submission
• Model after HIMSS Stories of Success application submission form http://www.himss.org/storiesofsuccess/howApply.asp
– Total 6 pages = 5 pages + 1 page Appendix
• Enterprise & Ambulatory Awards: 2 Core case studies: ROI and Clinical Value
• Enterprise Award: 3 Menu case studies (20+ topic options including dashboards & intelligence, mobile, and care coordination)
• Ambulatory Award: 2 Menu case studies (20+ topic options including dashboards & intelligence, mobile, and care coordination)
Case Study Review
• Peer Reviewed by HIMSS Davies Committee volunteers (most are former winners)
• Case Studies will use the SQUIRE methodology
• The SQUIRE “Guidelines” will be used for submissions and review.
• Award the “Excellent.” We are seeking “wow factor” stories.
Keys to a Winning Davies Case Study
• While the case studies serve as an awards application, the case studies should be written as if they were being submitted for a medical journal article. The problem must be clearly stated, data must be present to show the improvement of outcomes, and the role of the EHR in achieving that improvement must be showcased.
• Avoid marketing-style language and platitudes.
• Successful Davies case studies feature trending data points. For example, a strong clinical value case study would include:
– Quality data prior to the EHR implementation, indicating the status of quality at the facility prior to the implementation.
– Periodic data points between the date of implementation and quality data at the point of case study submission.
– Current quality data
Keys to a Winning Davies Case Study
• For menu case study financial considerations, do not state the overall cost of the EHR implementation. Identify cost points of the specific initiative, for example, for establishing a governance structure, identify the cost of any additional full time employees, the time-cost associated with training, and consultant costs.
• Lessons learned should identify unanticipated problems/failures, and the steps needed to correct those problems. Again, avoid platitudes and marketing language.
• Under Background Information, give a very brief (no more than two sentences) description of your organization, population served, leadership, and your organization’s mission. Spend the rest of the space focusing on how your organization designed the improvements to meet the needs of your patient population and review the reasons for your health IT solution.
Knowledge Dissemination • News releases
• Online Case Studies
• On-Demand Webinars - Quarterly
• Skype interviews
• Podcasts
• VCE – Twice each year – VCE – 2x/year – 3rd Tract for HIMSS Staff suggestions
• Annual Conference
• Chapter Programs
• GHIT
2012 Winners
• Enterprise
– Hawaii Pacific Health (Honolulu, HI)
– Mount Sinai Medical Center (New York, NY)
• Ambulatory
– Coastal Medical (Providence, RI)
– Dr. Jeremy Bradley (Owensboro, KY)
– Unity Healthcare (Washington, DC)
Questions?
Tuesday, March 5, 2013 - Wednesday, March 6, 2013
• HIT X.0 provides healthcare leaders a glimpse into emerging technologies and industry innovations. Presented in an atypical setting this event features the future of healthcare delivery through the innovation, imaginative and emerging IT available today.
Keynote Speaker: Dr. Eric Topol Including Speakers from: • Ford • Rest Devices • Hopelabs • AT&T • Lockheed Martin
Innovation Symposium: The Science and Practice of Innovation
Sunday, March 3, 2013, 8:30 a.m. – 4:30 p.m.
This newly expanded event will focus on the science and practice of innovation featuring leading experts that will help attendees: • Change the way they look at the innovation process • Identify ways to inspire innovation and creative thinking at any level in an organization • Recognize practical ways to operationalize innovation
Speakers Include: • Bob Eckert - New &Improved, LLC • Steve Krein - Startup Health • Charles ‘Chuck’ Tuchinda, MD – Hearst Media • Ritu Agarwal - Center for Health Information and Decision Systems, University of
Maryland • Dr. Rajshree Agarwal- Dingman Center for Entrepreneurship University of Maryland • Alex Fair - MedStartr.com • Mark Buchalter - Homal Anderson Design
Innovation Community
Event March 6, 3:30-5:30 PM
• A Community event will be organized for HIMSS13 in New Orleans
• Focus will be on sharing ideas and experiences and forming new connections among community members
• Will complement other HIMSS innovation-related events, such as the Innovation Symposium educational event and the HIT X.0 technology showcase
Book: Bending the Healthcare Cost Curve Through Innovation
• To be published in 2013 by HIMSS • Focus will be on spotlighting innovations in policy,
process and technology that have a demonstrable impact on the quality and cost of care
• Will be a “contributed chapter” book – containing content from Community members and other leaders in healthcare innovation
• Workgroup will be established in January to recruit authors and organize writing
Community Survey
• Workgroup will be established to create a survey for the Community to collect information about: • Who you are (role in healthcare and other
information) • What you would like to see the Community
accomplish • Your interest in participating in workgroups
“Grassroots” Healthcare Innovation Presented by Judi Painter, Healthcare Quality Strategies, Inc., MBA
Innovation Committee Member
•A “grassroots” movement is often referred as one driven by the politics of a community
•Implies creation of movement
•Flows bottom up
•Close to the people
•Strategic and human
•Breaking out of the old moulds to solve problems
•Being able to as a group coordinate, plan, research and act on ideas not able to be accomplished working alone
•Changing the world .
A Strategic Process
•Strategy for nurturing innovation within organizations
•Ideas are generated by those who are least likely to have access to the resources to make them happen
•Fosters local and regional activities, communities, businesses and healthcare facilities
•Awards people who share ideas even if when implemented they fail
Building Innovation
•Could be a simple as implementing a new workflow in your patient flow where bottlenecks used to exist •Coordinating community efforts to offer new health education programs on local health issues •Managing waste by laminating patient- registration sheets, HIPPA forms which are scanned, erasing them and using again •All ideas are welcome even if they were implemented and failed
Share with Us!
Introduction of presenter
Lyle Berkowitz
Jonathan Teich, MD, PhD, FHIMSS, FACMI
Where Innovation Meets Information Technology
THE HEALING EDGE
Lyle Berkowitz, MD, FACP, FHIMSS / [email protected] / DrLyle.com / @DrLyleMD
Associate Chief Medical Officer of Innovation, Northwestern Memorial Hospital
Medical Director of IT & Innovation, Northwestern Memorial Physicains Group (NMPG)
Associate Professor of Clinical Medicine, Feinberg School of Medicine, Northwestern University
Founder and Director, Szollosi Healthcare Innovation Program / TheShipHome.org
Founder and Chairman, healthfinch / healthfinch.com
HIMSS Innovation Community Webinar
December 14, 2012
Szollosi Healthcare Innovation Program (SHIP)
The SHIP is a charitable endeavor with a mission to use creative thinking and diverse technologies to produce a better healthcare experience for patients, physicians and others associated with their care. www.TheShipHome.org
Innovation Learning Network
The ILN brings together the most innovative healthcare organizations in the country to share the joys and pains of innovation.
Its purpose is to foster discussion on the methods of Design Thinking and application of innovation / diffusion, ignite the transfer of ideas, and provide opportunities for inter-organizational collaboration. http://www.innovationlearningnetwork.org
LYLE BERKOWITZ, MD
CHRIS MCCARTHY, MPH, MBA
The Innovation Process
Accelerate Move from pilot programs into standard operations
Incubate Move from ideas to pilot programs
Discover Investigate new ideas, programs, technologies
Chapter 1
The Healing Edge
Let Me Tell You A Story
• StoryTelling
• Voice of the Innovator
• Personas
Innovation + Information Technology
Chapter 1
The Healing Edge
Standardized Structure
• What, Why, How, Results, Lessons Learned, Future, and Conclusion
Three Sections
• EHR, TeleHealth, Edge
Innovation + Information Technology
Chapter 2
Mad for Method
Evidence-based human-centered design
Observation Synthesis
Ideation Prototyping
PDSA Pilot
Others…
Innovation + Information Technology
Computers are really good at
being computers, but they are lousy
at being paper! What if we really
took advantage of all we could do
with EHRs?
You Have An EHR. Now What?
Chapter 3
Inflection Navigator
Messaging and Chart Review
• Physician notifies Care Coordination Team about an “Inflection Point Checklist”
• Care Coordinator does authorizations, sets up tests and consults, and does final chart reviews
You Have An EHR. Now What?
Chapter 4
Making “Right” Easier
CDS Tools and Ordering
• Allows whomever is with a patient to easily see and act upon relevant “care opportunities” , while still respecting visit workflows.
You Have An EHR. Now What?
Chapter 5
Prevention Every Time
CDS Tools, Ordering and Reporting
• Pre-Visit Preventive Screening Tool
• An Instant Quality Measures Tool
• Real-Time Provider Performance Feedback Tool
You Have An EHR. Now What?
Chapter 6
Logic Rules
Conditional Logic, Ordering, Notes
• Pre-Visit Orders: helps staff pre-order lab tests before a patient's Annual Exam visit.
• Documentation Chooser: Helps MAs choose the correct documentation templates at an office visit.
You Have An EHR. Now What?
Chapter 7
Team Bundling
Alerts, Registry, Pt Outreach, Reporting • Team-based approach to care : Automating and Delegating tasks across team • All or None Bundle Philosophy: Report the % of pt who receive every element of recommended care (rather than % that achieve any particular measure).
You Have An EHR. Now What?
Chapter 8
Automatically Getting Better
Reporting Tools •Automated Adverse Event Detection: Queries EMR for abnormal labs (e.g. low glc, high INR) or meds (e.g. Naloxone, Vit K) • Nurse-led Analysis: To determine level of harm and whether it was preventable •Results : ADEs Fell from 90 to 30 % of all admissions (and total # decreased from 1.4 to 0.8 per admission)
You Have An EHR. Now What?
Office Visits are so old school! Time for a “whole lotta tele”:
Televisit, Teleconsult,
Telemonitoring and Teletranslation
Meet You At 01100101
Chapter 9
The Connected Patient
One of the First Patient Portals!
It offers patients the ability to view their medical information ("Health Record"), access relevant medical reference services ("Health Library"), and communicate with their physicians ("Mail Center").
Meet You At 01100101
Chapter 10
The Virtual Consult
Consulting Specialists
Asynchronous communication between physicians, either between Primary Care and a Specialist, or between Specialists. Assigns RVU in their Value based Reimbursement Model.
Meet You At 01100101
Chapter 11
TeleVisits Keep IT Local
Virtual visit with an endocrinologist
This virtual visit includes not only the remote diabetes specialist and diabetes nurse, but also the locally based community clinic nurse and sometimes even the primary care provider.
Meet You At 01100101
Chapter 12
Mommy Monitor
Home OB Monitoring
A telehealth system which allows a high-risk obstetrics (OB) clinic to monitor patients with high-risk conditions at home in between office visits. Includes a Glucometer, BP Monitor, and Scale.
Meet You At 01100101
Chapter 13
Every Language Now
Tele-Translators Collaborative of hospitals and providers that share the services of their trained language interpreters over a video and voice network Needed both innovative uses of technology and an organizational and governance structure to overcome the barriers that affect county-operated health systems.
Meet You At 01100101
Chapter 14
Rise of the ePharmacists
Virtual Pharmacist An ePharmacist is defined as a hospital trained pharmacist who works from a remote location using secured enabling technology to support bedside clinicians with an effective and timely method of providing medication treatments for patients.
Meet You At 01100101
The future of healthcare is
here, just look around! Happy
Exploring!!! On The Edge Of The Edge
Chapter 15
The Smartest Room
A Computer/Monitor in Every Room • Detects who is in a given hospital room and provides them with the information they need to complete their job efficiently and reliably. • Utilizes a real time locating system (RTLS) and a touch screen user interface designed to make input/output quick and simple for end users.
On The Edge Of The Edge
Chapter 16
One EMR To Go Please
Mobile EHR (mEHR) app • Enables providers to user their consumer smart phones to securely access the organization’s electronic medical record. • Heavily leveraged existing enterprise architecture, providing for high levels of security, availability, and agility.
On The Edge Of The Edge
Chapter 17
Real Time, Right Care
Ventilator-Associated Pneumonia (VAP) Quality Monitor
• Compares real time EMR data against pre-defined processes of care related to VAP.
• Presents results on a dashboard tool via a wall-mounted monitor (or on desktop PC).
On The Edge Of The Edge
Chapter 18
Dashboards 2.0
Over 40 dashboards have been developed
• Extract and analyze data from EMR and financial systems. Uses off-the-shelf business intelligence tools.
• The IT Dept isn’t the gatekeeper anymore—users are empowered to come up with creative ways to examine a problem and develop equally creative solutions.
On The Edge Of The Edge
Chapter 19
Patient Voice Amplified
Online panel of over 25,000 patients • Members contribute their opinions and insights about many aspects of the care and services they receive • This information helps guide quality improvement and the development of new features and services.
On The Edge Of The Edge
Chapter 20
The Gaming Edge
Gaming , IT and Health • Improve motivation, and engagement via use of elements such as: Fun, Goals, and Rewards. • Want to get into “The Flow”: Skills, Feedback, Focus, LOC, Transformation of Time. •Examples: From Twister to Wii to Nikeplus to SnowWorld to DrHero to FoldIt.
On The Edge Of The Edge
Where to Start?
GR
OW
TH
UNKNOWN KNOWN
LITTLE BETS BIG WINS
(Experimental (Planning)
Innovation)
Experimentation vs. Planning
"The reasonable man adapts himself to the world. The unreasonable one
persists in trying to adapt the world to himself. Therefore, all progress
depends on the unreasonable man.” George Bernard Shaw
Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the
only thing that ever has. Margaret Mead
Innovation + Information Technology
By Our Next Meeting:
• Significant enhancements to the community website • Further stages of workgroup formation • Next featured speaker: Michael L. Parchman, MD, MPH
Director, MacColl Center for Health Care Innovation, Researcher for The Primary Care Team Learning from Effective Ambulatory Practices (PCT-LEAP) Robert Wood Johnson Foundation
Next Meeting:
January 11, 2013, 3:00 PM – 4:30 PM EST
Questions? Thoughts?
• Community website (presentation will be posted): http://www.himss.org/asp/innovation_community_home.asp
• Contact: • Rod Piechowski, Senior
Director, HIMSS ([email protected])
• Ethan Baron, Program Manager, HIMSS ([email protected])