[eBook] Transforming Health: Enabling Integrated Care

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Information about [eBook] Transforming Health: Enabling Integrated Care
Health & Medicine

Published on March 11, 2014

Author: EMC_IIG

Source: slideshare.net


This eBook provides an overview of the findings, showing the commonalities and differences of how the integrated care delivery model is being adopted in Western Europe, the Middle East and Africa find short, medium and long-term strategies to enable integrated care.
You can download the full report: http://www.emc.com/integratedcare

TRANSFORMING HEALTHEnabling integrated Care EMEA Market Study Connect people, processes, and information where it counts – at the point of need

2 EMC asked IDC Health Insights to analyze the future of information sharing in the health sector. The goal was to better understand the business drivers influencing IT investments in hospitals, regional and national government healthcare entities. This eBook provides an overview of the findings, showing the commonalities and differences of how the integrated care delivery model is being adopted in Western Europe, the Middle East and Africa find short, medium and long-term strategies to enable integrated care. You can download the full report here. International Data Corporation (IDC) is the premier global provider of market intelligence, advisory services, and events for the information technology, telecommunications and consumer technology markets. IDC helps IT professionals, business executives, and the investment community make fact-based decisions on technology purchases and business strategy. More than 1000 IDC analysts provide global, regional, and local expertise on technology and industry opportunities and trends in over 110 countries worldwide. Learn more at www.idc.com EMC is a global leader in enabling businesses and service providers to transform their operations and deliver information technology as a service (ITaaS). Fundamental to this transformation is cloud computing. Through innovative products and services, EMC accelerates the journey to cloud computing, helping IT departments to store, manage, protect and analyze their most valuable asset — information — in a more agile, trusted and cost-efficient way. Learn more at www.emc.com

3 REPORT METHODOLOGY 188Hospital executives from a telephones survey (IT & non-IT) 12Government interviews with executives in charge of eHealth programs at both national & regional levels IDC’s Continuous MONITORING of the healthcare sector IT trends in Europe, Middle-East and Africa 25United Kingdom 35Turkey 28Germany 35Saudi Arabia 27France 38South Africa WESTERN EUROPE MIDDLE-EAST & AFRICA

INTEGRATED CARE At The Nexus of the Health Value Chain “A re-orientated healthcare system will ensure the future sustainability of service delivery. ”

5 THE HOSPITAL CENTRIC SYSTEM Traditionally the center of gravity of the healthcare system is the general hospital, which still accounts for This hospital-centric system deals efficiently and effectively with acute episodes, such as serious infections, or surgeries. These conditions require providing several days of acute care for a relatively small number of very ill patients. Integrated Care At The Nexus Of The Health Value Chain This system, however, does not deal efficiently and effectively with noncomunicable diseases (NCDs) that require continuous care for a large number of patients whose conditions are less acute but are often associated with long-term disabilities and premature deaths. 40%+of healthcare expenditure, in many developed countries.

6 Source: Lancet scientific magazine in 2012 THE HOSPITAL CENTRIC SYSTEM World Health Organization studies indicate that NCDs are an: “invisible epidemic...“ and “The burden is growing - the number of people, families and communities afflicted is increasing. Common, modifiable risk factors underlie the major NCDs. They include tobacco, harmful use of alcohol, unhealthy diet, insufficient physical activity, overweight/obesity, raised blood pressure, raised blood sugar and raised cholesterol.” In fact, the World Health Organization (WHO) estimates that: “Nearly 80% of NCD deaths - 29 million - occur in low- and middle-income countries” and “More than 90% of NCD deaths that occur before the age of 60, happen in low-and middle-income countries”. As a result, NCDs rose to the top of the healthcare policy agenda in emerging countries, because their impact on younger age people are a serious drag on economic development. A trend that is confirmed by this IDC-EMC study, as hospital executives in Turkey, Saudi Arabia and South Africa indicated that prevention and control of NCDs is as important, if not more important than other broad healthcare policy goals, such as increasing access to services. (See Figure 1) POLICY OBJECTIVES IN MIDDLE-EASTERN AND AFRICAN HOSPITALS Source: IDC 2013 #.## #.## #.## #.## Prevention and control of non-communicable disease initiatives Increase access to healthcare services Accreditation of programs and clinical patients Promotion of evidence-based clinical practice Figure 1 In the U.K., the number of people with three or more long-term conditions is predicted to rise 1.9M 2.9M 2008 2018 Large Ageing population More Long-term conditions additional expenditure by 2018.£5B will have a significant impact on health and social care and may require Integrated Care At The Nexus Of The Health Value Chain 1 5----------------------------------------------------- IMPORTANCE ---------------------------------------------------

7 TRANSITIONING TO A SUSTAINABLE SERVICE DELIVERY MODEL Integrated Care At The Nexus Of The Health Value Chain An integrated care delivery model can INCREASE PATIENT SAFETY HELP CONTROL COSTS Lessening the impact of risk factors through their mapping and prevention campaigns Strengthening primary healthcare early-detection and treatment capabilities to reduce the risk of acute episodes at later stages Re-orienting the overall health system to address the needs of people affected by NCDs +

8 TRANSITIONING TO A SUSTAINABLE SERVICE DELIVERY MODEL The re-orientated healthcare system will ensure the future sustainability of service delivery by coordinating all actors across the value chain, including hospitals, primary care, community care, private clinics, public health authorities, payers, life-science organization and, last but not least, patients. Hospitals Primary Care Professional Community & Social Care Life Science Research Organizations Day Hospital Clinics & Labs Integrated Care At The Nexus Of The Health Value Chain PatientsPayersGovernments & Public Education Institutions

INFORMATION IS THE CONNECTIVE TISSUE “Patient information needs to be reliable, complete, and relevant to the context in which it will be used.”

10 #1 ENABLE INFORMATION SHARING WITH INTEGRATED RECORDS Information is the connective tissue for integrated care that increases patient safety - The level of coordination and collaboration required by integrated care delivery across the health value chain is a step-change, particularly for hospitals that have been at the center of the delivery system for over a century. The need to coordinate among hospitals and other stakeholders will spur some consolidation but the vast majority of integrated care delivery will have to be enabled by cross-enterprise information sharing, through the creation of integrated patient records. When complemented by appropriate organizational processes and incentives, information technologies provide healthcare decision makers the meaningful and timely insights to make planning, management and service delivery decisions that improve patient safety and satisfaction, while controlling costs, across the end-to-end patient experience. In fact, patient care and satisfaction are the top business priorities for the hospital executives interviewed as part of this study. Taking precedence over regulatory compliance, and sensitive data protection. (See Figure 2) Hospital executives also feel patient safety outweighs cost controls. Source: IDC, 2013 Information Is The Connective Tissue Patient care and satisfaction enchancement 4.1 4.4 Sensitive data protection 4.0 4.3 Regulatory compliance 3.9 4.3 Clinical performance improvement 3.9 4.3 Organization contribution to business goals 3.8 4.1 Increase staff satisfaction 3.8 4.0 Reducing operational costs 3.8 4.0 Communication and external relations improvement 3.8 4.0 Procurement efficiency 3.8 3.9 Multi-channel strategies to suport patient services 3.6 4.1 Organizational restructuring and consolidation activities 3.7 3.8 EMEA HOSPITAL SECTOR BUSINESS PRIORITIES Organizational restructuring and M&A activities are not a business priority while patient care and satisfaction are at the top of the list. Figure 2 Western Europe Middle East & Africa 1 5------------------------ IMPORTANCE ----------------------

11 THE VALUE OF INFORMATION INSIGHTS Insights extracted from integrated patient records will be precious in a wide-variety of use cases, from hospital administrative processes, to clinical decision support, to collaboration of university hospitals with life-science research organization. Administrative information sharing can drive value for money in anti-fraud, and resource optimization. Clinical information sharing can help doctors apply the latest findings of medical research, thus providing personalized and evidence based care services. This will enable providing better care for patient current conditions and efficiently preventing complications and new disease developments. Life-science research organizations can improve clinical trial design and results analysis, speeding up research times, results accuracy and bench-to-bedside translation. Information Is The Connective Tissue

12 EMEA HOSPITAL SECTOR BIG DATA ADOPTION DRIVERS Figure 3 Volume Variety Velocity 3.45 3.91 3.55 3.68 3.60 3.83 Western Europe Middle East & Africa INTEGRATED CARE INFORMATION MANAGEMENT CHALLENGES Integrated care is not an entirely new business model. And so are the related information technologies that support it, such as telemedicine, electronic health records and clinical decision support systems. Pilot initiatives, particularly in Western Europe, North America and Australia have been running, for the past ten years; and in emerging countries, for the past three or four years. However, full-blown transformation has been hindered by a number of business and technical challenges. Information Is The Connective Tissue Governance models The transformation from traditional service delivery, to integrated care implies profound change in the governance of national healthcare systems and in the organization of individual providers. The fact that “organizational restructuring and consolidation” activities rank very low, among top business priorities, confirms the difficulty of driving change. (Link to Figure 2) Big data In many healthcare organizations, the BI/DW technology stack cannot leverage clinical documentation that is by nature unstructured. This has thwarted efforts by providers to create highly structured data warehouses common to other industries. Clinical data is also extensive, inconsistent and multidimensional, creating issues for warehouse designers. These BI architectures, and the scalability of the underlying infrastructure, will be challenged further by the increase in data volume, velocity and variety. (See Figure 3) Regulatory compliance In jurisdictions where cultural and religious considerations are carefully considered, lack of data privacy legislation has slowed down information integration. However, advances in IT security tools and information assurance management policies and practices permit further progress. Cultural change Within any given healthcare organization, the technical rationality of IT professionals and suppliers often collides with managerial rationality of hospital managers and the medical rationality that puts clinical care at its center. Effective change management during an implementation project becomes essential to educate staff about the potential benefits and risks to their daily routine, as well as their involvement in ensuring patient safety. 1 5 ---------------IMPORTANCE----------

13 Information Is The Connective Tissue INTEGRATED CARE: INFORMATION MANAGEMENT CHALLENGES EMEA HOSPITAL SECTOR 2014 ICT BUDGET OUTLOOK Figure 5 Increase Same Decrease Positive Outlook UK Germany France Turkey Saudi Arabia South Africa 12% 32% 56% 4% 43% 46% 48% 37% 7% 14% 65% 12% 46% 38% 17% 66% 29% Budget National healthcare services are mostly seeing a positive budget outlook from survey respondents. (See Figure 5) However, a large share of hospital ICT budgets are committed to maintaining and running legacy systems and infrastructure, (See Figure 6) leaving a small share of funding to radically innovate existing solutions. Data quality As care becomes patient centric, volume, speed, granularity, and variety of patient data will become more susceptible to risks of errors. Patient information needs to be reliable, complete, and relevant to the context in which it will be used, so that clinicians, administrators and patients can not only trust it, but so that it positively increase quality and outcomes. The time aspect, however, should not be neglected, as the rate in which individuals are affected by chronic diseases will change slowly as populations continue to grow. Maturity of ICT service delivery Western European countries have achieved a relatively high level of maturity of their ICT infrastructure and now must free up resources from maintenance budgets to continuously improve through consolidation, shared services and cloud computing. Emerging countries, on the other hand, suffer less from legacy maintenance issues, but rather have experienced hindrances finding skilled workers. (See Figure 4) Siloed legacy architectures To build an integrated patient record, information currently sitting in fragmented administrative and departmental systems must be pulled together. A top priority to survey respondents. (See Figure 4) This demand is expected to increase as more patient histories are digitized and must be combined with medical images, pathology tests and administrative patient information in order to provide optimal clinical and care management. EMEA HOSPITAL SECTOR 2014 ICT BUDGET BREAKDOWN Figure 6 Western Europe Middle East & Africa Upgrade Innovate Compliance Maintain 19% 12% 18% 23% 15% 20% 39% 54% EMEA HOSPITAL SECTOR IT ORGANIZATION PRIORITIES Figure 4 Western Europe Middle East & Africa Integrated and secure access to data and applications 4.18 4.39 Align IT projects and build flexible IT systems to support strategic business 4.06 4.23 Improve quality of IT skills within the organization 4.01 4.28 Proven data privacy protection 4.13 4.56 Speed and cost of regulatory compliance adaptation 4.01 4.20 Improve IT governance 3.93 4.25 Lower costs of IT 3.90 3.57 1 5------------ IMPORTANCE ----------

DOCUMENT LIFECYCLE MANAGEMENT “IT solutions strongly contribute to building the solutions needed for integrated patient records.”

15 Coherent archiving, retention, and disposal and most importantly, integrated access and interpretation of data can give administrative and clinical decision makers valuable insights for effectively planning, managing and operating business processes. AN INFORMATION-CENTRIC INTEGRATED CARE MODEL Solutions that support structured and unstructured information capture, archival and access across multiple EMR, EHR, COPE and departmental applications by decoupling the data from the business logic. Document LifeCycle Management Docum entlifecycle Cloudcom puting Big data & anal ytics SOLUTIONS

16 Document LifeCycle Management EMEA HOSPITAL SECTOR CLOUD COMPUTING INVESTMENT DRIVERS Figure 9 Western Europe Middle East & Africa Cost efficient 3.62 4.05 Helps deploy applications faster 3.60 4.00 Improves access from various devices and locations 3.86 4.19 Scalable 3.58 4.28 Helps establish standard processes 3.62 4.14 Innovate and expand the business 3.74 0.00 1 5------------ IMPORTANCE ---------- EMEA HOSPITAL SECTOR DOCUMENT LIFE-CYCLE MANAGEMENT 12 MONTH INVESTMENT PLANS Figure 7 Invest in a new solution Maintain or enchance exisiting solution UK Germany France Turkey Saudi Arabia South Africa 60% 57% 4% 89% 7% 23% 15% 94% 6% 11% 16% EMEA HOSPITAL SECTOR BI/ ANALYTICS 12 MONTH INVESTMENT PLANS Figure 8 Invest in a new solution Maintain or enchance exisiting solution UK Germany France Turkey Saudi Arabia South Africa 61% 63% 7% 15% 11% 94% 18% 26% 16% 56% 7% The overall adoption of big data solutions in the EMEA healthcare market is still small due to limited market maturity. However traditional BI solutions are increasingly being used to run analysis beyond simple financial data reporting, such as complications management, readmission management and disease progression. Further investments are expected. Document life cycle solutions support structured and unstructured information capture, archival and access across multiple EMR, EHR, CPOE and departmental applications by decoupling the data from the business logic. See Figure 7 These solutions, such as the EMC Documentum Integrated Patient Record solution suite, should rely on coherent archiving infrastructure that can provide reliability, redundancy and security, while orchestrating different tiers of storage to reduce the cost of managing increasing volumes of data. Big data and analytics beyond volume, variety and velocity—will enhance patient safety and satisfaction. Big data will also enable better coordination to manage population health, and support new business models to make healthcare services more financially sustainable. See Figure 8 Cloud computing solutions help deploy applications faster, offer access from multiple locations and devices and offer scalability to deal with the increasing volume of information that needs to be archived and retained for longer periods of time as part of a coherent archiving strategy that relies on hybrid storage infrastructures. See figure 9 AN INFORMATION-CENTRIC INTEGRATED CARE MODEL

17 INTEGRATED CARE DELIVERY: A PATIENT INFORMATION MANAGEMENT STRATEGY FRAMEWORK The adoption of technology alone will not deliver the expected results. With a consistent strategy and implementation approach, the ecosystem of healthcare providers can overcome business and technology challenges to share patient information effectively and efficiently. Document LifeCycle Management It is important to note, that most hospital IT and non-IT executives will not be able to define and control all variables. Countries that launched eHealth strategies as early as 2004, such as Turkey, or later adopting countries, such as Saudi Arabia that launched its first national eHealth strategy in 2010, have to deal with legacy governance arrangements, legacy business processes and technologies, changing budget and political priorities. EMEA HOSPITAL SECTOR PATIENT INFORMATION MANAGEGMENT STRATEGY FRAMEWORK Figure 10 OUTCOMES/GOALS OF INTEGRATED CARE INTEGRATED CARE GEOGRAPHICAL SCOPE PATIENT DATA OWNERSHIP & MANAGEMENT SCOPE OF PATIENT DATA REPOSITORY Patient saftey and satisfaction Cost effective allocation of healthcare expenditure Regulatory compliance SOFTWARE SOURCING APPROACH Best-of-breed End-to-end suite Best-of-suite INFORMATION INTEGRATION APPROACH Point-to-point application integration Service oriented architecture that updates a consolidated dataset real time Federated architecture, based on a master-patient index, that updates information from source systems International National Regional Community of providers National/regional department of health Individual hospital/ healthcare provider Patient Third-party PATIENT DATA MODEL Proprietary – application specific Open – Compliant with international standards BUSINESS LOGIC/ FUNCTIONAL CAPABILITIES Data capture, archival, retention, access, reporting and auditing Big data/analytics Clinical workflows Administrative workflows Patient administrative data Patient pathologies Patient medical tests Patient treatments and prescribed drugs USER ACCESS INTERFACE/ CHANNEL Healthcare provider portal Desktop application UI Department of health portal Third-party portal Native mobile apps BUSINESS STRATEGY INFORMATION GOVERNANCE ENTERPRISE ARCHITECTURE

18 Document LifeCycle Management OUTCOMES OF INTEGRATED CARE The strategic business outcomes of integrated care management and delivery are usually a combination of patient safety, cost-effectiveness and regulatory compliance. EMEA HOSPITAL SECTOR 2014 BUDGET EXPECTED TO BE ALLOCATED TO REGULATORY COMPLIANCE Figure 11 13.8% 16.5% 16.6% 18.6% 28.1% 16.2% Western Europe Middle East & Africa No plans to invest in new solution Maintain current solution Plans to invest or upgrade in 12 mos Patient safety and satisfaction The top priority for the vast majority of hospital executives. In an integrated care setting, outcomes are the result of effective coordination, collaboration and communication among multiple stakeholders. This helps prevent patient health deteriorating, and in cases where it does, apply the most appropriate treatment. Cost-effective allocation of healthcare expenditure A top objective for national and regional health policy-makers that want to free up resources to broaden citizen access to health services. A more cost effective allocation of resources can result in a balanced flow of patients between hospitals and other healthcare providers, and by proxy, reduces waiting times and shortens hospital stays, which improves patient experience. Regulatory compliance From an information management perspective, it is interesting to notice (See Figure 11) that the hospital executives that have already adopted document life-cycle management solutions and plan to maintain them in 2014 are also those that expect to allocate the largest share of ICT budget to regulatory compliance initiatives. (Link Figure 4) This is a clear indication that document life-cycle management solutions have been deployed to make sure that the increasingly complicated data privacy and retention laws and policies are applied consistently and in an automated manner across multiple business systems. In the future, this strong basis of securely and coherently archived patient data could be leveraged to generate higher business value in terms of patient safety and cost effectiveness.

19 Document LifeCycle Management International eHealth initiatives have been promoted over the years by the European Commission to ensure the free and safe flow of workers and tourists. However, beyond a standard European Health Insurance Card for patient identification and access to A&E services, EU member states have achieved little in terms of cross-border information sharing so far. National eHealth strategies, which include building integrated patient records, have been launched in countries such as the U.K., France and Saudi Arabia. These initiatives, however, still face challenges that need to be addressed, such as change management requirements. INTEGRATED CARE GEOGRAPHIC SCOPE The challenges that national programs encounter in supporting integrated care and integrated patient records indicates that a purely top- down national approach is not viable. As a result, policy-makers are breaking down national programs into community-level pilots and regional-level projects that are more sustainable in the long-term. Region-wide integrated health and eHealth programs have been the prevalent model in countries like Germany, Spain, Italy and the Nordics. In large regions with many patients and hospitals, the governance challenges are still big, but more manageable than at the national level. Decisions regarding data standards, procurement and program implementation can be managed through pilots and escalation mechanisms, built to reconcile points of view at the regional level, where the overall budget is held. Community healthcare providers revolve around one or a small group of hospitals that act as a small ecosystem. This is also the geographic scope of most patients’ mobility. The majority of patient interaction with healthcare providers takes place in the area where they live.

20 Document LifeCycle Management Patient Data Model The European Union and the United States government set up a Cooperation Initiative to promote interoperability of Electronic Health Records, so that: • Individual patients can be empowered • Clinical outcomes can be improved • Individual patient safety and population health can be improved Historically, patient data have been tightly coupled with application logic through proprietary data models, which made integration difficult. To achieve more open data models that ensure semantic interoperability, syntactic interoperability and patient mediated data exchange requires more than making software compliant with international standards. It will requires reconciling approaches with more loosely coupled architectures that combine structured and unstructured data management tools. Something that is very hard to deploy and manage at a national or regional level. Patient Data Ownership & Governance According to European Union legislations, the patient is the legal owner of his clinical and administrative data. However, national and regional departments of health, individual hospitals, or GPs end up managing patient records and are responsible for an integrated care ecosystem. The gap of health and regulatory compliance literacy is still too wide to expect patients take full ownership of an integrated patient record. However, more involvement from the patient will be necessary to ensure full orchestration, as not even GPs have a full view of clinical treatments, tests and prescriptions particularly over a long-period of time. Patient participation is also necessary because pieces of clinical and administrative information are held by third-parties, such as private clinics, employers and private health insurance companies. Scope Of Patient Data Repository When dealing with integrated patient information management, the business objectives have an impact on the scope of the patient repository. For instance, if the objective is to ensure free access to A&E services, access to basic administrative and clinical data is sufficient. But the more comprehensive the business objectives, the wider the set of data that should be archived and made available for analysis. This covers health information such as: • Patient administrative data: identity, address, reimbursement entitlement, etc. • Patient history of pathologies and acute episodes • Patient history of medical tests • Patient history of medical treatment and prescribed drugs

21 Document LifeCycle Management BUSINESS LOGIC & FUNCTIONAL CAPABILITIES The business objectives of integrated care management and delivery programs influence the evolution of business logic because initiatives that are purely focused on regulatory compliance can be satisfied with solutions that provide data capture, archival, retention, access, reporting and auditing capabilities. Big data and analytics enable integrated care ecosystems to extract value from integrated patient records to apply optimal treatment and give the right incentives to providers that need to collaborate through more granular measurement of outcomes. Clinical Workflow Capabilities CPOE & Electronic Prescribing Administrative Workflow Capabilities PAS admission-discharge- transfer functionalities to track reimbursement patterns In order to orchestrate clinical pathways across the health value chain, clinical and administrative workflow capabilities are required.

22 Document LifeCycle Management USER ACCESS / INTERFACE Access to patient information is increasingly moving away from pure desktop application specific UIs and being made available through portals and native mobile apps. Increasingly, native mobile apps for healthcare professionals and patients provide the same granularity and real-time consistency but with user- friendly access to information than legacy application UIs. The shift in usability enabled by mobile apps could bridge some of the patient information integration gap, particularly in clinical data consumption use cases.

23 Document LifeCycle Management SOFTWARE SOURCING APPROACH Hospital clinical information system architectures have historically used best-of-breed applications for electronic patient record, departmental systems, CPOE, medical imaging and laboratories. These fragmented architectures and proprietary data models have typically focused on leading-edge business capabilities for a small group of administrative or clinical users, which did not favor building a consistently integrated patient record, not even within individual hospitals. True end-to-end suites, including all administrative and clinical processes could solve the patient data integration issue and would ensure consistent management of the platform. But at this stage of market maturity, there are no real end-to-end suites that can satisfy all clinical and administrative users. Rather, they are loosely coupled modules offered by the same software provider. Sometimes they are running with different UIs and on different database, application server, and operating system versions that force users to customize code and build add-ons that jeopardize the out-of-the-box consistency. A best-of- suite approach provides a more sustainable model with core data and business capabilities that are sitting in one suite of products with ancillary capabilities and data being supported by other systems. It is in a best-of-suite scenario that solutions like document life-cycle management and vendor neutral archive can add value by not only automating regulatory compliance, but stitching together structured and unstructured data to create integrated patient records. (See Figure 12) WESTERN EUROPE HOSPITAL SECTOR INTERDEPENDENCE BETWEEN INVESTMENTS IN DOCUMENT LIFE-CYCLE AND OTHER SOLUTIONS Figure 12 No plans to invest Maintain current solution Plans to invest in next 12 months No plans to invest Maintain Current Plans to invest in next 12 months Hospital executives that plan to invest in document life-cycle management solutions in the next 12 months are also more likely to invest in EHR, particularly in Western Europe. EHR 21%44%35% 21%39%39% 50%17%33% DOCUMENT LIFECYCLE This investment forms the architectural foundation for federated access across the health value-chain and in vendor neutral archives, which is a key piece to complete the patient data repository with medical images coming from different PACS solutions. VNA 21%38%41% 26%12%62% 33%28% 39%

24 Document LifeCycle Management INFORMATION INTEGRATION APPROACH Software sourcing approaches, the relative openness of data models and the scope of integration are all factors that influence the way patient data integration can be addressed. Though, in a highly fragmented environment, point-to- point application connectors will be necessary to make sense of data. Alternatively, a community of providers, each with a consistent set of data residing in end-to-end suites, could build a service-oriented architecture that can consolidate data. With a set of best-of-suite environments, an HIE federated architecture based on a master-patient index can be built to offer access to information that is extracted from source systems.

ESSENTIAL GUIDANCE “Hospital executives should collaborate on a roadmap that includes more loosely integrated data architectures.”

26 INTEGRATING PATIENT INFORMATION: WHAT’S NEXT? The integrated care management and delivery model will INCREASE PATIENT SAFETY & SATISFACTION as demanded by hospital and other provider executives. Essential Guidance Integrating patient information in a secure manner will provide the connective tissue for collaboration across the health value chain, so that patients can be attended more promptly, treatments applied more appropriately, and unnecessary and costly intervention eliminated. To fully leverage information for improved patient outcomes, while complying with patient data regulation, federated architectures must be leveraged. KEEP COSTS UNDER CONTROL as mandated by policymakers and payers. +

27 Hospital executives should collaborate with other stakeholders across the value chain on a roadmap that includes more loosely integrated data architectures to combine clinical and administrative applications with: Essential Guidance Document life-cycle solutions to integrate structured and unstructured information, while applying regulatory requirements consistently. Big data & analytics solutions to extract insights from data sets of large volume, variety and velocity. Cloud computing solutions to ensure flexibility and scalability. INTEGRATING PATIENT INFORMATION: WHAT’S NEXT?

28 WHAT SHOULD HOSPITAL EXECUTIVES DO? Essential Guidance The short-term. Use the information management framework to evaluate your assets (technologies, standards and patient data), processes (clinical, administrative, and governance, risk and compliance related) and skills to discover untapped opportunities in patient data integration and analysis. For instance, document management tools applied only to automate patient data retention compliance could be used to improve safety of medical orders. Start to experiment with document life-cycle management, big data and cloud computing to build collaborative pilots that involve other stakeholders along the health value-chain. The medium-term. Design a roadmap for integrated care service delivery and integrated patient record initiatives, which identify gaps relative to existing assets, processes and skills. Combine the gap assessments with early evaluation of pilot projects in terms of business model sustainability to attract budget and scale them to include a larger number of stakeholders, medical specialties and patients. The long-term. Optimize clinical and administrative workflow by leveraging an integrated patient record to improve the appropriateness of care. Consolidate benefits by clearly communicating changes and how they impact the long-term goals. This allows new practices in patient data archiving, retention, access and analysis to be industrialized and new resources freed-up for new programs. Visit our blog to be a part of the conversation. Learn more about this study online

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