STEP into Value: Deriving Outcomes from HIT · • Computerized Provider Order Entry X Data Sharing: • Protection of Patient Health Information X Data Reporting: • Public Health

STEP into Value: Deriving Outcomes from HIT

Pat Wise, MA, MS, FHIMSS, COL (USA ret’d)

Vice President, HIS, HIMSS

Pat Wise

RN, MA, MS, FHIMSS COL (USA ret'd)

Vice President, HIS

HIMSS Health IT Value Suite

Conflict of Interest

COL Patricia Wise, RN, MA, MS, FHIMSS (USA ret’d)

Has no real or apparent conflicts of interest to report.

Agenda

• Review the Value Suite

• Discuss STEPS Model

• “AH-HA” Moment

• Introduce the Value Score

• Methodology for Measuring Value

Learning Objectives

• Define the STEPS framework

• Explore the HIMSS Value Score and Scoring Methodology

• Discuss best practices for utilizing the Value Score for quantifying your

organization’s HIT value realization

Data from HIMSS Analytics® Database © 2015 HIMSS Analytics

1.0% 4.1%

25.4%

34.6%

10.3%

17.3%

3.4%

1.8%

3.1%

2.8%

3.7%

10.3%

49.7%

15.4%

6.7%

10.5%

2010 Q3 2015 Q3

N = 5233 N = 5454

Complete EMR, CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP

Physician documentation (structured templates), full CDSS (variance & compliance), Closed loop medication administration

Full R-PACS

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


3.6% 4.1%

25.4%

34.6%

10.3%

17.3%

3.4%

1.8%

3.1%

17.9%

32.8%

14.0%

21.0%

5.1%

2.0%

3.7%

2014 Q4 2015 Q3

N = 5467 N = 5454



Full R-PACS







3.7% 4.1%

25.4%

34.6%

10.3%

17.3%

3.4%

1.8%

3.1%

23.6 %

32.3 %

13.2 %

18.2 %

3.6 %

1.9 %

3.3 %

2015 Q2 2015 Q3

N = 5464 N = 5454



Full R-PACS






MU Stage 3

MU Stage 2

MU Stage 1

Value Score by S-T-E-P-S

S

T

E

P

S

4,043

1,141

2,643

6,355

894

Total = 15,076

11 |

Value Statements by Provider Type

194

262

835

289

95

671

152

1,352

2,032

976

1,178

592

489

68

262

2,423

4,207

1,805

State

Public Health Organization

Other

Health Information Exchange

Consumer

Community Health Organization

Beacon Commumity

Small Speciality Physician…

Small Primary Care Practice…

Patient Centered Medical Home

Large Speciality Physician…

Large Primare Care Practice…

Accountable Care Organization

Rural Hospital

Critical Access Hospital

Community Hospital

Health Care System

Academic Medical Center

Larg

e h

osp

ital

syste

ms

Ind

ivid

ual

ho

sp

itals

P

ractic

es

O

ther

Total = 13,143 (some statements fall in multiple buckets)

SOURCE: HIMSS VS database as of January 8, 2016

12 |

Count of Value Statements by STEPS subtype Total = 12,719

Satisfaction

Treatment/Clinical

Electronic Secure

Info/Data

Prevention &

Patient education

Savings

648

898

1871

368

590

456

687

384

706

861

2301

118

2075

122

198

375

61

Operational Savings

Financial/Business

Efficiency Savings

Prevention

Patient Education and Engagement

Evidence Based Medicine

Data Sharing

Data Reporting

Enhanced Communication

Safety

Quality of Care

Other Trmnt/Clinical

Efficiencies

Staff Satisfaction

Provider Satisfaction

Patient Satisfaction

General Satisfaction

SOURCE: HIMSS VS database as of January 8, 2016

http://www.himss.org/ValueSuite

STEPS Framework

14 |

STEPS: Satisfaction

Total = 756

61

301

74

39

159

122

Satisfaction Benefits

Increased patient satisfaction and/orsurvey score

Reduced patient wait times

Improved quality of life

Increased provider satisfaction

Increased staff morale/job satisfaction

15 |

STEPS: Treatment/Clinical

Total = 5,371

97 415

250 279

438 184

408 118

691 411

17 156

260 536

17 66

35 62

50 132

75 187

120 367

Improved accessibility of lab/x-ray reports

Other efficiency benefits

Real time/remote access to health records

Improved clinical documentation

Improved management of congestive…

Other quality of care benefits

Reduction in ER visits

Reduction in hospital admissions

Reduction in length of inpatient stay

Other safety benefits

Reduction in medical errors

16 |

STEPS: Electronic Secure Info/Data

Total = 2,233

208 327

63 36

72 207

67 59

51 222

192 191

8 74

1 61 58

265 71

Improved communication among…

Improved communication with staff

Improved internal communication

Increased number of patients tracked

Improved/increased data reporting

Increased information sharing among…

Other data sharing

Availabilty of genetic data to make…

Increased access to evidence based…

Other evidence based medicine benefits

17 |

STEPS: Patient Engagement and Population Management Total = 958

51

58

207

76

64

134

4

108

24

50

82

49

51

Improved distribution of patient…

Improved patient compliance

Improved patient engagement

Other patient education benefit(s)

Improved patient education

Decreased obesity

Improvement in smoking cessation

Increased immunizations

Increased screenings

Other prevention benefits

Improvements in prevention

18 |

STEPS: Savings Total = 3,417

166

472

125

341

444

184

139

4

143

106

409

140

87

9

29

92

412

115

Improved claims management

Improved workflow/practice efficiency

Increased efficiency in scheduling patients

More efficient use of staff resources

Other efficiency savings

Increased efficiency

Reduction in transcription costs

Improved charge capture

Increased patient revenue

Increased patient volume

Other financial/business benefits

Improved financial results

Reduction in days in accounts receivable

Reduction in malpractice premiums

Improved business recovery planning…

Improved use of space

Other operational savings

Increased operational savings


STEPS Framework

• S=Satisfaction; 894

• T=Treatment/Clinical; 6,355

• E=Electronic Secure Data Exchange; 2,643

• P= Patient Engagement/Population Health; 1,141

• S=Savings; 4,043

• Total =15,076

HIMSS’s Value Collection

•Value Vocabulary – STEPS = framework for discussing, attributing value

– Value Suite = collection of 15,000 statements and 1,700 case studies

of derived value sorted into the STEPS framework

– Pathways to Value=tools and resources to drive value

– Value Score = numeric score summarizing value derived from HIT

HIMSS’s Value Framework

Now’s the Time for Phase Two

The HIMSS Value Score

• Establishes a universal global evidence-based method for evaluation

• Identifies opportunities for provider organizations to derive more

value from their health IT

• Challenges organizations to measure the value demonstrated by the

IT they have in-place

• Fueling further trust in, use and growth of health IT

What the Value Score Offers

Value Score

Perceived

Value

Baseline Value Innovative

Value

+ +

What is the Value Score?

Recognized

Value

+

Value Score

Perceived

Value

Baseline

Value

Innovative

Value

+ +

Value Score Model: Data Sources

Recognized

Value

+

PROVIDER – survey instrument

PROVIDER – internal documents

Value Score

Perceived

Value

Baseline

Value

Innovative

Value

+ +

Value Score Model

Recognized

Value

+

Baseline Value

Value Score

Perceived

Value

Baseline

Value

Innovative

Value

+ +

Value Score Model

Recognized

Value

+

Perceived Value: Question 1

NOT INSTALLED/USED

WHY THESE TECHNOLOGIES?

KEY WORDS

Perceived Value: Measure - 2

KEY PHRASE


S T E P S


S T E P S


STEPS Framework

Value Score

Perceived

Value

Baseline

Value

Innovative

Value

+ +

Value Score Model

Recognized

Value

+

35 |

Third Component of Value Score

Data Capture and Sharing

Advanced Processes

Improved Outcomes

Recognized Value expected

and realized

in specific areas by

using HIT

Expected Value Outcomes T E P Efficiencies: • Administrative & Care Delivery Workflow

• Electronic Prescribing

X

Safety: • Clinical Decision Support

• Computerized Provider Order Entry

X

Data Sharing: • Protection of Patient Health Information

X

Data Reporting: • Public Health and Clinical Data Registry

X

Patient Education/Engagement: • Patient Electronic Access to Health Information

X

Level 1: Data Capture and Sharing Select up to 2 examples

Recognized Value

T = Treatment/Clinical

E = Electronic Secure Data

P = Patient Engagement & Population Management

Expected Value Outcomes T E P Efficiencies: • Throughput of Congested Hospital Spaces (e.g. ED, OR, ICU)

• Reduction of Waiting Time (e.g. Clinics, ED)

X

Safety: • Reduction of Infection (e.g. Central Line, Catheter, Ventilator

Dependent Pneumonia)

X

Business Efficiencies: • Revenue Cycle Management

X

Data Sharing: • Improved Tracking of Chronic Disease Management

X

Enhanced Communication: • Health Information Exchange

X

Prevention: • Population Health Initiatives

X

Patient Education/Engagement: • Coordination of Care through Patient Engagement

X

Recognized Value Level 2: Advanced Processes Select up to three examples

Expected Value Outcomes T E P Efficiencies: • Use of Blood and Blood Products

X

Quality of Care: • 30 day Readmission Rate

X

Data Sharing: • Early detection of Infectious Disease Outbreaks

X

Evidence Based Medicine: • Change in Practice from the use of Clinical Analytics

X

Patient Education/Engagement: • Use of Patient Generated Health Data

X

Recognized Value Level 3: Improved Outcomes Select up to three examples

Recognized Value – Question 3

WHY THESE TECHNOLOGIES?

KEY PHRASE

TIMEFRAME?

Recognized Value – Examples KEY PHRASE KEY PHRASE

Value Score

Perceived

Value

Baseline

Value

Innovative

Value

+ +

Value Score Model

Recognized

Value

+

Innovative Value – Examples

Innovative Value (cont’d)

SATISFACTION OUTCOME MEASURE

SAVINGS OUTCOME MEASURE

Innovative Value (cont’d)

Value Score

Perceived

Value

Baseline Value

Innovative Value

+ +

Value Score: Value Weights

Recognized

Value

+

HIMSS Value Score

Baseline

Value

Perceived Value

Recognized

Value

Innovative Value

Inherent value derived

from having advanced

HIT capabilities

(EMRAM Stage 7 >

through Stage 3)

Understanding of value

realization through IT

permeates organization

Demonstrable clinical,

financial, operational,

strategic outcomes

Demonstrable

innovative outcomes

that drive the

industry forward

Leadership

Outcomes

Organization

Adoption

Questions?

• Pat Wise

[email protected]

@patwise

www.linkedin.com/in/pat-wise-90b0391

mailto:[email protected]

Documents

STEP into Value: Deriving Outcomes from HIT · • Computerized Provider Order Entry X Data Sharing: • Protection of Patient Health Information X Data Reporting: • Public Health