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www.england.nhs.uk
Jamie J Coleman1,2, Adam Khimji2,1, Ann Slee1, Neil Watson3
The ePrescribingDigital Maturity Tool
8th June 2015
1 College of Medical and Dental Sciences, University of Birmingham2 University Hospitals Birmingham NHS Foundation Trust3 The Newcastle upon Tyne Hospitals NHS Foundation Trust,
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EPMA Systems Adoption Availability
Digital Maturity Existing Solutions
The Tool Aim Objectives Method Development Pilot Benefits What Next
Outline:
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Clinical systems that utilize data from pharmacy, laboratory, radiology, and
patient monitoring systems to relay the physician’s or nurse practitioner’s
diagnostic and therapeutic plans, and alert the provider to any allergy or
contraindication that the patient may have so that the order may be
immediately revised at the point of entry prior to being forwarded
electronically for the targeted medical action.
EPMA(Electronic Prescribing Medication Administration) Systems
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Drivers
National Program for IT
NHS Technology Fund
Patient Safety
EPMA Systems: Adoption
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EPMA Systems: Availability
TO NAME JUST A FEW!
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Digital Maturity
Digital Maturity:‘Measure of electronic/ informatics capability.’
ePrescribing Digital Maturity:‘Measure of EPMA system capability.’
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Electronic Medical Record Adoption Model (EMRAM) –HIMMS
European EMR Adoption Model –HIMMS
Clinical Digital Maturity Index (CDMI) –EHI
United States EMR Adoption Model SM
Stage Cumulative Capabilities 2013 Q4 2014 Q1
Stage 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP 2.9% 3.1%
Stage 6 Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS 12.5% 13.3%
Stage 5 Closed loop medication administration 22.0% 24.2%
Stage 4 CPOE, Clinical Decision Support (clinical protocols) 15.5% 15.7%
Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 30.3% 27.7%
Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 7.6% 7.2%
Stage 1 Ancillaries - Lab, Rad, Pharmacy - All Installed 3.3% 3.2%
Stage 0 All Three Ancillaries Not Installed 5.8% 5.6%
Data from HIMSS Analytics® Database ©2014 N = 5458 N = 5449
Digital Maturity: Existing Solutions
EXISTING SOLUTIONS
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DIGITAL MATURITY TOOL
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AimTo establish a technological audit and quantifiable measuring methodology across settings to provide a digital capability position of NHS organisations in England and allow this to be tracked over time
Objectives Building on work Ensuring academic
methodology Comparability (where possible) Detailing capability, deployment,
use, benefits and outcomes
Buy-In Proof of Concept Creating open data repositories
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LITERATURE REVIEW
EXPERT CONSENSUS• Initial proposal• Wider
stakeholders
SMALL SCALE PILOT
LARGE SCALE PILOT
Method
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Organisational readiness
Functional ePrescribing
Mature ePrescribing
Development: Key Levels
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Development: Individual Component Maturity
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Development: Matrix
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Formed Component Groups More detailDefinitions included
Identified measuresCapability availableCapability in useEffective use/reach
Development: Refinement
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Fig.1- Raw table of questions
Fig.2-Formatted questions with macros
Development: Spreadsheet
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Radar Plot
Development: Example Output
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Percentage Scores for: Enabling Capabilities Functional Components Mature Components Total Maturity
Area summary Overall maturity Maturity breakdown
Maturity overview radar plot
Development: Additional Outputs
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Pilot: Summary
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Pilot: Results
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Total Maturity BreakdownPilot: Results
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Pilot: Individual Capability Review
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Comparative judgement of healthcare providers
Identify gaps in current clinical configuration
Benchmarking Beacon sites
Sites needing help
Realign user expectations
Easy to use
Potential Benefits
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Feedback
Web Portal launch
Clarification
What Next?