The Evidence-Based EPR Benefits and Cost Model A presentation to the The Northern, Yorkshire and Humberside NHS Directors of Informatics Forum Sean Brennan

The Evidence-Based EPR Benefits and Cost Model

A presentation to the The Northern, Yorkshire and Humberside NHS Directors of Informatics Forum

Sean Brennan

Inform Health & Associates Ltd - EPR Benefits and Cost Model

Evidence-Based EPR Benefits Model

Background

Who are Inform Health & Associates?

What is the EPR Benefits Model ?

How can the model be used by Trusts/Health Boards?

Further Information? www.informhealthassociates.co.uk

Background


All our yesterdays !

Linking the Benefits to each level of an incremental EPR started in 1998.

Decision support/ Clinical GuidelinesAccess to Knowledge

Order entry/Results reporting/Electronic Prescribing/Integrated Care pathways

PAS/MPI/ Departmental systems

Integrated departmental systemsLabs/X-ray/Pharmacy/Theatre

Specialty modules / Document Imaging

Multimedia / Telematics

Level 1

Level 3

Level 4

Level 5

Level 6

Level 2

By Year 2002 ?

33%

EPR 6 level model 1998: Target 1







Level 1

Level 3

Level 4

Level 5

Level 6

Level 2

By Year 2005 ?

100%

EPR 6 level model 1998: Target 2







Level 1

Level 3

Level 4

Level 5

Level 6

Level 2

In 1999 ( ie when Information for Health published)

6%

EPR 6 level model 1998: The Reality


The EPR CD Rom

The multi-media EPR CD Rom attempted to identify the benefits of each incremental Epr development

level.

The EPR benefits model has been developed over the last decade and more specifically with Inform Health team in the last three years.


0%

1%

47%

4%

9%

16%

15%

8%

* source: cohort of NHS sites used for the investigation by HIMSS assessment of NHS hospitals’ IT maturity using its EMRAM data (Electronic Medical Record Adoption Model),

NHS Currently *

HIMSS have adopted the same incremental levels approach to ‘growing’ an EPR


How are countries doing?


Another Maturity Index !

Another maturity index (?initially EHI and now adopted by NHS England) has TWO dimensions:Level of maturity and depth of take-up at each level


Benefits and Digital/System Maturity

We need a process to enable us to anticipate, with a level of confidence, the benefits that this increasing maturity of an EPR will bring.

The benefits model must be based on evidence and locally tailored to suit contexts/business.

It is sometimes difficult to assign a specific benefit to a particular change but the model allows adjustments when a benefit may be the result of multiple changes in practice.

The EPR model can support Options Appraisal or Business Case development or for those who are already in an implementation provide a degree of rigour to Benefits Realisation.





A small but highly experienced healthcare informatics consulting firm established in 2013. We only utilise Associates with exceptional NHS experience, typically with CIO or Director backgrounds.

We will only assign Associates that meet our stringent criteria

Supporting Trust Informatics Strategies

Inform Health & Associates provide specialist and experienced support in the area of Trust Informatics Strategies, including option appraisals, cost benefits of EPR options and Business Case development.

To date we have provided these type of services to numerous Trusts including the following: University Hospital of South Manchester & South Sector Group Royal Liverpool & Broadgreen University Hospitals University Hospitals of Morecambe Bay Calderdale & Huddersfield NHS Foundation Trust University Hospitals of North Midlands Wirral University Teaching Hospital

At the core of our offering is the UK’s most advanced EPR Benefits and Cost Model and Business Case collateral.


What is the EPR Benefits Model?

EPR Options Appraisal Process – Benefit and Cost Model

Inform Health Provide Overview of the Model to Trust Model provides starter set assumptions and evidence where possible

Set up Benefits Model for Trust Acute or Community Wide Option

Agree Supplier/Strategic Options to Evaluate

Trust Supply their activity, financial and manpower data, plus current IT system costs that will be displaced by EPR

Review and amend each EPR benefit assumption of impact Supplement with benefit studies and transformation work

Have any of these benefits been achieved already by existing systems or other planned solutions eg EPMA benefits?

Review and amend phasing of benefits delivery over the 10 years by supplier if required


EPR Benefits – Example Vignettes Provided

Inform Health & Associates provide as part of the EPR Benefits Model example ‘Vignettes’ that help Trusts assess their potential benefits from EPR Vignettes look at what a current pre EPR workflow would look like,

then compare to a workflow after the introduction of an advanced EPR.

Pre and post benefits are then calculated based on a standard acute hospital

Examples of EPR Benefit Vignettes are provided on the web site, go to www.informhealthassociates.co.uk


EPR Options Appraisal – Benefits Model

Supplier/Solution Evaluation allows each EPR benefit to be profiled with: Level of confidence (%) the solution will deliver that benefit This Level of Confidence can be driven by a more detailed structured

assessment. For example by assessing solutions by up to 6 categories Usability Assessment of UK Functionality Confidence in the Company to Deliver etc Trusts can define up to 6 categories and their weightings

Supplier/solutions can have different benefit delivery time profiles Supplier/solutions can have different cash releasing delivery time

profiles

Various EPR Benefit Reports provided based on Trust data and assumptions


EPR Options Appraisal – Benefits Model

Benefits are Grouped under 6 headings: Staff Efficiency Non Staff Savings Clinical Quality & Practice Variation Length of Stay, Readmissions & Demand Management IT Displaced Costs Income

Benefits Delivered to be Categorised into Types: Cash Releasing More Time for (or improvements in) Patient Care Increased Capacity Improved Income Cost Avoidance


EPR Options Appraisal – Cost Model

EPR Cost Model: Estimated Contract Costs for main suppliers EPR Programme Staffing Model calculates expected increase in

EPR staff by supplier option over the 10 years Training Costs calculated Procurement/preparation costs and data migration costs Investment in hardware etc

EPR Benefits and Costs Brought Together NPV calculations Various Reports, including relative costs and benefits of different

solutions

Benefit and Cost Outputs Feed EPR Outline Business Case if Required



EPR Benefits Model Menu I

BACKGROUND

Set Up Data & Assumptions Benefits & Phasing Supplier Evaluation

QUALITY & EFFICIENCY Efficiency Clinical Quality Displaced IT Costs Summary


BENEFITS

Suppliers by year Cash Released Plan by year Benefits & High Projection Cash Benefits by Supplier Non Cash benefits by

Supplier Benefits Realisation Plan Costs & Benefits Costs & Benefits summary

COSTS

Cost Analysis Supplier Costs Estimation Staffing Training Data Migration Procurement and prep

costs Supplier Costs

EPR Benefits Model Menu II

Using the EPR Benefits Model?



Using the EPR Benefits Model

EPR Options Appraisal EPR Business Case development EPR Cost Benefits EPR Strategies


How does it work?

Initial walk-through of model. No obligations.

Once signed up then: IH&A provides an overview of the model and provides starter set

assumptions and evidence where possible. ‘Localising’ the model through meetings with IH&A consultants and:

Nursing staff AHP Medical Staff Senior Managers Transformational change Anyone else as indicated

Data Assumptions sheet completed Follow-up meetings


Outputs/Conclusions

Reports generated by the IH&A team

Reports/results presented to Trust

Do you want further information?



Additional Information :

Contact:

Alan Spours Or Sean Brennan

Managing [email protected]

Inform Health & Associates Ltd

[email protected]

07585 807959

www.informhealthassociates.co.uk

Documents

The Evidence-Based EPR Benefits and Cost Model A presentation to the The Northern, Yorkshire and Humberside NHS Directors of Informatics Forum Sean Brennan