wij helpen uw zorg verbeteren door het verbinden van zorg ... presentatie-d&a-forcare … ·...
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Wij helpen uw zorg verbeteren door het verbinden van zorg met IT.
BEE
LDIN
ZIC
HT
HL7
IHE
IHE OVERVIEW IHEradiologie & beeldvorming
INTRODUCTIEINTEROPERABILITEIT
IHE ♦HL7 DICOM♦
XDS ADVANCED XDS/XDS-I XCA/XCA-I♦
REGIONALEUITWISSELING
IHE ITI XDS♦ ♦
INTEROPERABILITEITSTANDAARDENIHE HL7 DICOM♦ ♦
HL7 versie 2 HL7 versie 3 & CDA HL7 FHIRbasics, profiling & advanced
BETER METENanalyse van informatie
BATENMANAGEMENTIN DE ZORG
definiëren & realiseren
INTRODUCTIECODERINGSSYTEMEN
& TERMINOLOGIEZORG API
DIAMHIMSS ANALYTICS
strategic roadmap
DICOMintroductie
DICOMhands-on
DICOMadvanced
BEELDKWALITEIT& dosis registratie
PACS II & VNA DIGITAL PATHOLOGY
VIPPIN DE ZORG
ZIB BGZ HL7♦ ♦
8 Stages to master the challenges of digitization in Imaging IT
Digital Imaging Adoption Model (DIAM)
IMS within department, enabling electr. orders, images, reports
Data exchange through same user interface
Right patient/right exam, status and quality measurement
Structured documentation, cross-enterprise HIE
Big data, predictive risk analysis, preventive measures
Appropriateness criteria, coded content, CADx,
Images and education available for patients, regional HIE
DIAM 7
DIAM 4
DIAM 5
DIAMMaturity roadmap to higher adoption of IT in Imaging
DIAM 6
• Provide thought leadership and guidance regarding IT-supported processes in medical imaging
• Support users and buyers of medical imaging technology to
• Identify potential infrastructure or workflow gaps
• Monitor technological progress over time
• Create a roadmap for future investments
• Share best practice and learn from peers
• Push the market to adopt the right digital strategy and improve health outcomes
Samenwerking
HIMSS Analytics in Europe
European Society of Radiology
DATA COLLECTION, ANALYSIS AND REPORTING
HIMSS Analytics collects data from >9000 hospitals worldwide
TR: >650
ASPAC: >900
Europe: >2.000
hospitals
US + CN: >6.000
hospitals
Countries with partial focus by HIMSS currently
HIMSS Analytics Maturity Models are used in many countries around the world. Some of them are perceived being a global standard for assessing digital maturity in healthcare settings.
Projects with Governmental Authorities
Focus Countries
MATURITY MODELS SUITE
We drive the health IT market in the direction it needs to go
Improved Patient Care
and Health IT Insights
ALL MODELS HAVE 8 STAGES (0 – 7)
In Europe, so far, HIMSS has assessed organisations based on EMRAM, DIAM and CCMM
Under construction:
IT Value Adoption Model
8 Stages to master the challenges of digitization in Imaging IT
Digital Imaging Adoption Model (DIAM)
IMS within department, enabling electr. orders, images, reports
Data exchange through same user interface
Right patient/right exam, status and quality measurement
Structured documentation, cross-enterprise HIE
Big data, predictive risk analysis, preventive measures
Appropriateness criteria, coded content, CADx,
Images and education available for patients, regional HIE
FocusgebiedenSoftware Infrastructure
Health Information Exchange
Workflow and Process Security
Quality and Safety Management
Patient Engagement
Clinical Documentation
Clinical Decision Support
Pervasiveness of Use
Advanced Analytics
Personalised Medicine
Bron: HIMSS Analytics
Invullen DIAM vragenlijst
Kwaliteitscontrole HIMSS
Score en rapportage
DIAM proces
DELIVERABLES – GAP REPORT (EXTRACTS) – 1/2
Score and Achievement in %
Gaps for next Stage by Focus
Area
DELIVERABLES – GAP REPORT (EXTRACTS) – 2/2Target and Actions
needed for next Stage
Your performance compared to others
Stage 5a - Advanced Analytics and PersonalizedMedicine Capabilities
Advanced analyticsKPI’s, big data, predictive analytics,prescriptive analytics
Personalized medicineOptimaliseren procedures, radiogenomics,theranostics.
Pervasiveness of useStatistieken
A SIDE NOTE TO… ADVANCED ANALYTICS
Source: P. Mildenberger: „Innovation in Imaging IT“, 2016
Trends in Analytics
• Transition from „information“ to „knowledge“
• Evidence-driven BI and Analytics
• Real-time predictive analytics and complex events processing („not just dashboards“), incl. the consumation and analysis of large and complex data („Big data“)
• Need for high availability, scalability, and fault tolerance
Be
Act
ion
-Ori
en
ted
A SIDE NOTE TO… PERSONALISED MEDICINE
Personalised medicine (orprecision medicine) = medical procedure, separating patients into different groups.
Objective: Tailor medical decisions, practices, interventions and/or products to the individual patient based on their predicted response or risk of disease.
Imaging relevancy:Imaging biomarkers, prediction of response, selection of specific interventions/treatments, imaging biobanks…
Image source: Permedx (www.permedx.co.uk)
Patients with same diagnosis and receiving treatment
Stage 5b - Clinical Decision Support and Value-basedImaging
Software infrastructureSpraakherkenning
Clinical decision supportCAD, best practice guidelines, orders
Clinical documentationGestructureerde content
Quality and safetyRegionaal/nationaal
Clinical decision support
Clinical documentation
Stage 5c - Advanced Health Info Exchange and Patient Engagement
Patient engagementAfspraken maken, beelden inzien,online informatie
Workflow & ProcessMDO ondersteuning
Health information exchangeUitwisselingen extern, standaarden
5c Patient engagement
Even voorstellen
www.rsonl.nl
Some Early results
Since DIAM launch in early 2016 we have scored and collected feedback from 39 hospitals and/or diagnostic centers. Most of the are from Europe.But the assessment has also proven to work in the US, Middle East and Asia.
Organizations already scored on DIAM
13 different countries
39 organizations
Bron HIMSS Analytics, status sep 2017
… DIAM distributionSome Early results
3.1
n = 39
DIAM Score Distribution
Digital Imaging Adoption Model SM
Stage Results (September 2017)
Spe
cial
ise
d S
tage
s Stage 73 out of 3 achieved
1*
Stage 62 out of 3 achieved
0
Stage 51 out of 3 achieved
4
Seq
ue
nti
al S
tage
s
Stage 4 12
Stage 3 5
Stage 2 14
Stage 1 3
Stage 0 0
N 39
Country N Type of organisation
Netherlands 8 Hospitals
Germany 86 Hospitals, 1 Primary Care Radiology Network, 1 DiagnosticImaging Center and Hospital
Spain 65 Hospitals, 1 Primary Trust and Hospital Association
Russia 51 Hospital, 1 external Diagnostic Imaging Center
Sweden 2 Hospitals
USA 21 Hospital, 1 Multi Hospital System
Saudi Arabia 2 Hospitals
Belgium 1 Hospital
Finland 1 Regional Imaging Center
Italy 1 Hospital
Poland 1 Hospital
Singapore 1 Hospital
UAE 1 Hospital * candidate for Stage 6/7, not yet validated
Bron HIMSS Analytics, status sep 2017
… Software ApplicationsSome Early results
All countries (n=39)
All countries (n=35)
Installed Base
Type of Image Management Solution (IMS)
Bron HIMSS Analytics, status sep 2017
… Health Information ExchangeSome Early results
All countries (n=39)
All countries (n=39)
With what type of external organizations do you exchange diagnostic imaging studies online (i.e. system-to-system)?
What is the geographic scope of your external data exchange activities?
Bron HIMSS Analytics, status sep 2017
… Health Information ExchangeSome Early results
All countries (n=39)
What formats and standards are used for external data exchange?
Organisations indicating „fully“ or „somewhat enabled“
Bron HIMSS Analytics, status sep 2017
… Structured DocumentationSome Early results
Radiologists use structured templates for diagnostic image reports conforming to CDA or similar standards
Organisations indicating „fully“ or „somewhat enabled“
Share of reports captured in structured, discrete, computer-readable format conforming to CDA Level 2 (or similar) or higher standards
Bron HIMSS Analytics, status sep 2017
… Workflow and Process SecuritySome Early results
The software used in Radiology supports cumulative Radiation Dose Monitoring and Alerts
A closed loop medication administration process is in use
Bron HIMSS Analytics, status sep 2017
… Analytics CapabilitiesSome Early results
All countries (n=39)
All countries (n=39)
Radiology unit uses Data & Analytics for…
Radiology uses internal and/or external data for predictive risk analysis of patients
Bron HIMSS Analytics, status sep 2017
… Clinical Decision Support Tools & CapabilitiesSome Early results
All countries (n=39)
All countries (n=39)
Which of the following is integrated into your electronic workflow…?
Which of the following Computer Aided Detection (CAD) Tools are in use…?
Bron HIMSS Analytics, status sep 2017
… Organizational BenchmarksSome Early results
Performance Indicators Mean Median Min Max
DIAM Stage 3.1 3.0 1.0 7.0
Annual Operating Expense of department (in €) 66,839,356 13,499,145 76,007 940,645,320
Rad. Imaging Studies per year 251,459 167,150 7,000 1,100,000
Radiologists & Residents (FTE) reading imaging studies
59.8 49.0 7.0 226.0
… of which Residents (FTE) 19.3 16.0 1.0 60.0
… share of Residents (FTE) in % 34% 36% 9% 55%
Expense per Imaging Study (in €) 107.5 63.4 5.8 855.1
Expense per Radiologist FTE (incl. Residents) (in €) 596,556 346,154 6,910 4,162,147
Expense per Radiologist FTE (excl. Residents) (in €) 832,349 625,000 7,601 5,225,807
Imaging Studies per Radiologist FTE (incl. Residents)
5,242 4,867 1,182 12,800
Imaging Studies per Radiologist FTE (excl. Residents)
8,481 8,611 875 17,198
Number of peers available for benchmarking 39
Countries from which peers are availableGermany (8), Netherlands (8), Spain (6), Russia (5), Sweden (2), USA (2), Saudi Arabia (2), Italy (1), Finland (1), United Arab Emirates (1), Singapore (1), Poland (1), Belgium (1)
Ratio: Hospitals vs. (external) Diagnostic Imaging Centers vs. Other organization 84.6% / 5.1% / 10.3%Ratio: Non-profit vs. For-profit organizations 94.9% / 5.1%
Bron HIMSS Analytics, status sep 2017
12 hospitals in NL: gemiddelde 3.5
1 Hospital stage 6: King Abdulaziz Medical City in Saudi-Arabië
Results February 2018
DIAM BENEFITS
Guidance in the digitisation of imaging ITMove towards a fully digitised imaging IT environment based on a roadmap created by industry experts from globally recognised organisations in the world of health IT and Imaging
Decision Support for your IT StrategyUse the results of the DIAM assessment to identify key opportunities for improvement, to drive your IT strategy and alignment with the overall business strategy of your organization
Benchmark OpportunitiesCompare your Imaging-IT progress over time and with peers from your region, your country or across the globe, based on a standardized and vendor neutral-assessment
Healthcare market recognition for DIAM Stage 6 & 7 organisationsAnnouncement of your accomplishment at major HIMSS and ESR events, promotion of your organisation’s case study, use of the DIAM Stage 6 & 7 logo on your website
DIAM seminar 25 mei 2018 DIAM cursus 26 juni 2018