Achieving Enterprise Imaging Maturity

Transcription

1 Achieving Enterprise Imaging Maturity Kim Garriott Principal Consultant Logicalis, U.S. DIAM-EI development team chair; HIMSS-SIIM Enterprise Imaging Community co-founder and co-chair Dawn Cram IS Director, Enterprise Imaging Ochsner Health System DIAM-EI development team co-chair; HIMSS-SIIM Enterprise Imaging Community; SIIM Board of Directors; JDI Editorial Board

2 Session Objectives Understand the purpose of the Digital Imaging Adoption Maturity Model and how it relates to the EMRAM Analyze the 8 stages of maturity Determine organizational needs to achieve maturity Understand the vendor R&D still needed in the industry to assist organizations with achieving maturity

3 HIMSS Analytics Maturity Models ELECTRONIC MEDICAL RECORD ADOPTION MODEL (EMRAM) CONTINUITY OF CARE ADOPTION MODEL (CCMM) DIGITAL IMAGING ADOPTION MODEL (DIAM & DIAM-EI) OUTPATIENT ELECTRONIC MEDICAL RECORD ADOPTION MODEL (O-EMRAM) ADOPTION MODEL FOR ANALYTICS MATURITY (AMAM)

4 EMRAM Update Promotes Imaging to Stage 1 Requirement

5 What is the Digital Imaging Adoption Model (DIAM)? Roadmap-based assessment to master digital transformation in medical imaging Collaboration with international, cause-based, professional societies and very enthusiastic imaging experts from Europe, North America, Asia, Middle East and Latin America Key Contributors 8 Stage (0-7) maturity model; measures and benchmarks IT adoption in medical imaging Launched in 2016 Globally applicable Provides guidance for digital transformation of medical imaging, including best-practice sharing and public recognition opportunities

6 How did we get here? A brief history of the DIAM 2015 Launched HIMSS-ESR workgroup (in Europe) to develop the DIAM 2016 (March) DIAM launched at European Congress of Radiology - focused on Radiology DIAM rollout in various European countries with some interest in Middle East First discussions with HIMSS-SIIM Enterprise Imaging workgroup in North America Launched global DIAM workgroup (ESR, SIIM, EUSOMII); build on previous work Workgroup goals: 2017 (June) Expand DIAM into an Enterprise Imaging roadmap Update / refine existing DIAM criteria for Enterprise Imaging applicability Develop new DIAM assessment methodology for enterprise imaging assessments Retain existing Radiology assessment survey Set stage for developing DIAM assessment methodology for other imaging areas 2018 (March) First DIAM update; now meets Enterprise Imaging challenges and requirements

7 HIMSS Analytics DIAM workgroup participants Many thanks to the following workgroup members for their valuable contribution Workgroup Function Name Country Representing Organisation Job Title / Position Chair Kim Garriott USA SIIM Principal Consultant, Logicalis / Co-founder HIMSS-SIIM Enterprise Imaging workgroup Co-chairs Dawn Cram USA SIIM IS Director, Enterprise Imaging, Ochsner Health System / HIMSS-SIIM Enterprise Imaging workgroup member / SIIM Board of Directors / JDI Editorial Board Monief Eid Saudi Arabia None PACS Program Director at the MoH / HIMSS-SIIM Enterprise Imaging workgroup member Cheryl Petersilge USA SIIM MD, Cleveland Clinic / Gerald Tan Singapore none Deputy CMIO and Consultant Radiologist, Tan Tock Seng Hospital, Singapore John Daniels USA HIMSS Analytics Global Vice President Healthcare Advisory Services, HIMSS Analytics Jörg Studzinski Germany HIMSS Analytics Director Research and Advisory Services, HIMSS Analytics Lluís Donoso-Bach Spain ESR MD, PhD, Director Diagnostic Imaging Department Hospital Clínic of Barcelona / ESR President 2015/16 Luc Bidaut UK EUSOMII MD, PhD, Professor of Medical Imaging, University of Lincoln Neelam Dugar UK ESR MD, Consultant Radiologist, Doncaster & Bassetlaw Hospitals NHS Trust / Informatics Advisor for the Royal College of Radiologists Paul van Diest Netherlands none MD, PhD, Professor and Head of Pathology Department, University Medical Center Utrecht, Netherlands / Professor of Oncology at Johns Hopkins Oncology Center, USA Peter Mildenberger Germany ESR MD, PhD, Professor for Radiology and IT-Leader at the Dept. of Radiology, University of Mainz / Chair of ESR subcommittee for Professional Issues and Economics in Radiology Yulia Shevchuk Austria ESR MD, PhD, Manager at Dept. of European and International Affairs, ESR Office, Vienna

8 HIMSS Analytics DIAM key contributors Thank You!

9 How does it look from inside? A short walk through The DIAM Stages

10 DIAM Stage 0 (Enterprise Imaging) No or limited Electronic Image Management Less than 2 service areas have/use an enterprise or specialized information system for image acquisition and reports/notes management A service area = image producing unit / department, such as: - Radiology - Cardiology - Pathology - Opthalmology - Dentistry - Obstetrics, etc.

11 DIAM Stage 1 (Enterprise Imaging) Electronic Image Management covering service area(s) At least 2 service areas need to have electronic image management (no matter which): + o Modalities/devices to produce images in digital format o Information systems to manage image acquisition (order- or encounter-driven) manage reports/clinical notes related to medical images image archiving may have: supply and inventory management (where appropriate, e.g. Radiology/Cardiology) Potential Software Solutions RIS, CVIS, LIS, Dental IS etc. RIS, CVIS, LIS, Dental IS etc. PACS, VNA etc. Typically part of other systems, such as RIS, CVIS, EMR etc. A service area = image producing unit / department, such as Radiology, Cardiology, Pathology, Opthalmology, Dentistry, Obstetrics, etc.

12 DIAM Stage 2 (Enterprise Imaging) Electronic Image Management covering a variety of images across the enterprise At least 3 service areas (or 70% of all medical images/videos) need to have electronic image management (no matter which) + + Additional requirements: o Third party image management systems need to be integrated with the EMR (or similar solution) o Images should be directly accessible, e.g. by single or multiple links, via the EMR (or similar solution) o Images must have metadata assigned (e.g. MRN, name, description etc.) o External images can be imported for clinician access (if policy allows)

13 DIAM Stage 3 (Enterprise Imaging) Imaging Governance and Strategy; Workflow and Process Safety Governance & Strategy (incl. governing body / oversight) for Type of imaging solutions/technology, security etc. Information/data management (e.g. use of standards to ensure consistency) Formalized strategy (addressing the enterprise) and regular vetting Purchases/procurements Workflow and Process Safety Quality, safety and operational parameters across multiple imaging services are measured and under control Image acquisition workflows accross multiple imaging services are formalized, standardized and implemented Status management for imaging studies, reports/notes across multiple imaging services Processes to ensure right is associated with right image (and vice versa) Information Technology Financials Program Image Sharing and Accessibility Clinicians can access all types of images/multimedia through a consolidated ( universal ) viewer; specialists can use specialty viewers on top External referrers can access and view images online (through the organization s network/repository)

14 DIAM Stage 4 (Enterprise Imaging) Fully integrated image management with efficient enterprise-wide image sharing across different service areas Enterprise-wide image repository Enterprise-wide standardized workflows for image/multimedia/metadata capture, storage and sharing Use of internationally recognized standards, protocols and/or profiles to support system integration and clinical workflows Secure acquisition and easy viewing capabilities for mobile images (mobile platforms, handheld devices) Capability to directly ingest external images (incl. associated reports/notes, metadata etc.) Remote access to images and reports/notes Source: Roth CJ, Lannum LM, Persons KR. A Foundation for Enterprise Imaging: HIMSS-SIIM collaborative whitepaper. J Digit Imag 2016)

15 DIAM Stage 5A (Enterprise Imaging) Advanced Imaging Analytics Imaging platform provides infrastructure that enables enterprise data warehouses to use information from images and asscociated metadata Clinical and operational parameters are systematically tracked, benchmarked and can be presented in real-time Organisations use and incorporate external data sources Examples of using predictive and prescriptive analytics can be presented Capability to correlate genetic information from patients with imaging biomarkers Technology use is captured and analyzed to influence user behavior Imaging biomarker: Determination of the HER-2 status of paraffin embedded xenograft tumours by immunohistochemistry of HER-2 (Source: Wikipedia, Author: Mumssygris) Source:

16 DIAM Stage 5B (Enterprise Imaging) Clinical Decision Support and Value-based Imaging Organization uses Structured Reports and/or Natural Language Processing to generate discrete data that can feed algorithms/rules and trigger Clincial Decision Support Organizations have integrated electronic workflow support to check the appropriateness of imaging orders Imaging specialists have seamless access to medical imaging knowledge databases/libraries (integrated with the primary system) Computer-aided detection and/or Computer-aided diagnosis tools are in use (traditional or based on AI/Deep Learning) Best-practice guidelines are directly integrated into the electronic workflow Advanced Visualisation software is in use (Some of) the many faces CDS

17 DIAM Stage 5C (Enterprise Imaging) External Image Exchange and Patient Engagement Majority of image producing services shares images and reports/notes with care organizations of all types (i.e. primary, secondary, tertiary care etc.) within local care community, region, or even the whole country Use of recognised standards (e.g. relevant IHE profiles) for external data exchange Imaging applications support multidisciplinary interactive collaboration (MDTs, Instant-image sharing etc.) Patients can make appointments for examinations online access their images and reports/notes online access (targeted/context-specific) educational content online Upload, download their images and provide access to other care providers or family members Patient satisfaction (about services provided) is measured and under control Image source: Patient Engagement Framework (HIMSS Foundation)

18 How Can You Get Involved? Participate in the Survey Development Feedback Process!

19 Collecting Feedback Why o Ensure the model contains criteria that are relevant, specific, measurable, actionable and globally applicable o Enable key stakeholders (providers, industry) to improve the model and be engaged with its development How o Online feedback form o Public comment timeframe: May 14th June 8th Who o EI solution providers and consultants o Professionals (clinicians, IT etc.) that (intend to) use EI solutions What will happen with it o All responses will be analysed, normalized, categorized o The DIAM-EI workgroup will discuss and prioritize them based on relevancy, importance and alignment with the model; highly prioritized items will be included into the DIAM assessment survey and used to evaluate and score providers with regard to their EI capabilities

20 Guiding principles for feedback Suggested items / criteria must be: Globally applicable o i.e. independent of a health system or country Vendor-agnostic o i.e. not bound to a specific product, workflow or standard provided by one particular vendor Measurable and/or possible to demonstrate o o Evaluated providers must be able to collect that information from their organisations If requested by HIMSS, providers must be able to demonstrate the required capability through live demos, use cases etc. Achievable o Providers must be able to achieve a certain capability by implementing and using technology that is available on the market Aligned with the 8 Stages (0 7) of the DIAM for Enterprise Imaging o Criteria that are out of scope will not considered, e.g. criteria related to very specific (rare) types of imaging services criteria related to very specifc (rare) type of imaging providers

21 What we ask for Review The DIAM Enterprise Imaging Stages Description The feedback form Make comments and suggestions for all focus areas or for those focus areas that you are particularly interested in / knowledgeable Engage other colleagues in your organisation who might be able to contribute with valuable input Ideally consolidate your feedback within your own organisation before you submit it to us Invest at least 30min, if not a bit more

22 How it works Use this link to open our online feedback form: V_0VWc1ifOmn7WkBv Open stages description document Progress through the feedback form

23 What will be next? Solicit vendor feedback on survey framework Complete survey Role out globally Benchmarks, learnings, & improvements

24 Coming soon: DIAM - EI The new DIAM chart, with slight text adjustments to be inclusive of the Enterprise Imaging concept Next milestones Insert updated model (if available) Open Feedback collection (May June) Assessment kit development (Q2-Q3 2018) Public launch and assessments (Q4/2018) The updated model aligns with the current Radiologyfocused DIAM one model, but separate assessments (Radiology vs. Enterprise Imaging track)

25 Questions? Kim Garriott Principal Consultant Logicalis U.S. Chair, DIAM-EI Development Team Dawn Cram I.S. Director, Enterprise Imaging Ochsner Health System Co-Chair, DIAM-EI Development Team