Wij helpen uw zorg verbeteren door het verbinden van zorg met IT.

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2 Wij helpen uw zorg verbeteren door het verbinden van zorg met IT.

3 BEELD INZICHT HL7 IHE INTRODUCTIE INTEROPERABILITEIT IHE HL7 DICOM IHE OVERVIEW XDS ADVANCED XDS/XDS-I XCA/XCA-I REGIONALE UITWISSELING IHE ITI XDS IHE radiologie & beeldvorming INTEROPERABILITEIT STANDAARDEN IHE HL7 DICOM HL7 versie 2 HL7 versie 3 & CDA HL7 FHIR basics, profiling & advanced BETER METEN analyse van informatie VIPP IN DE ZORG ZIB BGZ HL7 BATENMANAGEMENT IN DE ZORG definiëren & realiseren INTRODUCTIE CODERINGSSYTEMEN & TERMINOLOGIE ZORG API DIAM HIMSS ANALYTICS strategic roadmap DICOM introductie DICOM hands-on DICOM advanced BEELDKWALITEIT & dosis registratie PACS II & VNA DIGITAL PATHOLOGY

4 Digital Imaging Adoption Model (DIAM) 8 Stages to master the challenges of digitization in Imaging IT Big data, predictive risk analysis, preventive measures Appropriateness criteria, coded content, CADx, Images and education available for patients, regional HIE Structured documentation, cross-enterprise HIE Right patient/right exam, status and quality measurement Data exchange through same user interface IMS within department, enabling electr. orders, images, reports

5 DIAM Maturity roadmap to higher adoption of IT in Imaging Provide thought leadership and guidance regarding IT-supported processes in medical imaging Support users and buyers of medical imaging technology to DIAM 7 Identify potential infrastructure or workflow gaps Monitor technological progress over time DIAM 6 Create a roadmap for future investments Share best practice and learn from peers DIAM 5 Push the market to adopt the right digital strategy and improve health outcomes DIAM 4

6 Samenwerking HIMSS Analytics in Europe European Society of Radiology

7 DATA COLLECTION, ANALYSIS AND REPORTING HIMSS Analytics collects data from >9000 hospitals worldwide 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. US + CN: >6.000 hospitals Europe: >2.000 hospitals TR: >650 ASPAC: >900 Projects with Governmental Authorities Focus Countries Countries with partial focus by HIMSS currently

8 MATURITY MODELS SUITE We drive the health IT market in the direction it needs to go Improved Patient Care and Health IT Insights

9 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

10 Digital Imaging Adoption Model (DIAM) 8 Stages to master the challenges of digitization in Imaging IT Big data, predictive risk analysis, preventive measures Appropriateness criteria, coded content, CADx, Images and education available for patients, regional HIE Structured documentation, cross-enterprise HIE Right patient/right exam, status and quality measurement Data exchange through same user interface IMS within department, enabling electr. orders, images, reports

11 Focusgebieden Software 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

12 DIAM proces Invullen DIAM vragenlijst Kwaliteitscontrole HIMSS Score en rapportage

13 DELIVERABLES GAP REPORT (EXTRACTS) 1/2 Score and Achievement in % Gaps for next Stage by Focus Area

14 DELIVERABLES GAP REPORT (EXTRACTS) 2/2 Target and Actions needed for next Stage Your performance compared to others

15 Stage 5a - Advanced Analytics and Personalized Medicine Capabilities Advanced analytics KPI s, big data, predictive analytics, prescriptive analytics Personalized medicine Optimaliseren procedures, radiogenomics, theranostics. Pervasiveness of use Statistieken

16 Be Action-Oriented A SIDE NOTE TO ADVANCED ANALYTICS 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 Source: P. Mildenberger: Innovation in Imaging IT, 2016

17 A SIDE NOTE TO PERSONALISED MEDICINE Personalised medicine (or precision medicine) = medical procedure, separating patients into different groups. Patients with same diagnosis and receiving treatment 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 (

18 Stage 5b - Clinical Decision Support and Value-based Imaging Software infrastructure Spraakherkenning Clinical decision support CAD, best practice guidelines, orders Clinical documentation Gestructureerde content Quality and safety Regionaal/nationaal

19 Clinical decision support

20 Clinical documentation

21 Stage 5c - Advanced Health Info Exchange and Patient Engagement Patient engagement Afspraken maken, beelden inzien, online informatie Workflow & Process MDO ondersteuning Health information exchange Uitwisselingen extern, standaarden

22 5c Patient engagement

23 Even voorstellen

24 Some Early results 39 organizations 13 different countries 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 Bron HIMSS Analytics, status sep 2017

25 Sequential Stages Specialised Stages Some Early results DIAM distribution Country N Type of organisation Netherlands 8 Hospitals Germany 8 Spain 6 Russia 5 Sweden 2 Hospitals USA 2 6 Hospitals, 1 Primary Care Radiology Network, 1 Diagnostic Imaging Center and Hospital 5 Hospitals, 1 Primary Trust and Hospital Association 1 Hospital, 1 external Diagnostic Imaging Center 1 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 DIAM Score Distribution Digital Imaging Adoption Model SM Stage Results (September 2017) Stage 7 3 out of 3 achieved Stage 6 2 out of 3 achieved Stage 5 1 out of 3 achieved 1* 0 4 Stage 4 12 Stage 3 5 Stage 2 14 Stage 1 3 Stage 0 0 N 39 UAE 1 Hospital * candidate for Stage 6/7, not yet validated 3.1 n = 39 Bron HIMSS Analytics, status sep 2017

26 Some Early results Software Applications Installed Base All countries (n=39) Type of Image Management Solution (IMS) All countries (n=35) Bron HIMSS Analytics, status sep 2017

27 Some Early results Health Information Exchange With what type of external organizations do you exchange diagnostic imaging studies online (i.e. system-to-system)? All countries (n=39) What is the geographic scope of your external data exchange activities? All countries (n=39) Bron HIMSS Analytics, status sep 2017

28 Some Early results Health Information Exchange What formats and standards are used for external data exchange? All countries (n=39) Organisations indicating fully or somewhat enabled Bron HIMSS Analytics, status sep 2017

29 Some Early results Structured Documentation Radiologists use structured templates for diagnostic image reports conforming to CDA or similar standards Share of reports captured in structured, discrete, computer-readable format conforming to CDA Level 2 (or similar) or higher standards Organisations indicating fully or somewhat enabled Bron HIMSS Analytics, status sep 2017

30 Some Early results Workflow and Process Security 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

31 Some Early results Analytics Capabilities Radiology unit uses Data & Analytics for All countries (n=39) Radiology uses internal and/or external data for predictive risk analysis of patients All countries (n=39) Bron HIMSS Analytics, status sep 2017

32 Some Early results Clinical Decision Support Tools & Capabilities Which of the following is integrated into your electronic workflow? All countries (n=39) Which of the following Computer Aided Detection (CAD) Tools are in use? All countries (n=39) Bron HIMSS Analytics, status sep 2017

33 Some Early results Organizational Benchmarks Performance Indicators Mean Median Min Max DIAM Stage Annual Operating Expense of department (in ) 66,839,356 13,499,145 76, ,645,320 Rad. Imaging Studies per year 251, ,150 7,000 1,100,000 Radiologists & Residents (FTE) reading imaging studies of which Residents (FTE) share of Residents (FTE) in % 34% 36% 9% 55% Expense per Imaging Study (in ) Expense per Radiologist FTE (incl. Residents) (in ) 596, ,154 6,910 4,162,147 Expense per Radiologist FTE (excl. Residents) (in ) 832, ,000 7,601 5,225,807 Imaging Studies per Radiologist FTE (incl. Residents) Imaging Studies per Radiologist FTE (excl. Residents) Number of peers available for benchmarking 39 Countries from which peers are available Germany (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 ,242 4,867 1,182 12,800 8,481 8, ,198

34 Results February hospitals in NL: gemiddelde Hospital stage 6: King Abdulaziz Medical City in Saudi-Arabië

35 DIAM BENEFITS Guidance in the digitisation of imaging IT Move 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 Strategy Use 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 Opportunities Compare your Imaging-IT progress over time and with peers from your region, your country or across the globe, based on a standardized and vendor neutralassessment Healthcare market recognition for DIAM Stage 6 & 7 organisations Announcement 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

36 DIAM seminar 25 mei 2018 DIAM cursus 26 juni 2018

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