Integrated Care Information Management Readiness. An IDC InfoBrief, Sponsored by Dell EMC October 2016

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1 Integrated Care Information Management Readiness Dell EMC October 2016

2 Introduction Dell EMC asked IDC Health Insights to analyze the progress of digital transformation in the health industry in the U.K. and the Nordics, with a special focus on mental health organizations. The goal was to evaluate the approach to integrated, identify gaps and lesson learned, and provide recommendations for the next steps to be taken, based around the IDC Health Insights Information Transformation Framework. This IDC InfoBrief provides an overview of the findings, showing the readiness of integrated information management. It also offers ad-hoc recommendations for health executives who are working toward an integrated delivery model. 1

3 The race toward integrated and the powerful value of information management U.K. and Nordics health organizations are progressively adopting integrated and personalized models, drawing on the support of information management. 2

4 Information digital transformation as a means to achieving integrated and personalized Drivers Rising costs of inappropriate and fragmented across health systems Shifting demographics: aging population and rising burden of chronic diseases and mental health conditions Increasing expectations of patients in terms of better experience of Improving quality and speed of clinical research Barriers Security and data protection concerns Regulatory compliance Health professionals reluctance to change Resource constraints Challenging financial environment U.K. and Nordics health organizations overall integrated information management readiness index 45% While only the 10% of organizations are ready for an integrated and personalized model, 45% plan to move in that direction over the next two years. Future Creators 18% 26% 14% 39% 31% Source: Integrated Care Information Management Readiness Index Survey, IDC Health Insights 2016 N = 137 7% 7% 3% Siloed, reactive Safe and compliant Efficient Appropriate 10% Integrated & personalized 3

5 Mental health vs. General health: the hidden challenge of health systems enabling integrated Growth of mental health illness Mental Health The need for integrated General Health The increase in comorbity Mental health executives plans are as aggressive as those of their non-mental health peers, approaching information management in a way that aligns with integrated and personalized delivery models. Patients often have more than one disease and/or condition simultaneously. Especially in psychiatry, patients often have multiple mental or somatic disorders, with symptoms that often overlap each other, making it difficult to make the proper diagnosis without the full picture of the patient s situation. In such circumstances integrated is to be part of the solution to deliver proper across sectors and thereby provide an opportunity to overcome the barriers to accessing services, reducing waiting time for patients, and delivering interventions at lower costs. 4

6 Moving toward an integrated model is about aligning strategy, governance and architecture Integrated information management strategy is ambitious and progressing rapidly. Governance readiness is lower than strategy, but health executives understand that they need to improve. Architecture is still very siloed and will require significant effort to enable a true 360 view of the patient. 5

7 Information Strategy Business Goals Strategy Readiness Index 42% 37% 42% Information management strategy is considered a key pillar of integrated and personalized in both the U.K. and the Nordics. A 360 view of the patient is still a distant goal, but sharing data with other health providers and initiating dialogues with social and public health is a feasible objective. The powerful value of information management is still not fully utilized to achieve integrated ; executives simply align it with the organization s compliance and operational performance goals. But as expectations rise among patients, becoming a significant partof the competitive landscape for integrated, health executives will increase the alignement of information management with quality goals. 6% 7% 2% Siloed, reactive 3% 2% Tactical and reactive 17% Safe and compliant 23% 11% Guided by regulatory compliance 16% 12% Efficient 42% 26% Aligned with the organization's compliance and operational performance business goals Appropriate 33% 20% 16% 16% Aligned with the organization's compliance, operational performance, and quality business goals Integrated & personalized 28% Providing an integrated and personalized end-to-end patient experience 50% 48% 54% Information management strategic alignment with business goals 6

8 The integration of patient information enhances the patient s experience with an omni-channel approach Mental Health Digital patient experience Web portal Mobile app Social media Telemedicine device 24% 20% 46% 63% 61% 85% 78% 90% Non-Mental Health Digital patient experience Web portal Mobile app Social media Telemedicine device 35% 45% 68% 65% 77% 92% 94% 89% Social media, telemedicine, and wearables are on the rise as part of the drive to improve patient engagement. Non-mental health organizations plan to invest more in mobile apps and social media. Wearable app Mental health institutions focus on telemedicine and wearables, which ensures a more controlled environment to interact with the patient and their family. In fact, a mental health clinical executive that IDC interviewed clearly explained how it is complex to design mobile apps or social media campaigns for different types of conditions, such as dementia, depression, or psychosis. 10% 61% Wearable app 13% 61% 7

9 Information Governance Patients as an active resource in health delivery Health executives want to give patients more control over their data to enhance engagement and make them aware of information sharing workflows, making them active participants in health delivery. Data ownership 43% 37% 45% The majority of health providers own patient data and have established standard rules for multilateral data sharing across the health ecosystem they recognize the value of sharing data across the ecosystem. But they still need to define guidelines for patient consent and implied consent, as the patient can still claim their own privacy rights. Within two years, 45% of health executives expect to co-own data with the patient and ask their consent to share data across the health ecosystem. Patients expectations of quality of are increasing, and generally they are looking for a better health experience. Health executives will therefore implement new strategies to realize the benefits of enhanced patient empowerment. 6% 4% Providers' ownership only for internal use 31% 11% Providers' ownership also for bilateral sharing Providers' ownership for sharing across the health ecosystem 19% Providers' ownership & patients' consent needed to share data 1% 2% Patient sole ownership 8

10 Enterprise Information Architecture Architecture is still very siloed, but executives and clinical staff keep trying to overcome this using multiple data types and accessing multiple data sources that together contribute to building an integrated view of the patient. Four barriers to reducing data silos: Clinical data Administrative & operational data Data type 95% 96% 93% 91% Clinical and administrative applications Unstructured data sources, such as nursing notes, s, etc. Data source 88% 88% 93% 87% Dependence on proprietary systems that generate complex point-to-point integration Population health data 64% 90% Images, videos, and machine-tomachine feeds 47% 85% Difficulty getting budgets for legacy data integration Limited scope of adoption of interoperability standards Clinical research data 55% 86% Patient portals or mobile apps, or social media 30% 65% Product-centric view of data integration Social data 37% 74% Medical remote monitoring devices and wearable 23% 68% 9

11 The approach to architecture integration Data sharing is difficult, as point-to-point integration of legacy applications based on proprietary technology prevails now (51%) and in two years (58%). Hospitals Approaches to architectural integration Hospitals have more resources available that allow them to apply more sophisticated architectural approaches to information integration than primary and community organizations can. But hospitals also have an additional challenge compared to community and primary the integration of clinical research data. Primary, usually a smaller enviroment than hospitals, can benefit from pointto-point integration, as it might be tailor-made by the vendor. Non-Hospitals Approaches to architectural integration 61% 60% 51% 57% 27% 33% 36% 17% 5% 1% 2% 6% 1% 4% 6% 4% 11% 6% 2% 11% No integration either internally or with other health organizations Fully working internal system integration Point-to-point application integration with other organizations Service-oriented architecture used to share data across health providers Real-time and dynamic integration of information across the health ecosystem No integration either internally or with other health organizations Fully working internal system integration Point-to-point application integration with other organizations Service-oriented architecture used to share data across health providers Real-time and dynamic integration of information across the health ecosystem 10

12 Legacy data integration plans There is strong latent demand for real-time integration of legacy data, rather than read-only workarounds. Legacy data integration 4% 1% Paper based 5% 1% Read-only applications 64% 29% Read-only applications and shared on request 26% 57% Digital format stored in proper databases 1% 11% Fully migrated to cloud and mobile technologies Health executives recognize the relevance of integrated business process automation into their existing solutions to get a comprehensive functionality for the archival, access, a management and reporting of the legacy health data. Furthermore, the demand for comprehensive clinical data to research upon is growing, making stand-alone read only applications irrelevant in that perspective. In a short term perspective of one year, budgets for legacy data integration is low. But keeping legacy applications in operation as read only is expensive, and a positive business case is achievable within only 2-4 years. The CIO has this long term view on legacy integration and only uses read only as proven and affordable, short term solution. 11

13 Essential Guidance 12

14 What should health executives do? Design an integrated information management model to support a 360-degree view of the patient. Information sharing between settings is critical to incorporate and manage the increasingly wide mix of data types and sources that can help build a 360-degree patient view. Develop and align strategy, governance and architecture capabilities to implement an integrated information management model to securely collect, archive, access, and analyze patient data. To establish a truly patient-centric longitudinal record to be used along the patient journey, health executives need IT systems to be interoperable and to support the end-to-end information management strategy. Strategy, governance and architecture capabilities have to be aligned to deliver integrated. Design a legacy data integration plan through the adoption of Third Platform technology. Mobility, cloud, social media, and Big Data and analytics help to overcome the limit of data sharing caused by point-to-point integration. Even if it still works for a small enviroment, point-to point integration limits the development of an integrated model in the long term

15 What should health executives do? Overcome the focus on siloed systems that limit the use of patient data to a single episode of. EHRs and EMRs, though still perceived as the cornerstone of patient data integration, risk limiting the ability to integrate, represent, and leverage the value of data across data types and sources. Enable mental health to become part of an integrated model. The continuing separation of general health and mental health services represents both a human and economic cost for health systems. Health executives should increase technology investments aimed at improving, removing barriers to services, reducing waiting times, and delivering interventions at lower cost. 14

16 Methodology The information for this InfoBrief is based on 137 telephone interviews with mental health and general health IT and non-it executives across U.K. and the Nordics. This is supplemented with eight in-depth interviews conducted by IDC analysts with senior executives from a mix of national/regional public health authorities, clinical professionals, and IT executives. The survey results were analysed using IDC s Health Insights Information Management Framework which evaluates the variables that should be considered by health executives when planning and implementing an information management model. Variables are classified in one of three interdependent information management areas: Business goals Ecosystem scope Innovation Patient data ownership Patient data governance Scope of patient data repository IT security Information integration approach Enterprise architecture management Accessing legacy data Business analytics Clinical research exploration It principles Governance Knowledge sharing Organizational structure Skills Data semantics Conceptual data interoperability User interface Enteprise content management Data sources Information strategy business goals Information governance Enterprise information architecture Source: Integrated Care Information Management Readiness Index Survey, IDC Health Insights 2016 Statistical analysis is performed to correlate and identify readiness in integrated and personalized. The IDC Health Insights Information Management Framework identifies the varying levels of readiness as: 1 = siloed, reactive 2 = safe and compliant 3 = efficient 4 = appropriate 5 = integrated and personalized 15

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