Building the Next-Gen Content Repository for Healthcare. Karim Y. Rizkallah, Presales Manager, EMC Turkey, Middle East &

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1 Building the Next-Gen Content Repository for Healthcare Karim Y. Rizkallah, Presales Manager, EMC Turkey, Middle East & Copyright EMC Corporation. EMC Corporation. All rights reserved. All rights reserved. 1

2 EMR Systems History & Physical Scanned Docs Informed Consent Current Medications LARGE & GROWING RIS/LIS Radiology Report PFS Volumes of information Allergies PACS 2

3 Operational expenses Capital expenses Challenges COST Performance degradation & availability 3

4 Challenges LEGACY SYSTEMS Legacy system experts in short supply Obsolete Systems Audit & discovery 4

5 Chronic diseases are making healthcare unaffordable Europe is at 90% 60% of deaths worldwide are due to NCDs Over 40% of loss of healthy life years worldwide are due to NCDs Source: WHO 2011 estimates of Non-Comunicable Diseases (NCD) and European Union estimates on NCD related expenditure 70-80% of healthcare costs in EU member states are caused by NCDs 5

6 Prevention: benefits... Top 5 risk factors for disability-adjusted life years in Western Europe Dietary risks Smoking High blood-pressure High body-mass-index Physical inactivity Source: Institute for Health Metrics and Evaluation (IHME), University of Washington, ) Healthy diet 2) Regular exercise 3) Control of weight, smoking, sleep and stress management 4) Quitting smoking Could prevent: 90% of type 2 diabetes 80% of coronary heart disease 70% of stroke Source: "Rethinking health: ICT-enabled services to empower people to manage their health" study published in the Biomedical Engineering, IEEE Reviews

7 ...and challenges: current public health policies are falling short Expenditure on prevention and public health as a % of total healthcare expenditure for selected EMEA countries 6% 4% 4% 4% 3% 3% 3% 2% 2% 2% 2% 2% 2% 2% 1% 1% 1% 0% Source: OECD, 2014 Expenditure on prevention is still anemic! 7

8 It s time to put patient engagement at the center of Integrated Care 8

9 The Era of Healthcare Convergence Health and social care providers Payers Public health authorities Clinical research 9

10 Waiting is not an Option: The New Patient Experience What patients expect: What patients really want: Quality and safety Appropriateness Continuity 10

11 The 5 steps to cure Healthcare Specialize & organize around the patients condition Measure & analyze outcomes & costs Integrate to remove duplication Hub and spoke Redefine current IT systems One of 4 finalists of the HBR McKinsey award 2013 for outstanding articles Source = HBR October

12 What Does Good Enabling IT Look Like? Patient centered, not discipline centered Encompasses all types of patient data Structured & Unstructured Uses common data definitions/standards Is accessible to all parties Templates and processes for each condition Able to extract (analyze) information 12

13 Copyright 2013 EMC Corporation. All rights reserved. 13

14 Solving the Medical Information Lifecycle Challenges Patient Lifecycle Infrastructure lifecycle Purchase Migration 1 Migration 2 Migration 3 Migration 4 Migration 5 Migration 6 Migration x Application lifecycle Purchase Migration 1 Migration 2 Migration 3 Migration x Scanned patient records, patient summaries, referral letters, correspondences Medical data lifecycle Medical images Lab results and e-prescriptions Other content: digital photos, audio, videos, s, etc. 14

15 However. Patient Encounter Content ADT (Admissions/ Discharges / Transfers) Patient Financial Services Patient Care (Clinicians) Medical Departments (e.g., Cardiology, Radiology, Surgical) Diagnostics (e.g., Lab Testing and Results) Clinical Research Patient consent forms Insurance forms Progress notes Physician reports Pathology reports Case report forms Patient health questionnaires Physician referrals Medical history HIPAA compliance Living will Medical directives Photo ID Insurance ID cards Patient billing Insurance billing Accounts receivable Explanation of Benefits Serialized device packing slides Orders Digital photographs Patient care plan Incident reports Discharge summaries Patient education Medical charts Physician orders or procedures Prescriptions Photographs Videos Lab reports Radiology reports Cardiology reports MRI X-ray CT PET Dictation Diagnostic tests Medical images Medical evaluations Adverse events reports 15

16 STILL FALL SHORT OF A PATIENT CENTRIC VIEW Information lives in siloed locations Too many formats and applications Information electronically is incomplete 16

17 EMR UNSTRUCTURED CONTENT CHALLENGES Costly & Difficult Not Intended for Content Performance Impact 17

18 Integrated Patient Care Transform how you access, manage, and share patient information to improve patient outcomes and reduce costs.

19 Integrated Patient Care Bridge the content gap in your EMR Unite fragmented patient information Combine structured & unstructured data Improve collaboration & care coordination Securely share information 19

20 OUR APPROACH AGGREGATE SHARE OPTIMIZE Maintain content in its natural form to facilitate search, analysis, data mining and business policy enforcement, such as disposition. Exchange data within an IHE community using standards in healthcare to share records outside the provider organization Optimize data through the creation of an IPR that also accesses the EMPI for PIX, and can also connect to imaging sources through DICOM. 20

21 Content Enabled Epic EMR Clinical Archiving Image and Content Management Digitized Paper Medical Records Integrated Patient Record (IPR) 21

22 Content Enabled EMR Enhance the value of your EMR investment by managing the complete patient record.

23 Content Enabled EMR Access to all the patient s information Ad Hoc Scanning Ad Hoc Import Media Viewing HL7 Messaging Release of Information 23

24 AGGREGATE & OPTIMIZE SHARE API EMPI XDS/i Epic EMR HL7 EMC HIP XCA/i HIE Community XDS DICOM Mobile Healthcare Integration Portfolio 24

25 CONNECT DESCRIBE DISCOVER End-to-End Information Management with Epic AD HOC SCANNING AD HOC IMPORT MEDIA VIEWING Hyperspace Information Silos CHART DEFICIENCIES EOB PROCESSING EPICCARE LINK INTEGRATION EMC DOCUMENTUM CONNECTOR FOR EPIC HL7 MESSAGING RELEASE OF INFORMATION Epic Users 25

26 Connector for Epic Benefits KEY FEATURES HIM Administration Mode Scanning Document Package Assembly CAPABILITY Allows privileged functionality for HIM team inside Epic (Change Document Type & Description, Print, Delete) Provides Epic users when scanning the ability to define multiple packages in the single scanning process BENEFIT Enables medical records admin to perform their function whilst remaining inside Epic Hyperspace Many documents can be scanned and indexed in a single transaction for multiple doc types HL7 Messaging EMPI, Epic & EMC HL7 message collaboration Ensure data integrity Eliminate manual reconciliation work Clinical Archiving Integration Provide Search Archive directly from Epic Hyperspace Simple Access to Historic Patient Records from the Retired Application Archive XDS XDS Transaction Expansion Automatically register all content to XDS Registry IHE Content Sharing & New Breed XDS Applications 28

27 Clinical Archiving ACTIVE ARCHIVE PURGE Decommission legacy systems, reduce costs, and ensure compliance while giving users access to a lifetime of patient information.

28 Clinical Archiving Access to a lifetime of patient information Patient discrete data & content Quick and easy search Application decommissioning & live archiving Standards-based OAIS, XML, XDS Information integrated and viewed in new ways 30

29 What it looks like Search 31

30 What it looks like List of matching patients 32

31 What it looks like Demographic data 33

32 What it looks like Patient images and documents 34

33 What it looks like View X-ray 35

34 Medical Image Management & Sharing Access, share and manage all clinical media and medical images in an interoperable, vendor-neutral archive (VNA).

35 Medical Image Management & Sharing Image enable your enterprise Standardize DICOM & non- DICOM formats Facilitate sharing of diagnostic content Manage the lifecycle of images Decrease IT investments & migration costs 37

36 Seamless Access to PACS Images 38

37 Digitized Paper Medical Record Digitize patient-critical paper documents for a comprehensive view of all patient information and services.

38 Digitized Paper Medical Record Complete the transition from paper records See a longitudinal view of all patient records Optimize care delivery Empower clinical & administrative efficiency Reduce operating costs 40

39 Current Process Patient Arrives at Hospital or is scheduled for appointment Records and Located and Pulled from Records Store Records are Transported to clinic and prepared for consultation Clinician & Patient Consultation from Paper Record Patient is referred for next stage treatment plan Paper Records are sent and referral process continues Treatment Plan is carried out until complete Treatment Complete & Patient is discharged Process is repeated for every visit or episode 41

40 New Process Patient Arrives at Hospital or is scheduled for appointment Records and Located and Pulled from Records Store & SCANNED Clinician & Patient Consultation from scanned records Patient is referred for next stage treatment plan via content enabled PAS workflow Treatment Plan is carried out until complete Treatment Complete & Patient is discharged Cost Reduction: Estates, Transportation, Resources 42

41 The 6 Pillars of ECM for Healthcare Content Interfaces Clinical Interfaces Patient Records Repository Imaging Repository Content Sharing IHE Standards Clinical Archive PatientVision Content Viewer Web Application Connector for EPIC Hyperspace Web Services Layer (DFS/DFC) DICOM Connector (Partnered Merge/J4Care) XDS.b Registry Services XCA Registry Services ArchiveVision Web Application Batch Scanning Solutions with Captiva Clinical Case Management Framework with xcp HL7 Messaging ADT MDM Patient Identity Message Factory Documentum Content Server Encryption Heirarchical Retention Database Documentum Healthcare Content Integration Server Portfolio? Encryption Heirarchical Retention Database Documentum XDS.b Repository Services Documentum xdb EMC InfoArchive Receiver Enumerator Ingestor Processer Documentum xdb EMC HealthCare Integration Porfolio 43

42 Building Healthcare Solutions

43 Integration with Wearables Process Reports & Dashboards Wearable User Portal XDS EMC Integrated Patient Record Multi-Channel Communitcation Wellness Program 45

44 CareSolutions STROKEPAD Overview Customer Problem/Challenge Patient transit through the Stroke Unit is made in as timely, effective, and efficient manner as possible as this saves lives and greatly improves patient outcomes. Stroke is the second biggest killer in the UK and costs $12bn p.a. Paper-based gathering and recording of information can lead to difficulty in interpretation, duplicates activity, generates inaccuracies and introduces degradation of data quality. All collection of clinical and management data for reporting at both local and National level is difficult and time-consuming. A person captures data on manual forms at source Manual forms are passed onto someone else at a later stage Data is inputted in software applications 46

45 Scenario - Getting Stroke in Office 47

46 National Healthcare Approaches

47 The Roadmap to a National Exchange Program From current fragmented healthcare system with islands of connectivity... Hospital Public health entities Lab Pharmacy Ambulatory Ambulatory Insurers Clinics Pharmacy Ambulatory Research organizations Lab Hospital Hospital Ambulatory Citizens Payer Hospital..Information Exchanges connecting medical ecosystem members Exchange Public health entities Lab Ambulatory Pharmacy Lab Ambulatory Pharmacy Research organizations Hospital Hospital Hospital Hospital Member state Exchange Payer Ambulatory PBM Payer Ambulatory...to hospital, regional, and national connectivity Public health entities Region Archive Citizens National Patient Registry Region Archive National Archive 49

48 Our Vision for Cloud Provisioned Healthcare Doctors Office Citizens Other HealthCare Ecosystem Actors Insurers Employers Auditors Agents Larger Hospitals HIS Central EHR Smaller Hospitals Commercial Cloud Central HIS HIS National Cloud 50

49 Hospital in a Box Converged Solution Solution Packages Healthcare whospital Application Framework Healthcare Information Platform Operating Systems Virtualization Reports & Dashboards Electronic Medical Record Rapid deployment model of virtualized health IT infrastructure Pre-integrated and validated solutions from EMC reduce total cost of ownership Compute Network Storage Service-level driven through predictable performance and operational characteristics Improved compliance/security and reduced risk to patient information 51

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