1. Avera Health’s HIMSS Analytics Stage 7 Journey: Lessons Learned
May 17, 2017
Avera Health’s HIMSS Analytics Stage 7 Journey: Lessons Learned
Susan Feilmeier, PharmD
IT Clinical Services Officer
Avera Sacred Heart IT Regional Information Officer

2. “A strategic roadmap for effective EMR adoption and maturity”
Journey to HIMSS Stage 7 Award
EMRAM
(EMR Adoption Model)
“A strategic roadmap for effective EMR adoption and maturity”
The HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) incorporates methodology and algorithms to automatically score hospitals around the world relative to their Electronic Medical Records (EMR) capabilities. This eight-stage (0-7) model measures the adoption and utilization of electronic medical record (EMR) functions. Move your organization closer to achieving a near paperless environment that harnesses technology to support optimized patient care by completing each stage

3. Journey to HIMSS Stage 7 Award
HIMSS EMRAM

4. HIMSS Analytics Stages
2016 Q3
2016 Q4
N:5449
N:5478 7
4.6%
4.8% 6
30.5% 5
34.5%
34.9% 4
10.1%
10.2% 3
14.1%
13.9% 2
2.2%
2.3% 1
1.7%
1.4%
2.4%
1.9%

5. Complete HIMSS Annual Study Scoring
HIMSS Annual Scoring
HIMSS Annual Scoring Tool
Complete HIMSS Annual Study Scoring

6. HIMSS Stage 6 – Telephone Interview Survey
Integrated Delivery Network –Self Attest

7. Journey to HIMSS Stage 7 Award
HIMSS EMRAM

8. Journey to HIMSS Stage 7 Award – Original Timeline

9. Use your EMR Vendor Go and See Mock it Up Timeline Realism
Lessons Learned
Use your EMR Vendor
Go and See
Mock it Up
Timeline Realism

10. VENDOR Baseline Assessment Lesson #1: Use your EMR Vendor
Journey to HIMSS Stage 7 Award - Tools
Lesson #1: Use your EMR Vendor
VENDOR
Baseline Assessment

11. HIMSS Stage 7 Reviewer Guide
Journey to HIMSS Stage 7 Award - Tools

12. Criteria Scoring Document
Journey to HIMSS Stage 7 Award - Tools

13. Journey to HIMSS Stage 7 Award

14. Lesson #2: Go and See Journey to HIMSS Stage 7 Award
Visit Other Health Systems HIMSS Stage 7 Surveys
Visit your own Departments and Observe

15. Acute CPOE Pervasiveness Acute BMV Pervasiveness OR/PACU Medication
Journey to HIMSS Stage 7 Award - GAPS
Journey to HIMSS Stage 7 Award
Acute CPOE Pervasiveness
Acute BMV Pervasiveness
OR/PACU Medication
Code Blue Medication
Clinical Relevant Document Scanning
Breast Milk Scanning
TAR

16. >90% for 4 consecutive months Providers & Midlevels
Journey to HIMSS Stage 7 Award - GAPS
Journey to HIMSS Stage 7 Award
Acute CPOE Pervasiveness
Acute BMV Pervasiveness
OR/PACU Medication
Code Blue Medication
Clinical Relevant Document Scanning
Breast Milk Scanning
TAR
>90% for 4 consecutive months
Providers & Midlevels

17. >95% for 4 consecutive months Patient and Medication Scan
Journey to HIMSS Stage 7 Award - GAPS
Journey to HIMSS Stage 7 Award
Acute CPOE Pervasiveness
Acute BMV Pervasiveness
OR/PACU Medication
Code Blue Medication
Clinical Relevant Document Scanning
Breast Milk Scanning
TAR
>95% for 4 consecutive months
Patient and Medication Scan

18. Journey to HIMSS Stage 7 Award - GAPS
Acute CPOE Pervasiveness
Acute BMV Pervasiveness
OR/PACU Medication
Code Blue Medication
Clinical Relevant Document Scanning
Breast Milk Scanning
TAR
OR and PACU Medications Entered into the EMR prior to patient transfer out of PACU

19. Journey to HIMSS Stage 7 Award - GAPS
Acute CPOE Pervasiveness
Acute BMV Pervasiveness
OR/PACU Medication
Code Blue Medication
Clinical Relevant Document Scanning
Breast Milk Scanning
TAR
Code Blue Medications Entered into the EMR prior to patient transfer to next level of care

20. Clinical Relevant (<24hours) Clinically Irrelevant (<72 hours)
Journey to HIMSS Stage 7 Award - GAPS
Journey to HIMSS Stage 7 Award
Acute CPOE Pervasiveness
Acute BMV Pervasiveness
OR/PACU Medication
Code Blue Medication
Clinical Relevant Document Scanning
Breast Milk Scanning
TAR
Clinical Relevant (<24hours)
Clinically Irrelevant (<72 hours)
Document Scanning into EMR

21. If NICU, Breast Milk scanning to mom and baby
Journey to HIMSS Stage 7 Award - GAPS
Journey to HIMSS Stage 7 Award
Acute CPOE Pervasiveness
Acute BMV Pervasiveness
OR/PACU Medication
Code Blue Medication
Clinical Relevant Document Scanning
Breast Milk Scanning
TAR
If NICU, Breast Milk scanning to mom and baby

22. >95% for 4 Consecutive Months Patient and Product Scan
Journey to HIMSS Stage 7 Award - GAPS
Journey to HIMSS Stage 7 Award
Acute CPOE Pervasiveness
Acute BMV Pervasiveness
OR/PACU Medication
Code Blue Medication
Clinical Relevant Document Scanning
Breast Milk Scanning
TAR
>95% for 4 Consecutive Months
Patient and Product Scan

23. Journey to HIMSS Stage 7 Award – Methodology
Plan Do
Check
Adjust

24. Journey to HIMSS Stage 7 Award
Lesson #3: Mock it Up

25. Vendor Mock Survey with Presentation Formal HIMSS Survey
Journey to HIMSS Stage 7 Award
Vendor Mock Survey
Self Mock Survey
Vendor Mock Survey with Presentation
Formal HIMSS Survey

26. Journey to HIMSS Stage 7 Award – Mock with Surveyor Guide

27. 90-120 Minutes Key Features Demographics and Awards
Journey to HIMSS Stage 7 Award - Presentation
Minutes
Key Features
Demographics and Awards
Health System Overview
Pervasiveness Data and CDS
IT Governance
CIBI
3 + Case Studies
HIE
Data Integrity, Security and Recovery

28. Honored Subject Matter Experts
Journey to HIMSS Stage 7 Award - Presentation
Case Studies
>12 mos RIO data
Required hours
Honored Subject Matter Experts
Highlight previous Paper-spaces converted to revenue-generating spaces

29. Lesson #4: Time Estimate 12+mos
Journey to HIMSS Stage 7 Award
Lesson #4: Time Estimate 12+mos
December 2015

30. Avera McKennan Hospital 12/2015 Avera Sacred Heart Hospital 10/2016
Journey to HIMSS Stage 7 Awards
Avera McKennan Hospital 12/2015
Avera Sacred Heart Hospital 10/2016
Avera Queen of Peace Hospital 12/2016

31. Journey to HIMSS Stage 7 Award – New HIMSS Tools

32. Clinical Data Repository HIE Clinical Charting Clinical Order Entry
Journey to HIMSS Stage 7 Award- O-EMRAM
Clinical Data Repository
HIE
Clinical Charting
Clinical Order Entry
eRX/Med Rec
CPOE
eMessages (referrals, consultants, patient messaging)
CDS
Provider Documentation
Incorporate Encounter, Growth Charts, Data in structured data
Exam Results
Patient Monitoring
Summary of ToC
Patient reminders letter
Patient/Consumer Functions

33. Stage 7 Stage 6 Stage 5 Stage 4 Stage 3 Stage 2 Stage 1
Journey to HIMSS Stage 7 Award- Proposed New Stages
Anesthesia EMR
CPOE Infusion Pumps
Stage 7
CPOE, BMV, TAR, Breast Milk, Barcode specimen collection
Security risk assessment submissions to authority
Stage 6
Provider Documentation/NLP create discrete data
Portable Device Security
Stage 5
>90% Allied Health & Nursing electronic documentation/eMAR/TAR & ED Live
Business Continuity: Meds, Allergies, Problems, Labs
Stage 4
>50% Allied Health & Nursing electronic documentation/eMAR/TAR & ED Live
Role-based security and intrusion detection
Stage 3
Clinical DR and context aware
Security, encryption, disposal policy, antivirus and firewall program
Stage 2
PACS
Non-DICOM image storage
Stage 1

34. THANK YOU
FOR YOUR TIME.