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

BEE

LDIN

ZIC

HT

HL7

IHE

IHE OVERVIEW IHEradiologie & beeldvorming

INTRODUCTIEINTEROPERABILITEIT

IHE ♦HL7 DICOM♦

XDS ADVANCED XDS/XDS-I XCA/XCA-I♦

REGIONALEUITWISSELING

IHE ITI XDS♦ ♦

INTEROPERABILITEITSTANDAARDENIHE HL7 DICOM♦ ♦

HL7 versie 2 HL7 versie 3 & CDA HL7 FHIRbasics, profiling & advanced

BETER METENanalyse van informatie

BATENMANAGEMENTIN DE ZORG

definiëren & realiseren

INTRODUCTIECODERINGSSYTEMEN

& TERMINOLOGIEZORG API

DIAMHIMSS ANALYTICS

strategic roadmap

DICOMintroductie

DICOMhands-on

DICOMadvanced

BEELDKWALITEIT& dosis registratie

PACS II & VNA DIGITAL PATHOLOGY

VIPPIN DE ZORG

ZIB BGZ HL7♦ ♦

8 Stages to master the challenges of digitization in Imaging IT

Digital Imaging Adoption Model (DIAM)

IMS within department, enabling electr. orders, images, reports

Data exchange through same user interface

Right patient/right exam, status and quality measurement

Structured documentation, cross-enterprise HIE

Big data, predictive risk analysis, preventive measures

Appropriateness criteria, coded content, CADx,

Images and education available for patients, regional HIE

DIAM 7

DIAM 4

DIAM 5

DIAMMaturity roadmap to higher adoption of IT in Imaging

DIAM 6

• Provide thought leadership and guidance regarding IT-supported processes in medical imaging

• Support users and buyers of medical imaging technology to

• Identify potential infrastructure or workflow gaps

• Monitor technological progress over time

• Create a roadmap for future investments

• Share best practice and learn from peers

• Push the market to adopt the right digital strategy and improve health outcomes

Samenwerking

HIMSS Analytics in Europe

European Society of Radiology

DATA COLLECTION, ANALYSIS AND REPORTING

HIMSS Analytics collects data from >9000 hospitals worldwide

TR: >650

ASPAC: >900

Europe: >2.000

hospitals

US + CN: >6.000

hospitals

Countries with partial focus by HIMSS currently

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.

Projects with Governmental Authorities

Focus Countries

MATURITY MODELS SUITE

We drive the health IT market in the direction it needs to go

Improved Patient Care

and Health IT Insights

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

8 Stages to master the challenges of digitization in Imaging IT

Digital Imaging Adoption Model (DIAM)

IMS within department, enabling electr. orders, images, reports

Data exchange through same user interface

Right patient/right exam, status and quality measurement

Structured documentation, cross-enterprise HIE

Big data, predictive risk analysis, preventive measures

Appropriateness criteria, coded content, CADx,

Images and education available for patients, regional HIE

FocusgebiedenSoftware 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

Invullen DIAM vragenlijst

Kwaliteitscontrole HIMSS

Score en rapportage

DIAM proces

DELIVERABLES – GAP REPORT (EXTRACTS) – 1/2

Score and Achievement in %

Gaps for next Stage by Focus

Area

DELIVERABLES – GAP REPORT (EXTRACTS) – 2/2Target and Actions

needed for next Stage

Your performance compared to others

Stage 5a - Advanced Analytics and PersonalizedMedicine Capabilities

Advanced analyticsKPI’s, big data, predictive analytics,prescriptive analytics

Personalized medicineOptimaliseren procedures, radiogenomics,theranostics.

Pervasiveness of useStatistieken

A SIDE NOTE TO… ADVANCED ANALYTICS

Source: P. Mildenberger: „Innovation in Imaging IT“, 2016

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

Be

Act

ion

-Ori

en

ted

A SIDE NOTE TO… PERSONALISED MEDICINE

Personalised medicine (orprecision medicine) = medical procedure, separating patients into different groups.

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 (www.permedx.co.uk)

Patients with same diagnosis and receiving treatment

Stage 5b - Clinical Decision Support and Value-basedImaging

Software infrastructureSpraakherkenning

Clinical decision supportCAD, best practice guidelines, orders

Clinical documentationGestructureerde content

Quality and safetyRegionaal/nationaal

Clinical decision support

Clinical documentation

Stage 5c - Advanced Health Info Exchange and Patient Engagement

Patient engagementAfspraken maken, beelden inzien,online informatie

Workflow & ProcessMDO ondersteuning

Health information exchangeUitwisselingen extern, standaarden

5c Patient engagement

Even voorstellen

www.rsonl.nl

Some Early results

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

13 different countries

39 organizations

Bron HIMSS Analytics, status sep 2017

… DIAM distributionSome Early results

3.1

n = 39

DIAM Score Distribution

Digital Imaging Adoption Model SM

Stage Results (September 2017)

Spe

cial

ise

d S

tage

s Stage 73 out of 3 achieved

1*

Stage 62 out of 3 achieved

0

Stage 51 out of 3 achieved

4

Seq

ue

nti

al S

tage

s

Stage 4 12

Stage 3 5

Stage 2 14

Stage 1 3

Stage 0 0

N 39

Country N Type of organisation

Netherlands 8 Hospitals

Germany 86 Hospitals, 1 Primary Care Radiology Network, 1 DiagnosticImaging Center and Hospital

Spain 65 Hospitals, 1 Primary Trust and Hospital Association

Russia 51 Hospital, 1 external Diagnostic Imaging Center

Sweden 2 Hospitals

USA 21 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

UAE 1 Hospital * candidate for Stage 6/7, not yet validated

Bron HIMSS Analytics, status sep 2017

… Software ApplicationsSome Early results

All countries (n=39)

All countries (n=35)

Installed Base

Type of Image Management Solution (IMS)

Bron HIMSS Analytics, status sep 2017

… Health Information ExchangeSome Early results

All countries (n=39)

All countries (n=39)

With what type of external organizations do you exchange diagnostic imaging studies online (i.e. system-to-system)?

What is the geographic scope of your external data exchange activities?

Bron HIMSS Analytics, status sep 2017

… Health Information ExchangeSome Early results

All countries (n=39)

What formats and standards are used for external data exchange?

Organisations indicating „fully“ or „somewhat enabled“

Bron HIMSS Analytics, status sep 2017

… Structured DocumentationSome Early results

Radiologists use structured templates for diagnostic image reports conforming to CDA or similar standards

Organisations indicating „fully“ or „somewhat enabled“

Share of reports captured in structured, discrete, computer-readable format conforming to CDA Level 2 (or similar) or higher standards

Bron HIMSS Analytics, status sep 2017

… Workflow and Process SecuritySome Early results

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

… Analytics CapabilitiesSome Early results

All countries (n=39)

All countries (n=39)

Radiology unit uses Data & Analytics for…

Radiology uses internal and/or external data for predictive risk analysis of patients

Bron HIMSS Analytics, status sep 2017

… Clinical Decision Support Tools & CapabilitiesSome Early results

All countries (n=39)

All countries (n=39)

Which of the following is integrated into your electronic workflow…?

Which of the following Computer Aided Detection (CAD) Tools are in use…?

Bron HIMSS Analytics, status sep 2017

… Organizational BenchmarksSome Early results

Performance Indicators Mean Median Min Max

DIAM Stage 3.1 3.0 1.0 7.0

Annual Operating Expense of department (in €) 66,839,356 13,499,145 76,007 940,645,320

Rad. Imaging Studies per year 251,459 167,150 7,000 1,100,000

Radiologists & Residents (FTE) reading imaging studies

59.8 49.0 7.0 226.0

… of which Residents (FTE) 19.3 16.0 1.0 60.0

… share of Residents (FTE) in % 34% 36% 9% 55%

Expense per Imaging Study (in €) 107.5 63.4 5.8 855.1

Expense per Radiologist FTE (incl. Residents) (in €) 596,556 346,154 6,910 4,162,147

Expense per Radiologist FTE (excl. Residents) (in €) 832,349 625,000 7,601 5,225,807

Imaging Studies per Radiologist FTE (incl. Residents)

5,242 4,867 1,182 12,800

Imaging Studies per Radiologist FTE (excl. Residents)

8,481 8,611 875 17,198

Number of peers available for benchmarking 39

Countries from which peers are availableGermany (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 2017

12 hospitals in NL: gemiddelde 3.5

1 Hospital stage 6: King Abdulaziz Medical City in Saudi-Arabië

Results February 2018

DIAM BENEFITS

Guidance in the digitisation of imaging ITMove 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 StrategyUse 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 OpportunitiesCompare your Imaging-IT progress over time and with peers from your region, your country or across the globe, based on a standardized and vendor neutral-assessment

Healthcare market recognition for DIAM Stage 6 & 7 organisationsAnnouncement 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

DIAM seminar 25 mei 2018 DIAM cursus 26 juni 2018