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Jamie J Coleman1,2, Adam Khimji2,1, Ann Slee1, Neil Watson3

The ePrescribingDigital Maturity Tool

8th June 2015

1 College of Medical and Dental Sciences, University of Birmingham2 University Hospitals Birmingham NHS Foundation Trust3 The Newcastle upon Tyne Hospitals NHS Foundation Trust,

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EPMA Systems Adoption Availability

Digital Maturity Existing Solutions

The Tool Aim Objectives Method Development Pilot Benefits What Next

Outline:

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Clinical systems that utilize data from pharmacy, laboratory, radiology, and

patient monitoring systems to relay the physician’s or nurse practitioner’s

diagnostic and therapeutic plans, and alert the provider to any allergy or

contraindication that the patient may have so that the order may be

immediately revised at the point of entry prior to being forwarded

electronically for the targeted medical action.

EPMA(Electronic Prescribing Medication Administration) Systems

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Drivers

National Program for IT

NHS Technology Fund

Patient Safety

EPMA Systems: Adoption

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EPMA Systems: Availability

TO NAME JUST A FEW!

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Digital Maturity

Digital Maturity:‘Measure of electronic/ informatics capability.’

ePrescribing Digital Maturity:‘Measure of EPMA system capability.’

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Electronic Medical Record Adoption Model (EMRAM) –HIMMS

European EMR Adoption Model –HIMMS

Clinical Digital Maturity Index (CDMI) –EHI

United States EMR Adoption Model SM

Stage Cumulative Capabilities 2013 Q4 2014 Q1

Stage 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OP 2.9% 3.1%

Stage 6 Physician documentation (structured templates), full CDSS (variance & compliance), full R-PACS 12.5% 13.3%

Stage 5 Closed loop medication administration 22.0% 24.2%

Stage 4 CPOE, Clinical Decision Support (clinical protocols) 15.5% 15.7%

Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Radiology 30.3% 27.7%

Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 7.6% 7.2%

Stage 1 Ancillaries - Lab, Rad, Pharmacy - All Installed 3.3% 3.2%

Stage 0 All Three Ancillaries Not Installed 5.8% 5.6%

Data from HIMSS Analytics® Database ©2014 N = 5458 N = 5449

Digital Maturity: Existing Solutions

EXISTING SOLUTIONS

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DIGITAL MATURITY TOOL

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AimTo establish a technological audit and quantifiable measuring methodology across settings to provide a digital capability position of NHS organisations in England and allow this to be tracked over time

Objectives Building on work Ensuring academic

methodology Comparability (where possible) Detailing capability, deployment,

use, benefits and outcomes

Buy-In Proof of Concept Creating open data repositories

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LITERATURE REVIEW

EXPERT CONSENSUS• Initial proposal• Wider

stakeholders

SMALL SCALE PILOT

LARGE SCALE PILOT

Method

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Organisational readiness

Functional ePrescribing

Mature ePrescribing

Development: Key Levels

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Development: Individual Component Maturity

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Development: Matrix

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Formed Component Groups More detailDefinitions included

Identified measuresCapability availableCapability in useEffective use/reach

Development: Refinement

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Fig.1- Raw table of questions

Fig.2-Formatted questions with macros

Development: Spreadsheet

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Radar Plot

Development: Example Output

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Percentage Scores for: Enabling Capabilities Functional Components Mature Components Total Maturity

Area summary Overall maturity Maturity breakdown

Maturity overview radar plot

Development: Additional Outputs

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Pilot: Summary

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Pilot: Results

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Total Maturity BreakdownPilot: Results

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Pilot: Individual Capability Review

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Comparative judgement of healthcare providers

Identify gaps in current clinical configuration

Benchmarking Beacon sites

Sites needing help

Realign user expectations

Easy to use

Potential Benefits

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Feedback

Web Portal launch

Clarification

What Next?