HIMSS Continuity of Care Maturity Model - an importent patient focus acros the continium of care

In a few weeks Himss is announcing the European model of HIMSS Continuity of Care Maturity Model: Transforming Health through Effective Usage of Interoperability and Analytics in Nice in the start of April at WOHIT.

Himss is renowned for its maturity model EMRAM within the hospital sector, where 7 stages defines the maturity of digitalization within the hospital. The Nordic countries and maybe Denmark in particular have always focused on the patients journey.The entire continuum of care from the GP, to the hospital, municipality, pharmacy etc. Denmark has a widespread digital landscape that shares data as messages between the participants with the patient in the centre.  The Continuity of Care Maturity Model will address exactly that, and more importantly it will drive change into a focus around the patient and not the Hospital. You could call the new maturity model a patient centred model!

I have participated in the project of developing the model with Himss analytics as the project manager. It has been fun and very rewarding to work closely with other healthcare partners across Europe, but also to develop something different, something new and substantial important for the health services and organisations across the European Union.

The above sounds like a little flamboyant, but a maturity model is important. Not that it matters if you get a 5, 6 or 7 in an isolated perspective, but the model and the eagerness to achieve greatness will drive the business, the hospitals and partners in a certain direction. It will be a driver of change, and the model will point the direction and set out the goals – so of course it is important, that it is designed properly. Data shows in the US, that the higher grade you have in the EMRAM the greater your hospital will be within quality metrics end efficiency. So it is ultimately not about the digitalization, the grade or us bragging in the bar late at night about my hospital being EMRAM 6 or even 7! – it is and always will be about cutting costs and improving quality – it is about the patient and nothing more actually. 

I truly believe Continuity of Care Maturity Model will in the future be a factor in that equation.

Himss on the model:

HIMSS Europe is presenting the Continuity of Care Maturity Model, that evaluates various aspects of delivering continual care covering both capabilities at organization and pan-organization levels. The Model will measure the readiness of an organization to deliver continuity of care as well as the maturity of a healthcare system in the continuity of care delivery. There will only be a global model but regional specifications are possible within the model’s framework.

The model has been designed by HIMSS Europe in collaboration with a pan-European workgroup including country teams from Spain, the Netherlands and the Nordics. It comprises 32 individuals representing regional and national health authorities, strategic planning organizations, CIOs of groups or regions, industry and HIMSS consultants.

Understanding How Business Goals Drive IT Goals

Sometimes great things happen to you, and yesterday I ran into an article by the very interesting name: “Understanding How Business Goals Drive IT Goals”. It is written by IT governance institute (ITGITM) which is a non-profit, independent research entity that provides guidance for the global
business community on issues related to the governance of IT assets.

In the introduction they write:

In today’s complex and constantly changing business world, IT’s alignment to the business and IT governance are high on the agenda of executive management. Strategic planning based on the alignment of IT goals to business goals is a key component in business/IT alignment. It is important that an enterprise start with a clear view of its mission and a thorough definition of its supporting strategy and business goals. This then needs to be translated into goals for the IT department, which are the basis for the IT strategy. Finally, the supporting IT processes must be carefully planned to translate the IT strategy into action. For these planning efforts, enterprises may be looking for guidance to identify the set of important business goals and IT goals, and how they interrelate.

The article goes on and describes a set of top ten business goals and how they relate to a set of IT goals. It gives you a great input on how to work with translating business goals and work with them when you are in a management position and desperately needs that next IT strategy for your business and IT department. The list can inspire you on how the business and IT correlates and it goes very nicely with the Strategic alignment model I have described in my blog.

The article goes on and describes in detail business goals for certain business areas as for example: “Manufacturing and Pharmaceuticals Sector” or “Government, Utilities and Healthcare Sector”

I must say when looking at the list for healthcare I like what I see. The five first is:

1. Maintain the security (confidentiality, integrity and availability) of information and processing infrastructure. Operational
2. Align the IT strategy to the business strategy. Corporate
3. Make sure that IT services are reliable and secure. User
4. Ensure IT compliance with laws and regulations. Corporate
5. Translate business functional and control requirements into effective and efficient automated solutions. User

And that is a great crosswalk between operational goals and development and new initiatives (goals). Looking at Nyt OUH and our coming hospital to be, we have two major constrains or goals set by the state. 20 pct fewer beds and therefor an increase in ambulatory production and a 8 pct efficiency increase. The 8 pct is about 400 mill dkr, which must be found year one after the new hospital is in use.  I guess number 2 and 5 in the above list addresses that issue.

How can IT, new equipment and digital solutions help the hospital succeed and reach those goals?.

If, lets say 40 pct of the 400 mill is supposed to be harvested by new innovative IT solutions, then it is time to discuss how it is done. We need a well defined process and a method, that will bring us closer to the right solutions.

It takes time, money and resources to choose, implement and operate those solutions – We need to make the right choices, so our money is spent wisely and in accordance to our business goals – otherwise it is IT for ITs sake – and that will not necessarily generate more efficiency or reduce the number of beds we need.

Never let perfect be the enemy of good

I attended Himss 14 in Orlando last week. I participated in the Nordic ehealth exchange program, which I found was a great success. We discussed in the Nordic group on which strategy to implement within our countries, regions or hospitals. Best of breed or best of suite. Let me tell you, nothing is easy within the healthcare IT sector and that question especially fuelled a lively debate between my Nordic colleagues. A representative from Kaiser Permanente introduced the term “Integrated suite approach”, where I guess the best of both worlds unite into a seamless integrated platform for the individual clinician.  Utopia or reality? Well I like the term and it is probably that rather pragmatic approach we all take, because no suite can handle it all and silo best of breed needs integration.

Besides the above I learned through a short status from Island (all countries gave one) that they have decentralised databases and by a quick calculation – they have a fragmented EHR landscape with approximately 1 DB pr 23.000 inhabitants.! I guess it is not easy even for small countries.

But as a general learning point we all are battling with the same issues. Less founding, more elderly and conical patients – You all know the song. When you try to fix the problems and do better every day for the good of the patients one thing is certain. Small steps where you test, learn, correct, test etc is crucial. We tend to fix everything in one project and the risk it introduces is just enormously. As one said –

Never let the perfect be the enemy of good.

I guess it is correct when you do business process improvements either by IT or other means of change. In Odense we are building a hospital on a bare field, and even though we can start all over, we also have to work with legacy systems, old habits and organisational forms and local desires. But maybe we are in a unique position to really try the business process re engineering? We are going to try a total different approach on our way of delivering logistics.

I hope it is for the better for I know it will never be entirely perfect.

Thank you all my Nordic colleagues for an intriguing 3 days in Orlando. We can do much on our own, but even more together – And the Nordics are in front – let us keep that way. My only regret is that I did not engage with other participants as much as I should have done - I guess it is my loss.. but hey..see you all next year.
----------
Read more: Is the correlation between business and IT strategy yesterday’s struggle?
Read more: Centre for Innovative Medical Technologies, CIMT