integrated care information management readiness integrated care information management readiness an...

Integrated Care Information Management Readiness

An IDC InfoBrief, Sponsored by Dell EMC | October 2016

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Integrated Care Information Management Readiness An IDC InfoBrief, Sponsored by

Dell EMC asked IDC Health Insights to analyze the progress of digital transformation in the healthcare industry in the U.K. and the Nordics, with a special focus on mental health organizations.

The goal was to evaluate the approach to integrated care, identify gaps and lesson learned, and provide recommendations for the next steps to be taken, based around the IDC Health Insights Information Transformation Framework.

This IDC InfoBrief provides an overview of the findings, showing the readiness of integrated care information management. It also offers ad-hoc recommendations for healthcare executives who are working toward an integrated care delivery model.

Introduction

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The race toward integrated care and the powerful value ofinformation managementU.K. and Nordics healthcare organizations are progressively adopting integrated and personalized care models, drawing on the support of information management.

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Future Creators

Information digital transformation as a means to achieving integrated and personalized care

Drivers• Rising costs of inappropriate and fragmented care across healthcare systems• Shifting demographics: aging population and rising burden of chronic diseases and mental health conditions• Increasing expectations of patients in terms of better experience of care• Improving quality and speed of clinical research

Barriers• Security and data protection concerns• Regulatory compliance• Healthcare professionals reluctance to change • Resource constraints• Challenging financial environment

While only the 10% of organizations are ready for an integrated and personalized care model, 45% plan to move in that direction over the next two years.

Source: Integrated Care Information Management Readiness Index Survey,IDC Health Insights 2016N = 137

Siloed, reactive

care

7% 7%

26%

14%

39%

31%

10%

45%

18%

3%

Safe and compliant

care

Efficient care

Appropriate care

Integrated & personalized

care

Now

In two years

U.K. and Nordics healthcare organizations overall integrated care information management readiness index

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Mental Health

The need for integrated care

General Health

Growth of mentalhealth illness

The increasein comorbity

Mental health vs. General health: the hidden challenge of healthcare systems enabling integrated care

Patients often have more than one disease and/or condition simultaneously. Especially in psychiatry, patients often have multiple mental or somatic disorders, with symptoms that often overlap each other, making it difficult to make the proper diagnosis without the full picture of the patient’s situation. In such circumstances integrated care is to be part of the solution to deliver proper care across sectors and thereby provide an opportunity to overcome the barriers to accessing services, reducing waiting time for patients, and delivering interventions at lower costs.

Mental health executives’ plans are as aggressive as those of their non-mental health peers, approaching information management in a way that aligns with integrated and personalized care delivery models.

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Moving toward an integrated care model is about aligning strategy, governanceand architecture• Integrated care information management strategy is ambitious and progressing rapidly.

• Governance readiness is lower than strategy, but healthcare executives understand that they need to improve.

• Architecture is still very siloed and will require significant effort to enable a true 360° view of the patient.

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Information StrategyBusiness GoalsInformation management strategy is considered a key pillar of integrated and personalized care in both the U.K. and the Nordics.

• A 360° view of the patient is still a distant goal, but sharing data with other healthcare providers and initiating dialogues with social care and public health is a feasible objective.

• The powerful value of information management is still not fully utilized to achieve integrated care; executives simply align it with the organization’s compliance and operational performance goals.

• But as expectations rise among patients, becoming a significant partof the competitive landscape for integrated care, healthcare executives will increase the alignement of information management with care quality goals.

54%

50%

48%

Siloed, reactive

care

6% 7%

16%

12%

42%

37%

20%

42%

17%

2%

Safe and compliant

care

Efficient care

Appropriate care

Integrated & personalized

care

Now

In two years

Strategy Readiness Index

Tactical and reactive

3%

11%

42%

26%

16% 16%

33%

28%

23%

2%

Guided by regulatory

compliance

Aligned with the organization's

compliance and operational

performance business goals

Aligned with the organization's compliance, operational

performance, and care quality business goals

Providing an integrated and personalized end-to-end

patient experience

Now

In two years

Information management strategic alignment with business goals

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The integration of patient information enhances the patient’s experience with an omni-channel approachSocial media, telemedicine, and wearables are on the rise as part of the drive to improve patient engagement.

• Non-mental health organizations plan to invest more in mobile apps and social media.

• Mental health institutions focus on telemedicine and wearables, which ensures a more controlled environment to interact with the patient and their family. In fact, a mental health clinical executive that IDC interviewed clearly explained how it is complex to design mobile apps or social media campaigns for different types of conditions, such as dementia, depression, or psychosis.

Mental Health —Digital patient experience

Non-Mental Health — Digital patient experience

85%

90%

46%

78%

24%

63%

20%

61%

10%

61%

Now

In two years

Web portal

Mobile app

Social media

Telemedicine device

Wearable app

92%

94%

68%

89%

45%

77%

35%

65%

61%

Now

In two years

Web portal

Mobile app

Social media

Telemedicine device

Wearable app13%

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Information Governance — Patients as an active resource in healthcare delivery

The majority of healthcare providers own patient data and have established standard rules for multilateral data sharing across the health ecosystem they recognize the value of sharing data across the ecosystem. But they still need to define guidelines for patient consent and implied consent, as the patient can still claim their own privacy rights.

Within two years, 45% of healthcare executives expect to co-own data with the patient and ask their consent to share data across the health ecosystem. Patients’ expectations of quality of care are increasing, and generally they are looking for a better healthcare experience. Healthcare executives will therefore implement new strategies to realize the benefits of enhanced patient empowerment.

Healthcare executives want to give patients more control over their data to enhance engagement and make them aware of information sharing workflows, making them active participants in healthcare delivery.

Providers' ownership only for internal use

6%

11%

43%

37%

19%

1%

45%

2%

31%

4%

Providers' ownership also

for bilateral sharing

Providers' ownership for sharing across

the health ecosystem

Providers' ownership &

patients' consent needed to share

data

Patient sole ownership

Now In two years

Data ownership

•

•

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Enterprise Information Architecture

Four barriers to reducing data silos:• Dependence on proprietary systems that generate complex point-to-point integration

• Difficulty getting budgets for legacy data integration

• Limited scope of adoption of interoperability standards

• Product-centric view of data integration

Architecture is still very siloed, but executives and clinical staff keep trying to overcome this using multiple data types and accessing multiple data sources that together contribute to building an integrated view of the patient.

Data type Data source95%

96%

93%

91%

64%

90%

55%

86%

74%

Now

In two years

Clinical data

Administrative & operational

data

Population health data

Clinical research data

Social care data

37%

88%

88%

93%

87%

47%

85%

30%

65%

68%

Now

In two years

Clinical and administrative

applications

Unstructured data sources, such as

nursing notes, emails, etc.

Images, videos, and machine-to-

machine feeds

Patient portals or mobile apps, or

social media

Medical remote monitoring

devices and wearable

23%

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Hospitals have more resources available that allow them to apply more sophisticated architectural approaches to information integration than primary and community care organizations can. But hospitals also have an additional challenge compared to community and primary care — the integration of clinical research data.

Primary care, usually a smaller enviroment than hospitals, can benefit from point-to-point integration, as it might be tailor-made by the vendor.

No integration either internally or with other healthcare

organizations

5% 2%

61% 60%

6% 4%

33%

27%

1% 1%

Fully working internal system

integration

Point-to-point application

integration with other

organizations

Service-oriented architecture

used to share data across healthcare providers

Real-time and dynamic

integration of information across the

health ecosystem

Now In two years

Hospitals — Approaches to architectural integration

The approach to architecture integrationData sharing is difficult, as point-to-point integration of legacy applications based on proprietary technology prevails now (51%) and in two years (58%).

No integration either internally or with other healthcare

organizations

6%

11%

36%

57%

6%

11%

17%

51%

4% 2%

Fully working internal system

integration

Point-to-point application

integration with other

organizations

Service-oriented architecture

used to share data across healthcare providers

Real-time and dynamic

integration of information across the

health ecosystem

Now In two years

Non-Hospitals — Approaches to architectural integration

•

•

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Legacy data integration plansThere is strong latent demand for real-time integration of legacy data, rather than read-only workarounds.

Paper based

4% 1%

64%

29%

Read-only applications and

shared on request

26%

57%

Digital format stored in proper

databases

Now In two years

5%

Read-only applications

1%

11%

Fully migrated to cloud

and mobile technologies

1%

Legacy data integration

Healthcare executives recognize the relevance of integrated business process automation into their existing solutions to get a comprehensive functionality for the archival, access, a management and reporting of the legacy healthcare data. Furthermore, the demand for comprehensive clinical data to research upon is growing, making stand-alone read only applications irrelevant in that perspective.

In a short term perspective of one year, budgets for legacy data integration is low. But keeping legacy applications in operation as read only is expensive, and a positive business case is achievable within only 2-4 years. The CIO has this long term view on legacy integration and only uses read only as proven and affordable, short term solution.

•

•

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Essential Guidance

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What should healthcare executives do?Design an integrated care information management model to support a 360-degree view of the patient. Information sharing between care settings is critical to incorporate and manage the increasingly wide mix of data types and sources that can help build a 360-degree patient view.

Develop and align strategy, governance and architecture capabilities to implement an integrated care information management model to securely collect, archive, access, and analyze patient data. To establish a truly patient-centric longitudinal record to be used along the patient journey, healthcare executives need IT systems to be interoperable and to support the end-to-end information management strategy. Strategy, governance and architecture capabilities have to be aligned to deliver integrated care.

Design a legacy data integration plan through the adoption of Third Platform technology. Mobility, cloud, social media, and Big Data and analytics help to overcome the limit of data sharing caused by point-to-point integration. Even if it still works for a small enviroment, point-to point integration limits the development of an integrated care model in the long term.360°

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What should healthcare executives do?Overcome the focus on siloed systems that limit the use of patient data to a single episode of care. EHRs and EMRs, though still perceived as the cornerstone of patient data integration, risk limiting the ability to integrate, represent, and leverage the value of data across data types and sources.

Enable mental health to become part of an integrated care model. The continuing separation of general health and mental health services represents both a human and economic cost for healthcare systems. Healthcare executives should increase technology investments aimed at improving care, removing barriers to services, reducing waiting times, and delivering interventions at lower cost.

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MethodologyThe information for this InfoBrief is based on 137 telephone interviews with mental health and general health IT and non-IT executives across U.K. and the Nordics. This is supplemented with eight in-depth interviews conducted by IDC analysts with senior executives from a mix of national/regional public health authorities, clinical professionals, and IT executives.

The survey results were analysed using IDC’s Health Insights Information Management Framework which evaluates the variables that should be considered by healthcare executives when planning and implementing an information management model. Variables are classified in one of three interdependent information management areas:

Statistical analysis is performed to correlate and identify readiness in integrated and personalized care. The IDC Health Insights Information Management Framework identifies the varying levels of readiness as:1 = siloed, reactive care2 = safe and compliant care3 = efficient care4 = appropriate care5 = integrated and personalized care

Business goalsEcosystem scopeInnovation

Patient data ownershipPatient data governanceScope of patient data repositoryIT security

Information integration approachEnterprise architecture managementAccessing legacy dataBusiness analyticsClinical research explorationIt principles

Data semanticsConceptual data interoperabilityUser interfaceEnteprise content managementData sources

GovernanceKnowledge sharingOrganizational structureSkills

Informationstrategy

business goals Informationgovernance

Enterpriseinformationarchitecture

Source: Integrated Care Information Management Readiness Index Survey,IDC Health Insights 2016

International Data Corporation (IDC) is the premier global provider of market intelligence, advisory services, and events for the information technology, telecommunications and consumer technology markets. IDC helps IT professionals, business executives, and the investment community make fact-based decisions on technology purchases and business strategy. More than 1,100 IDC analysts provide global, regional, and local expertise on technology and industry opportunities and trends in over 110 countries worldwide. For 50 years, IDC has provided strategic insights to help our clients achieve their key business objectives.

IDC is a subsidiary of IDG, the world’s leading technology media, research, and events company. Further information is available on our websites at www.idc.com

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