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Clinical Systems Applications and Related Technology: Today and into the Future 

Clinical Systems Applications and Related Technology: Today and into the Future . Prof. Steven H. Shaha, PhD, DBA Centre for Public Policy & Administration KLAS Research. For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com , 801-879-5543.

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Clinical Systems Applications and Related Technology: Today and into the Future 

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  1. Clinical Systems Applications and Related Technology: Today and into the Future  Prof. Steven H. Shaha, PhD, DBA Centre for Public Policy & Administration KLAS Research For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  2. Disclosures & Bio Prof. Steven H. Shaha, PhD, DBAProfessor, Center for Public Policy & AdministrationDirector, KLAS Performance Insights, KLAS Research 100+ peer-reviewed publications, 200+ peer-reviewed presentations, 2 books Advisory and consulting work for 10 governments in Asia, Australia and Europe including France, Spain, Switzerland, Netherlands, Singapore and Malaysia Advisory and consulting to over 50 non-healthcare organizations, including Disney, Ritz-Carlton, Coca-Cola, New Line Cinema, IBM, AT&T, Time Warner, Kodak, Johnson & Johnson, Marriott, U.S. Dept of Defense Employment history includes: Coca-Cola, RAND Corporation, UCLA Medical Center, Intermountain Health Care, Gartner Group, Inst Integrated Outcomes, Allscripts Professor or Lecturer or at 14 professional academies and graduate schools, e.g. Harvard, Columbia, Cornell, UCLA, MIT, UMass Academic Appointments (current): Center for Public Policy and Admin, Harvard (lecturer), Zayed Univ (UAE), University of Utah Education: PhD, Research Methods & Applied Statistics DBA, Business Administration (PhD) MA, MEd, BS For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  3. The EPR-Enabled Possibilities For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  4. Improved Stroke Outcomes Impact of Stroke Outcomes Toolkit: Comparative Quality with versus without Impact of EMR/EHR with Intelligent Order Sets and Advanced CDS Stroke Care Best Practices For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  5. Improved Stroke Outcomes CPOE w/ alerts alone Impact of EMR/EHR with Intelligent Order Sets and Advanced CDS Stroke Care Best Practices http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13 For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  6. Improved Stroke Outcomes With CDS-rich Order Set CPOE w/ alerts alone Impact of EMR/EHR with Intelligent Order Sets and Advanced CDS With CDS-rich Order Set 40.5% Greater Clinical Excellence Without Stroke Care Best Practices http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13 For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  7. Improved Stroke Outcomes With CDS-rich Order Set Readmissions in 31 Days CPOE w/ alerts alone Discharge Patterns 9.4% more (p<.001) 35.7 % fewer (p<.001) 16.0% fewer (p<.001) 21.4% fewer (p<.001) Length of Stay Financial Impact 11.4% lower (p<.05) 12.7% lower (p<.05) 7.5% lower 0.35 fewer days avg.(p<.001) Estimated savings of £140k-340k annualized http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13 For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  8. Improved Stroke Outcomes Continue after Discharged With CDS-rich Order Set CPOE w/ alerts alone Discharge Patterns 9.4% more (p<.001) 16.0% fewer (p<.001) 21.4% fewer (p<.001) http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13 For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  9. Better Outcomes after Discharge Admissions to Skilled Nursing Facilities With CDS-rich Order Set CPOE w/ alerts alone Readmissions in 31 Days Length of Stay 4.1 % shorter (p<.001) 7.7 % fewer (p<.001) • Additional Efficiencies • Capacity for 130 additional admissions • with NO staffing increases http://cwhonors.org/viewCaseStudy2010.asp?NominationID=186&Username=shssos, accessed 5-apr-13 For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  10. EPR Realities: “Not everyone can…” Challenges • Quest for Interoperability and Integration • Implementation Challenges • Local Uniquenesses • Conflicting Priorities Good News Quest for Interoperability and Integration Focus on Implementation Excellence Importance of Local Uniquenesses For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  11. Research Model 3,000+ Provider surveys and calls annually Scores on 25-item Survey Provider Narratives and Quotes Comparatives by Vendor, Market, Product Type For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  12. Coverage List For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  13. Comparative Vendor Performance For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  14. Comparative Vendor Performance Vendor A EMR Product Name A Vendor B EMR Product Name B Vendor C EMR Product Name C Vendor D EMR Product Name D Vendor E EMR Product Name E Vendor F EMR Product Name F Vendor G EMR Product Name G Vendor H EMR Product Name H Vendor I EMR Product Name I For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  15. Europe … For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  16. Vendor A Vendor B Vendor C Vendor A Vendor B Vendor C For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  17. An Intriguing Pattern … Variability in scores among top vendors? Variability between economies? Deeper search led to …. For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  18. Satisfaction: IT vs. Clinicians For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  19. Where are the differences? For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  20. Mean Ratings for Emergency Systems Niche 53.4% Higher Enterprise For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  21. Usability Study For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  22. Vendor A Vendor B Vendor C Vendor D Vendor E Vendor F For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  23. Two Approaches • Model B • More Prescriptive versus Adaptability & Customizability • Implement & Minimally Adjust • Application versus User that adapts • Model A • Less Prescriptive with Adaptability & Customizability • Implement & Adjust • Users versus Application that adapts For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  24. Comparative Usability For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  25. Comparative Time to Clinician as Expert For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  26. Comparative Time to Clinician as Expert For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  27. Prescriptive vs. Adaptive? For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  28. Prescriptive vs. Adaptive? Still 45% Customization Nearly 70% Customization For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  29. IT vs. Clinicians: Avoidable? For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  30. Clinicians Shared Needs IT • Quick, Impactful Implementation • System Stability & Reliability • Efficiency • Hassles • Waste • Quality of Care • Benefits of Outcomes • Error Avoidance • Go home • Sooner • More worry-free • Quick, Impactful Implementation • System Stability & Reliability • Efficiency • Hassles • Waste • Quality of Care • Benefits of Outcomes • Error Avoidance • Go home • Sooner • More worry-free For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  31. Clinicians Contrasting Needs IT • TCO • Maintenance & Upkeep • Interface requirements • Staff requirements • Vendor relationships • Coding accuracy • Financial repercussions • Administration's needs • Integrated across settings • Infinite customers • Needs and expectation • Evolving requirements • Specialty-specifics • Workflows • Diagnostics • Documentation • Information access • Population Management • Ease of Use • Quick uptake • Intuitiveness • Productivity • Clinical decision support • Error avoidance • Patient outcomes • Across Settings … For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  32. Can Both Sets of Urgencies be Met? • YES • System • Interoperability and Integration • Adaptability to Evolving Requirements • Coding • Reporting • Clinical Models • Culture • Balance of Stability with Adaptability • Silos versus Team Work • Micro versus Macro Perspectives • Vision • Population Health balanced with Individual Patient Needs • Exceptional Coding balanced with Information Value • Efficiency balanced with Quality For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  33. What Matters Most … Commodities Anchors Customer Ratings Nuisances Fires Predictive Importance (Correlation with Overall Satisfaction)

  34. What Matters Most? *Statistically Significant p<.01 Predictive Correlation to ‘Overall Satisfaction’ in Time Series

  35. Keys to Sustainable Impacts from Vendor • Delivery of “New Technology” • Supports Integration Goals • Relationship / Partnership • Usability • Strong, focused implementation • Internal relationships • Mission-focused culture For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  36. Keys to Sustainable Impacts from Provider Organization • Incorporation of “New Technology” • Quest for Integration Goals • Relationship / Partnership • Clinician Usability • Strong, focused implementation • Internal relationships • Mission-focused culture For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

  37. Clinical Systems Applications and Related Technology: Today and into the Future  Prof. Steven H. Shaha, PhD, DBA Centre for Public Policy & Administration KLAS Research For questions or comments, please contact Prof. Shaha at steve.shaha@KLASresearch.com, 801-879-5543

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