Achieving Enterprise Imaging Maturity Dawn Cram Kim Garriott Principal Consultant IS Director, Enterprise Imaging Logicalis, U.S. Ochsner Health System DIAM-EI development team chair; DIAM-EI development team co-chair; HIMSS-SIIM Enterprise Imaging Community HIMSS-SIIM Enterprise Imaging Community; co-founder and co-chair SIIM Board of Directors; JDI Editorial Board @SIIM_Tweets #SIIM18
Session Objectives • Understand the purpose of the Digital Imaging Adoption Maturity Model and how it relates to the EMRAM • Analyze the 8 stages of maturity • Determine organizational needs to achieve maturity • Understand the vendor R&D still needed in the industry to assist organizations with achieving maturity @SIIM_Tweets #SIIM18
HIMSS Analytics Maturity Models ELECTRONIC MEDICAL RECORD CONTINUITY OF CARE ADOPTION MODEL (EMRAM) ADOPTION MODEL (CCMM) DIGITAL IMAGING ADOPTION MODEL (DIAM & DIAM-EI) ADOPTION MODEL FOR ANALYTICS OUTPATIENT ELECTRONIC MEDICAL RECORD MATURITY (AMAM) ADOPTION MODEL (O-EMRAM) @SIIM_Tweets #SIIM18
EMRAM Update Promotes Imaging to Stage 1 Requirement @SIIM_Tweets #SIIM18
W hat is the Digital I m aging Adoption Model ( DI AM) ? Roadmap-based assessment to master digital transformation in medical imaging Key Collaboration with international, Contributors cause-based, professional societies and very enthusiastic imaging experts from Europe, North America, Asia, Middle East and Latin America 8 Stage (0-7) maturity model; measures and benchmarks IT adoption in medical imaging Launched in 2016 Globally applicable Provides guidance for digital transformation of medical imaging, including best-practice sharing and public recognition opportunities @SIIM_Tweets #SIIM18
How did w e get here? A brief history of the DIAM 2015 Launched HIMSS-ESR workgroup (in Europe) to develop the DIAM 2016 (March) DIAM launched at European Congress of Radiology - focused on Radiology • DIAM rollout in various European countries with some interest in Middle East 2016–2017 • First discussions with HIMSS-SIIM Enterprise Imaging workgroup in North America Launched global DIAM workgroup (ESR, SIIM, EUSOMII); build on previous work Workgroup goals: • Expand DIAM into an Enterprise Imaging roadmap 2017 (June) • Update / refine existing DIAM criteria for Enterprise Imaging applicability • Develop new DIAM assessment methodology for enterprise imaging assessments • Retain existing Radiology assessment survey • Set stage for developing DIAM assessment methodology for other imaging areas 2018 (March) First DIAM update; now meets Enterprise Imaging challenges and requirements @SIIM_Tweets #SIIM18
HI MSS Analytics DI AM w orkgroup participants Many thanks to the following workgroup members for their valuable contribution Workgroup Name Country Representing Job Title / Position Function Organisation Chair Kim Garriott USA SIIM Principal Consultant, Logicalis / Co-founder HIMSS-SIIM Enterprise Imaging workgroup Co-chairs Dawn Cram USA SIIM IS Director, Enterprise Imaging, Ochsner Health System / HIMSS-SIIM Enterprise Imaging workgroup member / SIIM Board of Directors / JDI Editorial Board Monief Eid Saudi Arabia None PACS Program Director at the MoH / HIMSS-SIIM Enterprise Imaging workgroup member Cheryl Petersilge USA SIIM MD, Cleveland Clinic / Gerald Tan Singapore none Deputy CMIO and Consultant Radiologist, Tan Tock Seng Hospital, Singapore John Daniels USA HIMSS Analytics Global Vice President Healthcare Advisory Services, HIMSS Analytics Jörg Studzinski Germany HIMSS Analytics Director Research and Advisory Services, HIMSS Analytics Lluís Donoso-Bach Spain ESR MD, PhD, Director Diagnostic Imaging Department Hospital Clínic of Barcelona / ESR President 2015/16 Luc Bidaut UK EUSOMII MD, PhD, Professor of Medical Imaging, University of Lincoln Neelam Dugar UK ESR MD, Consultant Radiologist, Doncaster & Bassetlaw Hospitals NHS Trust / Informatics Advisor for the Royal College of Radiologists Paul van Diest Netherlands none MD, PhD, Professor and Head of Pathology Department, University Medical Center Utrecht, Netherlands / Professor of Oncology at Johns Hopkins Oncology Center, USA Peter Mildenberger Germany ESR MD, PhD, Professor for Radiology and IT-Leader at the Dept. of Radiology, University of Mainz / Chair of ESR subcommittee for Professional Issues and Economics in Radiology Yulia Shevchuk Austria ESR MD, PhD, Manager at Dept. of European and International Affairs, ESR Office, Vienna @SIIM_Tweets #SIIM18
HI MSS Analytics DI AM key contributors Thank You! @SIIM_Tweets #SIIM18
How does it look from inside? A short walk through The DIAM Stages @SIIM_Tweets #SIIM18
DI AM Stage 0 ( Enterprise I m aging) No or lim ited Electronic I m age Managem ent Less than 2 service areas have/use an enterprise or specialized information system for image acquisition and reports/notes management A service area = image producing unit / department, such as: - Radiology - Cardiology - Pathology - Opthalmology - Dentistry - Obstetrics, etc. @SIIM_Tweets #SIIM18
DI AM Stage 1 ( Enterprise I m aging) Electronic I m age Managem ent covering service area( s) At least 2 service areas need to have electronic + image management (no matter which): o Modalities/devices to produce images in digital format Potential Software Solutions o Information systems to… RIS, CVIS, LIS, Dental IS etc. − manage image acquisition (order- or encounter-driven) RIS, CVIS, LIS, Dental IS etc. − manage reports/clinical notes related to medical images PACS, VNA etc. − image archiving Typically part of other systems, such − may have: supply and inventory management (where as RIS, CVIS, EMR etc. appropriate, e.g. Radiology/Cardiology) A service area = image producing unit / department, such as Radiology, Cardiology, Pathology, Opthalmology, Dentistry, Obstetrics, etc. @SIIM_Tweets #SIIM18
DI AM Stage 2 ( Enterprise I m aging) Electronic I m age Managem ent covering a variety of im ages across the enterprise At least 3 service areas (or 70% of all medical images/videos) need to have + + electronic image management (no matter which) Additional requirements: o Third party image management systems need to be integrated with the EMR (or similar solution) o Images should be directly accessible, e.g. by single or multiple links, via the EMR (or similar solution) o Images must have metadata assigned (e.g. MRN, name, description etc.) o External images can be imported for clinician access (if policy allows) @SIIM_Tweets #SIIM18
DI AM Stage 3 ( Enterprise I m aging) I m aging Governance and Strategy; W orkflow and Process Safety Technology Governance & Strategy (incl. governing body / oversight) for − Type of imaging solutions/technology, security etc. − Information/data management (e.g. use of standards to ensure consistency) Information Program − Formalized strategy (addressing the enterprise) and regular vetting − Purchases/procurements Financials Workflow and Process Safety − Quality, safety and operational parameters across multiple imaging services are measured and under control − Image acquisition workflows accross multiple imaging services are formalized, standardized and implemented − Status management for imaging studies, reports/notes across multiple imaging services − Processes to ensure right is associated with right image (and vice versa) Image Sharing and Accessibility − Clinicians can access all types of images/multimedia through a consolidated („universal“) viewer; specialists can use specialty viewers on top − External referrers can access and view images „online“ (through the organization‘s network/repository) @SIIM_Tweets #SIIM18
DI AM Stage 4 ( Enterprise I m aging) Fully integrated im age m anagem ent w ith efficient enterprise-w ide im age sharing across different service areas Enterprise-wide image repository Enterprise-wide standardized workflows for image/multimedia/metadata capture, storage and sharing Use of internationally recognized standards, protocols and/or profiles to support system integration and clinical workflows Secure acquisition and easy viewing capabilities for mobile images (mobile platforms, handheld devices) Capability to directly ingest external images (incl. associated reports/notes, metadata etc.) Remote access to images and reports/notes Source: Roth CJ, Lannum LM, Persons KR. A Foundation for Enterprise Imaging: HIMSS-SIIM collaborative whitepaper. J Digit Imag 2016) @SIIM_Tweets #SIIM18
DI AM Stage 5 A ( Enterprise I m aging) Advanced I m aging Analytics Imaging platform provides infrastructure that enables enterprise data warehouses to use information from images and asscociated metadata Clinical and operational parameters are systematically tracked, benchmarked and can be presented in real-time Imaging biomarker: Determination of the HER-2 status of paraffin embedded xenograft tumours by immunohistochemistry of HER-2 (Source: Wikipedia, Author: Mumssygris) Organisations use and incorporate external data sources Examples of using predictive and prescriptive analytics can be presented Capability to correlate genetic information from patients with imaging biomarkers Technology use is captured and analyzed to influence user behavior Source: https://www.governanceanalytics.org/knowledge-base/Main_Tools/Data_classification_and_analysis @SIIM_Tweets #SIIM18
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