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| Jörg Studzinski |
Jörg Studzinski, is senior consultant at HIMSS Analytics, and is responsible for product development, market reports, and consulting services around the EMR Adoption Model. Jörg’s professional background includes academic research, as well as experience in internationally active market research and extensive experience in data collection, data analysis, report writing, and in solution-finding by working closely together with the client. He supports hospital directors, IT executives and clinicians with their strategies to adopt and use healthcare information technology. Before joining HIMSS in 2010 he was the responsible project manager for the European eHospital Census, the most comprehensive study on the installed base of hospital IT applications, supplier structure and market influencing factors in Europe, at dii GmbH.
The analytics unit of HIMSS Europe collects and analyzes data related to healthcare IT processes and environments in order to support strategic decisions of the different parties involved in Healthcare IT. HIMSS Europe is part of HIMSS Worldwide, a global, cause-based, not-for-profit organization focused on better health through information technology (IT). Mr. Studzinski’s role with HIMSS Europe includes frequent speaking engagements at events ranging from healthcare providers to industry. He recently spoke about the Digital Imaging Adoption Model (DIAM) at the 2016 European Congress of Radiology in Vienna.
Q. Can you give me a brief history of how and why the Digital Imaging Adoption Model (DIAM) has come to be?
The idea to develop the DIAM was triggered in conversations between HIMSS Europe and the ESR (European Society of Radiology). The ESR has noticed the success of the HIMSS Analytics Electronic Medical Records Adoption Model (EMRAM), which has been used for more than 10 years by hospitals and ambulatory facilities around the world to measure and benchmark care providers’ success in implementing Electronic Medical Records and to create a paperless environment that enables improved quality of care and organizational performance.
So we wanted to create something similar for the imaging world, an assessment that specifically addresses the challenges of IT supported processes in Imaging, helping organizations to understand where they stand today and where they could improve in the future. HIMSS Europe and the ESR signed a memorandum of understanding to develop such a model and bring it to the market. We had a workgroup formed that met regularly over the course of 2015 and beginning of 2016 with representatives from radiology, the hospital CIO community and subject matter experts from ESR and HIMSS.
Q. What is the primary objective of the initiative?
We want to provide thought leadership and guidance regarding IT supported processes in medical imaging. In essence it is our goal to support users and buyers of medical imaging technology to:
- • Identify potential infrastructure or workflow gaps
- • Monitor technological progress over time
- • Create a roadmap for future investments
- • Share best practices and learn from peers
- • Enable benchmarking with peers in a certain region, country or worldwide
- • With this model we want to help care providers to adopt the right digital strategy in order to improve health outcomes. Participating in the assessment and using the results should also help heads of departments in negotiations with their management boards.
Q. Why is there a need to standardize the adoption of a digital strategy?
It is not our intention to standardize digital strategies. What we wanted to standardize is the assessment of available capabilities so that organizations can compare themselves with each other, and that policy makers could use the assessment results to provide the right incentives or develop the right legal or financial framework in order to support an organization, a region, or a country with their Imaging IT strategies – based on objective facts.
The model does not provide a prescriptive pathway to a Digital Imaging Nirvana, it only shows what organizations could achieve using advanced imaging technologies in order to improve health outcomes and patient safety. We have embedded some flexibility in the assessment allowing for individual or country-specific pathways to success and opportunities to specialize in one or more focus areas. And even if the journey to optimally digitize imaging will never really come to an end, we think that a mature organization should be able to support continuity of care by advanced health information exchange capabilities, make the information available to patients, and to use features and procedures like clinical decision support, advanced analytics, or personalized medicine.
Q. Is there a danger that a standardized strategy might hinder innovation?
Yes, I think so. I am in full support of competition between various strategies. But it is typically helpful to have a goal in mind when developing a strategy. And the DIAM provides those goals. May it be to become a Stage 7 organization (the highest possible), or to become a leading organization in the field of value-based Imaging, or simply to master a certain DIAM stage within a specific time period. Imaging centers or even healthcare authorities should define their goals themselves. Perhaps we can help them with our model to define that goal or to take the appropriate actions to get there. If this is possible, we are already successful.
Q. How is the DIAM being implemented? Is compliance required? or is it more of a guideline?
We have developed a survey with more than 100 compliance statements and some additional indicators from 10 different focus areas, such as Software Infrastructure, Workflow and Process Security, Pervasiveness of Use or Patient Engagement. Most of the items can be answered by using a three-point Likert Scale.
Organizations need to complete that survey and send it back to us. So far our experience is that it will take them between one to three hours to fill in the assessment. If they like, they can get phone support in order to understand our questions correctly in order to help them provide the most appropriate answer. Once we have the data collected, we analyze it and calculate the DIAM Score (Stage) as well as a Compliance Rating (from 0 – 100%).
Each stage of the model is associated with different compliance requirements. Achieving a stage requires 70% (or higher) compliance on that stage and all previous stages. This means an organization can achieve Stage 3 on the Model if they meet at least 70% of the requirements for Stage 1, Stage 2 and Stage 3. If they would achieve more than 70% in Stage 1, but less than 70% in Stage 2 and then again perhaps more than 70% in Stage 3 they would still only be a Stage 1 organization. This sort of sequential logic is true for Stages 0 – 4.
For Stage 5, 6 and 7 we have implemented a non-sequential logic, so that organizations could focus on any of the three highest Stages. If they meet the 70 percent rule for one out of the three highest Stages, then they would be a Stage 5 organization, if two out of three are achieved they’d be entitled for Stage 6, and if all three are achieved they can become a Stage 7 organization. So like a radiologist who starts with general medical education and then specializes in some field like neuroradiology or interventional radiology an organization could specialize in different IT-maturity areas.
Q. If successfully implemented, how will healthcare in Europe be changed?
First of all we would have much more transparency about the variety of technology usage and maturity in imaging. With this it will be much easier for the individual organization, but also for a whole health region or even country, to justify the best digital strategy for their specific purposes. It would also help care providers in negotiations with their software vendors, because they could refer to an internationally acknowledged framework of necessary capabilities and hold them accountable for meeting the target. We would have identified and published a number of leading organizations that can share their success stories so that others can learn from them. Eventually imaging, thanks to the proper usage of technology, would be more efficient, would play an even bigger role in interdisciplinary care delivery and would be safer than today.
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