PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Hannover Medical School

Petra Knaup-Gregori, Klaus-Hendrik WolfD. ICT tools in health care

Health Care in the Information Society. On the prognosis for the Year 2013

On the prognosis for the year 2013 − Part D 2

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D.ICT Tools in Healthcare

21.05.2013

Use of● T27: computer-based ICT tools

● T28: mobile devices

● T29: continuous measures of patient parameters

● T30: reference processes

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Methods

21.05.2013 On the prognosis for the year 2013 − Part D 3

● Survey– 11 experts in the field of ICT in hospital, answers for

• own hospital• all hospitals in Germany

● Evidence– IT-report Health Care, Focus: IT in Hospitals.

Niedersächsisches Ministry for Economy, Arbeit und Verkehr, Hannover 2012 and 2013

– Dobrev A, Haesner M, Hüsing T, Korte W, Meyer I. Benchmarking ICT Use among General Practitioners in Europe: Final Report. 2008.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − T27

21.05.2013 On the prognosis for the year 2013 − Part D 4

T27: The use of computer-based ICT tools will increase dramatically in hospitals, practices, and other health care institutions.

On the prognosis for the year 2013 − Part D 5

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

21.05.2013

P27.1: Over 80% of the hospitals will make computer-based ICT tools available to nearly every clinical workplace and to every health care professional.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence IT-support hospitals (aministration)

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Source: IT-Report Gesundheitswesen. Schwerpunkt IT im Krankenhaus. Niedersächsisches Ministerium für Wirtschaft, Arbeit und Verkehr, Hannover 2012. page 37.

P27.1: Over 80% of the hospitals will make computer-based ICT tools available to nearly every clinical workplace and to every health care professional.

n=180

accounting (inpatient)

human resources

assets accounting

accounting (ambulat)

medical controlling (DRG)

controlling

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence clinical documentation

21.05.2013 On the prognosis for the year 2013 − Part D 7

Source: IT-Report Gesundheitswesen. Schwerpunkt IT im Krankenhaus. Niedersächsisches Ministerium für Wirtschaft, Arbeit und Verkehr, Hannover 2012. page 29.

P27.1: Over 80% of the hospitals will make computer-based ICT tools available to nearly every clinical workplace and to every health care professional.

n=180

admission note/statement

medica documentation

OP documentation

anesthesia documentation

medication

nursing documentation

intenisve care doc.

On the prognosis for the year 2013 − Part D 8

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P27.2

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P27.2: Over 98% of the privately practicing physicians will make use of computers.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Expert

21.05.2013 On the prognosis for the year 2013 − Part D 9

P27.2: Over 98% of the privately practicing physicians will make use of computers.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence

21.05.2013 On the prognosis for the year 2013 − Part D 10

● 2007:87% GPs in EU use a computer (administrative data)– Denmark (97%), Estonia (98%), Hungary (100%), the

Netherlands (97%), Finland (100%), Sweden (96%), UK (95%), Iceland (99%) and Norway (98%)

– Germany: 92.5%

Source: Dobrev A, Haesner M, Hüsing T, Korte W, Meyer I. Benchmarking ICT Use among General Practitioners in Europe: Final Report. 2008.

P27.2: Over 98% of the privately practicing physicians will make use of computers.

On the prognosis for the year 2013 − Part D 11

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P27.3

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P27.3: At least 20% of the patient rooms will be equipped with a computer in the inpatient health care sector.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

21.05.2013 On the prognosis for the year 2013 − Part D 12

P27.3: At least 20% of the patient rooms will be equipped with a computer in the inpatient health care sector..

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence – IT report

21.05.2013 On the prognosis for the year 2013 − Part D 13

● Bedside terminals – 243 hospitals– 6.2%

P27.3: At least 20% of the patient rooms will be equipped with a computer in the inpatient health care sector..

http://www.extenway.com/en/medical_bedside_terminals.html

On the prognosis for the year 2013 − Part D 14

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − T28

21.05.2013

T28: Beside telephones and personal computers, mobile communication and devices will be in use for communication and data entry. New mobile ICT tools support communication (speech and text, direct and asynchronous (telephone and email) and organization (calendars and task lists)). The connection of mobile end devices will be achieved asynchronously through ‘docking stations’ or synchronously via radio waves.

On the prognosis for the year 2013 − Part D 15

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P28.1

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P28.1: The average number of ICT tools in hospitals will surpass the average number of employees.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

21.05.2013 On the prognosis for the year 2013 − Part D 16

P28.1: The average number of ICT tools in hospitals will surpass the average number of employees.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence IT-support hospitals (aministration)

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Source: Böckmann B, Akce A. Effectiv‐IT. Wertschöpfung von IT – Hemmnisse und ökonomische Bewertung von health-IT in Krankenhäusern. Abschlussbericht. FH Dortmund. page 37.

P27.1: Over 80% of the hospitals will make computer-based ICT tools available to nearly every clinical workplace and to every health care professional.

Number of computer desks Number of user accounts

P28.1: The average number of ICT tools in hospitals will surpass the average number of employees.

On the prognosis for the year 2013 − Part D 18

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P28.2

21.05.2013

P28.2: The mobile ICT tools will find use in over 10% of the hospitals, however, wide spread use will be achieved in only 5%.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

21.05.2013 On the prognosis for the year 2013 − Part D 19

P28.2: The mobile ICT tools will find use in over 10% of the hospitals, however, wide spread use will be achieved in only 5%.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence – IT report

21.05.2013 On the prognosis for the year 2013 − Part D 20

P28.2: The mobile ICT tools will find use in over 10% of the hospitals, however, wide spread use will be achieved in only 5%.

n=185

On the prognosis for the year 2013 − Part D 21

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P28.3

21.05.2013

P28.3: On average, the hospitals will use more mobile than ‘stationary’ ICT tools.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

21.05.2013 On the prognosis for the year 2013 − Part D 22

P28.3: On average, the hospitals will use more mobile than ‘stationary’ ICT tools..

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence – IT report 2013

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n=243

P28.3: On average, the hospitals will use more mobile than ‘stationary’ ICT tools..

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence - IT report 2013

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n=243

P28.3: On average, the hospitals will use more mobile than ‘stationary’ ICT tools..

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P28.4

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P28.4: Mobile ICT tools at the clinical work places will posses data transfer rates large enough to transfer nearly all patient data via radio waves, with the exception of videos.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

21.05.2013 On the prognosis for the year 2013 − Part D 26

P28.4: Mobile ICT tools at the clinical work places will posses data transfer rates large enough to transfer nearly all patient data via radio waves, with the exception of videos...

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence – IT report

21.05.2013 On the prognosis for the year 2013 − Part D 27

P28.4: Mobile ICT tools at the clinical work places will posses data transfer rates large enough to transfer nearly all patient data via radio waves, with the exception of videos...

Available patient data on ward rounds on mobile tools

n=192

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − T29

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T29: The use of computer-based ICT tools for direct, permanent monitoring of patients’ vital signs, as well as the direct, synchronous transfer of these data to health care institutions, will increase. This will result in part through implanted devices (insulin pumps, etc.).

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P29.1

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P29.1: Special computers will regularly monitor the health condition of over 5% of the chronically ill patients (vital signs, i.e. pulse, blood pressure, etc.) and transfer the results to the treating health care institution.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

21.05.2013 On the prognosis for the year 2013 − Part D 30

P29.1: Special computers will regularly monitor the health condition of over 5% of the chronically ill patients (vital signs) and transfer the results to the treating health care institution....

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence

21.05.2013 On the prognosis for the year 2013 − Part D 31

P29.1: Special computers will regularly monitor the health condition of over 5% of the chronically ill patients (vital signs) and transfer the results to the treating health care institution....

Source: http://www.aerztezeitung.de/praxis_wirtschaft/telemedizin/article/836596/telemedizin-ebm-pauschale-rueckt-weite-ferne.html

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P29.2

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P29.2: In over 5% of the chronically ill patients, these special computers will also be used therapeutically, for example by administering a specified dosage of a prescribed medication when the monitored parameters drop or rise above a specified level.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

21.05.2013 On the prognosis for the year 2013 − Part D 33

P29.2: In over 5% of the chronically ill patients, these special computers will also be used therapeutically.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence

21.05.2013 On the prognosis for the year 2013 − Part D 34

P29.2: In over 5% of the chronically ill patients, these special computers will also be used therapeutically.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − T39

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T30: The importance of reference processes will increase.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P30.1

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P30.1: Reference processes exist for core organizational processes, i.e. admission, transfer, cooperative care, within, as well as, among health care provision institutions.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

21.05.2013 On the prognosis for the year 2013 − Part D 37

P30.1: Reference processes exist for core organizational processes, i.e. admission, transfer, cooperative care, within, as well as, among health care provision institutions.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence – IT report

21.05.2013 On the prognosis for the year 2013 − Part D 38

P30.1: Reference processes exist for core organizational processes, i.e. admission, transfer, cooperative care, within, as well as, among health care provision institutions.

n=69

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

D. ICT tools in health care − P30.2

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P30.2: The quality of the processes will be decisive in the accreditation of the institutions.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

German Experts

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P30.2: The quality of the processes will be decisive in the accreditation of the institutions.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Evidence

21.05.2013 On the prognosis for the year 2013 − Part D 41

P30.2: The quality of the processes will be decisive in the accreditation of the institutions.

SBG V § 135a Verpflichtung zur Qualitätssicherung(1) Die Leistungserbringer sind zur Sicherung und Weiterentwicklung der Qualität der von ihnen erbrachten Leistungen verpflichtet. Die Leistungen müssen dem jeweiligen Stand der wissenschaftlichen Erkenntnisse entsprechen und in der fachlich gebotenen Qualität erbracht werden.(2) Vertragsärzte, medizinische Versorgungszentren, zugelassene Krankenhäuser, Erbringer von Vorsorgeleistungen oder Rehabilitationsmaßnahmen und Einrichtungen, mit denen ein Versorgungsvertrag nach § 111a besteht, sind nach Maßgabe der §§ 137 und 137d verpflichtet, 1. sich an einrichtungsübergreifenden Maßnahmen der Qualitätssicherung zu beteiligen, die insbesondere zum Ziel haben, die Ergebnisqualität zu verbessern und2. einrichtungsintern ein Qualitätsmanagement einzuführen und weiterzuentwickeln, wozu in Krankenhäusern auch die Verpflichtung zur Durchführung eines patientenorientierten Beschwerdemanagements gehört.

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Summary

21.05.2013 On the prognosis for the year 2013 − Part D 42

PETER L.REICHERTZ INSTITUTEFOR MEDICALINFORMATICS

Acknowledgement

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● Our anonymous experts from all over Germany● Ursula Hübner