For a recent HTN Now webinar we were joined by a team from Ideal Health, including Stephanie Spencer, director of implementation services; Martin Roe, technical consultant; and Paul Chiles, digital specialist. Through the session, Stephanie discussed a variety of topics and issues relating to digital maturity and building digital maturity roadmaps.
To begin, she shared a brief introduction: “Ideal Health is a HIMSS technology health partner, and we support trusts in identifying their current state of digital maturity and in building roadmaps so that they can take action on the assessments that have been taken. Today, I’ll be exploring the current assessment methods, and demonstrating how they can be used to articulate priorities within your organisation.”
The digital transformation lifecycle
Stephanie took the audience through the digital transformation lifecycle and the digital maturity models underpinning that transformation, focusing on INFRAM, the infrastructure adoption model; EMRAM, the electronic medical records adoption model; and AMAM, the analytics adoption model.
“People tend to use INFRAM just before they undergo large EPR transformations or anything that’s going to be particularly challenging on their infrastructure,” she said, “and they do that so that they can understand what the gaps are and how they can close them.
“They use EMRAM just before and also just after EPR implementation, to understand their level of digital maturity with regards to medical records; to see how it’s being improved, and to understand what areas to focus on post-implementation.”
The analytic model AMAM, meanwhile, “builds on the fact that you now have a rich data source; your EPR build will be used more and more for clinical decision support, and that data then offers you opportunities to be able to look at the operations and outcomes of health delivery.”
Stephanie likened this to “no longer having to look in the rearview mirror” at last month’s activity reports to understand what is happening, noting that it enables you to start using data to understand what will be happening in a much more predictive way.
“You’ll also be able to look at data sets that can be combined to improve your understanding, like weather reports or reports from social services about resource availability, or information around the locale of your hospital in terms of sporting events,” she highlighted. “You can bring that data together to predict what the impact on the hospital will actually be. This can then be used, for example, to look at your staffing model, perhaps in your emergency department – and as the use of your information improves, you’ll be able to look at dashboards and start predicting what needs to be done in the near future.”
Digital maturity, digital capabilities framework and HIMSS
Stephanie shared an analogy for the difference between maturity and capability, stating that whilst capability allows you to boil an egg, maturity enables you to master the art of baking. In order to make this leap, she continued, new processes, upgraded tools, and new skills would be required.
“In the digital healthcare context, being in possession of a more capable EPR does not, of itself, mean that you’re operating at a higher level of digital maturity,” she pointed out.”You also need to develop processes, skills and governance to ensure the system has been fully adopted to claim that maturity.”
Stephanie went on to discuss some of the differences between the digital capabilities framework (DCF) and HIMSS, including that the DCF is an input-focused model, whereas the HIMSS maturity model is output-focused.
Expanding on her point, Stephanie explained that “input-focused” tends be asking what the system can do; what are its capabilities? For example, can the EPR automatically detect escalating risk and deteriorating patient conditions and push the relevant alerts, notifications or tasks through to clinicians?
“HIMSS tends to focus on the outputs – it’s looking for the effect of those inputs, covering things like risk of sepsis, risk of medication error,” she said. “It may be a nuance, but I think it’s important that digital maturity tools remain focused on the impact that they have in healthcare and the improvements that they can bring to patients, rather than improvement on the system for system’s sake.”
For DCF, Stephanie continued, level of adoption is implied by three categories of capability: core capabilities or minimum capabilities; transformation capabilities, which may be functionally available but are not always in widespread use; and innovation capabilities, which are the aspirations of a digitally mature system.
In HIMSS, by contrast, adoption is “a key empirical measure linked to the maturity stage,” Stephanie stated. “For example, what they’re actually looking for would be the percentage of clinical documentation that is recorded as structured documents; so it is much more explicit about the expectation of the usage of the system.”
DCF’s areas of focus include storage and management of records, assessments and plans; transfers of care; diagnostics management; decision support tools; and remote and assistive care. HIMSS, meanwhile, is broken down into five domains, including data capture and HIE; patient engagement; analytics and outcomes; resilience management; and clinical user adoption.
Stephanie noted that selecting which model will work best for your organisation will depend on what you want to achieve. She shared her views that HIMSS “excels” at the analysis of factors constraining digital maturity, at building digital maturity roadmaps; and as an internationally established comparison. For DCF, she commented that its strengths lie in demonstrating the range of capabilities you currently have and/or those you seek to address by an upcoming investment, and the fact that it is closely linked with the What Good Looks Like framework.
Digital maturity assessments
Stephanie went on to look at digital maturity assessments and highlighted what these assessments actually reveal. Presenting an example taken from the HIMSS EMRAM assessment, Stephanie took us through the best ways to identify priority areas of focus for levelling up, focusing on the areas preventing an organisation from meeting the requirements for that next level.
“An example of that would be an organisation which hasn’t met the 70 percent requirement for clinical user adoption, but has met requirements in every other area – we would look first at getting that metric up to the necessary level, and what steps we could take to achieve that,” she said.
Summarising her presentation, Stephanie shared some key takeaways on digital maturity. “It’s not just a number,” she stated. ‘The most important thing you will get from doing your digital maturity assessment will be your roadmap, because it helps you to identify where to go next. Analysing the results you will get is not straightforward, and it’s something which organisations do benefit from having a technology partner to help with; but it is addictive once you start understanding what’s holding you back.”
Many thanks to Stephanie for sharing her insights.
To find out more or to contact the Ideal Health team, visit their website here.
