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DHBs eye up ‘quick wins’ in digital maturity

Thursday, 18 June 2020  
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Return to home page editor Rebecca McBeth


DHBs are looking to rapidly improve their digital maturity scores after completing Digital Maturity Assessments over the past financial year.


Five DHBs have completed the assessments, which are being funded by the Ministry of Health for all 20 of the country’s DHBs using four HIMSS Analytics maturity assessments.


These are; the electronic medical record adoption model (EMRAM), outpatient model EMRAM (O-EMRAM); the continuity-of-care maturity model (CCMM); and the infrastructure adoption model (INFRAM) assessment.


EMRAM scores hospitals on a scale from 0–7.


All DHBs have previously been assessed on EMRAM, but their scores have dropped significantly because both the questions asked and scoring criteria have changed substantially since the last assessment.


For an organisation to move past a level they now have to be 100 per cent compliant.


However, DHB leaders spoken to by are confident of being able to quickly improve their scores, with the necessary implementations already in the pipeline.


Southern was chosen by the Ministry in 2018 to pilot the assessments and work with the Ministry on a NZ Glossary to localise the content.


The DHB received an EMRAM score of 0.0765, an O-EMRAM of 1.163 and an INFRAM score of 4 and was confident of improving its scores reasonably rapidly with the implementation of some key systems.


MidCentral, Canterbury, West Coast and Counties Manukau DHBs have also been assessed and received their final reports. Capital and Coast and Hutt Valley DHBs have had their assessments, but their final review and feedback session has been delayed due to Covid-19.


The MoH says all further assessments have been delayed until the new financial year, due to Covid-19.


Draft results for Canterbury and West Coast DHBs’ hospital settings released to are EMRAM 1 and O-EMRAM 2. Canterbury gained an INFRAM score of 1 and West Coast 2.


MidCentral District Health Board Chief Digital Officer Steve Miller says the overall results for MidCentral DHB were low, but those for THINK Hauora and other community partners were three to four times higher.


“In some of the higher levels of digital maturity, MidCentral DHB has almost completed the requirements, therefore for small investments we expect to have some quick wins improving our overall digital maturity,” says Miller.


He says the DHB and its partners found the process useful, as it established a common language and understanding of the baseline of their digital maturity.


Miller says that parallel to the HIMMS assessment process, the district developed an initial view of a District Reference Architecture and reviewed seven layers of capability within this.


“For MDHB, both the HIMMS assessment and Reference Architecture review highlights the effect of a sustained lack of historic investment, and the burden legacy technology and application portfolio creates,” he says.


The assessments will inform the development of the DHBs long term electronic patient record roadmap and the required portfolio investment to deliver it.


“As a result of this activity the district will now move onto the next stage of the district’s Te Awa digital strategy by developing a road map of digital health activity that will be implemented in the district in the coming years,” Miller says.


Counties Manukau Health deputy CIO Megan Milmine says the DHB started the maturity assessment process in September last year and described it as “a significant piece of work”.


She says the bulk of the effort went into completing the CCMM and the DHB found it was quite a difficult model to work with in the New Zealand context because of the large number and variety of community health providers.


She says that by grouping all community providers into one response, some complexity and richness of the sector environment is lost.


CM Health was the first DHB in the Northern Region to complete the assessments and Milmine says the work done will inform the other DHBs, particularly the infrastructure assessment which was completed by shared services provider healthAlliance.


One system that will help the DHB improve its maturity is for Non-DICOM Images and is on the capital plan for next year. This will likely require an RFP process.


“Another key area is around clinical documentation for nursing and allied health staff,” says Milmine.


CM Health plans to implement eProgress notes for electronic clinical notes, which was developed in-house at Waitemata DHB.


“We've also got a piece of work underway across the region, looking at how we can give GPs and other NGOs, not just viewing access into our clinical portal, but the ability to interact and do things as well,” she says.


“We're certainly looking at improving our scores and it doesn't actually take a huge amount of work to progress through the stages pretty quickly once you're on that journey.”


Due to Covid-19, further digital maturity assessments have been delayed.


If you would like to provide feedback on this news story, please contact the editor Rebecca McBeth.


Read more news:

Digital maturity assessments rolled out to all DHBs

Southern DHB’s digital maturity assessment a “healthy exercise”

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