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By Bruce Winzar, Executive Director Information Services & CIO, Bendigo Health

Rome wasn’t built in a day, and the same could certainly be said for an electronic medical record (EMR) system. It’s a journey rather than a project – but at Bendigo Health in Victoria, Australia, the most difficult part of the process isn’t the EMR implementation. Rather, it’s building the business case, identifying the benefits, defining the key performance indicators (KPIs) and establishing governance around it.

At the beginning of this year, we moved into the new Bendigo Hospital. It’s the largest regional hospital development in the state of Victoria, with 3,500 rooms and approximately 500 beds for in-patient, same-day and mental health patients. Implementation of our new EMR and clinical information system started over a year ago, and is expected to go live at the end of 2017.

However, building the business case for the EMR started over five years ago and the benefits realisation

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Dr. John Payne, cardiologist and InterSystems physician executive for Scotland

The benefits of the electronic health record (EHR) are well established in the eHealth community; they serve as a critical tool for improving patient safety, care connectivity and clinical outcomes.  However, while the EHR is a key component of digital maturity ambitions in hospitals across the world, there is still more work to be done to educate those in the medical community on what it means to implement and effectively  use the technology to improve the way that we deliver care.

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I am the first to admit the value of claims for analytics and reporting.  Many years ago when I managed the analytics department for two different managed Medicaid plans, claims data was our bread and butter.  We had best of breed systems, ETL, a data warehouse, data marts and a team of hotshot analysts.  We were able to create cost and utilization reports, identify our high flyers, look at the performance of our provider network through HEDIS measures, and even do risk prediction with a set of tools based on claims.

However, that was back when we were paying fee for service, and lived in a largely paper-based clinical world.  Even though our internal team of analytics generated our HEDIS measures, we still needed to send out a flotilla of contracted nurses to do the chart reviews for the hybrid measures.

We are still physicians at heart.

This is my primary takeaway and personal realization from a recent executive roundtable with five other physicians who also happened to be healthcare executives. We were meeting to discuss value-based care transformation efforts from the perspective of the physician executives driving them.

As an emergency physician myself, I soon realized that we all were coming from a place where “the patient in front of me now is what matters.” So, yes, as physicians first, these executives suggest framing value-based care for staff physicians as a path toward clinical improvement.

Thirty years ago, interoperability was a lot simpler. If you could exchange data between two IT systems, you had interoperability. But in the 3 decades since, the amount of data and the number of sources of data for an individual or a population have both increased exponentially. Now interoperability is about accessing data across many systems, both inside and outside the organization, as a single, concordant view, and presenting it to clinicians in a way that is usable and actionable in their workflows.

FHIR – HL7 Fast Healthcare Interoperability Resources – is quickly becoming the foundation for the future of interoperability. The FHIR standard has the ability to provide vastly simplified, accelerated, and effective clinical information sharing between systems, and it’s creating opportunities for tremendous innovations in the healthcare IT industry.