Similar to the well-known EMR Adoption model, HIMSS analytics in Europe, in partnership with the European Society of Radiology (ESR), introduced at the 2016 ECR congress a digital imaging adoption model (DIAM) which promises to be a great model for institutions to benchmark their progress with regard to implementing a healthcare imaging IT strategy. The model is quite comprehensive, it is defined using a scoring system of over 100 indicators from 10 focus areas, i.e. Software Infrastructure, Health Information Exchange, Workflow and Process Security , Quality and Safety Management, Patient Engagement, Clinical Documentation, Clinical Decision Support, Pervasiveness of Use, Advanced Analytics and Personalized Medicine. The model is currently being tested and piloted in several institutions in Europe in its initial phase.
The different stages include the following:
Stage 0: Baseline, no electronic image management is present. Note that this does not mean that there are no digital modalities, but, rather, the information is not archived and actively managed.
Stage 1: Orders are electronically exchanged and available at the modalities. Images are exchanged and managed and reports are available and distributed electronically as well. All this is only on a departmental level, e.g. within radiology or a clinic.
Stage 2: The images are shared and available at the enterprise level for other physicians and specialties, for example through web access, or as a plugin on an EMR.
Stage 3: Workflow and process security is provided through status and change management so that the right images are available for the right patient at the right time. Quality measures are implemented such as peer reviews and critical result reporting and security and privacy controls such as audit trails are implemented.
Stage 4: Fully integrated image management at the enterprise level is provided through a Health Information Exchange, which can be private, i.e. managed by the enterprise. An enterprise can span multiple hospitals and clinics. Structured documentation is provided for measurements and other observations.
Stage 5, 6, and 7 include the following:
· Advanced HIE functionality and Patient Engagement: A regional, typically a public HIE facilitates image exchange among practitioners, and patients are engaged such as through a portal.
· Clinical Decision Support and Value based imaging: this provides feedback to a physician at time of ordering about the appropriateness of a procedure based on the patient preconditions, history and using practice guidelines.
· Advanced analytics and personalized medicine: this allows for patient personalized or precision medicine based information to be used.
This model is a great tool for institutions as well as the user community as it will rank the level of imaging adoption. The next phase will potentially include non-European countries and include other non-radiology services. Hopefully it will be rolled out and take hold in the US and other countries soon as it can be a major differentiator between the various institutions.