Presentation

The Evidence-Based EPR Benefits and Cost Model
A presentation to the The Northern, Yorkshire and Humberside NHS
Directors of Informatics Forum
Sean Brennan
Evidence-Based EPR Benefits Model
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Background
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Who are Inform Health & Associates?
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What is the EPR Benefits Model ?
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How can the model be used by Trusts/Health Boards?
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Further Information?
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www.informhealthassociates.co.uk
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Background
Inform Health & Associates Ltd - EPR Benefits and Cost Model
All our yesterdays !
Linking the Benefits to each
level of an incremental EPR
started in 1998.
EPR 6 level model 1998: Target 1
Level
6
Multimedia / Telematics
Level
5
Specialty modules / Document Imaging
Level
4
Decision support/ Clinical Guidelines
Access to Knowledge
Level
3
Order entry/Results reporting/Electronic
Prescribing/Integrated Care pathways
Level
2
Integrated departmental systems
Labs/X-ray/Pharmacy/Theatre
Level
1
PAS/MPI/ Departmental systems
By Year 2002 ?
33%
EPR 6 level model 1998: Target 2
Level
6
Multimedia / Telematics
Level
5
Specialty modules / Document Imaging
Level
4
Decision support/ Clinical Guidelines
Access to Knowledge
Level
3
Order entry/Results reporting/Electronic
Prescribing/Integrated Care pathways
Level
2
Integrated departmental systems
Labs/X-ray/Pharmacy/Theatre
Level
1
PAS/MPI/ Departmental systems
By Year 2005 ?
100%
EPR 6 level model 1998: The Reality
Level
6
Multimedia / Telematics
Level
5
Specialty modules / Document Imaging
Level
4
Decision support/ Clinical Guidelines
Access to Knowledge
Level
3
Order entry/Results reporting/Electronic
Prescribing/Integrated Care pathways
Level
2
Integrated departmental systems
Labs/X-ray/Pharmacy/Theatre
Level
1
6%
PAS/MPI/ Departmental systems
In 1999 ( ie when Information for Health published)
The EPR CD Rom
The multi-media EPR
CD Rom attempted to identify the
benefits of each incremental Epr
development level.
The EPR benefits model has been
developed over the last decade
and more specifically with Inform
Health team in the last three
years.
Inform Health & Associates Ltd - EPR Benefits and Cost Model
NHS
Currently *
HIMSS have
adopted the
same
incremental
levels approach
to ‘growing’ an
EPR
0%
1%
47%
4%
* source: cohort of NHS
sites used for the
investigation by HIMSS
assessment of NHS
hospitals’ IT maturity
using its EMRAM data
(Electronic Medical
Record Adoption Model),
9%
16%
15%
8%
Inform Health & Associates Ltd - EPR Benefits and Cost Model
How are countries doing?
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Another Maturity Index !
Another
maturity index
(?initially EHI
and now
adopted by NHS
England) has
TWO
dimensions:
Level of maturity
and depth of
take-up at each
level
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Benefits and Digital/System Maturity
We need a process to enable us to anticipate, with a
level of confidence, the benefits that this increasing
maturity of an EPR will bring.
The benefits model must be based on evidence and
locally tailored to suit contexts/business.
It is sometimes difficult to assign a specific benefit to a
particular change but the model allows adjustments
when a benefit may be the result of multiple changes in
practice.
The EPR model can support Options Appraisal or
Business Case development or for those who are
already in an implementation provide a degree of
rigour to Benefits Realisation.
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Who are Inform Health &
Associates?
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Who are Inform Health & Associates?
A small but highly experienced healthcare
informatics consulting firm established in 2013.
We only utilise Associates with exceptional NHS
experience, typically with CIO or Director
backgrounds.
We will only assign Associates that meet our
stringent criteria
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Supporting Trust Informatics Strategies

Inform Health & Associates provide specialist and experienced
support in the area of Trust Informatics Strategies, including option
appraisals, cost benefits of EPR options and Business Case
development.

To date we have provided these type of services to numerous Trusts
including the following:
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University Hospital of South Manchester & South Sector Group
Royal Liverpool & Broadgreen University Hospitals
University Hospitals of Morecambe Bay
Calderdale & Huddersfield NHS Foundation Trust
University Hospitals of North Midlands
Wirral University Teaching Hospital
At the core of our offering is the UK’s most advanced EPR Benefits
and Cost Model and Business Case collateral.
Inform Health & Associates Ltd - EPR Benefits and Cost Model
What is the EPR Benefits
Model?
EPR Options Appraisal Process – Benefit and Cost Model
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Inform Health Provide Overview of the Model to Trust
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Model provides starter set assumptions and evidence where possible
Set up Benefits Model for Trust
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Acute or Community Wide Option
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Agree Supplier/Strategic Options to Evaluate

Trust Supply their activity, financial and manpower data, plus current IT
system costs that will be displaced by EPR
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Review and amend each EPR benefit assumption of impact

Supplement with benefit studies and transformation work

Have any of these benefits been achieved already by existing systems
or other planned solutions eg EPMA benefits?

Review and amend phasing of benefits delivery over the 10 years by
supplier if required
Inform Health & Associates Ltd - EPR Benefits and Cost Model
EPR Benefits – Example Vignettes Provided
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Inform Health & Associates provide as part of the EPR Benefits
Model example ‘Vignettes’ that help Trusts assess their potential
benefits from EPR

Vignettes look at what a current pre EPR workflow would look like, then
compare to a workflow after the introduction of an advanced EPR.

Pre and post benefits are then calculated based on a standard acute
hospital
Examples of EPR Benefit Vignettes are provided on the web site, go
to www.informhealthassociates.co.uk
Inform Health & Associates Ltd - EPR Benefits and Cost Model
EPR Options Appraisal – Benefits Model

Supplier/Solution Evaluation allows each EPR benefit to be
profiled with:

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Level of confidence (%) the solution will deliver that benefit
This Level of Confidence can be driven by a more detailed structured
assessment. For example by assessing solutions by up to 6 categories
 Usability
 Assessment of UK Functionality
 Confidence in the Company to Deliver etc
 Trusts can define up to 6 categories and their weightings
Supplier/solutions can have different benefit delivery time profiles
Supplier/solutions can have different cash releasing delivery time profiles
Various EPR Benefit Reports provided based on Trust data
and assumptions
Inform Health & Associates Ltd - EPR Benefits and Cost Model
EPR Options Appraisal – Benefits Model
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Benefits are Grouped under 6 headings:
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Staff Efficiency
Non Staff Savings
Clinical Quality & Practice Variation
Length of Stay, Readmissions & Demand Management
IT Displaced Costs
Income
Benefits Delivered to be Categorised into Types:

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Cash Releasing
More Time for (or improvements in) Patient Care
Increased Capacity
Improved Income
Cost Avoidance
Inform Health & Associates Ltd - EPR Benefits and Cost Model
EPR Options Appraisal – Cost Model
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EPR Cost Model:
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EPR Benefits and Costs Brought Together
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Estimated Contract Costs for main suppliers
EPR Programme Staffing Model calculates expected increase in EPR
staff by supplier option over the 10 years
Training Costs calculated
Procurement/preparation costs and data migration costs
Investment in hardware etc
NPV calculations
Various Reports, including relative costs and benefits of different
solutions
Benefit and Cost Outputs Feed EPR Outline Business Case if
Required
Inform Health & Associates Ltd - EPR Benefits and Cost Model
EPR Benefits Model Menu I
BACKGROUND

Set Up

Data & Assumptions

Benefits & Phasing

Supplier Evaluation
QUALITY & EFFICIENCY

Efficiency

Clinical Quality

Displaced IT Costs

Summary
Inform Health & Associates Ltd - EPR Benefits and Cost Model
EPR Benefits Model Menu II
BENEFITS
COSTS
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Suppliers by year
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Cost Analysis
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Cash Released Plan by year

Supplier Costs Estimation

Benefits & High Projection

Staffing

Cash Benefits by Supplier

Training

Non Cash benefits by
Supplier

Data Migration

Procurement and prep costs

Supplier Costs

Benefits Realisation Plan

Costs & Benefits

Costs & Benefits summary
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Using the EPR Benefits
Model?
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Using the EPR Benefits Model

EPR Options Appraisal
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EPR Business Case development
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EPR Cost Benefits

EPR Strategies
Inform Health & Associates Ltd - EPR Benefits and Cost Model
How does it work?
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Initial walk-through of model. No obligations.
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Once signed up then:
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IH&A provides an overview of the model and provides starter set
assumptions and evidence where possible.
‘Localising’ the model through meetings with IH&A consultants and:
 Nursing staff
 AHP
 Medical Staff
 Senior Managers
 Transformational change
 Anyone else as indicated
Data Assumptions sheet completed
Follow-up meetings
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Outputs/Conclusions

Reports generated by the IH&A team

Reports/results presented to Trust
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Do you want further
information?
Inform Health & Associates Ltd - EPR Benefits and Cost Model
Additional Information :
Contact:
Alan Spours
Or Sean Brennan
Managing Director
sean@eprarms.com
Inform Health & Associates Ltd
aspours@inform-health.co.uk
07585 807959
www.informhealthassociates.co.uk
Inform Health & Associates Ltd - EPR Benefits and Cost Model

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