HIMSS Studies in Turkey
Turkish Republic Ministry of Health (MoH) has taken important steps since 2003, which was started by the Health Transformation Program, showing that the meaningful use of the Electronic Health Record (EHR) is very well understood. In 2003, there was no Hospital Information System (HIS) in almost any public hospital; the expansion of HIS and its scope and the increase in the level of usage of it have been extended to 2010 and the usage level in hospitals has reached 100%. However, realizing that the presence and use of HIS does not mean that the EHR is used effectively for patient safety and health service quality. MoH contacted to HIMSS in 2013 and completed the necessary preparations and Ankara Gazi Mustafa Kemal Public Hospital had Stage 6 certificate in May 2013. MoH, which informed the hospitals about HIMSS EMRAM model with a workshop held in September 2013, signed a cooperation protocol with HIMSS in November 2013 to be valid for 5 years. Within the scope of this protocol, HIMSS was requested to conduct surveys in all public hospitals at least twice in accordance with the EMRAM model, and to visit hospitals in levels 6 and 7 to perform on-site evaluation.
HIMSS built a team in Turkey for both activities; HIMSS Analytics studies and HIMSS Conference. In 2013-2015, 567 participants from public hospitals were trained to fill the questionnaire according to the EMRAM model. Three HIMSS conferences were held between the years 2013-2016. During the same period 15 public hospitals were accredited as Stage 6 and 1 hospital as Stage 7. However, at the beginning of the 2017, HIMSS distinguished to divide the activities in Turkey into two distinct parts. HIMSS made two separate agreements for conducting HIMSS analytics activities such as surveying according to the EMRAM model, training and validation visits, etc. with Istanbul Medipol University and Ekspoturk organizing the HIMSS conference and events in Turkey.
In 2017, 10 separate workshops were held between 25 May and 31 July 2017, involving the managers of 771 hospitals (approximately 2,500 directors). These workshops were turning points for our hospitals and were held in İzmir, İstanbul, Ankara, Bursa, Erzurum, Tokat, Kahramanmaraş, Mersin, Afyonkarahisar, Siirt and Ankara,. In these workshops where the managers of our previously Stage 6 and 7 hospitals shared their own experiences, our hospital managers realized that the current status of their own hospitals was not too far from EMRAM Stage 6 and those steps to be taken were not difficult. After each workshop, serious efforts and rapid progress were observed in the participating hospitals. In this way, approximately 250 surveys were completed before the end of 2017, and 154 hospitals were validated as the Stage 6 standards. Apart from these workshops, a workshop was held in 9 June 2017 with HIS companies, which is an important shareholder in the process, and information about the requirements was shared.
At the base of Ministry’s cooperation with HIMSS was an important gain in measuring its own status in a meaningful use of the EHR and using it for policy-making as well as comparing it with other countries. When we look at it from this perspective, total number of Level 6 hospitals in Turkey quite left Europe behind in terms of the number of hospitals in the world and seems to settle Turkey in second place after the United States. (Note: The reason why the total number of validations is still higher than the number of hospitals in Stage 6 is that the validity of some hospitals was validated after the validity period of 3 years).
 HIMSS, “HIMSS EMRAM Stage 6/7 Community.” [Online].
http://www.himss.eu/communities/himss-emram-stage-6-7-community. [Access: 11-Jan-2018].
What is waiting for us in 2018?
The requirements of the stages in HIMSS EMRAM have changed by 2018. Surveys organized according to the new standards are aimed at serving users by April 2018 at the latest. Immediately afterwards, as planned in 2017, regional workshops are planned, with the aim of raising awareness of new standards and coordinating preparations. The HIMSS event, which lasts for four years in a national congress atmosphere, is a big event that will bring delegates from more than 40 countries this year. This event, planned to be organized in Istanbul on 25-27 October 2018, is named HIMSS Eurasia (https://himsseurasia.com/). In this way, Turkey’s momentum achieved with the Health Transformation Program will move further with the steps taken in improving the health of the technology and would be a good model for the countries in the region. We will have dozens of hospitals that have started their preparations for Stage 6 in 2017 and have made significant progress, will be re-filled by 2018 and will be rated according to new criteria. According to the questionnaires, on-site visits will be performed and validations will be carried out for our hospitals with Stage 6.