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Explore the role of Health IT in improving healthcare access, quality, and efficiency in rural America. Learn about barriers to adoption and solutions provided by the Office of the National Coordinator for Health Information Technology.
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Bringing Health Information to Life in Rural America ELISABETH HANDLEY, MPA Deputy National Coordinator for Operations, Office of the National Coordinator for Health Information Technology, US Department of Health & Human Services
Today’s Agenda • Health IT and Its Role • Barriers and Solutions • Rural Health Initiative • Questions and Answers Office of the National Coordinator for Health Information Technology
Indiana: A Leader in Health IT Office of the National Coordinator for Health Information Technology
Office of the National Coordinator for Health Information Technology
1. Health IT and Its Role Office of the National Coordinator for Health Information Technology
A Familiar Story: A Broken System COST $Billions in unnecessary and wasteful spending QUALITY Despite rapid advances, thousands of patients die each year from medical error COVERAGE 51 million uninsured; many more underinsured Office of the National Coordinator for Health Information Technology
Chasing fees. “It’s thornlike in appearance, but I need to order a battery of tests.” 7 Office of the National Coordinator for Health Information Technology
Moving past Hippocrates • Information: • lifeblood of medicine. • We manage information as Hippocrates did in 400 B.C. • Health IT: • The circulatory system of modern health care. Office of the National Coordinator for Health Information Technology
How many physicians learned to practice medicine: Office of the National Coordinator for Health Information Technology
How the next generation will practice medicine Office of the National Coordinator for Health Information Technology
More practically: EHR: Electronically capturing and processing information about patients HIE: Exchanging health information CDS: Improved care decisions Office of the National Coordinator for Health Information Technology
2. Barriers and Solutions Office of the National Coordinator for Health Information Technology
Major Barriers to EHR Adoption Percent of physicians reporting a “major barrier” Source: DesRoches CM et al. Electronic health records in ambulatory care—a national survey of physicians. N Engl J Med. 359(1):50-60, 2008 Jul 3. Office of the National Coordinator for Health Information Technology
The Federal Government’s Response: HITECH ACT Part of American Recovery and Reinvestment Act of 2009 (ARRA). Comprehensive approach Economic incentives Care improvement Quality measurement Reward “Meaningful use” of electronic health records Office of the National Coordinator for Health Information Technology
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Conceptual Approach to Meaningful Use 2015 2013 2011 Healthit.hhs.gov Office of the National Coordinator for Health Information Technology
Meaningful Use Summary Office of the National Coordinator for Health Information Technology
Meaningful Use Examples for Eligible Health Professionals and Eligible Hospitals Core Set Menu Set 18 • Use CPOE • Implement drug-drug, drug-allergy, drug-formulary checks • Maintain an up-to-date problem list • Maintain active medication list • Maintain medication allergy list • Record demographics • Record and chart changes in vital signs Incorporate clinical lab-test results into EHR as structured data Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, and outreach Report ambulatory quality measures to CMS Office of the National Coordinator for Health Information Technology
Office of the National Coordinator for Health Information Technology
HITECH ACT – Addressing Barriers Bipartisan support for key components Addresses major barriers through: Financial provisions, market reform. Technical assistance, support . Standards Health information exchange Privacy and security. Office of the National Coordinator for Health Information Technology
HITECH FRAMEWORK: MEANINGFUL USE Regional Extension Centers ADOPTION Improved Individual and Population Health Outcomes Increased Transparency and Efficiency Improved Ability to Study and Improved Care Delivery Workforce Training Medicare and Medicaid Incentives and Penalties MEANINGFUL USE State Grants for Health Information Exchange EXCHANGE Standards and Certification Framework Privacy and Security Framework Research to Enhance Health IT Beacon Community Program Office of the National Coordinator for Health Information Technology
Financial provisions • Medicare/Medicaid incentives: $9-27 billion starting 2011. • Physicians: $44,000/$63,750 over 5-10 years. • Penalties starting in 2015. • Hospitals: $2M bonus plus extra DRG payments. • Support for adoption: $2 billion to Office of National Coordinator for Health Information Technology (ONC). Office of the National Coordinator for Health Information Technology
Technical Assistance with Adoption • $693 million • 62 Regional Extension Centers covering entire U.S. • Health Information Technology Research Center. • $118 million • Training over 40,000 new health IT support personnel • First class graduated 9/10 from UT Austin. Office of the National Coordinator for Health Information Technology
The Health Information Technology Research Center • $50 million to help Regional Extension Centers identify and share best practices in: • EHR adoption • Meaningful use • Provider support Office of the National Coordinator for Health Information Technology
Health Information Exchange • Laying the Basic Foundation • Multi-faceted approach: • Setting standards and certification criteria • Providing local leadership • Supporting exchange of information through the Nationwide Health Information Network (NHIN) Office of the National Coordinator for Health Information Technology
State Health Information Exchange Program • $564 million • Promote HIE through State leadership Office of the National Coordinator for Health Information Technology
Nationwide Health Information Network NHIN Exchange NHIN Direct Office of the National Coordinator for Health Information Technology
Privacy and Security as a Foundation. Health IT Outcomes Privacy & Security Office of the National Coordinator for Health Information Technology
FEDERAL GOVERNMENT’S ROLE:Privacy & Security Banned sale of health information without consent. Federal activity in enforcement Expanded patient rights to access their information Improved encryption technology to prevent breaches MORE to COME Office of the National Coordinator for Health Information Technology 29
Workforce • ONC allocated $84 million • Community College Consortia to Educate Health Information Technology Professionals, $36 million • University-Based Health IT Training, $32 million • Curriculum Development Centers, $10 million • Competency Examination Program, $6 million Office of the National Coordinator for Health Information Technology
Remaining challenges HITECH a great start, but many challenges to implementation. Getting regional centers up and running Assuring infrastructure for exchange Training necessary workforce Defining future stages of meaningful use Sustaining economic incentives for adoption and meaningful use Office of the National Coordinator for Health Information Technology
3. Rural Initiative Office of the National Coordinator for Health Information Technology
Rural providers’ barriers to adoption Broadband access Financing Personnel and expertise Office of the National Coordinator for Health Information Technology
Reducing Rural Health IT Disparities Need to address the specific needs of rural healthcare providers Office of the National Coordinator for Health Information Technology
Federal Resources that Benefit Rural Healthcare Providers ONC programs, resources, and initiatives Regional Extension Centers Critical Access Hospital Supplement Communities of Practice State Health Information Exchange Workforce Training Beacon Community Program Health Resources and Services Administration programs Centers for Medicare and Medicaid programs Indian Health Service programs Office of the National Coordinator for Health Information Technology
Coordination of Federal Resources Continued US Department of Agriculture Community Facilities Program Programs that support the development of broadband infrastructure Federal Communications Commission Rural Health Care Support Mechanism Office of the National Coordinator for Health Information Technology
5. Thinking Outside the Box • Be part of this inevitable revolution in modern medicine. Office of the National Coordinator for Health Information Technology
7. QUESTION & ANSWER Office of the National Coordinator for Health Information Technology 38