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Stage 1 2011-12

Meaningful Use objectives and standards will change over time, focusing today on structured data and exchange. Stage 3 2014-15. Stage 2 2012-13. Stage 1 2011-12. Better clinical outcomes Improved population health outcomes Increased transparency and efficiency Empowered individuals

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Stage 1 2011-12

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  1. Meaningful Use objectives and standards will change over time, focusing today on structured data and exchange Stage 3 2014-15 Stage 2 2012-13 Stage 1 2011-12 • Better clinical outcomes • Improved population health outcomes • Increased transparency and efficiency • Empowered individuals • More robust research data on health system • Standards will be become higher in Stage 2-3 • Menu items will become Core objectives

  2. HIE Building Blocks • Community record Does require some type of centralized storage of data Shared services • Secure routing to public health and patients Does not require central storage of clinical data • Secure routing among providers Increasing cost Increasing complexity Increasing value potential NH HIEPI Steering Committee Meeting v0.1

  3. Lab results delivery • Prescribing & Medication Reconciliation • Health summaries for continuity of care • Quality & immunization reporting, if available 2011 • Substantially steps up exchange • Provider to lab • Pharmacy to provider • Office to hospital & vice versa • Office to office • Hospital/office to public health & vice versa • Hospital to patient • Office to patient & vice versa • Hospital/office to reporting entities • Registry and public health reporting • Claims and eligibility checking • Electronic ordering • Receive public health alerts • Home monitoring • Populate PHRs 2013 • Access comprehensive data from all available sources • Experience of care reporting • Medical device interoperability • Starts to envision routine availability of relatively rich exchange transactions • “Anyone to anyone” • Patient to reporting entities 2015 Meaningful Use and Health Information Exchange Meaningful Use objectives facilitated by health information exchange: • MU Phase 1 does not require the use of a centralized HIE activity, it just requires that certain HIE transactions are performed • Increases volume of transactions that are most commonly happening today • Lab to provider • Provider to pharmacy • Summary of care record is new process step

  4. Federal Advisory Group Recommendations for MU Stages 2 & 3 • Proposed Stage 2 and 3 requirements increase the existing HIE requirements and add some new ones • May begin to see standards for transport as well as content • May allow connection to a centralized HIE to count as fulfillment toward a number of HIE requirements

  5. How will individual clinical users get “interoperable” today? ? User 1 User 2 • Existing retail applications (e.g., secure email, encrypted file transfer) • Proprietary directed exchange (e.g., eCW P2P, Epic Care Everywhere) • NwHINDirect • National HIE services (Verizon, AT&T, Surescripts, other??) • IDN/Hospital/IPA/PHO health information exchange • State/regional cross-entity health information exchange

  6. NwHIN Components & Links NwHINConnect NwHINlimited production NwHINDirect NwHINGateway http://www.nationalehealth.org http://wiki.directproject.org/

  7. Health Center Controlled Network Identifying areas where NH HIO could provide value

  8. Large Hospital System Identifying areas where NH HIO could provide value (DRAFT)

  9. Office Visit Opt-In Match MPI Encounters Demographics Import / Export* Dept. Reports Lab / Rad PACS Other Diagnostic Demographics Export* Opt-In Match MPI Hospital Records NBeHC Health Information Exchange… 14 Practices – EHR’s Note smile! Provider Merged eHealth Summary – eHX / CCR Patient Acute Care * Filtered by per occurrence consent items (HIV & Genetic Testing)

  10. March 13, 2010 What Affects Clinicians’ Usage of Health Information Exchange? Robert S. Rudin Steven R. Simon Lynn A. Volk David W. Bates Key words: health information exchange, electronic health records, interoperability Word Count: Abstract 100, total 4418

  11. There are Factors that affect HIE use and Adoption… Legal / Privacy Some states have statutory restrictions on collaborative HIE activities HIPAA & HITECH HIE Capability Full HIE Use & Adoption Patient Level of Participation Richness of information Timeliness of information Ease of use / access Connectivity outside the area Communication Challenges Visit Patterns Complex conditions Willingness to participate Physician Competing sources of information No patient crossover – specialty Adoption and awareness Workflow modifications PCP’s not accepting new patients Time constraints

  12. HITECH – how the pieces fit together! Regional Extension Centers Workforce Training ADOPTION Improved Individual & Population Health Outcomes Increased Transparency & Efficiency Improved Ability to Study & Improve Care Delivery MEANINGFUL USE Medicare and Medicaid Incentives and Penalties State Grants forHealth Information Exchange Standards & Certification Framework Privacy & Security Framework EXCHANGE 14

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