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Patient Safety & Health IT: A Meaningful Moment

Patient Safety & Health IT: A Meaningful Moment. David R. Hunt, MD, FACS Office of Provider Adoption Support Office of the National Coordinator for Health IT. Barbara McClintock (1902 – 1992).

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Patient Safety & Health IT: A Meaningful Moment

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  1. Patient Safety & Health IT: A Meaningful Moment David R. Hunt, MD, FACS Office of Provider Adoption Support Office of the National Coordinator for Health IT

  2. Barbara McClintock (1902 – 1992) “It soon became clear, however, that tacit assumptions -- the substance of dogma-- served as a barrier to effective communication.” Nobel Laureate, Medicine (1983) Nobel Banquet, December 10, 1983

  3. mo·ment (mōיmənt) • n.[ME. < L. momentum, movement, impulse, brief space of time, importance < movimentum < movere, to MOVE] 1. an indefinitely brief period of time 2. a definite point in time 3. a brief time of being important 4. importance; consequence 5. Mech. the tendency to cause motion about a point or axis

  4. Archimedes of Syracuse (287 - 212 BC) 100 10 5. Mech. the tendency to cause motion about a point or axis

  5. Take Home Messages • Meaningful change must be led by clinicians • Meaningful success is wholly dependent on partnership • Transition requires a system, resources, and courage

  6. ensuresthat each patient's health information issecure… improveshealth carequality, reduces medical errors, reduces health disparities… reduceshealth carecosts… provides appropriate information… ensuresthe inclusion of meaningfulpublic input… improvesthe coordinationof care… improves public healthactivities… facilitates healthand clinicalresearchand health carequality;…” Section 3001: The National Coordinator shall develop infrastructure that …

  7. (9)promotesearly detection, prevention, andmanagementof chronic diseases; (10)promotesa more effectivemarketplace, greatercompetition, greater systemsanalysis, increased consumerchoice, and improvedoutcomesin health care services; and (11) improves efforts toreduce health disparities. Cont’d… improve, ensure, reduce, protect, facilitate, promote, improve…

  8. HITECH Act • Define Meaningful Use • Support Attainment of Meaningful Use • Establish Public Trust • Foster Health IT Innovation

  9. EHR Use in U.S. Office-based Physicians dashed = 2009 Preliminary est. Source: CDC/NCHS National Ambulatory Medical Care Survey http://www.cdc.gov/nchs/data/hestat/emr_ehr/emr_ehr.htm

  10. Major Barriers to Adoption of Electronic Health Records DesRoches, V, et. al.; Electronic Health Records in Ambulatory Care — A National Survey of Physicians N Engl J Med July 2008;359:50-60.

  11. Maslow's Hierarchy of Needs Maslow, Abraham (1954). Motivation and Personality.New York:. Harper. p. 236

  12. Health IT Hierarchy of Implementation HIE, Public Health, Efficiency, Research Public Good Adoption & Implementation Engagement Business case, ROI, Financial and Non-financial incentives Incentives & Penalties Functional, Reliable, Interoperable Usable Principles, Policies, Procedures, Protections, Enforcement Privacy

  13. March 14, 2007—Vol 297, No. 10, pg. 1103 “…health care reform must focus on improving health and health care value for patients… …Physicians can lead this change and return the practice of medicine to its appropriate focus: enabling health and effective care.”

  14. March 14, 2007—Vol 297, No. 10, pg. 1103 • Improved individual and population health outcomes • Increased transparency and efficiency • Improved ability to study and improve care delivery “…health care reform must focus on improving health and health care value for patients… …Physicians can lead this change and return the practice of medicine to its appropriate focus: enabling health and effective care.”

  15. Public Heath Nutrition Individual Responsibility Health Literacy Prevention & Chronic Disease Management Education • Improved individual and population health outcomes • Increased transparency and efficiency • Improved ability to study and improve care delivery Meaningful Use of EHRs Medical Education Quality Clinical Research Basic Science Research Payment Reform Comparative Effectiveness Research

  16. Improved individual and population health outcomes • Increased transparency and efficiency • Improved ability to study and improve care delivery Medicare & Medicaid Incentives and penalties Meaningful Use of EHRs

  17. Adoption of EHRs • Improved individual and population health outcomes • Increased transparency and efficiency • Improved ability to study and improve care delivery Medicare & Medicaid Incentives and penalties Meaningful Use of EHRs Exchange of health information

  18. HITECH Act Regional extension centers Adoption of EHRs Workforce training • Improved individual and population health outcomes • Increased transparency and efficiency • Improved ability to study and improve care delivery Meaningful Use of EHRs Medicare & Medicaid Incentives and penalties State grants for health Information exchange Exchange of health information Standards & certification framework Privacy & Security framework Research to enhance HIT Blumenthal D. Launching HITECH. N Engl J Med. 2010 Jan 4. http://healthcarereform.nejm.org/?p=2669

  19. P. Breughel, the Elder, “Turmbau zu Babel,” 1563 Kunsthistorisches Museum, Vienna

  20. Mark Twain 1835-1910 “A man who carries a cat by the tail learns something he can learn in no other way.”

  21. davidr.hunt@hhs.gov202-690-0024 http://healthit.hhs.gov

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