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HIT Policy Committee Meaningful Use Workgroup Presentation to HIT Policy Committee. Paul Tang, Palo Alto Medical Foundation, Chair George Hripcsak, Columbia University, Co-Chair June 8, 2011. Workgroup Membership. Co-Chairs: Paul Tang Palo Alto Medical Foundation
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HIT Policy CommitteeMeaningful Use WorkgroupPresentation to HIT Policy Committee Paul Tang, Palo Alto Medical Foundation, Chair George Hripcsak, Columbia University, Co-Chair June 8, 2011
Workgroup Membership Co-Chairs: Paul Tang Palo Alto Medical Foundation George Hripcsak Columbia University Members: • David Bates Brigham & Women’s Hospital • Michael Barr American College of Physicians • Christine Bechtel National Partnership/Women & Families • Neil Calman Institute for Family Health • Art Davidson Denver Public Health • Marty Fattig Nemaha County Hospital • James Figge NY State Dept. of Health • Joe Francis Veterans Administration • David Lansky Pacific Business Group/Health • Deven McGraw Center/Democracy & Technology • Judy Murphy Aurora Health Care • Latanya Sweeney Carnegie Mellon University • Karen Trudel CMS • Charlene Underwood Siemens
Agenda • Context • Alignment with National Quality Strategy • Timing proposal • Revised recommendations to HITPC—incorporating: • May 11 HITPC feedback • Additional public hearing • Specialists issues • Early experience from the field • Next steps • Recommendations to ONC • Requests for HIT Standards Committee (HITSC)
Key Principles Driving Stage 2 Recommendations • Align Meaningful Use (MU) objectives with National Quality Strategy priorities • Ensure MU lays adequate HIT infrastructure to achieve delivery system changes required for Affordable Care Act (ACA) reforms • Ensure technical and implementation feasibility • Encourage and reward early adopters
Escalator Principle: Slope = Rise/Run Data Capture & Sharing Add in key elements of NQS/delivery system reforms
EHR Core Functionalities Lay Foundation for Better Outcomes EHR Core Functionalities
Reminder of Stage 2 Timing IssueTiming of EHR Certification and MU Stage Objectives
Draft Timing OptionsRelative Impact on Program Attributes • Maintain current timeline and one-year EHR reporting period; or • Maintain current timeline and permit 90-day EHR reporting period; or • Delay transition from stage 1 to stage 2 by one year only for providers who qualify for MU in 2011 ++ = implementing this option strongly supports this attribute; + = implementing this option supports this attribute 0 = implementing this option has relatively no impact on this attribute; - = implementing this option negatively impacts this attribute; -- = implementing this option has a significant negative impact on this attribute
Draft Stage 2 MU ObjectivesImproving Quality, Safety, Efficiency & Reducing Disparities
Draft Stage 2 MU ObjectivesImproving Quality, Safety, Efficiency & Reducing Disparities, II
Draft Stage 2 MU ObjectivesImproving Quality, Safety, Efficiency & Reducing Disparities
Draft Stage 2 MU ObjectivesImproving Population and Public Health
Draft Stage 2 MU ObjectivesEnsure Privacy and Security Protections
Priorities for the Health IT Standards Committee • Demographics--Stage 3 includes expansion of existing fields • CDS attributes for certification • Display source/citation of CDS • Configurable based on patient context (e.g., problems, meds, allergies, lab results) • Presented at a relevant point in clinical workflow • Alerts presented to users who can act • Integrated with EHR (ie., not standalone) • eMAR attributes for certification • 1) Check for right patient • 2) Check right medication • 3) Check right dose • 4) Check right route • 5) Record time medication administered • View and capability to download information • 1) Track number of views • 2) Track number of downloads • 3) Electronically counted for compliance and measurement • Summary of care record/plan: Stage 2 includes additional data elements • to be included in the record/plan
Priorities for the Health IT Standards Committee • Hospital labs provide structured electronic lab results in LOINC, where available • PH objectives: consider a single standard to be used for the submission of all public health data • PH objective of submitting reportable cancer conditions: Possible use of IHE cancer reporting implementation guide • Timely Electronic Access: P&S Tiger Team consider including a warning message before downloading personal health information
Priorities for the Health IT Standards Committee for • Privacy and Security • Standards for recording family history • Patient-generated data submitted to public health agencies • Add new fields in demographics per IOM report • Capability to retrieve AD from EHR • Mechanism for patient entered data • Single factor authentication (user and password) for patient online account • Audit trails for access to patient online account • Provisions for data provenance • View and download function should be secure • Compliance with NWHIN governance policies should be included in Stage 3 certification criteria. Stage 3
Summary Recommendations • Delay transition from stage 1 to stage 2 by one year only for providers who qualify for MU in 2011 • Approve recommendations for stage 2 Meaningful Use objectives • Refer stage 2 objectives to HITSC for recommendations on applicable standards