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Bridging the Chasm. Nina Schwenk, MD FACP Washington DC April 20, 2009. Meeting Goals. Establish the value of standards and interoperability to the clinical community Identify priorities from a clinical perspective Have clinicians clearly articulate their requirements in non-technical terms
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Bridging the Chasm Nina Schwenk, MD FACP Washington DC April 20, 2009
Meeting Goals • Establish the value of standards and interoperability to the clinical community • Identify priorities from a clinical perspective • Have clinicians clearly articulate their requirements in non-technical terms • Identify common processes by which the specialty groups can define and communicate information requirements to the HIT community
Health Care Information Technology Standards & Interoperability SummitNovember 18 - 20, 2008 Providers invited to summit included: • Mayo Clinic • Ochsner Health System • Palo Alto Medical Foundation • Partners Healthcare • University of Pittsburgh Medical Center • Vanderbilt Medical Center • Virginia Mason Medical Center • Cleveland Clinic • Dartmouth • Health Partners • Henry Ford Health System • Kaiser Permanente • Intermountain Healthcare • Lahey Clinic
Health Care Information Technology Standards & Interoperability SummitNovember 18 - 20, 2008 Vendors invited to summit included: • IBM • Intel • Lawson • McKesson • Microsoft • Oracle • Siemens • Sun Microsystems • Avaya • Cerner • Cisco • Dell • Epic • GE Health Care • Google • Hewlett Packard
Summit Goal Through a consensus process identify three to six health care IT-dependent solutions that will overcome critical barriers to patient-centered health care delivery through increased interoperability and application of established national and international standards. Engage participating provider and IT partner groups to work collaboratively to develop these solutions.
Agenda • Barriers to Patient-Centered Care Delivery • Using Health IT to Advance Health Care Reform: Moving Beyond Theory to Pragmatic Solutions • Dr. Robert Kolodner • Engaging Health Care IT to Reduce Barriers to Patient-Centered Care Delivery • Creating an Action Plan for Providers
Which of these statements best describes theU.S. health care system today? (select one) • Complete state of crisis • Overall – major problems • Some segments with major problems • Few segments with major problems • No significant problems
Rank these entities on the degree they would influence health reform:(Rank each item 1 to 10 with 1 being no influence, 10 being major influence) Federal government State government Health care providers Health care payers Employers/non-health organizations Consumers/individuals
In your opinion, how much influence do you think the following groups have had on increasing medical costs in the United States?(Rank the list in order of influence) • Doctors and hospitals • Drug companies • Medical technology companies • Insurance companies • People who don’t take care of themselves
Difficulty In the next 100 days, how difficult/important will it be for President Elect Obama to address the following topics:(Rank each item 1 to 10 with 1 being not difficult,10 being very difficult) • Healthcare • War • Illegal immigration • Automaker bailout • Banking bailout • Foreign Policy
Importance In the next 100 days, how difficult/important will it be for President Elect Obama to address the following topics:(Rank each item 1 to 10 with 1 being not important, 10 being very important) • Healthcare • War • Illegal immigration • Automaker bailout • Banking bailout • Foreign Policy
Importance Difficulty
Barriers to Patient-Centered Care Delivery • Health Care Reform Cornerstones • Creating Value • Coordinated Care • Payment Reform • Health Insurance for All
Barriers to Patient-Centered Care Delivery • Perspectives • Patient • Provider • Purchaser • Payer
Using Health IT to Advance Health Care Reform • “Moving Beyond Theory to Pragmatic Solutions” • Dr. Robert Kolodner
Overview of the Federal Health IT Strategic Plan • Establish a governance structure that coordinates organizational processes • Protect the privacy and security of patient health information • Enable the movement of health information by setting standards that allow interoperability • Promote adoption of technologies • Establish a nationwide health information network
* Information Sharing & Exchange* Standards & Interoperability
Engaging Health Care IT to Reduce Barriers to Patient-Centered Care Delivery
Health Care Ecosystem Today Patients Government Providers Compliance Purchasers Regulators Payers Industry
Business Case for “Interoperable”Health Care Ecosystem • Value • Cost • Coordinated Care • Innovation • New Business Opportunities • Effectiveness and Efficiency • Intelligence gathering • Market
Personal Health Record Patient Provided Information Vocabulary Universal Patient Identifier Clinical Data Architecture Standard, interoperable core medical information Affordability to purchasers and patients/efficiency Standard measures of value Safety (clinical quality) Coordination of care Device manufacturer standardization Clinical decision support tools Medication reconciliation Standardized network-to-network interoperability Infrastructure vendor collaboration EMR vendorcollaboration Health Care IT Dependent Opportunities
Patient Centered (Rank each item 1 to 10 with 1 being low priority, 10 being high priority) Personal Health Record Patient provided information Vocabulary Universal patient identifier Clinical data architecture Core medical information Affordability to purchasers and patients /Efficiency Standard measures of value Safety (Clinical quality) Coordination of care Device manufacturer standardization Clinical decision support tools Medication reconciliation Standardized Network-to-network interoperability Inter-organizational interoperability Infrastructure vendor collaboration EMR vendor collaboration
Business Value (Rank each item 1 to 10 with 1 being low priority, 10 being high priority) Personal Health Record Patient provided information Vocabulary Universal patient identifier Clinical data architecture Core medical information Affordability to purchasers and patients /Efficiency Standard measures of value Safety (Clinical quality) Coordination of care Device manufacturer standardization Clinical decision support tools Medication reconciliation Standardized Network-to-network interoperability Inter-organizational interoperability Infrastructure vendor collaboration EMR vendor collaboration
Provider prioritiesto support health care Value andCoordinated Care • Universal patient identifier • Standardized, interoperable core medical information (meds, allergies, problem list as a starting point) for communication among EMRs, PHRs, medical devices and more. • Vocabulary • Standardized network-to-network interoperability (i.e. NHIN) • Medication reconciliation
Creating an Action Plan for Providers • Establish a provider coalition that would drive a collective agenda to advance the top two priorities developed here • Establish a provider coalition to advance the top two priorities developed here that connects to the larger landscape • Advance the top two priorities developed here by integrating with the existing landscape
Creating an Action Plan for Providers • Establish a provider coalition to advance the top two priorities developed here that connects to the larger landscape
Agenda • Review Provider session outcomes • Engage IT Vendors in discussion regarding barriers and solutions • Determine next steps
Provider expectations for IT Partners Universal patient identifier • IT partners must support the use of a voluntary and/or required universal patient identifier
Provider expectations for IT Partners Standardized, interoperable core medical information (meds, allergies, problem list as a starting point) for exchange among EMRs and PHRs and others. • Vocabulary • Standardized network-to-network interoperability (i.e. NHIN) • Medication reconciliation IT partners must support interoperability standards
Joint Action Plan for Providers and IT Vendors • Establish a coalition to advance the top two priorities developed here that connects to the larger landscape
Coalition Output to Date • Letter of support to Congress (HIT funding) • HIT Framework for Action (principles for HIT investment) • Input to the ONC on its Strategic Plan update
Coalition Output to Date • Position on “Meaningful Use” provision in the Stimulus Bill • Grant proposal for stimulus funding to further coalition objectives • Invite additional members?