Health IT Council and Advisory Committee Meeting. June 18, 2012 One Ashburton Place, 21 st Floor Boston, MA

Transcription

1 Health IT Council and Advisory Committee Meeting June 18, 2012 One Ashburton Place, 21 st Floor Boston, MA

2 Agenda I. Approval of April 30, 2011 minutes (HIT Council Motion) II. Introduction of Laurance Stuntz, new MeHI Director Discussion of current state of HIT in Massachusetts as compared to Strategic Health IT Goals III. Preliminary MeHI FY13 Budget Review IV. MeHI Programmatic Review HIE Last Mile Update REC and Medicaid Services Update V. HIE Advisory Workgroup Report Brief Project Status Update Brief Cross Workgroup Update Technology and Implementation Workgroup Recommendations VI. Other 2

3 3 MeHI Director s Update

4 2010 Strategic Plan for Health IT - Objectives Improve access to comprehensive, coordinated, personfocused health care through widespread provider adoption and meaningful use of certified EHRs. Demonstrably improve the quality and safety of health care across all providers, through Health IT that enables better coordinated care, provides useful evidence-based decision support applications, and can report data elements to support quality measurement. Slow the growth of health care spending through efficiencies realized through the use of Health IT Improve the health of the Commonwealth s population through public health programs, research and quality improvement efforts, enabled through an efficient, accurate, reliable and secure health information exchange processes. 4

5 2010 Strategic Plan for Health IT - Strategies Establish Multi-Stakeholder Governance Continue progress, general consensus is we re on the right path Establish a Privacy Framework to Guide the Development of a Secure Health IT Environment Some underlying principles are in place, but needs more work Implement Interoperable Health Records in all Clinical Settings and Assure they are used to Optimize Care Pretty well on the path for physicians, needs support and emphasis in other clinical settings Develop and Implement a Statewide Health Information Exchange (HIE) Infrastructure to Support Care Coordination, Patient Engagement and Population Health Improvement On the right path, approach seems strong, and funding model is close to complete Create a Local Workforce to Support Health IT Related Initiatives Very little has been done to date, needs emphasis Monitor Success Need to establish baseline metrics and ongoing culture to measure and report success and opportunity for improvement 5

6 Next Steps 1. Finish implementing the highway EHRs and the HIE are the necessary precursor supporting our Objectives 2. Drive adoption Make it easier and cheaper to use the HIE for any healthcare communication The HIE is a Commonwealth resource Provider and Consumer engagement Goal to be at >80% provider use of the HIE by the end of Establish a measurement culture Define metrics (Adoption, Cost, Quality) Set goals Publish progress Acknowledge and learn from missteps 4. Leverage the infrastructure MDPHNet Distributed population health queries and EHRs that allow testing of public health interventions Support clinical research Support real time data contribution to disease registries 6

7 7 FY13 Budget Review

8 MeHI FY13 Budget Overview MeHI s primary activities in FY13 are focused on executing its responsibilities under the REC and HIE federal grant award programs and its Medicaid Services contract with MassHealth FY13 REC, HIE and Medicaid Services Budgets built to support those grant program and contract activities MeHI is operating within, or favorably to, federal grant program budgets and to MassHealth contract budget 8

9 MeHI P&L Analysis FY12 vs FY13 9

10 MeHI FY13 P&L by Activity 10

11 Key FY13 Budget Points (HIE) Detailed last-mile budget includes: $1.7 million for 25 EHR vendors (avg $67K) $1.9 million for Systems Integrator(s) $3.1 million to help connect 1,200 providers and 20 hospitals HIE Challenge grants continue to operate under original federal award budgets Operating expenses in good control and will be well less than federal grant budget 11

12 HIE Program Budget Performance 16,000,000 Health Information Exchange Federal Program Budget vs. Current Projections (Life of Program) 14,000,000 $14M $14M 12,000,000 10,000,000 $9.5M $11.2M Federal Program Budget 8,000,000 6,000,000 $7.1M $6.3M Current Projections 4,000,000 2,000,000 0 $2.1M $2.7M Federal Funding Financial Assistance Operating Expenses Amount of State Match 12

13 Last-mile Budget Discussion Points HIE Advisory Committee SME support Covered by MeHI through July Plan to transition to EOHHS under Phase 2 IAPD Recommend shifting some SI budget to support gap Marketing/Outreach Education budget REC and HIE funding does not allow for direct consumer outreach Can market to consumer through the provider Medicaid may have a small amount of funding for direct consumer outreach Budget reflects spend in provider education and outreach through website, seminars, webinars, social media, and limited paid media; i.e., print and online journals 13

14 Key FY13 Budget Points (REC) 1,205 more providers projected to meet MU Milestone 3, for a total of 1,767 at 6/30/13 REC membership renewals will be $100 / provider if MU achieved; $300 / provider if MU not achieved Operating expenses in good control and will be well less than federal grant budget No state funds projected to be needed for match; match will be satisfied with REC membership fees 14

15 REC Program Budget Performance 16,000,000 14,000,000 $14M $14M Regional Extension Center Federal Program Budget vs. Current Projections (Life of Program) 12,000,000 10,000,000 8,000,000 6,000,000 4,000,000 2,000,000 $2.9M $2.1M $8.4M $9.8M $4.3M $2.7M $5.2M $3.4M $939K Federal Program Budget Current Projections 0 Federal Funding REC Membership & 3rd Party Revenue Financial Assistance (Direct Assistance) Operating Expenses (Direct Assistance) Operating Expenses (Core) Amount of State Match 15

16 Key FY13 Budget Points (Medicaid Services) Projecting we will process at least 2,200 more incentive apps for providers and 50 for hospitals during FY13 We are operating within the EOHHS contract budget 16

17 FY13 Budget Points (Other) Governor s Conference planned for spring; budgeted to break even Beginning to explore economic development activities; no funding assumed in FY13 budget Marketing and Outreach will include provider and limited consumer outreach Mechanisms include events, online discussion forums (HIT Community), provider training, social media, public relations, and limited paid media 17

18 MeHI ehealth Fund FY13 and Beyond Uses Contingency, other federal match and e- Health activities beyond FY13, $2,034,152 Currently Projected Federal Program Requirements, $2,743,136 FY13 Budgeted Operating Expenses, $371,063 18

19 MeHI Programmatic Review HIE and Last Mile Update REC and Medicaid Services Updates 19

20 MeHI Last Mile Plan Overview HIE Backbone 'Go-Live' 10/15/12 EHR Assessment Complete 7/15/12 DIRECT Integration Complete 5/31/13 Last Mile Grants End 1/31/ /15/12-7/15/12 EHR Assessment 7/1/12-9/14/12 Systems Integrator Selection 8/1/12-5/31/13 EHR Vendor Implementation of Direct 10/15/12-1/31/14 Last Mile Assistance 20

21 Last Mile Deployment Roles MeHI Role Issue the EHR Vendor Grants and Systems Integrator procurement Manage the Last Mile Direct Assistance Grants Coordinate activities between the System Integrator, MassHealth, and the providers Host the knowledge repository for HIE integration EOHHS and HIE Vendor Role Provide testing / certification environment Provide provider enrollment infrastructure and initial training materials Systems Integrator Role Oversee and support the EHR Vendor Direct Implementations Support the Last Mile Direct Assistance programs Develop and maintain the knowledge repository for HIE integration Provider Implementation Teams (IOOs) Provide high-touch in provider practices Efforts modeled on existing REC processes May be supported by Last Mile Direct Assistance grants 21

22 Last Mile EHR Vendor Integration Program Two-phase grant process Initial focus on market share e.g. identification of ~25 vendors comprising 90% share Outreach to remaining vendors to ensure open bidding Projected funding allocations will provide limited incentive to comply with required integration windows Will need to leverage existing provider relationships Will need to leverage the opportunity for publicity and significant uptake in Massachusetts to help convince vendors to participate SI will possess technical expertise to assist with addressing issues, removing obstacles, testing, and ensuring EHR vendor compliance with DIRECT standards A rolling schedule approach will be used Deployments can start immediately for practices associated with DIRECT-enabled EHRs Deployments will be initiated as vendors reach compliance 22

23 Last Mile Direct Assistance Program Targets underserved provider populations 1,000 practices, 100 long term care and 100 behavioral health providers MeHI knowledge base and minimal support from the SI will be available to providers without direct support 23

24 # of Providers REC Milestone Performance 3000 Regional Extension Center Meaningful Use Milestone Achievement Projections Milestone 2 Milestone 3 0 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 24

25 Massachusetts Medicaid EHR Incentive Performance Metrics *Please note: The number of apps in process decreased from March to April due to applications exceeding program participation time limit, Total Incentive Payments Disbursed as of 5/31/12 25

26 Massachusetts Medicaid EHR Incentive Performance Metrics (cont.) Top 10 EHR Vendors Based on Total Number of Medicaid EHR Applications Received YTD 2% 1% 1% 9% 5% 23% eclinicalworks LLC NexGen Healthcare Epic Systems Corporation GE Healthcare 11% 13% 18% Allscripts EHR MedSeek Inc & Cerner Corporation AthenaHealth, Inc Netsmart Technologies MEDITECH e-mds, Inc. 17% 26

27 MeHI Medicaid EHR Operations Update The Medical Assistance Provider Incentive Repository version 4.0 went live on May 13, Eligible professionals may now attest to stage 1 meaningful use. Successfully conducted our first regional meeting at MetroWest Medical Center on Friday, June 1, Received 2011 MassHealth Fee-For-Service and Managed Care Organization Claim files on 6/1/12 to begin processing 2012 eligible professional incentive applications. Conducted over 3,000 cold calls during the months of April and May to those professionals that may be eligible to participate in the Massachusetts Medicaid EHR Incentive Payment Program. Identified barriers to EHR adoption and program participation. Eligible professionals do not fully understand the Medicaid patient volume threshold requirement. Practices are struggling with pulling required data to meet meaningful use measures. Providers are in the process of transitioning from paper to EHR. 27

28 HIE Advisory Workgroup Report Project Status Update Cross Workgroup Update Technology Workgroup Recommendations 28

29 HIE Workgroups Project Update EOHHS is finalizing the procurement effort for an implementation vendor for the HIE. Many organizations have indicated interest in becoming early adopters of the HIE A few include Beth Israel Deaconess Medical Center, Partners Healthcare, and Baystate Medical Center, among others. WGs are on a two-meeting per month schedule, along with a Cross-WG roundtable to allow discussion and review of materials across all workgroups In anticipation of the October Go-Live, the meeting schedule will continue with frequent individual WG meetings as well as monthly Cross-WG meetings through the summer 29

30 Current Project Timeline 30

31 May Cross-WG Roundtable Update The May Cross-WG Meeting was held on Thursday May 30 th and had good representation from all work groups, EOHHS, and MeHI with approximately 30 people in attendance Agenda & Key Points of discussion: Technology & Implementation Work Group Discussion of recommendations for Transport, Encryption/Decryption, Identity Validation, Certificate Assignment, Metadata, Data Retention Consumer & Public Engagement Work Group Discussion of consumer/patient communication and desired consumer facing documents Legal & Policy Work Group Discussion of legal framework outline Finance & Sustainability Work Group Update on HIE informational letter and discussion of levers to encourage HIE usage Provider Engagement & Adoption Work Group: Discussion of HIE Rollout and the Golden Spike Next Cross WG Meeting scheduled to occur on June 21st from 9:30am-12pm, in person at the Mass Medical Society 31

32 Technology WG Recommendations 32

33 Technology WG Recommendations (con t) 33

34 Technology WG Recommendations (con t) 34

35 35 Other