Moving HIT and Meaningful Use Tim Gutshall, MD March 30, 2011 EHR Adoption in Iowa Less than 50 percent of Iowa physicians have adopted EHRs As late as 2009, 89 percent of Iowa s hospitals still used some paper records Barriers to EHR Adoption Financial Expense of system Uncertainty around ROI Provider and staff productivity Uncertainty about financial incentives Technical Concerns about technically supporting a system Lack of necessary computer skills right IT staff Finding the right EHR to suit practice needs usability Possibility of information overload Organization Change Disruption of workflow and productivity Privacy and security concerns Maintaining patient centeredness and satisfaction Implementation timeline can be lengthy 1
Meaningful Use Improving quality, safety, efficiency and reducing health disparities Engage patients and families in their health care Improve care coordination Improve population and public health Ensure adequate privacy and security protections for personal health information Reward provides with incentive payments Meaningful Use Roll Out 2009 HITECH Policies 2011 Stage 1 MUCriteria Capture and share data 2013 Stage 2 MU Criteria Advanced care processes with decision support 2018 Stave 3 MUCriteria Improved Outcomes Medicare Eligible Providers Medicare fee for service Doctor of medicine or osteopathy Doctor o fdental surgery or dental medicind Doctor of podiatric medicine Doctor of optometry Chiropractor Acute care hospitals Critical access hospitals 2
More Than 37 Million Dollars CMS has disbursed $37,570,328.55 under the Medicare and Medicaid EHR Incentive Programs so far this year Medicaid Eligible Providers Physicians Nurse practitioners Certified nurse midwives Dentists Physician i assistants working in a federally qualified health center or rural health clinic Acute care hospitals Critical access hospitals Children s hospitals MU Stage 1 Core Measures Overview 1. Use of CPOE 2. Implement drug to drug and drug allergy interaction checks 3. E prescribing (EPs) 4. Record demographics 5. Maintain an up to date problem list 6. Maintain active medication list 7. Maintain active medication allergy list 8. Record and chart changes in vital signs 9. Record smoking status 3
MU Stage 1 Core Measures, cont. 10. Implement one clinical decision support rule 11. Report clinical quality measures (6 EPs/15 hospitals) 12. Electronically exchange key clinical information 13. Provide patients with an electronic copy of their health information 14. Provide patients with an electronic copy of their discharge instructions (hospitals) 15. Provide clinical summaries for patients for each office visit (EPs) 16. Protect electronic health information created or maintained by certified EHR MU Stage 1 Menu Measures Overview Implement drug formulary checks Record advance directives for patients 65 years or older (hospitals) Incorporate lab test results into certified EHR technology as structured data Generate lists of patients t by specific conditions to use for quality improvement. Reduction of disparities, research or outreach Send reminders to patients per patient preference for preventive/follow up care (EPs) Provide patients with timely electronic access to their health information within four business days (EPs) MU Stage 1 Menu Measures, cont. Use certified EHR technology to identify patient specific education resources and provide them when appropriate When receive a patient from another setting or provider of care or believes an encounter is relevant should perform medication reconciliation Capability and submission of electronic data to immunization registries or systems Capability and submission of electronic data on reportable lab results to public health agencies (hospitals) Capability and submission of electronic syndromic surveillance data to public health agencies 4
IFMC HITREC Advocates for the provider Works with any EHR Has no financial interest in products Team approach to services EHR implementation ti advisors di Quality improvement advisors Help desk Information architect Physician informaticist Consulting attorney HITREC Comprehensive Support Plan Readiness assessment EHR system selection Transition Practice workflow redesign HIT education & training Implement EHR implementation Partnering with state and local HIEs Operate & Maintain Achieve meaningful use Prepare for future pay for performance Service Packages to Meet Customer Needs Technical assistance packages EHR assessment and planning EHR selection and implementation with quality reporting and e Rx Evaluation and improvement tto achieve meaningful use Help to register and complete attestation for meaningful use Ala cart services to meet your needs 5
Free Webinars Meaningful Use Measures Deep Dive April 6 Drug, Medication, erx Related April 13 Recording Patient Data April 20 Interoperability, Exchanging Data Outside the Clinic April 27 Information/Data Exchange with Patients May 4 Using EHR Function, Protecting Data, Reporting All webinars provided at noon Register at www.iowahitrec.org How the HITECH Pieces Together EHRs and Health Information Exchange HIE starts with EHR adoption The HIE is a hub that facilitates the exchange of clinical information between providers Privacy and security controls are needed at both the providerandhie levels Primary Care Provider Specialty Provider Public Health Hospital Lab Health System HIE Pharmacy 6
PCMH and ACO ACO Administrative Capabilities Medical home is the logical hub of the ACO wheel ACO is the logical extension of medical home Coaches Navigators Hospital Specialists Medical Home Other providers of care Pharmacy The Changing Business of Health Care A medical home doesn t provide all the health care but it does hold all the health care information and Health care is an information business Contact Information Tim Gutshall, MD tgutshall@ifmc.org In Partnership with: The Office of the National Coordinator for Health Information Technology (ONC) U.S. Department of Health and Human Services grant 90RC0004/01. IA HITREC 03/11 239 7