blue button: promising practices for...
TRANSCRIPT
Blue Button: Promising Practices for Providers
HHS Auditorium
Sept 16th 2:15pm - 4pm
Ellen V. Makar, MSN RN-BC, CCM, CENP Senior Policy Advisor, Office of Consumer e-Health
Office of the National Coordinator for Health IT Department of Health & Human Services, Washington DC
In this session, we will
Show examples of promising practices for providers to engage with patients
Dialogue with those on the front line who are “Implementing” Blue Button:
• What they are doing?
• How are they doing it?
• Why are they doing it?
Discuss how Blue Button supports new payment models (Shared Savings,
Patient Centered Medical Home)
• Highlight pilot projects
• Examples of consumer engagement services via Regional Extension
Centers.
• Learn about resources to support providers
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Breakout Format
Introduction
Ellen Makar, Office of Consumer eHealth
Moderated Panel: Blue Button-Promising Provider Practices
Adam Dole, Presidential Innovation Fellow
Blue Button & Beyond: New Care and Payment Models
Mat Kendall, Office of Provider Adoption Support
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Blue Button
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Action
Attitudes
Access
2:00 1:59 1:58 1:57 1:56 1:55 1:54 1:53 1:52 1:51 1:50 1:49 1:48 1:47 1:46 1:45 1:44 1:43 1:42 1:41 1:40 1:39 1:38 1:37 1:36 1:35 1:34 1:33 1:32 1:31 1:30 1:29 1:28 1:27 1:26 1:25 1:24 1:23 1:22 1:21 1:20 1:19 1:18 1:17 1:16 1:15 1:14 1:13 1:12 1:11 1:10 1:09 1:08 1:07 1:06 1:05 1:04 1:03 1:02 1:01 1:00 0:59 0:58 0:57 0:56 0:55 0:54 0:53 0:52 0:51 0:50 0:49 0:48 0:47 0:46 0:45 0:44 0:43 0:42 0:41 0:40 0:39 0:38 0:37 0:36 0:35 0:34 0:33 0:32 0:31 0:30 0:29 0:28 0:27 0:26 0:25 0:24 0:23 0:22 0:21 0:20 0:19 0:18 0:17 0:16 0:15 0:14 0:13 0:12 0:11 0:10 0:09 0:08 0:07 0:06 0:05 0:04 0:03 0:02 0:01 End
Exercise
Explain your understanding of Blue Button to the person next to you
Synthesis
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Action
Attitudes
Access
Blue Button is a…
Movement
Mode
Mechanism
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Blue Button is a…
Movement for patient engagement
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Blue Button is a…
Mode for consumers to get their health
information from providers and other
sources, electronically.
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Blue Button is a…
Mechanism for providers to meet
Meaningful Use Stage 2
(View, Download, and Transmit)
requirements.
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NeHC Patient Engagement Framework
10 http://www.nationalehealth.org/patient-engagement-framework
Blue Button Pledge
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…on the Blue Button pledge…
... Making “good”
Moderated Panel: Promising Practices for
Implementing Blue Button Adam Dole
Presidential Innovation Fellow, Office of Consumer eHealth
ONC
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Moderated Panel:
Promising Practices for Implementing
Blue Button #BlueButton
#HealthITWeek
Jeff Donnell, PHR - President NoMoreClipBoard http://www.nomoreclipboard.com/
Mary Griskewicz, Senior Director Health IS - HIMSS http://blog.himss.org/author/mgriskewicz/
Donna Mazyck RN, Exec. Dir. National Assoc. of School Nurses- NASN http://www.nasn.org/ToolsResources/DocumentationinSchoolHealth/ElectronicDocumentationSystems
Karen Smith MD, Small Rural Provider- Delegate AAFP http://www.karensmithmd.com/
Kim South RN, PHR- VP, FollowMyHealth http://www.jardogs.com/Company.aspx
Jan Walker RN, Co-Principal Investigator, Open Notes- Harvard, BIDMC http://www.myopennotes.org/
Moderator: Adam Dole, Presidential Innovation Fellow , Office of Consumer eHealth ONC
Blue Button & Beyond: New Care and Payment Models
Mat Kendall
Director, Office of Provider Adoption Support
ONC
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Mat Kendall, MPH Director, Office of Provider Adoption Support (OPAS) Office of the National Coordinator for Health IT U.S. Department of Health & Human Services NOTE: This slide deck links to tools and resources that support provider adoption of consumer engagement. To receive a copy of this deck email [email protected]
Patient Engagement is Foundational for New Health Care Payment and
Service Delivery Models
Better health, better care
Big Picture: Consumer Engagement to Better Health
New Payment Models/Practice
Efficiencies
Practice Transformation
Support
MU Tools/Functionality
• Accountable Care Programs • Comprehensive Primary Care initiative • Patient Center Medical Home (PCMH) • Private Payers
• Workflow redesign • Patient/Practice consumer engagement
assessment • Assistance with portal implementation • Consumer access to immunization records
• Patient ability to electronically View, Download & Transmit (VDT) health information
• Clinical summaries • Patient-specific education resources • Use Secure Electronic Messaging
Private Payer ACOs: UnitedHealth Patient Engagement
• UnitedHealth Group announced that it expects to double its accountable care contracts over the next five years across employer- sponsored, Medicaid, and Medicare plans
• Currently, more than $20 billion in those contracts include more than 575 hospitals, 1,100 medical groups, and 75,000 physicians nationwide
New Payment Model: Medicare Shared Savings Program
• Overview: An Medicare, Physician-Led ACO model designed to improve Medicare
Fee-For-Service beneficiary outcomes and increase value by coordinating care, redesigning care, and putting patients at the center
• Financial implications to providers: An upfront, fixed payment of $250,000
plus a variable payment: $36 per aligned beneficiary plus a monthly payment of $8 per beneficiary
• ACOs must demonstrate a strong patient-centeredness element ACO Measure Title: Patient/Caregiver Experience
– Shared Decision Making (Part of CAHPS and MU2: Core #17)
– Health Promotion and Education (Part of CAHPS and MU2: Core #13)
– Getting Timely Care, Appointments, and Information (Part of CAHPS and MU2: Core #7, #8)
– Health Status/Functional Status (Part of CAHPS and MU2: Core #7, #8)
– Patient Rating of Doctor (CAHPS)
New Payment Model: Comprehensive Primary Care Initiative
• Overview: a multi-payer collaboration between public and private health care payers to strengthen primary care at 497 primary care practices, 2347 providers and 315,000 beneficiaries
• Financial implications to providers: In the first two years of the initiative, the per-beneficiary, per-month (PBPM) amount will average $20 which can translate into $30,000 for a typical panel size of 1500 for a family practice
• Patient/Consumer engagement elements: Integrate culturally competent self management into usual care. Involved patient and family decision making in all aspects of care. Engage patients and families to guide improvement in the system of care.
Year One Milestones:
– Milestone 4: Improve Patient Experience - Use patient experience data to inform practice transformation priorities and implementation (CAHPS, MU2: Core #17)
– Milestone 6: Care Coordination in Medical Neighborhood (MU1: Core #12, #13, Menu #5, #8; MU2: Core #15)
– Milestone 7: Shared Decision Making (MU1: Core #12, #13, Menu #5, #8; MU2: Core #7, #8, #17)
New Care Delivery Model: PCMH/Advanced Primary Care
• Overview: test the effectiveness of doctors and other health professionals working in
teams to coordinate and improve care for up to 195,000 Medicare patients.
• Financial implications to providers: Participating FQHCs will receive a monthly care
management fee of $6.00 for each eligible Medicare beneficiary attributed to their practice
• Foundation consumer engagement elements Participating FQHCs are expected
to achieve Level 3 patient-centered medical home recognition, help patients manage chronic conditions, as well as actively coordinate care for patients.
NCQA PCMH
– PCMH Standard 1: Enhance Access and Continuity: Electronic access to clinical advice (MU1: Core #12, #13. Menu #5)
– PCMH Standard 4: Provide Self-Care/Community Resources: Provide educational tools and resources (MU1: Menu #6)
– PCMH Standard 5: Track and Coordinate Care: E-summary of care (MU1: Menu #8)
Money is not enough: Providers need help to optimize their health IT systems so they can successfully engage their patients
Help is not only on the way, it’s here!
REACH/Stratis: Consumer Engagement to Help Practices Achieve PCMH
Who are they helping? - 4879 primary care providers and 112
critical access hospitals across Minnesota and North Dakota
What are they doing? - Ongoing assistance with best practices
for portal implementation, messaging, PHR support
- Deploying and maintaining an Engaging Care Teams in Patient Engagement portal or toolkit
- Providing tools/resources to motivate staff to leverage health IT
- Educating providers on why consumer engagement can improve outcomes and reduce costs
NeHC: Helping Providers Assess How They Are doing with Patient Engagement
• Sending
What are they Doing: The Framework is the result of nearly a year of collaboration and vetting by over 150 top experts in healthcare, technology and human behavior, and is designed to assist healthcare organizations of all sizes and in all stages of implementation of their patient engagement strategies. This Framework can help your organization navigate the path toward more efficient and effective models of care that treat patients as partners instead of just customers.
M-CEITA/Altarum: Helping Providers Understand Engagement Needs of Consumers
Who are they helping? - 4,854 providers and 31 CAHs
across Michigan
What are they doing? - Assessing Consumer
Engagement (ACE) survey to help providers best leverage health IT to engage consumers
- Promoting shared decision making and reducing patient-induced demand for high-tech imaging
- Helping providers implement e-Tools for patient access, immunization, portals, care plans, quality and price transparency
Iowa REC/Telligen: Supporting Consumer Engagement in Rural and Underserved Areas
Who are they helping? - 1,200 providers and 84
critical access/rural hospitals in Iowa
What are they doing? - Helping CAHs and rural
health clinics leverage MU to support patient engagement and Patient Centered Medical Home (PCMH) through intensive, hands-on practice transformation work
- Increasing awareness through real patient testimonials at face-to-face events statewide
- Supporting statewide health information exchange, especially in rural areas
Beacon Learning Guides
Who are they helping? Leveraging the experiences of the 17 selected Beacon Communities these are resources that can help communities/providers leverage health IT to support new care models
What are they doing? Developed Learning Guides on: - Strengthening Care Management
with Health Information Technology
- Improve Hospital Transitions and Care Management Using Automated Admissions, Discharge and Transfer Alerts
- Enabling Health Information Exchange Strategies to Support Community Goals
- Capturing High Quality Electronic Health Records Data to Support Performance Improvement
Quality Insights of Delaware
• Educating consumers on MyMedicare.gov to download Blue Button data and share it with their care team
• Providing patient education on Patient Portal utilization for View, Download and Transmit and its importance
• Supporting practices as they select, implement and use Patient/Provider Portals
• Building standard CDS workflow for chronic care, preventive services and Million Hearts measures that includes the patients’ VDT
Aetna– Aps to Support Patient Engagement
Link to iTriage tool and other Aetna Patient Engagement Resources
But wait,
there’s more!
Provider Breakout:
The Future is Now: MyVax Indiana
HHS Auditorium Sept 16th 2:15pm - 4pm
James B. Daniel, MPH Public Health Coordinator, Office of Provider Adoption and Support Office of the National Coordinator for Health IT Department of Health & Human Services, Washington DC
Agenda
• Overview of Immunization Registries
• Blue Button and Immunization Registries
• Indiana MyVax Pilot
• Future
Immunization Information Systems (IIS) Consumer Access Overview
• Almost every state has an IIS • Traditionally web based access for users
• Provides full immunization history, forecast of shots, reminder/recall functions
• Users health care providers, health departments, school nurses
• Meaningful Use moving towards bi-directional data exchange model
• 2 major “vendors” for states: – Wisconsin Immunization Registry/WIR (Open source) – Scientific Technologies Corporation (Proprietary)
Blue Button and Immunization Registries
• Future is happening now – Direct access to consumer to Immunization
Registry Data
• First foray into access to health information – Easy to understand information
• Benefits for providers and consumers – Time and cost savings
– Direct access to school and camp forms
– Validation of data
MyVax Indiana
• Developed by Indiana State Department of Health
• Launched July 2012
• Aligns with ONC recommendations
– Security and patient authentication
Building on Blue Button Success
• Consumer Engagement Pilots in Five Public Health jurisdictions – CDC funding – National Vaccine Program Office (HHS/OS) funding for adult focus
• Build upon previous success – myVax Indiana
• Work with major vendors – STC myIR.net (COTS cloud hosted solution) – WIR Collaborative process
• Build re-usable Communications Tool Kits • Align both technical and communications materials with Blue Button • Additional funding for inter-state data exchange
– Live in DC but get your shots in Maryland? – Explore consumer mediated exchange models
Break out Session 3: Promising Practices for Implementing Blue Button
National Association For Trusted Exchange (NATE) PHR Ignite Pilot
HHS Auditorium
Sept 16th 1:45 – 4pm
Aaron Seib CEO, NATE; Contractor to the California Office of Health Information Integrity
Agenda
• Overview of NATE and SHPC
• PHR Ignite Pilot
• RFA in California
• Pilot Use Cases
National Association For Trusted Exchange (NATE)
NATE is a consortium of states which focuses on finding common solutions to optimizing national exchange of health information.
• NATE is executing PHR Pilot with support from the ONC’s State Health Policy Consortium (SHPC).
• Please visit our website to learn more
www.nate-trust.org
PHR Ignite Pilot
• Pilot Goal - Identify and overcome policy, governance and technical challenges of transporting patient data bi-directionally between untethered PHRs (patients) and providers.
• California, Oregon and Alaska are leading pilot projects under this program
• Other member states contributing to Policy Development of this program include Nevada, Utah, Hawaii, North Dakota, Michigan and Florida
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PHR Ignite Pilot
• Pilot Deliverables – Identify and establish minimum technical, security and privacy
requirements for PHRs participating in the pilot
– Develop a trust mechanism known as a “trust bundle” to facilitate the determination of trust on the part of NATE participants interested in either sending and/or receiving information to/from a PHR source
– Identify and support PHR vendors and providers as they provide consumers with access to their data via Direct-enabled exchange
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Pilot Use Cases
• Use Case 1: Recruited providers will send structured data
to a patient-subscribed NATE qualified PHR using Direct secure messaging/BlueButton+ specifications.
• Use Case 2: Patient data will be sent by the test patient from their PHR to a second provider using Direct secure messaging/BlueButton+ specifications.
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Pilot Use Case
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California RFA
• The California Office of Health Information Integrity (CalOHII) RFA
– In partnership with NATE, CalOHII is piloting the exchange of patients’
personal health records to providers using real world patients and providers.
– The goal of the pilot is to inform a roadmap for proceeding to a scalable deployment of a trusted mechanism that will enable the use of PHRs across multiple states.
– A total of $400,00.00 will be awarded to qualified entities.
– Proposals due September 13th.
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Getting involved
• NATE will be reaching out to other interested parties to contribute to the policy development that we will be tackling between now and the end of 2013.
• If you are interested in learning more please contact me at:
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Now it’s Your Turn to Talk:
• What are you doing in your community?
• What do you want to do?
• Who do you need to partner with?
• How can we help?
Provider Next Steps
1. Share with ONC what you are doing
2. Help spread the word about why consumer engagement is critical to improving population health AND new payment modules
3. Connect providers to resources that can assist them with practice transformation
4. Continue to learn about how Blue Button is helping patients engage
Resources Grid
Beacon Nation Learning Guide - Strengthening Care Management with Health IT
Blue Button - Frequently Asked Questions
• M-Ceita/Altarum • Telligan • Stratis Health
CMS Innovation Models
Patient Ability To Electronically View, Download & Transmit (VDT) Health Information
• National Association For Trusted Exchange (NATE)
• https://myvaxindiana.in.gov/
CMS Meaningful Use Stage 2 Toolkit
Resources for Critical Access & Small Rural Hospitals
NEHC - The Patient Engagement Framework
Regional Extension Centers
ONC Providers Achieving Meaningful Use Stage 2
VA Blue Button Features for 2013
Email: [email protected]
Take the BB Pledge: http://www.healthit.gov/patients-families/pledge-info Visit the Blue Button Connector: http://www.healthit.gov/bluebutton
…Continue the Blue Button conversation throughout Health IT week
Spread the message within your sphere, and assist in widespread adoption of Blue Button!
Want more Blue Button ?
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