putting the pieces together: ehr incentive programs, meaningful use, and health information exchange
TRANSCRIPT
Putting the pieces together:EHR Incentive Programs, Meaningful Use, and Health
Information Exchange
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MAEHC Mission: Facilitate Universal EHR Adoption
• Company launched September 2004
–Non-profit registered in the Commonwealth of Massachusetts
• CEO on board January 2005
• Backed by broad array of 34 non-profit MA health care stakeholders
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MAeHC Selected Three Pilot Sites From 35 Applicants: Brockton, Newburyport, North Adams
• Provided EHRs to ~600 clinicians practicing in over 200 office locations
• Created health information exchanges connecting the physicians with each other and with the hospitals
• Created a quality data center to extract clinical data from EHRs to evaluate effectiveness and measure performance
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Since the pilot program, MAeHC has expanded its experience base and involvement in a variety of projects
300 Physician EHR implementation – Beth Israel Deaconess Physician Organization (BIDPO)
Community-wide EHR Implementation, HIE, and Quality Data Center – Large Healthcare Foundation
HEAL 5 New York – New York State Department of Health and New York eHealth Collaborative (NYeC)
HEAL 10 New York – Adirondack Region Medical Home Pilot
State-level HIE technical services vendor procurement – Missouri HIO
State Level Health Information Exchange Strategic and Operational Plan Development – New Hampshire
Regional Extension Center planning, deployment, and operations – New York, Massachusetts, Rhode Island, New Hampshire
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Regional Extension Center of New Hampshire Award
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Program requires a full-service REC, which we are creating through a mix of REC staff and local partnerships
• Education and outreach
• Vendor selection and group purchasing
• Implementation and project management
• Practice and workflow redesign including:
- Sharing of best practices from the National Learning Consortium
- Sharing of privacy and security best practices
- Functional interoperability and health information exchange
- Progress towards meaningful use
• Local workforce support
We are providing these services through a combination of:
• REC staff
• Sub-recipient partners
Exact mix will be determined as we get more information on target PPCP population and potential partner capabilities
Required REC Direct Assistance Services
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Overview of the New Hampshire Regional Extension Center
- Sources:- $6,240,415 (federal share)- $ 693,379 (non-federal share)
- Uses:- $1,500,000 (core funding)- $ 4,506,415 (direct assistance - $3,500 or $5,000 per PPCP)- $ 234,000 (direct assistance $18,000 per CAH)- $ 693,379 (flexible – “in-kind services”)
Leverage hospital EHR strategies and programs Integrate EHR and HIE strategies and programs Tailored program to provide EHR and HIE capacity to level-set and accelerate
Hospital and EP MU Stage 1 achievement
Total award is for $6.9 million to cover 1,000 clinicians and 13 CAHs
Overall Strategy
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Practice and Workflow Redesign
People
TechnologyProcess
• Staff roles & responsibilities• Credentials and capabilities
• Using technology effectively• Privacy & Security
• Right place, right time• Policies & Procedures
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Meaningful Use is distributed throughout the medical office correlating to health related goals
CPOE RxDrug-Drug *FormularyePrescribe
DemographicsProblems
MedicationsRx Allergy
VitalsSmoking
CDSCQM
*eLabs*Dx List
*RemindersPt. eCopy
Clinical Summary*Pt. eAccess
*EducationHIE Capable
*Rx Reconcile*Referral summary
*Immunizations*Syndromic Data
Privacy & Security
`
* Menu Items
Improve quality, safety, efficiency and reduce 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
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Re-organizing Meaningful Use tasks can follow patient flow
Pre-Visit
Registratio
n
Patient
Intake
Provider Visit
Check-Out
Post Visit
*Dx List*Reminders
DemographicsVitals
SmokingRx Allergy
*Rx ReconcileCPOE Rx
Drug-Drug*FormularyePrescribe
ProblemsMedications
CDS*eLabs
Pt. eCopyClinical Summary
*Pt. eAccess*Education
CQMHIE Capable
*Referral summary*Immunizations
*Syndromic DataPrivacy & Security
`
* Menu Items
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Meaningful Use is built into the major common components of patient visit flow and at the point of care in the medical office
Pre-Visit
Registratio
n
Patient
Intake
Provider Visit
Check-Out
Post Visit
Privacy & Security
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• Lab results delivery
• Prescribing
• Health summaries for continuity of care
• Quality & immunization reporting, if available
2011
Increases volume of transactions that are most commonly happening today– Lab to provider– Provider to pharmacy
Summary of care record is new process step
• Registry and public health reporting
• Claims and eligibility checking
• Electronic ordering
• Receive public health alerts
• Home monitoring
• Populate PHRs
2013
Substantially steps up exchange– Provider to lab– Pharmacy to provider– Office to hospital & vice versa– Office to office– Hospital/office to public health & vice versa– Hospital to patient– Office to patient & vice versa– Hospital/office to reporting entities
• Access comprehensive data from all available sources
• Experience of care reporting
• Medical device interoperability
2015Starts to envision routine availability of relatively rich exchange transactions– “Anyone to anyone”– Patient to reporting entities
Meaningful Use objectives requiring health exchange
Meaningful Use and Health Information Exchange
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New Hampshire Health Information Exchange Plan
• Approved by ONC
• The plan is the result of collaborative planning among over 80 stakeholders
• 380 stakeholder comments were addressed in the current version
• The plan will continue to evolve as we refine the strategy, obtain broader stakeholder input, and add more detail
Current strategic plan is posted at http://www.dhhs.nh.gov/hie/strategic.htm
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Leveraging existing networks with platform for secure routing
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Medicare and Medicaid Incentives and Penalties
Improved Individual & Population HealthOutcomes
IncreasedTransparency & Efficiency
ImprovedAbility to Study &Improve Care Delivery
ADOPTIONADOPTION
EXCHANGEEXCHANGE
State Grants forHealth Information Exchange
Standards & Certification Framework
Privacy & Security Framework
Regional Extension Centers
Workforce Training
MEANINGFUL USEMEANINGFUL USE
16
HITECH – how the pieces fit together
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New Hampshire Unified Health IT Vision
MAeHC
RECNH
NH Stakeholder Advisory
Committee New Hampshire DHHS
NH HIO
Advisory roleFiduciary responsibility
Contractors
Sub-recipientsREC field staff
Core Staff (EP) Core Staff (CAH)
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http://www.maehc.org/rec_nh_index_.html
Massachusetts eHealth Collaborative © MAeHC. All rights reserved.
Up-to-Date Information and User Groups
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Jeff Loughlin Jen Monahan Leo McNamaraExecutive Director Program Coordinator Project Manager(508) 326-3944 (603) 717-5420 (781) 434-7755
[email protected] [email protected] [email protected]
Nancy Fennell Jaime Dupuis Dave Delano Practice Consulting Practice Consulting CAH Consultant(603) 717-5021 (603) 717-5225 (339) 222-4036
[email protected] [email protected] [email protected]
Regional Extension Center of New Hampshirec/o New Hampshire Medical Society
7 North State StreetConcord, NH 03301Tel: 603.717.5420Fax: 866.440.3007
Massachusetts eHealth Collaborative © MAeHC. All rights reserved.