yesterday, today, and tomorrow

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Yesterday, Today, and Tomorrow. Judy Murphy, RN, FACMI, FHIMSS, FAAN Deputy National Coordinator for Programs & Policy Office of the National Coordinator for Health IT Department of Health & Human Services Washington DC. A look at. Yesterday - what we’ve gotten done - PowerPoint PPT Presentation


  • ONCs Consumer Engagement Strategy: The Three AsCatalyze development of tools and services that help consumers (and providers) take action using their health information. Support a shift in attitudes and expectations regarding consumer (and provider) roles. Give consumers electronic access to their health information. AccessActionAccessAttitudesAction


    ACCESS: Consumer eHealth Pledge Program

    Over 400 organizations have Pledged to provide access to personal health information for 1/3 of Americans


    Taking the Blue Button nation-wide Get more organizations to offer Blue ButtonMake Blue Button a household name = electronic access to my health dataAdvance technical capabilities = set it and forget itOne of 5 game-changing projects involving the 2012 Presidential Innovation Fellows


    ACTION: Making it easier for Patients to use Health ITSurgeon Generals Healthy Apps Challenge More at:

    PHR Model Privacy Notice More at:



    Blue Button Mash-Up Challenge develop an app that mashes up PHR data with other health-related data sets

    Leon Rodriguez, Director-Office of Civil Rights: clarification of the patients right to access their own health information under HIPAA (videos, pamphlets, answers to questions, and other guidance) More at:


    ATTITUDE: Health IT Animation

    1 and 3 minute versions of the animation are available to use for patient teaching


    Beat Down Blood PressureConsumer Video Challenge


    A Regular Guy Beats Down Blood Pressure:

    Beat Down Blood Pressure Winner


    Whats in Your Health RecordConsumer Video Challenge


    Whats in Your Health Record Winner

    Wright and Luft:


    Stages of Meaningful UseStage 1Stage 2Stage 3TOMORROW The biggest challenges in our future


    HIT as the means, not the endDr. David Blumenthal, previous National Coordinator of HIT, emphasizesHIT is the means, but not the end. Getting an EHR up and running in health care is not the main objective behind the incentives provided by the federal government under ARRA. Improving health is. Promoting health care reform is.

    At the National HIPAA Summitin Washington, D.C. on September 16, 2009

  • Best Care at Lower CostThe Path to Continuously LearningHealth Care in America

    September 2012

  • Foundational elements1. The digital infrastructure Improve the capacity to capture clinical, delivery process, and financial data for better care, system improvement, and creating new knowledge. 2. The data utility Streamline and revise research regulations to improve care, promote the capture of clinical data, and generate knowledge.

    Care improvement targets Clinical decision support Patient-centered care Community links Care continuity7. Optimized operations

    Supportive policy environment8. Financial incentives.9. Performance transparency10. Broad leadership

    10 Recommendations


    Our National Quality Strategy


    Health Information TechnologyHealth IT:Helping to Drive the 3-Part Aim


    Stage 2 MUACOs Stage 3 MUPCMH3-Part AimRegistries to manage patient populationsTeam based care, case managementEnhanced access and continuity Privacy & security protections Care coordinationPrivacy & security protections Patient centered care coordinationImproved population healthRegistries for disease managementEvidenced based medicine Patient self managementPrivacy & security protections Care coordinationStructured data utilized Data utilized to improve delivery and outcomesData utilized to improve delivery and outcomesPatient informedPatient engaged, community resourcesStage 1 MUPrivacy & security protections Basic EHR functionality, structured dataMeaningful Use as a Building Block


    Meaningful Use Is Just the Beginning: Other Three Part Aim Programs A recent analysis identified that the national network of RECs are currently working on over 190 different programs to help providers meet the Three Part Aim

    * Based on information from 53 of 62 RECs. Some are working on several different Three-Part Aim Programs .





    Part. for Patients/ Care Trans.

    Payer Pay for Performance

    Innovation Challenge

    Million Hearts

    Bundled Payments

    Other Three-Part Aim programs


    Type of InitiativePCMHACOPart. for Patients/ Care Trans.Payer Pay for PerformanceInnovation ChallengeMillion HeartsBundled PaymentsOther Three-Part Aim programs

    % of respondents98%34%43%51%32%26%8%85%

    To resize chart data range, drag lower right corner of range.






    *The last two Administrations wanted every American to benefit from health IT and especially from access to EHRsPresident Bush:Executive order established the Office of the National Coordinator for Health Information Technology (ONC) as part of the Dept of Health & Human Services (HHS)Dr. David Brailer appointed the first National CoordinatorPresident Obama: February 17, 2009 the American Reinvestment and Recovery Act (ARRA Stimulus Bill) is signed into lawHITECH component of ARRA provides an incentive program to stimulate the adoption and use of HIT, especially EHRsDr. David Blumenthal appointed the new National CoordinatorCongress authorized HHS to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT and private and secure electronic health information exchange. ***Funded by the CDC, the Beacons for Public Health project is going to allow us to explore how technology is helping to support achievement of our population health goals.

    Several Beacon Communities are actively engaged in technology-enabled public health efforts.

    The successes and lessons learned from these initiativeswhich the Beacon Communities for Public Health Project is documentingwill be useful for other public health departments as they support health information exchange and EHR infrastructure for providers and public health facilities in their communities.

    SE Minnesota, for example is partnering with public health departments in 11 counties as they consider their exchange strategy for the community.

    San Diego is working on a more advanced immunization registry initiative and electronic exchange with EMS in their community

    NOTE: RTI/CDC are here today and have copies of these case studies!****The role of the patient and the provider have changed considerably in the last 150 years, as demonstrated by this statement from the AMA.



    The image is from

    A bedridden sick young woman being examined by a doctor, accompanied by her anxious parents. Engraving by F. Engleheart, 1838, after Sir D. Wilkie. Available through Creative Commons license.

    *This updated statement by the AMA and the quotes from actual patients -- represent a shift toward patient engagement in healthcare and health. This change is due to multiple factors, including changes in attitude about the capabilities of patients, as well as other trends from outside of healthcare, such as the wide adoption of information technology, that are changing our society in numerous ways:

    Assumptions about consumer engagement in health: - Actionable information (right info, right place, right time) contributes to individuals ability to effectively engage in their health- Actionable information for individuals can contribute to the following health outcomes: - Increased ability to coordinate care among multiple providers - Stronger partnerships with providers in patient-centered care- Better self management - The goal is effective engagement not necessarily more engagement; effective health engagement by individuals should be guided by scientific evidence - Provider and patient attitudesnot just technical and financial considerationsimpact individuals ability to use information to engage effectively in their health

    Powerful megatrends support consumer engagement in health:- Communication technology is getting cheaper and more ubiquitous (cell phones, smart phones, tablets, etc)- Online communities are growing and proliferating (Facebook, Twitter, etc) - Technology for information collection and analysis is getting cheaper and ubiquitous (sensors, more powerful computers, etc.)- Trends are toward opportunities for greater consumer engagement in most (other!) aspects of our lives- Meaningful Use and other factors are bringing health information held by providers online- Market forces (including health reform) are requiring consumers to take greater responsibility for their health and health care



    This version of the AMA code was written in 1993 and remains current.

    The patients and quotes pictured are from actual people interviewed by ONC. Go to for more. *