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A Meaningful Look at EHRs and Health Information ExchangeISCEBS Symposium - September 7, 2011Susan Brown, TelligenKory Schnoor, IDPH
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Objectives
Describe federal and state health IT environments Provide background on HITECH & meaningful use of health IT Discuss Telligen’s HIT Regional Extension Center Explain the background and services of the Iowa Health
Information Network (IHIN) Describe how IHIN can improve quality, safety and efficiency
of health care
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Objectives #1 & #2
Describe federal and state health IT environments Provide background on HITECH & meaningful use of health IT
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If you want to promote better coordination between doctors, you need to be able to quickly move health information wherever it’s needed. If you want to empower consumers to take charge of their health care, they need to be able to access their health information without calling up five different doctor’s offices.― Kathleen Sebelius Secretary of Health and Human Services
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Improved Quality, Safety and Efficiency
BetterCommunication and
care coordination
FasterDelivery of
information and results
SaferTreatment viae-Prescribing
More efficientCoding and billing
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HITECH: Catalyst for Transformation
HITECH Act EHRs & HIEPaper records
Pre 2009 2009 2014A system plagued by inefficiencies
Meaningful Use Incentive Program and 62 Regional Extension Centers
Widespread adoption and meaningful use of EHRs
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Why Meaningful Use of Health IT?
Improve quality, safety, efficiency Engage patients and families in their health care Improve care coordination Improve population and public health Ensure privacy and security of electronic health information
Adapted from National Priorities Partnership. National Priorities and Goals: Aligning Our Efforts to Transform America’s Healthcare. Washington, DC: National Quality Forum; 2008
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Snapshot of EHR Benefits
Quick access to patient records from inpatient and remote locations for more coordinated, efficient care
Enhanced decision support, clinical alerts, reminders, and medical information
Performance-improving tools, real-time quality reporting
Legible, complete documentation that facilitates accurate coding and billing
Interfaces with labs, registries, other EHRs and HIEs
Safer, more reliable prescribing
For Providers: Reduced need to fill out the same forms
at each office visit Reliable point-of-care information and
reminders notifying providers of important health interventions
Convenience of e-prescriptions electronically sent to the pharmacy
Patient portals for online interaction with providers
Electronic referrals allow for easier access to follow-up care with specialists
For Patients:
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Opinions
Over 90% of all physicians with EHRs are satisfied with their EHR-New England Journal of Medicine 2008, 359:50-60.
78% of Americans favor the use of electronic medical records (NORC study: U of Chicago)– No more clipboards!– E-Prescribing!– Better informed!– Less duplicate testing!
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The Key to Healthier Living
“Take a Walk, Eat More Plants”
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According to preliminary estimates from a CDC survey released December, 2010, 24.9% of office-based physicians had access to a “basic” EMR system, while only 10.1% had a “fully functional” system.
Physician EHR Adoption is Limited
AMA, January 17, 2011, American Medical News
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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
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EHR Adoption Challenges
• Expense of system• Uncertainty around ROI• Provider and staff productivity• Uncertainty about financial incentives
• Disruption of workflow and productivity• Privacy and security concerns• Maintaining patient centeredness and satisfaction
• Concerns about technically supporting a system• Lack of necessary computer skills • Finding right EHR to suit practice needs (“usability”)• Having the right IT staff in place• Possibility of information overload
Financial
Technical
Organization Change
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Meaningful Use Incentive Programs
Medicare– Up to $44,000 per eligible provider– Hospital: Payment formula– Payments began May 2011– Penalties begin 2015
Medicaid– Up to $63,750 per eligible provider– Hospital: Payment formula– Payments began in Iowa January 2011– Over $13M paid in Iowa to date
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Stage 1 Objectives: Medicare
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Objective #3
Discuss Telligen’s HIT Regional Extension Center.
THE TRUSTED HEALTH IT ADVISOR
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Regional Extension Centers
Regional Extension Centers assist providers seeking to adopt & become meaningful users of certified
electronic health records (EHRs)
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Regional Extension Center Program
Assisting small primary care practices, rural health clinics, and critical access/rural hospitals with EHRs
and meaningful use through 2014!
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Telligen REC
Territory: State of Iowa Assisting:
1200 Primary Care Providers 87 Critical Access & Rural Hospitals
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Telligen REC
Advocates for the provider Team approach to services
– EHR Advisors– Clinical Advisors– Help desk– Information architect– Physician informaticist– Attorney
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Comprehensive Support
Plan1 2 Transition 3 Implement 4 Operate & Maintain
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Common Vendors
Iowa REC:• Advocates for the provider
• Works with any EHR chosen by our clients• Has no financial interest in products• Does not purchase or install EHRs
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Iowa REC Sign-Ups
Ambulatory Providers: 883
Critical Access/Rural Hospitals: 57
“Trusted Health IT Advisors”
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HITECH: How the Pieces Fit Together
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Objectives #4 & #5: IDPH
Explain the background and services of the Iowa Health Information Network (IHIN)
Describe how IHIN can improve quality, safety and efficiency of health care
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[email protected] 866-924-4636
www.IowaeHealth.org
www.IowaHITREC.org
www.ime.state.ia.us
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Information and Resources