Download - Dean Lampman, MPA, DTM
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Tarrant County Voices for Health
What changes will occur over the next 10 years impacting the local
economy?
Dean Lampman, MPA, DTM Regional Surveillance Coordinator
Southwest Center for Advanced Public Health Practice (APC) Tarrant County Public Health
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Technological Forces of Change: The Ascendance of Health Informatics
Prepared and presented by
Dean Lampman, MBA, DTM
October 31, 2012 2
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Agenda
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What is biosurveillance?
Meaningful use & heath information
exchanges: an overview
MU & HIEs: opportunities & threats
A call to action
Technological Forces: The Ascendance of Health Informatics
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Biosurveillance
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• Captures healthcare data
• Best if it’s in near real-time
• Algorithms used to classify data
• Free text and/or ICD9 codes
• Cast in syndromes and medical subgroups
• Analyzes all categories for anomalies
• Temporal or spatial / check vs. expected values
• Automated reports, alerts for anomalies
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Benefits
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• Yield recognition (via alerts) of:
• Symptoms w/ unusual / unexpected event
• Unexpected # of illnesses, syndromes
• Illness or syndromes in an unusual population
• Eases collaboration and problem solving
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Window of opportunity
• Initial detection (identify event rapidly)
• Quantification (how many folks are ill?)
• Localization (where is the event happening?)
• Investigation (demographics, etiology, conveyance)
• Subsequent detection (identify more cases)
• Outbreak management (confirm, track cases)
• Countermeasures (isolation, vaccination)
• Target (illness, deaths recede)
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Scope of North Texas network
• Connected nearly 60 hospitals in 49-county region
– All Tarrant County acute-care facilities
• Near real-time automated EMS data
– Data from 40K transports annually
• OTC medication data analyzed
– From 90 percent of pharmacies
• School health surveillance portal
• Law enforcement / first responder alerting system
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People and organizations who:
• Share resources effectively, efficiently
• Achieve separate but related solutions
• Partners, resources, practices
Public heath community of practice
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Issues we continuously address:
1. Data types [< or = meaningful use]
2. Technical standards for connection
3. Data quality, accessibility
4. Response protocols
5. Cost-effectiveness
6. Scalability, replicabilty
7. A community of practice
What the work requires
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“It’s not rocket science … but it’s not trivial.”
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Agenda
What is biosurveillance?
Meaningful use & heath information
exchanges: an overview
MU & HIEs: opportunities & threats
A call to action
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Meaningful use overview
• Laws offer $17 billion for EHR incentives
– Established via HITECH Act (2009)
– Administered by CMS
• References three criteria stages:
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Achieving meaningful use
Must
• Be Eligible Professional (EP) or a critical access hospital
• Use certified electronic health record (EHR)
• Meet criteria for incentives in each stage
Cumulative (5 yr) incentive for EPs:
• $44,000 under Medicare
• $63,750 under Medicaid
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Data capture, sharing
Electronic capture of health information
Communicate info for care coordination
Implement clinical decision support tools • Ease disease, medication management
• Use EHRs to engage patients, families
Report public health information
Report clinical quality measures
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Options for public health sharing
Opt. 1: Submit data to
immunization registry
Opt. 2: Submit syndromic
surveillance data
Goal: improve population, public health
Method: Communicate w/ PH agencies
Measure: Perform 1 test to show capability to
submit data, if public health can take it.
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Stage 1 MU data elements
1. Facility identifier
2. Facility / visit type
3. Report date / time
4. Unique patient ID
5. Unique visiting ID
6. Diagnosis type
7. Age
8. Age units
9. Gender
10. Zip Code
11. County
12. Race
13. Ethnicity
14. Visit date / time
15. Chief Complaint
16. Diagnosis / injury cause code
17. Discharge disposition
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Health information exchanges
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HIEs can run on either a public or private cloud or private network
In HIEs, health data can flow in a complex array of directions and authorized users can gather and use it in many ways
Other data providers
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Agenda
What is biosurveillance?
Meaningful use & heath information
exchanges: an overview
MU & HIEs: opportunities & threats
A call to action
18 Technological Forces: The Ascendance of Health Informatics
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Providers
efficiency
info access
collaboration
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Opportunities Threats
costs
accountability
competition
“The EHR has decreased the time ancillary staff spends on issues that
used to involve paper and increased the time the physician spends on
the same issues … it is, so far, a money-losing proposition.”
-- Ted Wojno, MD, Emory Clinic
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Public health
relevance
info access
collaboration
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Opportunities Threats
expectations
accountability
costs
“The ability to monitor [laboratory] test orders could be one of the
earliest indicators of a change in health conditions or as means to
detect outbreaks of new disease.”
-- Steven Hinrichs, Nebraska Health Dept.
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Consumers
info access
choices
convenience
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Opportunities Threats
accountability
costs & taxes
data privacy
“We can't successfully implement [healthcare] reforms without an
underlying healthcare IT infrastructure to connect our fragmented
system and report on how providers are performing.”
-- Consumer Partnership for eHealth
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Agenda
What is biosurveillance?
Meaningful use & heath information
exchanges: an overview
MU & HIEs: opportunities & threats
A call to action
22 Technological Forces: The Ascendance of Health Informatics
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Call to action
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Stay informed
Get involved
Protect your health
Talk to your doctor
“This [meaningful use] will translate
to the kind of better provider-patient
relationships and more patient-
centered care that providers and
patients both want.”
Consumer Partnership for eHealth
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Technological Forces of Change: The Ascendance of Health Informatics
Prepared and presented by
Dean Lampman, MBA, DTM
October 31, 2012 24