how future-proof hit infrastructure supports data sharing ......how future-proof hit infrastructure...
TRANSCRIPT
How Future-Proof HIT Infrastructure
Supports Data Sharing
March 1, 2016John D. Halamka, MD, MS
Jonathan Bush
Learning Objectives
• Define the stages of interoperability, and where and how eachof them are operating today
• Clarify how a healthcare system that continually “learns” through interoperable data advances accountable care
• Explore the role of record locator services, provider directories,and quality registries in the advancement of interoperability
THE DISCONNECT
THE INFORMATION SUPERHIGHWAY
Connected Care and the Patient Experience survey; Surescripts, 2015
of patients report that
their medical history
is missing or incompletewhen they visit their doctor
55%
HOW WE GOT HERE
WHERE WE ARE NOW
% A1C
% HEMOGLOBIN A1C
% HGB A1C
% HGBA1C
%A1C
%HBA1C
A1C
A1C %
A1C (FOR HGB A1C CALCULATION)
A1C - LAV
A1C CALC
A1C CONCENTRATION
A1C HEMOGLOBIN
A1C HPLC
A1C TODAY 5.9
A1C%
A1C-%HBA1C
A1C-2
A1C-2*
A1C2
HA1C
HA1C (GLYCOHEMOGLOBIN)
HA1CB
HB A1C
HB A1C DIABETIC ASSESSMENT
HB A1C, %
HBA1C
HBA1C (HEMOGLOBIN A1C), BLOOD
HBA1C ESTIMATED AVERAGE GLUCOSE
HBA1C II.
HBA1C-
HBG A1C
HBG A1C%
HBGA1C
HEAMOGLOBIN A1C
HEMA1C
HEMAGLOBIN A1C
HEMO A1C
HEMOA1C
HEMOBLOBIN A1C
HEMOGLOBIN (FOR A1C CALCULATION)
HEMOGLOBIN (HGB)
HEMOGLOBIN (HGB) SOLUBILITY
HEMOGLOBIN A1C
HEMOGLOBIN A1C%
HEMOGLOBIN A1C, POC
HEMOGLOBIN A1C.
HEMOGLOBIN A1C:
HGA1C
HGB A
HGB A %
HGB A1
HGB A1C
HGB A1C %
HGB A1C (GLYCO-HGB)
HGB A1C GLYCOHB
HGBA1
HGBA1C
HGBA1C - DIABETES MELLITUS
HGBA1C - DIABETIC MONITORING
HGBA1C - DIABETIC MONITORING -65 YRS OR
GREATER
HGBA1C - PRE-DIABETES MELLITUS
HGBA1C - SCREENING OR PREDIABETIC MONITORING
HGBA1C POC
HGBA1C-T
…
SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey, Electronic Health Records Survey.
18.2 17.3 17.320.8
23.9
29.2
34.8
42
48.351
57
71.8
78.4
0
20
40
60
80
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
EHR Adoption
As of October 30, 2015
2,825 Vendors
CONNECTING THE DISCONNECT
2018:
90% of Medicare payments
tied to quality
2020:
75% of commercial plans will be
value-based
Jan 2015. http://www.hhs.gov/news/press/2015pres/01/20150126a.html
Number of Americans with high-
deductible plans:
RISING DEDUCTIBLES ARE DRIVING CONSUMERIZATION IN HEALTH CARE
SOURCE: athenaNet data
The Growth of Retail Clinics
Source: Merchant Medicine LLC.
-
500
1,000
1,500
2,000
2007 2008 2009 2010 2011 2012 2013 2014 2015
Re
tail
Clin
ics
at
Sta
rt o
f Y
ea
r
Year
VIRTUAL HEALTH CARE WILL
REVOLUTIONIZE THE INDUSTRYIF WE LET IT
“
- FORBES TECH
”
of pediatric
scans are read
by the correct
sub-specialist
50%
ONLY
CHEYENNE
WYOMING
CHEYENNEWYOMING
AMC W/BONE
EXPERTAMC W/
BRAINEXPERT
CLINIC W/LUNG
EXPERT
AMCGENERALIST
COMMUNITYHOSPITAL
CHEYENNEWYOMING
AMC W/BONE
EXPERTAMC W/
BRAINEXPERT
CLINIC W/LUNG
EXPERT
AMCGENERALIST
COMMUNITYHOSPITAL
EpicCerner
NextGen eClinicalWorksathenahealth
Meditech
WHAT IF HEALTH CARE
WORKED AS IT SHOULD?
She would get a text
reminder to schedule
a mammogram
Scan routed to
sub-specialist
via cloud
Complete view of
history, genomics,
care preferences
Images are shared in the
cloud with specialists
via secure text
Care team coordinates
and shares care plan
with patients and
families
Clinical trial data made
available to all
“Post-cure” care
done close to or
in the home
PRIMARY CARE
PHYSICIAN
CARE
MANAGER
RADIATION
ONCOLOGISTSURGEON
ONCOLOGIST
It’s now possible to connect the entire health ecosystem.
It’s time to replace compliance with conviction.
It’s happening… with or without you!
1
2
3