physicians’ use, exchange, and evaluation of electronic medical … · 2019. 1. 23. ·...
TRANSCRIPT
Physicians’ Use, Exchange, and Evaluation of Electronic Medical Records Lorie MayerAHCCCS HIT CoordinatorCHiR Annual Stakeholder Leadership MeetingJanuary 23, 2019
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HITECH Act • The Health Information Technology for
Economic and Clinical Health (HITECH) Act, enacted as part of the American Recoveryand Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology
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Steps for MU Implementation for Health Information Technology (HIT)
Stage 1Data Capture and Information Sharing2011-2013
Stage 2Advanced Clinical Practices (Clinical Decision Making Support)2014-2016
Stage 3 Using CEHRT to Improve Outcomes2017-2021
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MU Criteria are Implemented in Three Stages
CHiR Physician Survey
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Collaboration Producing Results • Ongoing partnership between Arizona physician licensure
Boards and applications and ASU/CHIRo Been in place since 1992o Arizona Medical Board and the Arizona Board of
Osteopathic Examiners • AHCCCS joined the survey project in 2007• Publications including: CHIR Health Care Workforce
Reports and Articles and • Physician’s Use Exchange and Evaluation of Electronic
Medical Records 2016- 2018 https://chs.asu.edu/sites/default/files/physicians_use_exchange_evaluation_of_emrs_2016-2018-annual_report-rev20181221-upl20190103.pdf
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AZ Provider EHR Adoption Data • The percentage of Arizona physicians using EMRs increased from
45% in 2007-2009 to 91% in 2016-2018.• Solo practice physicians are less likely to adopt EMRs than are
physicians in other practice settings, but the prevalence of solo practice is declining.*
• The growth in EHR adoption has been partially credited to CMS EHR Incentive Program (Medicare and Medicaid)
• More than 90% of Arizona physicians treat AHCCCS enrollees. • AHCCCS physicians are also more likely to use EMRs than non-
AHCCCS physicians.
*ASU Center for Health Information and Research (CHIR) 6
• Medicaid EP Payments: $108,265,936
• Medicare EP ,Payments: $159,111,555
• Total AZ EP Payments: • $267,377,491
• Dually Eligible EH Payments: $406,720,215
• Medicare EH Payments: $3,059,472
• Medicaid Only EH Payments: $11,910,387
• Total AZ EH Payments: $421,690,074
AZ PI Incentive Payment TotalsSeptember, 2018
Total AZ PI Program Payments:$689,067,565
Data Source: CMS January 2011 to September, 2018
Total All States and Territories:$37,920,483,579
Survey has allowed AHCCCS to:• Track provider EHR Adoption Rates
o Develop comparisons between Medicaid providers and non-Medicaid providers
• Create and build HIE strategies off of the adoption rates
• Monitor for gaps and challenges by county• Satisfaction with existing EHRs vendors to
anticipate major delays in taking on HIE8
Transition to Health Information Exchange
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The CMS Road to Interoperability
10Reaching across Arizona to provide comprehensive quality health care for those in need Data Source CMS Regional 2018
Health Information Exchange with Health Current
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Since 2006: Strategy for Building Out Health Information Exchange (HIE)
10+ Years: Providers want access to real time clinical data elements to improve care delivery • Hospital information • Laboratory Results and• Medication History and Use and now• Value Based Care Payment Arrangements
A single non-governmental organizational entity was needed to ensure better policy coordination, a single set of operating rules, and
an ability to have LOWER COSTS For ALL Participants
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Health Current Monthly Growth (as of January 11, 2019)
HIE Participants (as of January 11, 2019)List of Health Current Participants: 567• ACOs & Clinically Integrated networks (15)• Behavioral Health Providers (79)• Community Providers (269)• FQHCs & Rural Health Clinics (21)• Health Plans (17)• Hospitals & Health Systems (53)• Labs, Imaging Centers & Pharmacies (5)• Long-Term & Post Acute Care (84)• State & Local Government (7)• Emergency Medical Services (18)https://healthcurrent.org/hie/the-network-participants/
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What’s Next for AHCCCS and HIE? • Working with Health Current to address technical and policy challenges for integration
of BH and PH data and Part 2 infrastructure
• Supporting providers to meet bi-directional exchange requirement (Year 3- 2019 Targeted Investments (TI))
• Ongoing support for MU Education and Promoting Interoperability
• AHCCCS identifying top 100 providers with each plan by county to ensure recruiting the highest volume providers
• ADHS/ Public Health Connectivity Discussions ongoing
• Promoting Value Based Payment Program for Providers (Differential Adjusted Payment Rates) https://www.azahcccs.gov/AHCCCS/Downloads/PublicNotices/rates/DifferentialAdjustedPayment_DAP_20181001_FinalNotice.pdf
• Requiring improvements in E-Prescribing Benchmarks for Plans
• Administrative Efficiencies /Eligibility Determinations
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