Connecting Patients, Providers and Payers John Halamka Keynote
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Transcript of Connecting Patients, Providers and Payers John Halamka Keynote
Connecting Patients, Providers, and Payers
John D. Halamka MD
The US Healthcare IT Program
• Improving quality, safety, efficiency, and reducing health disparities
• Engaging patients and families in their health care
• Improving care coordination
• Improving population and public health
• Ensuring adequate privacy and security protections for personal health information
Physician GoalsCore Objective Measure
1. CPOEUse CPOE for more than 60% of medication, 30% of laboratory, and 30% of radiology
2. E-Rx E-Rx for more than 50%
3. Demographics Record demographics for more than 80%
4. Vital Signs Record vital signs for more than 80%
5. Smoking Status Record smoking status for more than 80%
6. Interventions Implement 5 clinical decision support interventions + drug/drug and drug/allergy
7. Labs Incorporate lab results for more than 55%
8. Patient List Generate patient list by specific condition
9. Preventive RemindersUse EHR to identify and provide reminders for preventive/follow-up care for more than 10% of patients with two or more office visits in the last 2 years
Physician GoalsCore Objective Measure
10. Patient AccessProvide online access to health information for more than 50% with more than 5% actually accessing
11. Visit Summaries Provide office visit summaries for more than 50% of office visits
12. Education ResourcesUse EHR to identify and provide education resources more than 10%
13. Secure Messages More than 5% of patients send secure messages to their EP
14. Rx Reconciliation Medication reconciliation at more than 50% of transitions of care
15. Summary of Care
Provide summary of care document for more than 50% of transitions of care and referrals with 10% sent electronically and at least one sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR
16. Immunizations Successful ongoing transmission of immunization data
17. Security AnalysisConduct or review security analysis and incorporate in risk management process
Hospital Goals
Core Objective Measure
1. CPOEUse CPOE for more than 60% of medication, 30% of laboratory, and 30% of radiology
2. Demographics Record demographics for more than 80%
3. Vital Signs Record vital signs for more than 80%
4. Smoking Status Record smoking status for more than 80%
5. InterventionsImplement 5 clinical decision support interventions + drug/drug and drug/allergy
6. Labs Incorporate lab results for more than 55%
7. Patient List Generate patient list by specific condition
8. eMAReMAR is implemented and used for more than 10% of medication orders
Hospital Goals
Core Objective Measure
9. Patient AccessProvide online access to health information for more than 50% with more than 5% actually accessing
10. Education Resources Use EHR to identify and provide education resources more than 10%
11. Rx Reconciliation Medication reconciliation at more than 50% of transitions of care
12. Summary of Care
Provide summary of care document for more than 50% of transitions of care and referrals with 10% sent electronically and at least one sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR
13. Immunizations Successful ongoing transmission of immunization data
14. Labs Successful ongoing submission of reportable laboratory results
15. Syndromic SurveillanceSuccessful ongoing submission of electronic syndromic surveillance data
16. Security AnalysisConduct or review security analysis and incorporate in risk management process
Patient Profile Screen
Patient Profile Screen, cont’d
Problems
Medications
Medication History and Reconciliation
Reports
External Reports
Orders
Sheets
Care Plans
Health Information Exchange
eCW EHXNEHEN
SafeHealthMD
MDMD MD
Fallon Clinic UMass Memorial
Statewide HISP
PKI/certificate mgmtWebportal
Provider/entitydirectory
Auditlog
MD MD
MD
MDMD
MD
BIDMCPartners
Direct gateway services
EOHHS NwHIN
MassHealth
DPH
Atrius
20
Updated plan
Original high-level plan from 12/11/2011 Updated plan as of 10/23/2012
Multi-Stakeholder Governance Model
Legal & PolicyWorkgroup
Technology & implementation
Workgroup
Finance & sustainability Workgroup
Consumer and public engagement
workgroup
Provider engagement &
adoption workgroup
Co-Chairs:-Wendy Mariner-Gillian Haney
Facilitator: -Ray Campbell
Business Analyst: -Christina Moran
Co-Chairs:-John Halamka-Manu Tandon
Facilitator: -David Delano
Co-Chairs:-Andrei Soran-Steve Fox
Facilitator: -Micky Tripathi
Business Analyst: - Christina Moran
Co-Chairs:-John Halamka-Manu Tandon
Facilitator: -Micky Tripathi
Business Analyst: -Mark Belanger
Co-Chairs:-Jessica Costantino-Kathleen Donaher
Facilitator: -Christina Moran
Co-Chairs:-Michael Lee, MD-Dirk Stanley, MD
Facilitator: -Mark Belanger
HIT Council
HIE-HIT Advisory Committee
Chair: Secretary Judy Ann Bigby, MD
Analytics via Expert Query
• Hospital Analytics group
• Community Practice Analytics group
• Includes data cleansing, validity checking and creating repeatable queries
• Databases and data marts governed by a multi-stakeholder governance committee
• Primarily for Care Management, Government reporting, and Population Health
Analytics via Self Service
• Web-based graphical tool to query BIDMC’s Clinical Data Repository
• Includes 2 million patients and 200 million “facts” (e.g., demographics, diagnoses, medications, lab tests, and procedures) from 1997 to the present
• Aggregate counts (e.g., preliminary data for grant proposals, population studies, etc.) do not require an IRB protocol
• With IRB approval, data sets can be obtained with help from the Decision Support team
Self Service Web Interface
Analytics via Repeatable Reports
• Parameter driven web-based reports in Performance Manager
• Acceleration of business intelligence capabilities with SQL Reporting and Analysis Services
• Dedicated expert consultant devoted to implementation
• Primarily for clinical and administrative operational support
Analytics via Outsourced Community Quality Repository
and Claims Registry
• Combines BIDMC, HMFP, BIDPO, APG, API data into a single clinical care respository
• Used for all our Meaningful Use Measures, PQRS reporting, and AQC contract
• Also creates data marts of clinical data to support all payer claims data warehouse run by HDS
• Primarily for Pioneer ACO and Managed Care efforts
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Patient-Level Information Assets
BIDPOQDC
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Provider Metrics and Measures Measure sets:
• 35 Contract Incentive Measures• 44 NQF Meaningful Use Measures• 24 PQRS Measures• 31 Pioneer ACO Measures
Qualified registry for the CMS 2010 PQRS program
Certified as an ONC-ATCB (CCHIT) certified as a modular EHR for Eligible Providers for all 44 MU Stage 1 measures
- -Massachusetts eHealth CollaborativeSlide title © MAeHC. All rights reserved.
Provider Measure Scorecard
Analytics via Innovative Pilots
• Natural Language Processing for intelligent searching of free text
• QueryHealth
• PopHealth
Universal Availability of PHRs
• Tethered (Patientsite and eCW Patient Portal)
• Non-Tethered (Healthvault and others)
• OpenNotes
Required PHR Functionality
• Secure Messaging with Provider
• Access to all records
• Convenience Transactions
• Request Appointments
• Medication Refills
• Referrals to Specialists
• Education
• Disease specific content
• Links to medication information
• Diagnostic test explanations
Decision Support Service Providers
10
17
Questions?