Connecting Patients, Providers and Payers John Halamka Keynote

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Connecting Patients, Providers, and Payers John D. Halamka MD

description

Connecting Michigan for Health 2013 http://mihin.org/

Transcript of Connecting Patients, Providers and Payers John Halamka Keynote

Page 1: Connecting Patients, Providers and Payers John Halamka Keynote

Connecting Patients, Providers, and Payers

John D. Halamka MD

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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

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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

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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

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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

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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

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Patient Profile Screen

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Patient Profile Screen, cont’d

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Problems

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Medications

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Medication History and Reconciliation

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Reports

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External Reports

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Orders

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Sheets

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Care Plans

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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

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Updated plan

Original high-level plan from 12/11/2011 Updated plan as of 10/23/2012

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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

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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

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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

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Self Service Web Interface

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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

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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

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- -Massachusetts eHealth CollaborativeSlide title © MAeHC. All rights reserved.

Provider Measure Scorecard

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Analytics via Innovative Pilots

• Natural Language Processing for intelligent searching of free text

• QueryHealth

• PopHealth

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Universal Availability of PHRs

• Tethered (Patientsite and eCW Patient Portal)

• Non-Tethered (Healthvault and others)

• OpenNotes

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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

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Decision Support Service Providers

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Questions?