EHI Blueprint for Change HealthTechNet November 16, 2007 Page 1 Transforming Care Delivery at the...
-
Upload
dwight-waters -
Category
Documents
-
view
215 -
download
0
Transcript of EHI Blueprint for Change HealthTechNet November 16, 2007 Page 1 Transforming Care Delivery at the...
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 1
Transforming Care Delivery at the Point of Care:
Barriers and Solutions
Christine BechtelVice President, Public Policy and Government Relations
eHealth Initiative
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 2
Who we are…
Our Mission:
Driving improvements in the quality, safety,
and efficiency of healthcare
through information and information
technology
eHI Members include:
clinicians, consumer groups, employers and healthcare
purchasers, health plans, health information technology (HIT) suppliers, hospitals and other
providers, laboratories, pharmaceutical and medical device manufacturers, pharmacies, public
health agencies, quality improvement organizations, standards groups, and state,
regional and community-based organizations
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 3
What we do…
Develop, disseminate and advocate for multi-stakeholder consensus
Monitor, analyze and influence the policy environment
Develop and disseminate tools and resources
Provide hands on technical assistance Launch learning laboratories
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 4
HIT Adoption
Adoption rates relatively low Overall 5%-39% with full or partial EHR,
depending on study• 5% functional EHR**• 14% minimally functional EHR**
– Hospitals: 24% with CPOE
Adoption of HIT that includes all critical functions is highly variable.
**Source: Preliminary data from MGH Institute for Health Policy, GWU and RTI, Nov. 2007
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 5
Minimally Functional EHR: Defined
Clinical notes Computerized orders for
– Prescriptions– Labs– Radiology
Viewing Results for – Imaging– Labs
Source: Preliminary data from MGH Institute for Health Policy, GWU and RTI, Nov. 2007
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 6
Functional EHR: Defined
Clinical notes Computerized orders for
– Prescriptions– Labs– Radiology
Viewing Results for – Imaging– Labs
Patient demographic data Patient problem lists Patient Rx lists Notes include medical
history, follow up Orders sent electronically
for Rx, labs and radiology Elec. Images returned Alerts for interactions, etc Out of range lab levels
highlighted Reminders for guideline
based interventionsSource: Preliminary data from MGH Institute for Health Policy, GWU and RTI, Nov. 2007
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 7
EHR Adoption Rates
Source: Preliminary data from MGH Institute for Health Policy, GWU and RTI, Nov. 2007
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 8
Barriers to EHR Adoption and Use
Lack of a sustainable business model– Unclear ROI, lack of capital
Concerns about the privacy and security aspects of this– Patients and Providers
Concerns about liability– What do I do with all this data?
Lack of demand – From patients, providers and payors
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 9
Barriers to EHR Adoption and Use
System selection Workflow change, loss of productivity Physician resistance
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 11
Driving Transformation
Under current conditions, widespread adoption in physician practices by 2024 (Ford et al, JAMIA, January 06)
– Small practices largest challenge; deliver 60% of care Changing the trajectory requires:
– Aligning incentives to support a business case– Engaging Consumers – Creating interoperable standards – Supporting development of HIE– Privacy and Security Policies– Supporting physician adoption, esp. among small
practices
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 12
Federal Activities Offer Building Blocks
Office of the National Coordinator Standards Harmonization (HITSP) Standards Certification (CCHIT) Development and Testing of NHIN Prototypes (NHIN
Prototypes) – New Awards Just Announced Addressing Privacy and Security: The Health
Information Privacy and Security Collaboration (HISPC)
AHIC Now Transitioning to the Private Sector Secretary’s Value-Driven Healthcare Initiative CMS Demonstrations Funding by Other Agencies: AHRQ, HRSA, etc
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 13
National Private Sector ActivitiesServe as Building Blocks
Purchasers and Health Plans Beginning to Consolidate Expectations (in sync with Four Cornerstones); AQA, QASC, Employer Toolkit released in Feb 2007
Incentives Initiatives Getting Traction: Bridges to Excellence (18 markets) and IHA – focus on quality improvement, performance measurement and use of health IT
Consumer Facing Applications Rolling Out: Microsoft, Dossia, Google, RevolutionHealth, AHIP and BCBSA, rolling out as we speak, as market leaders such as WebMD continue to increase penetration
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 14
State-Level Policy Activity
In 2007 so far, 208 bills have been introduced across 50 states that refer to the adoption or implementation of health IT, nineteen of which have been signed into law in sixteen different states.
To date, 20 executive orders have been issued by governors in 15 states, which are designed to drive improvements in health and healthcare through the use of IT--eight executive orders in 2007 alone
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 15
Highlights From Our Survey of State, Regional and Local Efforts
2006 survey indicated 165 state and regional initiatives operating in 49 states, D.C. and Puerto Rico.
Most difficult challenge: sustainable business model
Payment system has great impact but there are near-term opportunities for sustainability
Criteria for success: building social capital, good business acumen and execution
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 16
Regional Approaches to Improving Health Care
“In the absence of substantial national health care reform, regional quality improvement efforts appear to offer the best hope for transforming American healthcare.”
Dr. Ed Wagner, MacColl Institute
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 17
With all of this activity, what do we do?
Where do we begin?
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 18
eHealth Initiative Blueprint?
A plan for action at the national, state and local levels that represents consensus among multiple stakeholders in healthcare on – shared vision, set of principles, strategies and
specific actions (including timelines) – for improving health and healthcare through
information and information technology.
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 19
eHI Blueprint
A guide to enhancing healthcare improvement strategies through use of health IT and health information exchange.
Key elements:– Role of Health IT in addressing healthcare challenges – Shared Vision– Consensus principles, strategies and actions in 5 areas– Overview of current initiatives– Key resources
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 20
Our Shared Vision High-performing healthcare system where:
– All those engaged in the care of the patient are linked together in secure and interoperable environments,
– The decentralized flow of clinical health information directly enables the most comprehensive, patient-centered, safe, efficient, effective, timely and equitable delivery of care [1]
• Where and when it is needed most – at the point of care.
[1] Institute of Medicine, 2001.
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 21
Our Shared Vision
Financial and other incentives are aligned to directly support and accelerate all of the key elements of transformation – – engaging consumers– transforming care delivery – improving population health
in a secure, private, and trusted environment
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 22
Process
More than 100 stakeholders participated directly in development – hands-on approach
More than 200 organizations participated in a broad variety of ways
Senior Staff and Outside Experts 36 committee meetings between April –
September
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 23
Transforming Care Delivery at the Point of Care
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 24
Transforming Care Delivery Shared Vision
Patient care is high quality, patient-centered, for a lifetime, and reflects a coordinated and collaborative approach.
Complete, timely and relevant patient-focused information and clinical decision support tools are available at the point of care– as part of the provider’s workflow
High quality and efficient patient care is supported by interoperable health IT and secure data exchange across all relevant stakeholders.
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 25
Overarching Strategies
Move Providers to Adopt Health IT Systems: – Getting Providers to Make the Decision
Supporting Adoption and Effective Use: – Providers Have Made the Decision to Adopt HIT, What Do They
Do Now?
Transforming Care Delivery Through HIT and HIE: – Providers have implemented the system, how do they transform
care?
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 26
Caveats
HIT not the goal; improved quality is HIT as essential enabling infrastructure Driving quality vs. HIT adoption
– First two broad categories focus on infrastructure development
– Third broad category focuses on transformation
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 27
Strategies for Transformation
1. Research what motivates providers to purchase health information technology,
as well as best practices for how health information exchange networks can play a role in HIT adoption.
2. Educate and motivate providers to adopt health information technology and use it effectively.
3. Educate providers about currently available incentives and financing options.
4. Monitor and report on adoption rates.
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 28
Strategies
5. Improve and expand incentives and financing options.
6. Provide education, tools and support, tailored to provider size and specialty, to help providers select and implement health information technology and use it effectively.
7. Ensure interoperability between and across all relevant stakeholders through common standards.
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 29
Strategies
8. Enable providers to collect electronic data at all points of care as part of the normal workflow, and to use health information for multiple purposes, including quality improvement, care management, billing, decision support, performance measurement, research, and initiatives to reduce health disparities and improve the health of the general population.
9. Establish and use quality measures and decision support tools.
10. Use and exchange digital health information to transform care at the point of care, in a team environment and across settings.
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 31
Key Take-Aways
Driving healthcare change will require aligning efforts around:– Engaging consumers– Transforming care delivery– Improving population health– Aligning incentives
With the foundational underpinnings of health IT, – while assuring privacy and security
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 32
Key Take-Aways
Will require finding common ground and building social capital across all the stakeholders in the healthcare system
Requires focus at multiple levels: national, state and local
It’s in the intersections that we will accelerate progress
eHI Blueprint for ChangeHealthTechNet
November 16, 2007Page 33
Questions and Feedback
Search the Blueprint Online:– www.ehealthinitiative.org/blueprint
Christine Bechtel, Vice President of Public Policy and Government Relations– [email protected] – 202-624-3270