shaping a brighter future advancements in health it ccg submission
TRANSCRIPT
February 16-18, 2012 | Philadelphia, PA 1
Shaping a brighter
Future: Advancements in Health IT
Understanding Health IT and how it relates to you
• What does Health IT mean to you?
• Do you know what an EMR is?
• How do you see Health IT playing a role in your personal life?
• How do you see it affecting your business, if at all?
• How do you feel overall about the health care system?
• What opportunities do you foresee taking place with technology in health care?
• Are there any particular advancements you would like to see?
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Despite the current U.S health care investment of over $1.7 trillion annually, Americans are still plagued by quality care concerns
• Per capita health care expenditure in the United States far outstrips expenditure in other nations, yet Americans suffer from the burden of chronic disease at a higher rate than their counterparts in other nations
• Most providers lack the information systems necessary to:
– Coordinate a patient’s care with other providers and share needed information
– Monitor compliance with prevention and disease-management guidelines
– Measure and improve performance
• Incentives within the U.S. health care system are misaligned, contributing to the high costs of care
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• Insured patients, who are largely insulated from the costs of care, demand the most/best treatment, including interventions, prescriptions, etc. that may have little efficacy
• The media intensifies this feeling of entitlement and highlights “miracle cures”
Demand Side Incentives Supply Side Incentives
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• Physicians and hospitals are still largely paid under a fee-for-service model that provides additional payment for each visit/procedure, offering little incentive to control utilization
• Liability concerns fuel the tendency to provide all possible interventions
Over the last 10 years, recent and aggressive legislation has helped guide the development of Health IT in an effort to improve health care
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Legislation Impact on HIT
President’s Health Information Technology Plan
• Executive Order signed by President Bush in 2004 • Outlined a broad ten year plan to increase the reach of Health IT (HIT) with a
focus on patients’ needs, values, and education • Established the Office of the National Coordinator for Health Information
Technology
Health Information Technology for Economic and Clinical Health (HITECH) Act
• A component of the American Recovery and Reinvestment Act of 2009, signed into law by President Obama in 2009
• Serves as the guiding framework for expansion of HIT • Defines “meaningful use” and provides incentives and support to providers who
adopt “meaningful use” of HIT into their practices • Addresses privacy and security concerns and implemented new rules regarding
the accounting of disclosure of patient health information
Patient Protection and Affordable Care Act (ACA)
• Signed into law by President Obama in March 2010, the ACA includes requirements that the federal and state governments establish new electronic systems for enrolling individuals in health insurance plans
• The ACA emphasizes: — Transparency of the online process — Guidance for consumers to make informed decisions — Accommodations for a range of users — Privacy and security
• Health IT is the comprehensive management of health information across computerized systems and its secure exchange between consumers, providers, government and quality entities, and insurers and includes:
• Implementing Health IT solutions would:
– Improve care quality and reduce errors
– Reduce overall health care cost by an estimated $77B per year*
– Increase patient involvement and collaboration
– Increase administrative efficiency, reducing cost, effort, and time to complete tasks
• Current Health IT solutions include:
– Electronic Medical records (EMRs)
– Computerized provider order entry (CPOE)
– E-Prescribing (eRx)
– Electronic data immunization
– Electronic syndromic surveillance data
– E-copies of health info to patients
By adopting Health IT solutions, standards, and best practices, health care providers will be able to offer superior care
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Estimated Annual Benefits from Inpatient Computerized Physician Order Entry Systems, After Full Adoption
Source: Rand Corporation Study, Can HIT Lower Costs and Improve Quality?
To enable a smooth adoption of Health IT, the industry must understand EMRs and the role it plays in future health services
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8 Information Technologies to Supplement EMRs
Electronic Transcribing – automated clinical note taking that creates document-sharing among multiple locations
Electronic Lab Reporting (ELR) – automated web-based lab reporting, that helps timeliness, reduction of manual data entry errors, and more complete reports
E-Prescribing – automated prescribing Clinical Content Repository – clinical content
management that offer users flexibility to change and manage content on their own
Document Imaging – scanning and paper digitalization to assist with “medical grade” documentation and productivity
Patient Registry and CRR Bulletin Board – basic patient population management, proven to improve chronic disease care
Clinical Groupware – software that helps streamline work and automatically prioritizes the most time-consuming or needy patients
Electronic Medical Record (EMR) is a computerized medical record created in an organization that delivers care, i.e. hospital or physician's office
• Usage– only 10% of hospitals have integrated their systems
• Legal Status– EMRs must be kept in its unaltered form, by the health facility
• Tech Feature – EMRs enables patient records to be read & created on workstations and mobile devices; and access to Personal Health records to consumers
• Event Monitoring – EMR systems monitor clinical events such as, predicting, preventing adverse events i.e. discharges, transfers, lab results and others
• Role in electronic Research network– connects medical practitioners to researchers , promotes practice based research networks and facilitates clinical research
“Meaningful Use” seeks to drive clinicians toward improved decision-making, acknowledging that adoption of EMRs alone is insufficient to transform care
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When utilizing Health IT, especially EMRs, it’s important to understand “Meaningful Use” and its impact on provider and patient services
“Meaningful Use” of EMRs is an effort to:
• Improve quality, safety, and efficiency
• Reduce health disparities
• Engage patients and families
• Improve care coordination
• Ensure privacy and security
• Control costs
• Improve public health
• Facilitate research
Furthermore:
• Health information must be exchanged and used to inform clinical decisions at point of care
• EMRs must provide a minimum set of required functionality and should be certified as such
Ultimately, EMRS are just a vehicle, not the end goal; and it’s up to doctors, not technology, to help patients make the right decisions.
A phased implementation approach of “Meaningful Use” will guide the development of Health IT into the coming years
• Electronic health data in a coded format
• Tracking of key clinical conditions
• Communication of care outcomes & care coordination
• Implementation of clinical decision support tools for disease/ medication management
• Reporting outcomes for public health purposes
• Increase SSA’s capacity to hear and decide cases
• Improve workload management practices of the hearings process
Stage 1 – Data Capture and Sharing (Current state)
Stage 2 – Advanced Clinical Processes (2013)
• Encourages health IT use to enhance computerized provider order entry
• Transitions of care
• Electronic transmission of diagnostic test results and research
Stage 3 – Improved Outcomes (2015)
• Promotes improvements to quality and safety
• Focus on clinical decision support
• encourages patient access and involvement to enhance health data
Despite tremendous adoption efforts, challenges to implementing and adapting to Health IT are inevitable
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• Laws prohibiting advancement, such as HIPPA
• Paper based records are the most common method of recording patient information, and as such, a majority of doctors still use paper records compared to digital records
• State requirements mandate that physical records be held for a minimum of seven years
• Portability and Security vulnerabilities are incredibly concerning to many patients, as it is uncertain who will see what information, and how that information will be used
Opportunities for the advancement of Health IT------Update
Mayo Clinic
Cleveland Clinic
Johns Hopkins
Clinic
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• Managing and improving your own health
• Mobile app development
• Systems development
• Change management
• Medical device innovation
• Cyber security needs
• Hardware and software innovation and migration
Can you identify other
areas for opportunity, personally or professionally?
Understanding the health care environment will help you navigate your personal health, and your business, in the years to come
Update and manage your
personal medical records
Identify a source, be it a
journal or online news
column, to stay current
Be proactive in
seeking new information
Build a network of
diverse professions, one
being in the health field
Be inventive, and flag any
opportunities that may
relate to your business
Staying up to date in
the health care field,
and making it
relevant to you
Anticipate change in IT
and be ready to
react quickly
Get to know your health
environment, i.e., your
physician and office
Stay current on your work
environment trends
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Questions and Contact Information
Kristine Martin Anderson
Vice President
Booz Allen Hamilton Inc.
1101 Wootton Pkwy
Rockville, MD 20852
Tel (240) 314-5790
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Chris Foster
Principal
Booz Allen Hamilton Inc.
8283 Greensboro Drive
Mclean, VA 22102
Tel (703) 377-0870
Additional Resources
• 10 Technologies to Embrace before EMRs (http://www.healthcareitnews.com/news/10-
technologies-embrace-emrs)
• Five ways health IT will reduce the cost of care (healthcareitnews.com/news/five-ways-
health-it-will-reduce-cost-care)
• Information Exchanges Let Doctors Share Patient Data Efficiently
(http://www.informationweek.com/news/healthcare/EMR/221601130)
• Kaiser Health Information Background brief (http://www.kaiseredu.org/Issue-
Modules/Health-Information-Technology/Background-Brief.aspx)
• Rand Corporation Study, Can HIT Lower Costs and Improve Quality?
(http://www.rand.org/pubs/research_briefs/RB9136/index1.html)
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