Regional Collaboratives (Text Version)

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On September 15, 2009, Micky Tripathi made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (3.64 MB).

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Slide 1

REGIONAL COLLABORATIVES

September 14, 2009

Slide 2

MAeHC ROOTS ARE IN MOVEMENT TO IMPROVE QUALITY, SAFETY, EFFICIENCY OF CARE

 

Slide 3

MAeHC ARCHITECTURE AND DATA FLOWS

 

Slide 4

QUALITY MEASURES DON'T HAPPEN, THEY GET DONE

Illustrative EHR Implementation Value Chain

Overall project management

• Vendor contracting and management
• Readiness assessment & planning
• Practice transformation & workflow planning
• System deployment & Implementation
• Reporting, decision support, and performance measurement
• Inter-operating with internal and external systems
• Post- implementation support

Gaps at any point along the way will undermine adoption
 

Slide 5

WHY DO SO MANY PHYSICIANS OFFICES LOOK LIKE THIS?

• Courier just dropped off more envelopes
• Prescription refill request on fax machine (Right behind the joke of the day)
• Unopened mail
• Printer with results from one lab
• "Hey Sally! Where is Mrs. Jones x-ray?"
• Unsorted results
• About to ring with stat results
• Web portal (from one hospital)

 

Slide 6

CLINICAL USE OF DEPLOYED EHRs
%of Encounters Documented Clinically in EHRs (Q2 2006—Q2 2008)

Graph showing percentages between 3 communities.
 

 

Slide 7

BREAKOUT OF CLINICAL USE MEASUREMENT

Percentage chart of specific use measures.

Slide 8

NORTH ADAMS HIE SCREEN SHOT

 

Slide 9

MAeHC ARCHITECTURE AND DATA FLOWS

Chart review

• How to handle consent policy for unanticipated expansion of use, even if it's legally allowed?
• Is 5-10% opt-out acceptable for public health and population health?
• How to handle physician desire for routine re-identification?
• Are physicians enthusiastically pursuing consent? How to deal with "non-believers" and free-riders?

Slide 10

DATA BEING SENT TO THE MAEHC QDC TODAY

• Problems
• Procedures
• Allergies
• Medication
• Demographic [de-identified]
• Social/Family—if it can be sent in discrete data
• Smoking status—if it can be sent over in discrete data
• Visits
• Diagnosis
• Lab results
• Rad results
• Future [impatient data to include surgical history]

Slide 11

Records Received By MAeHC QDC
Through May 2009

Bar graph mueasurements of visits, medications, lab/rad, vaccinations, problems with a geographic breakdown between Brookton, Newsburyport, and North Adams.

• 437,000 total records since Jul 2008
• 57,000 records received in May 2009

Slide 12

MAEHC QDC DATA COUNTS (I)

Four bar graphs with geographic information from North Adams,
Newburyport, and Brockton.

• Patients
• Patient visits
• Diagnoses
• Procedures

Slide 13

MAEHC QDC DATA COUNTS (II)

Four bar graphs with geographic information from North Adams,
Newburyport, and Brockton.

• Problems
• Lab results
• Medications
• Vaccinations

 

Slide 14

MAEHC QDC LOG-IN SCREENSHOTS

Main screen before login

Slide 15

MAEHC QDC REPORT SCREENSHOTS

• Peer comparison report (1)
• Drill-down report
• Benchmark summary report
• Peer comparison report (2)

The practice manager wants to view the performance of the practice compared to other practices in the community on a given measure regardless of specialty

Newburyport, Cornerstone, peer snapshot report, Q2 2008, all specialties, diabetes cholesterol test done.

Slide 16

QUALITY DATA CENTER IS BECOMING A "PUBLIC UTILITY"
AS WELL AS A COMMERCIAL PLATFORM.

 

Slide 17

MEANINGFUL USE INTEROPERABILITY REQUIREMENTS COULD PUSH THE ENTIRE INDUSTRY TOWARD HIE

Meaningful Use objectives requiring health exchange

2011

• Lab results delivery
• Prescribing
• Claims and eligibility checking
• Quality & immunization reporting, if available

Increases volume of transactions that are most commonly happening today

• Lab to provider
• Provider to pharmacy

2013

• Registry reporting adn reporting to public health
• Electronic ordering
• Health summaries for continuity of care
• Receive public health alerts
• Home monitoring
• Populate PHRs

Substantially steps up exchange

• Provider to lab
• Pharmacy to provider
• Office to hospitals & vice versa
• Office to office
• Hospital/office to public health & vice versa
• Hospital to patient
• Office to patient & vice versa
• Hospital/office to reporting entities

2015

• Access comprehensive data from all available sources
• Experiences of care reporting
• Medical device ineroperability

Starts to envision routine availability of relatively rich exchange transactions

• "Anyone to anyone"
• Patient to reporting entities

 

Slide 18

CREATING INFRASTRUCTURE TO FACILITATE MEANINGFUL USE

$598 million
Regional Health IT Extension Centers

• Non-profit implementation assistance organizations to facilitate meaningful use among "priority primary care providers"
• 70 will be set up across the country
  • 3 cycles of funding
    
  • 12/09, 4/10, 9/10
• Awards of $1M to $30M—does NOT pay for hardware, software, or interfaces
• Must commit to getting at least 1000 priority PCPs to meaningful use in 2 years
• Matching funds required:
  
  • Years 1 & 2: 10%
    
  • Years 3 & 4: 90%
    

$564 million
State-level HIE

• Each state given planning and implementation grants to implement HIE
• 50 awards across the country
  
  • Awards announced 12/09
• Awards of $4M to $40M
• Managed by States or non-profit state-designated entities (SDEs)
• Must implement state plans aligned with federal goals
  • State-level directories
    
  • Eligibility and claims
    
  • ERX & medication histories
    
  • Lab ordering and results
    
  • Public health reporting
    
  • Quality reporting
    
  • Clinical summary exchange
• Matching funds required:
  • FY 2010: 0%
    
  • FY 2011: 10%
    
  • FY 2012: 25%
    
  • FY 2013: 12.5%

Slide 19

www.maehc.org

Micky Tripathi, PhD MPP
President & CEO
mtripathi@maehc.org
781-434-7905