What Did I Work on in Washington?

1. What Did I Work on in Washington? John Glaser April 16, 2010

2. Transformational Change in Health Care Delivery & Population Health Electronic Health Records as a Foundation Technology Adoption 2012? TIME 2004

3. EHR Adoption in Physician Office Practices 25 100 20 80 15 60 10 40 5 20 0 0 Size of Practice Level of EHR Function > 50 physicians Basic System 13% 50% Percentage Percentage Fully Functional 1 - 3physicians 4% 9% DesRoches CM et al., N Engl J Med 2008;359:50-60.

4. Title XIII $2B to the Office of the National Coordinator for Health IT to develop the foundation necessary for broad adoption of EHRs Title IV $23B in Medicare and Medicaid financial incentives to providers who are Meaningful Users of certified, interoperable EHRs (first payment year FY 2011) American Recovery and Reinvestment Act (ARRA)

5. The Core Idea Adoption Meaningful Use Outcomes

6. Examples of Meaningful Use

7. Providers Must Submit Quality Measures

8. EHRs Must Support Standards

9. FY 11 Privacy and Security Standards Must be Implemented

10. To Receive Payments and Avoid Penalties Providers Must • Implement applications needed to support meaningful use • Certify their electronic health record • Support required data, transaction and quality measure reporting standards • Meet privacy and security standards • Achieve meaningful use goals

11. Status of Strategy • Meaningful Use NPRM has been released and comments are being reviewed • Standards and certification criteria IFR has been released and comments are being reviewed • Certification process NPRM was released in February and comments are being received

12. To Support the Achievement of Meaningful Use Several Grant Programs have been Developed • Extension centers to provide EHR assistance to: • Public or not for profit hospitals or critical access hospitals • Federally qualified health centers • Entities in rural and other areas that serve uninsured, underinsured, and medically underserved individuals • Individual and small group primary care practices • State health information exchanges (HIE) to: • Develop and implement HIE privacy and security requirements • Develop interoperability directories and technical services • Coordinate with Medicaid and state public health programs • Ensure effective HIE governance and accountability

13. To Support the Achievement of Meaningful Use Several Grant Programs have been Developed • Workforce development grants to: • Establish electronic health record curriculum • Provide training through community colleges and universities • Develop competency-based exams • Beacon communities • Identify 15 communities that will address a community health concern using interoperable electronic health records

14. To Support the Achievement of Meaningful Use Several Grant Programs have been Developed • Advanced research centers (SHARP) to fund breakthrough research in: • Security of health information technology • Patient-centered cognitive support • Healthcare application and network platform architectures • Secondary use of EHR data

15. Status of Strategy • Grants/contracts have been awarded for: • Regional extension centers • State health information exchanges • Workforce development • Research centers • Beacon community grants will be announced shortly

16. CMS Estimates of the Number of Providers who will be Meaningful Users in 2011 Baselines considerations (2008): 29% of hospitals have some level of medication CPOE (AHA) 4% of eligible professionals have a full function electronic health record

17. You Can’t Beat the View

18. You Meet Some Nice People