Quality Matters:

1. Quality Matters: Optimizing Health IT Adoption in Puerto Rico Fadesola Adetosoye, M.S. Project Officer, Regional Extension Center Program Office of the National Coordinator for Health IT June 16, 2011

2. HITECH: Catalyst for Transformation Pre 2009 2009 2014 A system plagued by inefficiencies EHR Incentive Program and 62 Regional Extension Centers Widespread adoption & meaningful use of EHRs

3. HITECH: Supported Programs • Regional Extension Center Program • Community College Workforce Program • Beacon Community Programs • State Health Information Exchange Programs • Standards and Certification Framework • Privacy and Security Framework Office of the National Coordinator for Health Information Technology

4. HITECH: How the Pieces Fit Together Regional Extension Centers Workforce Training ADOPTION Improved Individual & Population Health Outcomes Increased Transparency & Efficiency Improved Ability to Study & Improve Care Delivery Medicare and Medicaid Incentives and Penalties MEANINGFUL USE State Grants forHealth Information Exchange Standards & Certification Framework Privacy & Security Framework EXCHANGE Health IT Practice Research 3

5. The Healthcare system today… System plagued by inefficiencies Inconsistent and inadequate health care delivery Eroding health care coverage Increasing costs at exponential rates

6. The Healthcare system of “tomorrow”… Office of the National Coordinator for Health Information Technology

7. Big Picture Goal… Paper-Based Practice Support Network REC-Provider Partnership Fully Functional EHR • Regional Extension Center • Community College Workforce • Communities of Practice • Health Information Technology Research Center (HITRC) Population Health Health Care Efficiency Patient Health Outcomes Education and Outreach • Workforce • Vendor Relations • Implementation • Workflow Redesign • Functional Interoperability • Privacy and Security • Meaningful Use Office of the National Coordinator for Health Information Technology

8. How do we Improve Clinical Outcomes for ALL Puerto Ricans? Building a case for: Health Information Technology Office of the National Coordinator for Health Information Technology

9. Making the case for Health IT in PR 12.9% of the Puerto Rican population is diabetic (2nd Highest prevalence rate in the Country) Over 4,500 cases of Dengue (2005) Less than 30% of adults have received their influenza (flu) or pneumococcal vaccinations (the U.S. average for both is over 65%) Information not readily available on Puerto Rico providers Office of the National Coordinator for Health Information Technology

10. We need to…. Optimize electronic health record adoption Achieve quality standards to produce desired health outcomes Increase patient education on the opportunities and benefits available to them via health information technology (the patient-centric approach) So that we can….. Office of the National Coordinator for Health Information Technology

11. Improve Health Outcomes for All

12. In Puerto Rico Today… • 625 out of 930 Pharmacies have the capability of accepting electronic prescriptions from the electronic health record • Less than 1% of physicians in Puerto Rico are actively e-prescribing • Less than 10% of providers in Puerto Rico have adopted an electronic health record • Limited patient engagement in managing their health care Office of the National Coordinator for Health Information Technology

13. Opportunities for Puerto Rico… • Meaningful Use Incentive Program • Patient-Center Medical Homes • Accountable Care Organizations • State Health Information Exchange • Regional Extension Center Program Office of the National Coordinator for Health Information Technology

14. 62 Regional Extension Centerscover 100% of the U.S. and its territories Goal: 100,000 priority primary care providers achieve meaningful use (MU) by 2012 • RECs assist providers with: • Education • EHR vendor selection • EHR implementation • Project Management • Workflow redesign • Achieving Meaningful Use Ponce School of Medicine is the Regional Extension Center for Puerto Rico and the U.S. Virgin Islands Office of the National Coordinator for Health Information Technology

15. Ponce School of Medicine:Regional Extension Center of PR and USVI MISSION To Provide accessible and effective solutions, technical resources and educational programs to facilitate the transformation of 4,038 primary care practices in PR and USVI through the adoption of certified EHRs and meaningful use of health information technology. GOAL To assist more than 4,000 providers meaningfully use their electronic health record VISION • Service Area Profile • Total # PCPs: 7,000 • Total # PPCPs: 6,000 • Total # providers: 12,750 To establish an information-driven health care delivery system where providers and patients participate in decisions which result in improved health status, healthcare quality and service access. PSM has committed to assisting over 30% of providers in PR with EHR adoption and MU! Office of the National Coordinator for Health Information Technology

16. 2,300 Providers and counting… Office of the National Coordinator for Health Information Technology

17. Provider make-up by Practice Setting Office of the National Coordinator for Health Information Technology

18. Follow the Money….While Meaningful Use is one incentive, Health IT providesnumerous cost-saving opportunities! Public Health Improved care coordination ↓ Medication errors ↑ Medical Reconciliation Save time Meaningful Use Patient-Centered Medical Homes Reduce Administrative cost Billing system and payments Office of the National Coordinator for Health Information Technology

19. Challenging, but possible… Dr. Aida Blasini pictured with Michelle Piatek (Office Manager) Dr. Blasini is the first provider in PR and one of the first in United States to successfully attest to Meaningful Use! Office of the National Coordinator for Health Information Technology

20. ¡ Puerto Rico, SI SE PUEDE! Office of the National Coordinator for Health Information Technology

21. Visit the ONC Web site: www.HealthIT.hhs.gov/programs/REC/ Fadesola Adetosoye Fadesola.adetosoye@hhs.gov Office of the National Coordinator for Health Information Technology