Health Information Technology and the Transformation of Care Delivery

1. Health Information Technology and the Transformation of Care Delivery California Council on Science and Technology February 1, 2006 Center for Economic Services

2. CMA Activity in Health IT • Patient Safety Institute – in full operation today, exchanging health information between hospitals and doctors in Seattle. • Participation at the national level • Physicians’ Foundations activity • Resource development • Research and action Center for Economic Services

3. Record Locator approach Hospitals and Physicians exchanging data today. PSI’s technology is open and available for use as a public benefit. Patient Safety Institute Center for Economic Services

4. Working With: ONC Connecting for Health eHealth Initiative CCHIT Physicians’ Foundations Quality Performance Measures development Focused On: Technology Clinical Quality Standardization Practice Redesign Incentives Knowledge Resources Regulations National Level Participation Center for Economic Services

5. Physicians’ Foundations • Finding meritorious tools that enable migration from paper to technology • Information to empower physicians in technology selection • Strategies to create market forces • Engaging leaders in the profession to embrace the transformation Center for Economic Services

6. Challenges Center for Economic Services

7. Improving, an Access Gap Remains Access to Computer Access to Internet Center for Economic Services

8. EHR Market Has No Leader • Recent CMA survey –72 practices using 49 commercial and 9 home grown “EMR” systems • 48% of respondents plan to purchase EMR within 4 years • Expense, selection risk and implementation challenges are serious obstacles Center for Economic Services

9. Innovation = Desire X Capacity National 75th percentile of productivity is 5,035 visits per year. In California, the first 3,810 are necessary to just cover overhead. When running that hard, will you Outlay $10-20K for uncertain technology? Lose productivity while learning new processes? Embrace innovation? Beleagured Physicians Average primary care practice overhead = 60-62% of revenue Average revenue outstanding 62% Average allowed amount: Medicare - $51; Medi-Cal - $24; WC - $48 Commercial ? Center for Economic Services

10. Extreme Makeover of the Solo and Small Group Practice • Bring together • Physicians and staff • Subject matter experts • Well designed technology • Organizational design leadership • Redesign office flows and pilot these designs • Measure pre and post • Can we eliminate non value added activity and improve access, satisfaction and capacity? • Can we replicate these results? Center for Economic Services

11. Opportunities for California • Explore PSI technology as a potential resource • “Wire” the state • Boost skill development at basic levels of computer use • Increase resources to help safety net providers to acquire and implement technology • Remember this is a care delivery problem, not just a technology problem. Investment is needed in people and process as much or more than software and servers. • Design solutions to address diverse needs, populations and challenges – one size will not fit all. Center for Economic Services