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Association for Health Data Integrity 11-10-07

Association for Health Data Integrity 11-10-07. Revolution? Evolution?. Presentation Overview. Pressure for Change Marshalling the Forces Pick the Right Battles Win-Lose or Win-Win Training and Leadership. Pressure for change. Regional Health Status.

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Association for Health Data Integrity 11-10-07

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  1. Association for Health Data Integrity11-10-07

  2. Revolution? • Evolution?

  3. Presentation Overview • Pressure for Change • Marshalling the Forces • Pick the Right Battles • Win-Lose or Win-Win • Training and Leadership

  4. Pressure for change

  5. Regional Health Status

  6. Drug Caused Death Rates 2002 - 2003

  7. Regional Health Problems

  8. Projected Cost and Waste in Tri-Cities TN / VA Region $5.5 B Unnecessary Cost $1.7 B $2.8 B $800 M Aggregate Waste $12.5 Billion 2004 2006 2007 2008 2009 2011 2012 2013 2005 2010 Source: U.S. Department of Health and Human Services, Gordian Project analysis

  9. Value is Derived from Better Medical Decisions Treatment Diagnostic Redundancy Patient Data Errors Electronic Medical Record Clinical Data Sharing Decision Support Source: SBCCDE, CITL, Gordian Project analysis

  10. Convergence of Data Clinical Patient-Centered Care Administrative Billing & Claims Personal Health Record Research Best Practices

  11. Do…or Be “done to” • Force • Change • Motion

  12. (R)evolution’s Timeline Office of the National Coordinator issues NHII Framework Pres Exec Order: EMR for every American by 2014 CCHIT certification for ambulatory EMR NGA Alliance for eHealth IOM: Crossing the Quality Chasm NHIN, HITSP, CCHIT, HISPC contracts awarded HISPC harmonization eHI Connecting Communities AHIMA state best practices NHIN Demo’s Jan 2007 Jan 2004 Oct 2005 Jul 2004 Jul 2006 Nov 2007 1996

  13. National effort to remove barriers • Coordination through policy-making body: American Health Information Community • “Harmonization” of state / federal / organization policies and regulations -- HISPC • Move to establish data standards that support interoperability, certification for electronic medical records—HITSP • Nationwide Health Information Network—NHIN Prototype Demonstration, NHIN Trial Implementation • Pilots for financial incentives to encourage adoption and spur private investment—CMS Pilots • Definition of best practices for state / RHIO efforts –NGA’s State Alliance for eHealth, AHIMA State-level HIE Consensus Project

  14. Private Sector on the Move • Clinical Systems: • HIMSS, IHE, EHR Vendor Association • Administrative Billing & Claims: • America’s Health Insurance Plans • Personal Health Records: • Dossia, My HealthVault, Google • Research, Best Practices • NCQA, JCAHO, NIST

  15. RHIO’s and HIE’s • Regional Health Information Organization: • geographic healthcare market • multi-stakeholder governance • consensus-building, shared decision-making • stewardship for use of data • Health Information Exchange: • technical infrastructure for data flow • one or more “use cases” • sustainable business model • interoperability standards and certification (NHIE)

  16. 750,000 patients in multi-state region Hospitals: 18 Physicians: 1200 Public Health: 7 regional, 2 state Payor: 25% Medicare 20% Medicaid 18% uninsured 2-20% commercial Small – Med Employers: Eastman Chemical 7500 ETSU – 6500 Hospitals – 5500, 5400 2/3 of patients live in Tennessee 1/3 live in Virginia 5% in other states

  17. CareSpark’s Mission Regional Population Has High Disparities of: • CareSpark’s mission is to improve the health • of people in NE Tennessee and SW Virginia through the collaborative use • of health information • Diabetes • Cardiovascular Disease • Hypertension • Lung Disease • Cancer • Premature Mortality CareSpark region has $2,400 higher per capita patient care coststhan other regions of the country

  18. Community-Wide Collaboration • Active, representative participation, including • Employers: Eastman Chemical Company, CGI-AMS, AFG, General Shale, BAE Systems • Payors: Blue Cross Blue Shield, John Deere Health / United Healthcare, Cariten PHP, Highlands • Wellmont Health Network • Hospitals: Mountain States Health Alliance, Wellmont Health System, Johnston Memorial • Hospital, Quillen V.A. Medical Center, Laughlin Memorial • Physician Practices: Holston Medical Group, Highlands Physicians, Health Alliance PHO, • Cardiovascular Associates, ETSU University Physicians, Clinch River Health Services, Med-Alliance • Management, Rural Health Services Consortium, Southwest Virginia Community Care Network • Health Education: East TN State University School of Medicine, College of Nursing, College • of Public and Allied Health, Appalachia College of Pharmacy, UVa’s College at Wise • Public Health:Sullivan and Northeast Regional Health Departments in TN, Cumberland • Plateau and Lenowisco Health Districts in VA • Community Non-Profits: Kingsport Tomorrow, • United Way of Kingsport, Rotary Club of Kingsport • Patient Advocacy Groups: American Cancer Society, • Minority Health Coalition, Mountain Empire Older Citizens • Local Technology Companies: Intellithought, LucentGlow, • Deliberare, Holston Technology, the Creative Trust, ntara

  19. CareSpark RHIO Consortium Partners • National / International: Local / Regional: • ActiveHealth the Creative Trust AllScripts Deliberare • Cisco Holston Technology • CGI Intellithought • Dell LucentGlow • GE Healthcare ntara • HP State: • Initiate Tennessee • Intel Virginia • Misys • Oracle Federal: • Quovadx HHS / ONC • Siemens Market / thought leaders committed to interoperability, collaboration and results

  20. Parallel Pathwaysto our goal • Interoperable EHR Adoption – Encourage and supportincreased use of EHRs(with e-prescribing and decision support tools) by clinicians • Regional HIE Platform – Implement infrastructure and connectivity for sharing of information among providers, payors, public health • Align with AHIC national standards and Nationwide Health Information Network infrastructure to connect with other networks • Public Health Improvement – community-wide aggregation and study, improved disease reporting and biosurveillance, prevention services and chronic disease identification, research to improve health status • 4. Financial Incentives – fair proportion of financial savings for all stakeholders: physician, patient, and purchasers (employers, taxpayers, insurers)

  21. CareSpark Data-Sharing Options

  22. What Will CareSpark Do? • Outcomes Improvement • Individual health outcomes Population health status • Decision Support • (real-time, at point of care, across all systems) • Patient-specific info (Rx, Dx, Hx) • Clinical Best Practices • PHR / EMR / CCR • Cost-Efficient Use of Resources • Reduced duplication, errors, administrative costs

  23. Making Progress?

  24. Quality Measures For VACompared With Best Practices 17 Measures 2002 Data

  25. Measurable Outcomes • Population Health • Premature Mortality • New Diabetes Cases • Lipid Panel • Flu Vaccines for 65+ • ER Visits for Health Attack • Post- MI followup Clinical • Adult diabetics, RX filled, vision / foot, HbA1C <7 • LDL < 100 • Cancer screenings (PAP, Mammogram, colorectal) • Pneumo vaccine for 65+, <2 • Stroke therapy

  26. Accepting the challenge Leadership Continuous Improvement Re-training Collaborative governance

  27. ¡Viva la evolución!

  28. Pioneers for Progress • www.carespark.com • Liesa Jenkins, Executive Director • 423-963-4970 • ljenkins@carespark.com

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