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A Meaningful Look at EHRs and Health Information Exchange. ISCEBS Symposium - September 7, 2011 Susan Brown, Telligen Kory Schnoor, IDPH. Objectives. Describe federal and state health IT environments Provide background on HITECH & meaningful use of health IT

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a meaningful look at ehrs and health information exchange

A Meaningful Look at EHRs and Health Information Exchange

ISCEBS Symposium - September 7, 2011

Susan Brown, Telligen

Kory Schnoor, IDPH

objectives
Objectives
  • Describe federal and state health IT environments
  • Provide background on HITECH & meaningful use of health IT
  • Discuss Telligen’s HIT Regional Extension Center
  • Explain the background and services of the Iowa Health Information Network (IHIN)
  • Describe how IHIN can improve quality, safety and efficiency of health care
objectives 1 2
Objectives #1 & #2
  • Describe federal and state health IT environments
  • Provide background on HITECH & meaningful use of health IT
slide4

If you want to promote better coordination between doctors, you need to be able to quickly move health information wherever it’s needed. If you want to empower consumers to take charge of their health care, they need to be able to access their health information without calling up five different doctor’s offices.

― Kathleen Sebelius Secretary of Health and Human Services

improved quality safety and efficiency
Improved Quality, Safety and Efficiency

Better

Communication and care coordination

Safer

Treatment viae-Prescribing

Faster

Delivery of information and results

More efficient

Coding and billing

hitech catalyst for transformation
HITECH: Catalyst for Transformation

Paper records

HITECH Act

EHRs & HIE

Pre 2009

2014

2009

Widespread adoption and meaningful use of EHRs

A system plagued by inefficiencies

Meaningful Use Incentive Program and 62 Regional Extension Centers

why meaningful use of health it
Why Meaningful Use of Health IT?
  • Improve quality, safety, efficiency
  • Engage patients and families in their health care
  • Improve care coordination
  • Improve population and public health
  • Ensure privacy and security of electronic health information

Adapted from National Priorities Partnership. National Priorities and Goals: Aligning Our Efforts to Transform America’s Healthcare. Washington, DC: National Quality Forum; 2008

snapshot of ehr benefits
Snapshot of EHR Benefits

For Providers:

For Patients:

  • Quick access to patient records from inpatient and remote locations for more coordinated, efficient care
  • Enhanced decision support, clinical alerts, reminders, and medical information
  • Performance-improving tools, real-time quality reporting
  • Legible, complete documentation that facilitates accurate coding and billing
  • Interfaces with labs, registries, other EHRs and HIEs
  • Safer, more reliable prescribing
  • Reduced need to fill out the same forms at each office visit
  • Reliable point-of-care information and reminders notifying providers of important health interventions
  • Convenience of e-prescriptions electronically sent to the pharmacy
  • Patient portals for online interaction with providers
  • Electronic referrals allow for easier access to follow-up care with specialists
opinions
Opinions
  • Over 90% of all physicians with EHRs are satisfied with their EHR

-New England Journal of Medicine 2008, 359:50-60.

  • 78% of Americans favor the use of electronic medical records (NORC study: U of Chicago)
    • No more clipboards!
    • E-Prescribing!
    • Better informed!
    • Less duplicate testing!
the key to healthier living
The Key to Healthier Living

“Take a Walk, Eat More Plants”

physician ehr adoption is limited
Physician EHR Adoption is Limited
  • According to preliminary estimates from a CDC survey released December, 2010, 24.9% of office-based physicians had access to a “basic” EMR system, while only 10.1% had a “fully functional” system.

AMA, January 17, 2011, American Medical News

ehr adoption in iowa
EHR Adoption in Iowa
  • Less than 50 percent of Iowa physicians have adopted EHRs
  • As late as 2009, 89 percent of Iowa’s hospitals still used some paper records
ehr adoption challenges
EHR Adoption Challenges
  • Expense of system
  • Uncertainty around ROI
  • Provider and staff productivity
  • Uncertainty about financial incentives

Financial

  • Concerns about technically supporting a system
  • Lack of necessary computer skills
  • Finding right EHR to suit practice needs (“usability”)
  • Having the right IT staff in place
  • Possibility of information overload

Technical

  • Disruption of workflow and productivity
  • Privacy and security concerns
  • Maintaining patient centeredness and satisfaction

Organization Change

meaningful use incentive programs
Meaningful Use Incentive Programs
  • Medicare
    • Up to $44,000 per eligible provider
    • Hospital: Payment formula
    • Payments began May 2011
    • Penalties begin 2015
  • Medicaid
    • Up to $63,750 per eligible provider
    • Hospital: Payment formula
    • Payments began in Iowa January 2011
    • Over $13M paid in Iowa to date
objective 3
Objective #3
  • Discuss Telligen’s HIT Regional Extension Center.

THE TRUSTED HEALTH IT ADVISOR

regional extension centers
Regional Extension Centers

Regional Extension Centers assist providers seeking to adopt & become meaningful users of certified electronic health records (EHRs)

regional extension center program
Regional Extension Center Program

Assisting small primary care practices, rural health clinics, and critical access/rural hospitals with EHRs and meaningful use through 2014!

telligen rec
Telligen REC
  • Territory: State of Iowa
  • Assisting:
    • 1200 Primary Care Providers
    • 87 Critical Access & Rural Hospitals
telligen rec1
Telligen REC
  • Advocates for the provider
  • Team approach to services
    • EHR Advisors
    • Clinical Advisors
    • Help desk
    • Information architect
    • Physician informaticist
    • Attorney
comprehensive support
Comprehensive Support

Plan

Transition

Implement

Operate & Maintain

1

2

3

4

common vendors
Common Vendors
  • Iowa REC:
  • Advocates for the provider
  • Works with any EHR chosen by our clients
  • Has no financial interest in products
  • Does not purchase or install EHRs
iowa rec sign ups
Iowa REC Sign-Ups

Ambulatory Providers: 883

Critical Access/Rural Hospitals: 57

“Trusted Health IT Advisors”

objectives 4 5 idph
Objectives #4 & #5: IDPH
  • Explain the background and services of the Iowa Health Information Network (IHIN)
  • Describe how IHIN can improve quality, safety and efficiency of health care
slide26

Information and Resources

ehealth@idph.iowa.gov

866-924-4636

www.IowaeHealth.org

IowaHITREC@telligen.org

800-373-2964

www.IowaHITREC.org

Imeincentives@dhs.state.ia.us

515-974-3071

www.ime.state.ia.us