Regional Collaboratives (Text Version)

Slide Presentation from the AHRQ 2009 Annual Conferenc

On September 15, 2009, Micky Tripathi made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (3.64 KB) (Plugin Software Help).

Slide 1

REGIONAL COLLABORATIVES

September 14, 2009

Slide 2

MAeHC ROOTS ARE IN MOVEMENT TO IMPROVE QUALITY, SAFETY, EFFICIENCY OF CARE

Slide 3

MAeHC ARCHITECTURE AND DATA FLOWS

Slide 4

QUALITY MEASURES DON'T HAPPEN, THEY GET DONE

Illustrative EHR Implementation Value Chain

Overall project management

• Vendor contracting and management
• Readiness assessment & planning
• Practice transformation & workflow planning
• System deployment & Implementation
• Reporting, decision support, and performance measurement
• Inter-operating with internal and external systems
• Post- implementation support

Gaps at any point along the way will undermine adoption
 

Slide 5

WHY DO SO MANY PHYSICIANS OFFICES LOOK LIKE THIS?

• Courier just dropped off more envelopes
• Prescription refill request on fax machine (Right behind the joke of the day)
• Unopened mail
• Printer with results from one lab
• "Hey Sally! Where is Mrs. Jones x-ray?"
• Unsorted results
• About to ring with stat results
• Web portal (from one hospital)

Slide 6

CLINICAL USE OF DEPLOYED EHRs
%of Encounters Documented Clinically in EHRs (Q2 2006—Q2 2008)

Graph showing percentages between 3 communities.
 

Slide 7

BREAKOUT OF CLINICAL USE MEASUREMENT

Percentage chart of specific use measures.

Slide 8

NORTH ADAMS HIE SCREEN SHOT

Slide 9

MAeHC ARCHITECTURE AND DATA FLOWS

Chart review

• How to handle consent policy for unanticipated expansion of use, even if it's legally allowed?
• Is 5-10% opt-out acceptable for public health and population health?
• How to handle physician desire for routine re-identification?
• Are physicians enthusiastically pursuing consent? How to deal with "non-believers" and free-riders?

Slide 10

DATA BEING SENT TO THE MAEHC QDC TODAY

• Problems
• Procedures
• Allergies
• Medication
• Demographic [de-identified]
• Social/Family—if it can be sent in discrete data
• Smoking status—if it can be sent over in discrete data
• Visits
• Diagnosis
• Lab results
• Rad results
• Future [impatient data to include surgical history]

Slide 11

Records Received By MAeHC QDC
Through May 2009

Bar graph mueasurements of visits, medications, lab/rad, vaccinations, problems with a geographic breakdown between Brookton, Newsburyport, and North Adams.

• 437,000 total records since Jul 2008
• 57,000 records received in May 2009

Slide 12

MAEHC QDC DATA COUNTS (I)

Four bar graphs with geographic information from North Adams,
Newburyport, and Brockton.

• Patients
• Patient visits
• Diagnoses
• Procedures

Slide 13

MAEHC QDC DATA COUNTS (II)

Four bar graphs with geographic information from North Adams,
Newburyport, and Brockton.

• Problems
• Lab results
• Medications
• Vaccinations

Slide 14

MAEHC QDC LOG-IN SCREENSHOTS

Main screen before login

Slide 15

MAEHC QDC REPORT SCREENSHOTS

• Peer comparison report (1)
• Drill-down report
• Benchmark summary report
• Peer comparison report (2)

The practice manager wants to view the performance of the practice compared to other practices in the community on a given measure regardless of specialty

Newburyport, Cornerstone, peer snapshot report, Q2 2008, all specialties, diabetes cholesterol test done.

Slide 16

QUALITY DATA CENTER IS BECOMING A "PUBLIC UTILITY"
AS WELL AS A COMMERCIAL PLATFORM.

Slide 17

MEANINGFUL USE INTEROPERABILITY REQUIREMENTS COULD PUSH THE ENTIRE INDUSTRY TOWARD HIE

Meaningful Use objectives requiring health exchange

2011

• Lab results delivery
• Prescribing
• Claims and eligibility checking
• Quality & immunization reporting, if available

Increases volume of transactions that are most commonly happening today

• Lab to provider
• Provider to pharmacy

2013

• Registry reporting adn reporting to public health
• Electronic ordering
• Health summaries for continuity of care
• Receive public health alerts
• Home monitoring
• Populate PHRs

Substantially steps up exchange

• Provider to lab
• Pharmacy to provider
• Office to hospitals & vice versa
• Office to office
• Hospital/office to public health & vice versa
• Hospital to patient
• Office to patient & vice versa
• Hospital/office to reporting entities

2015

• Access comprehensive data from all available sources
• Experiences of care reporting
• Medical device ineroperability

Starts to envision routine availability of relatively rich exchange transactions

• "Anyone to anyone"
• Patient to reporting entities

Slide 18

CREATING INFRASTRUCTURE TO FACILITATE MEANINGFUL USE

$598 million
Regional Health IT Extension Centers

• Non-profit implementation assistance organizations to facilitate meaningful use among "priority primary care providers"
• 70 will be set up across the country
  • 3 cycles of funding
    
  • 12/09, 4/10, 9/10
• Awards of $1M to $30M—does NOT pay for hardware, software, or interfaces
• Must commit to getting at least 1000 priority PCPs to meaningful use in 2 years
• Matching funds required:
  
  • Years 1 & 2: 10%
    
  • Years 3 & 4: 90%
    

$564 million
State-level HIE

• Each state given planning and implementation grants to implement HIE
• 50 awards across the country
  
  • Awards announced 12/09
• Awards of $4M to $40M
• Managed by States or non-profit state-designated entities (SDEs)
• Must implement state plans aligned with federal goals
  • State-level directories
    
  • Eligibility and claims
    
  • ERX & medication histories
    
  • Lab ordering and results
    
  • Public health reporting
    
  • Quality reporting
    
  • Clinical summary exchange
• Matching funds required:
  • FY 2010: 0%
    
  • FY 2011: 10%
    
  • FY 2012: 25%
    
  • FY 2013: 12.5%

Slide 19

www.maehc.org

Micky Tripathi, PhD MPP
President & CEO
mtripathi@maehc.org
781-434-7905