MEANINGFUL USE (Text Version)

Slide Presentation from the AHRQ 2009 Annual Conferenc

Slide presentation from the AHRQ 2009 conference.

On September 19, 2009, Mickey Tripathi made this presentation at the 2009 Annual Conference. Select to access the PowerPoint® presentation (2.84 MB) (Plugin Software Help).

Slide 1

MEANINGFUL USE
 

 

Slide 2

THIS IS GOING TO BE VERY, VERY, VERY MESSY

  • In 1901, there were 2,000,000 phone users in the US
  • Cumulative public and private investment was $500M, or $13B in 2009 dollars (about $6500 per user)
  • Networks were operated by:
    • AT&T: ~1.3m
    • Independent networks: ~700k
  • Number of independent networks: 2,811

 

Slide 3

RECOVERY ACT FUNDING FLOWS

 

Slide 4

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 5

THE EHR MARKET IS MOVING, SLOWLY, BUT ALSO CREATING A DIGITAL DIVIDE IN THE PROCESS

Source: CDC; Center for Health Systems Change; National Ambulatory Care Survey
 

 

Slide 6

HEALTH IT SPENDING IN ARRA

$45B - Direct payments to individual providers
$2B - Various studies and reports
Health information exchanges
Regional health IT resource center
Regional health IT extension centers
State implementation and planning grants
EHR loan funds
NIST certication infrastructure
$47B - TOTAL
 

 

Slide 7

US GOV'T EXPECTING TO GET 50% PAYBACK ON ARRA HEALTH IT INVESTMENTS


 

Slide 8

MEANINGFUL USE DOESN'T JUST HAPPEN, IT GETS DONE

Illustrative EHR Implementation Value Chain

Overall project management
Vendor contracting and managementReadiness assessment & planningPractice transformation & workflow planningSystem deployment & ImplementationReporting, decision support, and performance measurementInter-operating with internal and external systemsPost- implementation support

Gaps at any point along the way will kill adoption
 

Slide 9

PAYMENTS MAY NOT COVER THE OUTLAYS AT AN INDIVIDUAL PHYSICIAN-LEVEL

YearPhysician cost ($K)Medicare incentive ($K)
2009-30--
2010-5--
2011-5+18
2012-5+12
2013-5+8
2014-10+4
2015-5+2

Net gap:
-$21K

 

Slide 10

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 and 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 hospital & 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
  • Experience of care reporting
  • Medical device interoperability

Starts to envision routine availability of relatively rich exchange transactions

  • “Anyone to anyone”
  • Patient to reporting entities

 

Slide 11

ESTIMATED STATE-LEVEL HIE FUNDING ALLOCATIONS

State$ Millions
CA42,016,898
TX33,421,644
NY23,957,218
FL23,463,200
IL22110,630
PA18,427,519
MI17,952,270
MO17,626,933
OH16,077,526
GA15,336,681
NC14,658,721
WA13,741,315
MN13,056,584
KS12,982,284
TN12,846,882
VA12,667,539
LA12,408,520
NJ12,186,552
KY12,144,692
WI12,092,046
IN12,045,669
IO12,023,188
MA11,914,180
MS11,583,650
AL11,017,733
SC10,913,935
CO10,411,944
OK10,059,242
NE10,017,625
MD9,856063
OR9,818236
AZ9,788,419
AR9,524,811
WV8,647,893
CT7,792,452
ME7,511,236
SD7,448,673
MT7,409,437
ID7,252,296
ND7,196,996
UT7,192,321
NM6,948,526
NV6,581,920
NH6,484,543
HI6,251,319
AK6,009,331
WY5,748,313
VT5,737,112
RI5,574,930
DC5,55,5567
DE5,173,455

 

Slide 12

Measure Process Workflow

Source: HIT Standards Committee, 9/15/2009
 

 

Slide 13

MAeHC ARCHITECTURE AND DATA FLOWS

 

Slide 14

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

Community 1: 97%, 82%
Community 2: 94%, 81%
Community 3: 91%, 75%

 

 

Slide 15

BREAKOUT OF CLINICAL USE MEASUREMENT

 

Slide 16

Quality Data Center Is Becoming A “Public Utility,” As Well As A Commercial Platform

Image: Chart shows the members of the Massachusetts eHealth Collaborative.

 

Slide 17

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

 

Slide 18




www.maehc.org

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

Current as of December 2009
Internet Citation: MEANINGFUL USE (Text Version): Slide Presentation from the AHRQ 2009 Annual Conferenc. December 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/events/conference/2009/tripathi3/index.html