Slide #1.

Leveraging Health Information Technology to Improve Care: Early Lessons from the ONC HITECH Programs Mat Kendall, MPH Director, Office of Provider Adoption Support (OPAS) Office of the National Coordinator for Health IT U.S. Department of Health & Human Services
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Slide #2.

Presentation Learning Objectives: • Overview of the Health Information Technology for Economic and Clinical Health Act (HITECH) • How ONC is Supporting Providers to Achieve Meaningful Use of Health IT • Who is Working To Achieve Meaningful Use and What Challenges They Are Facing • How Meaning Use of Health IT is Supporting Providers to Improve the Care They Deliver to Their Patients 03/14/19 Office of the National Coordinator for Health Information Technology 2
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Slide #3.

HITECH: Catalyst for Transformation Ultimate Goals : Better Healthcare 03/14/19 Better Health Reduced Costs Paper Records HITECH Act Electronic Health Records Pre 2009 A system plagued by inefficiencies 2009 EHR Incentive Program and 62 Regional Extension Centers 2014 Widespread adoption & meaningful use of EHRs Office of the National Coordinator for Health Information Technology 3
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Slide #4.

Meaningful Use as a Building Block Use information to transform Improved population health Improve access to information Data utilized to improve delivery and outcomes Data utilized to improve delivery and outcomes Patient self management Patient engaged, community resources Care coordination Care coordination Patient centered care coordination Patient informed Evidenced based medicine Team based care, case management Basic EHR functionality, structured data Structured data utilized Registries for disease management Registries to manage patient populations Privacy & security protections Privacy & security protections Privacy & security protections Privacy & security protections Stage 1 MU Office of the National Coordinator for PCMHs Health2Information Technology Stage MU Utilize technology to gather information 03/14/19 Enhanced access and continuity 3-Part Aim ACOs Stage 3 MU 4 4
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Slide #5.

OPAS Strategic Priorities Goal: Assist All Providers to Achieve Meaningful Use of EHR Systems Regional Extension Centers (REC) HealthIT.gov Provider Adoption Optimization Services Catalyze IT Workforce Development 03/14/19 Harness MU to Achieve Three-Part Aim Goals Leverage Business Intelligence Office of the National Coordinator for Health Information Technology 5
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Slide #6.

62 Regional Extension Centers (RECs) Cover 100% of the USA Initial Program Goal: 100,000 priority primary care providers achieve meaningful use (MU) by 2014 Every REC: • Has a defined service area and specific number of providers • Provides unbiased, practical support throughout process • Serves as two-way pipeline to federal and local resources Approach differs by REC: • Independent operations • Affiliation with QIOs and universities • Partnership with other ONC grantees (Beacon and HIE) • Variety of hospital and payer partnerships 03/14/19 Office of the National Coordinator for Health Information Technology 6
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Slide #7.

Comprehensive Support Beyond the EHR Implementation Process Improve Care Quality: 5 Plan: 1 • Assess ACO, PCMH models • Conduct readiness assessment • Prepare for future pay for performance • Identify tools needed for change (i.e. EHR system, workflow changes, etc) • Empower patients in their own health care Primary goal: Give providers as much support as possible Operate & Maintain: 4 2 Transition: • Continuous quality improvement • Redesign practice workflow • MU Stages 1,2,3 • Perform HIT education & training 3 Implement: • Provide technical assistance • Partner with local stakeholders, HIEs 03/14/19 Office of the National Coordinator for Health Information Technology 7
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Slide #8.

Health IT Dashboard for the Medicare and Medicaid Electronic Health Record Incentive Programs http://dashboard.healthit.gov/meaningfuluse • • • • Map & Dashboard Created by: U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology Office of Economic Analysis, Evaluation, and Modeling http://healthit.gov http://dashboard.healthit.gov/ Email: [email protected] 03/14/19 Program Administered & Data Provided by: U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services Office of E-Health Standards and Services http://cms.gov http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms Office of the National Coordinator for Health Information Technology 8
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Slide #9.

Where We Are Today: Who Are RECs Helping? Practice Type* # of Providers Enrolled with RECs % of Total RECEnrolled Providers # of Providers Demonstrating MU Proportion of REC Increase since last Providers who are month demonstrating MU 131,000 Priority Primary Care 51,643 35% Specialty Practice 3,351 2% Rural Health Clinic 3,665 3% Critical Access Hospitals Private Practice 11+ 4,779 3% 627 Other Underserved Setting Rural Hospital Private Practice 1 – 10 >> 131,000 Priority Primary Care 23,353 45% Providers (PPCPs) Providers (PPCPs)are areenrolled enrolled with RECs 920 27% with RECs >>1129 10,000 also 10,000specialists specialists 31% also enrolled enrolled 2% 1% 2% 1170 24% 2% 0% 137 22% -1%* 17,432 12% 7,513 43% 3% 2,472 2% 845 34% 2% Community Health Center Practice Consortiums 22,802 16% 5,747 25% 3% 21,515 15% 11,630 54% 3% Public Hospitals 17,820 12% 6,550 37% 4% 146,106 100% 58,994 40% 2% TOTAL 03/14/19 Office of the National Coordinator for Health Information Technology ONC CRM data as of May 1, 2013 *Proportional decrease is due to an increase in providers enrolled in this practice type. 9
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Slide #10.

Who RECs Are Helping: PPCPs by Specialty Priority Primary Care Providers (PPCPs)Enrolled with RECs >>132,000 132,000Priority PriorityPrimary PrimaryCare Care Providers (PPCPs) are enrolled Providers (PPCPs) are enrolled with withRECs RECswhich whichisismore morethan than 43% of the 303,000 Primary 43% of the 303,000 Primary Care CareProviders Providersininthe theU.S. U.S. 03/14/19 Office of the National Coordinator for Health Information Technology Data Source: ONC CRM, September 17, 2012; SK&A Office-based Providers Database. Q4, 2011 10
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Slide #11.

REC Enrolled Providers by Credential 03/14/19 ONC CRM data as of March 19, 2013. Office of the National Coordinator for Health Information Technology 11
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Slide #12.

RECs are Getting NPs Registered and Paid NPs Paid by CMS RR=1.59* RR=1.59* *p<0.0001. ONC CRM data as of March 19, 2013, merged with CMS Office of the National Coordinator for 03/14/19Funds data through January 31, 2013. EHR Incentive Health Information Technology 12
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Slide #13.

Who Are RECs Helping? Specialists RECs RECsare areworking workingwith withmore more than than10,000 10,000Specialists Specialistsinin38 38 different specialties in different specialties in addition additiontoto132,000 132,000enrolled enrolled PCPs PCPs Opportunity: Opportunity: - -Already working in the Already working in the settings settings(FQHCs, (FQHCs,practice practice consortiums) consortiums) - -Some states are paying Some states are paying RECs RECstotowork workwith withMedicaid Medicaid Specialists using 90/10 Specialists using 90/10funds funds SOURCE: ONC CRM, 12/7/2012 03/14/19 Office of the National Coordinator for Health Information Technology 13
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Slide #14.

REC Success: • A GAO report found that Medicare providers working with RECs were over 2.3 times more likely to receive an EHR incentive payment then those who were not partnered with an REC2 • REC enrollment rates are higher for small rural (non-CBSA, 56%) and micropolitan areas (47%) compared to urban or metropolitan areas3 • Since November, 2011 more than 25,000 MU challenges have been documented by RECs at approximately 18,000 sites to help identify common challenges providers are facing Data Source: ONC CRM Data March 26, 2013 Source: Customer Relationship Management (CRM) Tool, maintained by the Office of Provider Adoption and Support (OPAS) at ONC, data as of March, 26 th 2013. Provider denominators obtained from the SK&A Office-based Providers Database, Q4, 2011. 2 GAO, Electronic Health Records: Number and Characteristics of Providers Awarded Medicare Incentive Payments for 2011, GAO-12-778R (Washington, D.C.: July 26, 2012). 3 Furukawa M, Samuels C, King J, Adetosoye F, Samy L. Engaging Providers in Underserved Areas to Adopt Electronic Health Records. AJMC, In Press, 2013. CBSA indicates Core Based Statistical Area. HPSA indicates Health Professional Shortage Area. 1 03/14/19 Office of the National Coordinator for Health Information Technology 14
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Slide #15.

REC are also collecting specific practices level data on challenges that providers are experiencing Primary and Secondary Challenges Categories Being Tracked by RECs Complete list of Challenges categories, tertiary Office of theincluding National Coordinator for categories and descriptions 03/14/19 Health Information Technology of the categories, is available at healthit.gov/data. 15
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Slide #16.

Top Ten Secondary Category Challenges • Overall Top Ten Challenges • Top Ten Newly Reported Challenges Overall Secondary Challenge Rank (N) Category Overall Rank (N) Secondary Challenge Category 1 (1,835) Provider engagement 1 (134) MU Measures 3 2 (1,504) Administrative practice issues (Paperwork/Planning/Merger) 2 (80) Administrative practice issues 2 3 (43) Provider engagement 5 4 (19) Medicare technical issues 6 5 (16) Practice financial issues 12 6 (14) Technical vendor issues 11 7 (9) Vendor delays in Implementation/Installation 8 8 (8) Medicaid technical issues 13 9(8) Practice staffing 14 10 (7) Inaccurate reports and/or data 7 3 (986) Practice workflow adoption 4 (931) Vendor Selection 5 (642) Vendor delays in Implementation/Installation 6 (541) Practice financial issues 7 (482) Practice staff training 8 (463) Medicaid technical issues 9 (431) Technical vendor issues 10 (374) Reports Slow/Not Available Office of the National Coordinator for 03/14/19 Health Information Technology Data from the ONC CRM as of January 7, 2013. N=number of challenges reported. Rank Last Month 16
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Slide #17.

Top Five Challenges by Practice Type MU Measures Attestation Process Office of the National Coordinator for Practice Issue Vendor Issue Top five 03/14/19 based on number of challenges submitted. Data as of December 31, 2012, pulled from the ONC CRM. Non-priority hospitals did not report any 17 Health Information Technology challenges.
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Slide #18.

What We are Hearing: Health IT Workforce Shortage will Stunt Sector Growth Worker shortage: America’s next healthcare epidemic. Today’s epidemic is tomorrow’s pandemic. 03/14/19 Health IT worker shortage will stunt sector growth, study says Office of the National Coordinator for Health Information Health ITTechnology 18
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Slide #19.

Address WorkForce Needs: Community College Consortia Number of students who successfully completed the Community College Consortia Program by state: 03/14/19 Last updated: March 2012 Office of the National Coordinator for Health Information Technology 19
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Slide #20.

Ways that Health IT Can Be Meaningfully Optimized to Improve Patient Health Health Information Technology 03/14/19 Office of the National Coordinator for Health Information Technology 20
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Slide #21.

New/ Improved Ways of Delivering Care New Opportunity 03/14/19 New Needs: Office of the National Coordinator for Health Information Technology 21
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Slide #22.

New Payment Models New Opportunity 03/14/19 New Needs: Office of the National Coordinator for Health Information Technology 22
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Slide #23.

Population Health Awareness New Opportunity 03/14/19 New Needs: Office of the National Coordinator for Health Information Technology 23
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Slide #24.

Training for an Evolving Health IT Landscape • Sound educational models need to be developed for different stages of training • Professional schools to select, support and train PCMH ready clinicians • Team work/interdisciplinary training • Life-long learning of key skills for all health care workers (IOM Report) • New education models on-line • New efforts to collect and disseminate curricula Office of the National Coordinator for Health IT 24
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Slide #25.

Stay Connected, Communicate and Collaborate •Questions? Browse the ONC website at: healthIT.gov click the Facebook “Like” button to add us to your network •Contact us at: [email protected] •Subscribe, watch and share:  @ONC_HealthIT  http://www.youtube.com/user/HHSONC  HealthIT and Electronic Health Records  http://www.scribd.com/HealthIT/  http://www.flickr.com/photos/healthit Health.IT.gov/buzz-blog
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