What Lies Ahead for ONC: Meaningful Use and Beyond
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1) The document discusses recent trends in health IT policy and implementation including Meaningful Use and regional extension centers. 2) It outlines upcoming payment reforms like accountable care organizations and bundled payments that will further incentivize health IT innovation. 3) The document proposes next steps for advancing health IT through the proposed Stage 2 of Meaningful Use regulations to promote improved health outcomes, care coordination, and patient engagement through 2015.
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What Lies Ahead for ONC: Meaningful Use and Beyond
- 1. What Lies Ahead for ONC Meaningful Use and Beyond Farzad Mostashari, MD ScM National Coordinator for Health Information Technology
- 2. Last Year’s Notable Heath IT Trends • Policy Ú Implementation of HITECH – MU and certification – Regional Extension Centers THE TIME IS – State HIEs and Beacons – Workforce programs • Direct Project & Blue Button • Anticipation of delivery reform – Hospital consolidation, ACO service providers – National Quality Strategy, Partnership for Patients – getting the music out of the piano (tribute to Duke)
- 3. Health IT and Data are Foundational for Health Reform Sustainable health, quality & efficiency improvements Care Measurement Consumer & Payment Delivery Engagement Reform Innova0ons Provider Feedback Health IT, Informa0on Exchange, and Data
- 4. Payment Reforms will Motivate and Reward Innovation at a Whole New Level Pa0ent • Organized outpa0ent care, IT Innova0ons Needed: Centered coordina0on and team-‐based Medical Homes approaches Timely Clinical Data, Decision Support Accountable • Shared savings; redesigned care Care processes for high quality, efficient Care Integra0on Tools Organiza0ons delivery Technology to Extend Bundled • Pilot program for episodes of care; Physician Reach incen0vizes reduced costs around Payments eight condi0ons Consumer Engagement Tools/PlaIorms/Apps Readmission • Mo0vates hospitals to engage with Reduc0on care coordinators and beGer Data Mining/Analy0cs Programs organize delivery systems
- 5. HITECH and Meaningful Use Regional Extension Centers ADOPTION Improved Individual & Workforce Training Popula0on Health Outcomes Medicare and Medicaid Increased Incen0ves and Penal0es MEANINGFUL USE Transparency & Efficiency Improved State Grants for Ability to Study & Health Informa0on Exchange EXCHANGE Improve Care Delivery Standards & Cer0fica0on Privacy & Security Framework 5
- 6. Conceptual Approach to Meaningful Use 2015 2013 Improved Outcomes Advanced 2011 care processes Capture / with decision share data support 6
- 7. Meaningful Use Regulation • “Stage 1” regula0on (2011-‐2012) – July 2010: Final rule published – Jan 2011: Registra0on began – May 2011: First Medicare payments • 65% of non-‐federal acute care hospitals and 32% of office-‐based physician prac0ces planning to apply in 2011 or 2012 Source: American Hospital Associa0on Informa0on Technology Survey, 2010; Na0onal Center for Health Sta0s0cs, Na0onal Ambulatory Medical Center Survey, 2010. 7
- 8. Fewer Premature Deaths (CV) • Demographics • Quality Measurement • Blood Pressure • CDSS • Smoking • Registry • BMI • Problem List • Med List • Lab Data
- 9. Safer Care • Demographics • Quality Measurement • Blood Pressure • CDSS • Smoking • Registry • BMI • CPOE • Problem List • Drug-Drug, Drug-Allergy • Med List • eRx • Allergy • eMAR* • Lab Data * Recommendation of the Meaningful Use Workgroup of the Health IT Policy Committee
- 10. Patient-Centered Care • Demographics • Quality Measurement • Blood Pressure • CDSS • Smoking • Registry • BMI • CPOE • Problem List • Drug-Drug, Drug-Allergy • Med List • eRx • Allergy • After Visit Summary • Lab Data • Reminders • Patient Education • Pa0ent Copy View & • Online Access Download* • Secure Messaging* * Recommendations of the Meaningful Use Workgroup of the Health IT Policy Committee
- 11. More Coordinated Care • Demographics • Quality Measurement • Blood Pressure • CDSS • Smoking • Registry • BMI • CPOE • Problem List • Drug-Drug, Drug-Allergy • Med List • eRx • Allergy • After Visit Summary • Lab Data • Reminders • Patient Education • Patient Copy • Online Access • List of care team members* • Medication Rec Longitudinal • Share Care Summary care plan* • Electronic progress notes* * Recommendations of the Meaningful Use Workgroup of the Health IT Policy Committee
- 12. Next Steps: Meaningful Use Stage 2 • Incorporate HITPC feedback and hearing findings into final MU WG recommendations for stage 2 • June 8: Present final draft recommendations to HITPC for approval • June 2011: Submit final HITPC stage 2 Meaningful Use recommendations to ONC and CMS • End-2011: anticipate HHS MU NPRM • Mid-2012: anticipate HHS MU Final Rule 12
- 13. Expert Panel Projections: Office-based Physicians’ Adoption of EHRs
- 14. Regional Extension Center Regional Extension Center Provider Registration Total Priority Primary Care Total Priority Primary Care Providers Enrolled Providers Enrolled By Specialty 14
- 15. Health Information Exchange Portfolio 15
- 16. Rising Health Data Liquidity The Direct Project “Blue Bu^on” • The ability for any veteran or • Collabora0ve project to develop a Medicare beneficiary to download simple method for enabling secure an electronic copy of their own transmission of health care personal health or claims informa0on over the Internet informa0on • Launched 3/10, specs posted 6/10, • Launched 10/10, u0lized by over first produc0on transac0on 1/11, now 310,000 unique users thus far being implemented by 65+ vendors
- 17. …while protec0ng privacy and security: Federal Government’s Actions To Date • Prevent sharing of health informa0on without consent • Strengthen communica0ons about breaches • More enforcement • Expand pa0ent rights to access their informa0on 17
- 18. What Comes Next? • Accountable care rewarded (ACO, bundled payment, PCMH, shared savings, VBP, etc) • Virtuous Cycle (information, payment, redesign) • Tipping point for health IT (business case) • Beyond EHRs – Business intelligence, hot spotting, population management, patient engagement, Consumer eHealth-PCHR
- 19. ONC Health IT Strategy (What’s Next?) BeGer Technology Achieve Adoption and Information Exchange ↑ Transparency through Meaningful Use of Health IT ↑ Data Liquidity Improve Care, Improve Population Health, and Reduce Health Care Costs through the QM 2.0 Use of Health IT Beacon Lessons BeGer Informa0on NwHIN Inspire Confidence and Trust in Health IT Governance Empower Individuals with Health IT to Improve their Health and the Health Care System PCHRs Arrive? Achieve Rapid Learning and Technological Meta Data Tagging Transform Advancement Distributed Query Health Care 19
- 20. … to Make this Vision, At Long Last, a Reality