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MEANINGFUL USE (Text Version)

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).


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 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 kill adoption
 

Slide 9

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

Year Physician 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
CA 42,016,898
TX 33,421,644
NY 23,957,218
FL 23,463,200
IL 22110,630
PA 18,427,519
MI 17,952,270
MO 17,626,933
OH 16,077,526
GA 15,336,681
NC 14,658,721
WA 13,741,315
MN 13,056,584
KS 12,982,284
TN 12,846,882
VA 12,667,539
LA 12,408,520
NJ 12,186,552
KY 12,144,692
WI 12,092,046
IN 12,045,669
IO 12,023,188
MA 11,914,180
MS 11,583,650
AL 11,017,733
SC 10,913,935
CO 10,411,944
OK 10,059,242
NE 10,017,625
MD 9,856063
OR 9,818236
AZ 9,788,419
AR 9,524,811
WV 8,647,893
CT 7,792,452
ME 7,511,236
SD 7,448,673
MT 7,409,437
ID 7,252,296
ND 7,196,996
UT 7,192,321
NM 6,948,526
NV 6,581,920
NH 6,484,543
HI 6,251,319
AK 6,009,331
WY 5,748,313
VT 5,737,112
RI 5,574,930
DC 5,55,5567
DE 5,173,455

 

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). December 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/news/events/conference/2009/tripathi3/index.html

 

The information on this page is archived and provided for reference purposes only.

 

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