america’s voice for community health care
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America’s Voice for Community Health Care. The NACHC Mission To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved people. - PowerPoint PPT PresentationTRANSCRIPT
America’s Voice for Community Health Care
The NACHC Mission
To promote the provision of high quality, comprehensive and affordable health care that is coordinated, culturally and linguistically competent, and community directed for all medically underserved people.
Health Information TechnologyA Primer
Michael Lardiere, LCSW
Director, Health Information Technology
Sr. Advisor, Behavioral Health
National Association of Community Health Centers
Date: February 13, 2008
Objectives
What is HIT?What are the various Forms of HIT?Why is HIT useful/necessary?What is the Ultimate Goal of Using HIT?Where Do We Start? How Do We Know if We are Ready?Change Management and Workflow ProcessesHow Do We Go About Selecting a Vendor/System?Are We in this Alone?
What is HIT?
HIT consists of an enormously diverse set of technologies for transmitting and managing health information for use by
Consumers
Providers
Payers
Insurers, and
All the other groups with an interest in health and
health care.
What are the Various Components of HIT?
Applications
Patient Registries
Accounting/Practice Management Systems (PMS)
CPOE/CDS (Computerized Physician Order Entry with Clinical
Decision Support)
ePrescribing
Electronic Medical/Health Records (EMRs/EHRs)
Patient Health Records (PHRs)
What are the Various Components of HIT?
Applications
Results Reporting
Electronic Documentation
Appointment Scheduling
Patient Kiosks
Telemedicine
Interface Engines
What are the Various Components of HIT?
Communications
Messaging StandardsHL7, ADT, NCPDP, X12, DICOM, UB92,
HCFA, ASTM, EDIFACT, etc.
Coding StandardsLOINC, ICD-9, CPT, NDC, RxNorm,
Snomed CT, etc.
What are the Various Components of HIT?
Process
HIE (Health Information Exchanges)
RHIOs (Regional Health Information Organizations)
MPI (Message Passing Interface)
HIPAA Security/Privacy
What are the Various Components of HIT?
Devices
Servers
Desktops
Laptops
Tablet PCs
Mice
Pens
Bar Coding
Why is HIT Useful/Necessary?
Healthcare delivery is inherently fragmented
Multiple Providers/Services & Multiple PayersMore than 360,000 care delivery sites in the USInefficient or Absent communicationIncreased Provider Specialization
Why is HIT Useful/Necessary?
Fragmentation leads to miscommunication and errors
Duplicate Testing Medication Lists not reconciled properly causing medication interactions and ineffective therapy as meds are stopped pre-maturely Poor documentation, illegible handwriting and other mis-communication causing errors Increased healthcare utilization and increased cost of care Reduced timeliness of care Inappropriate or Unnecessary Care And many other problems ….
Why is HIT Useful/Necessary?
Adverse Drug Events (ADEs) are a leading cause of morbidity (and mortality) in the USIn a meta-analysis of ADEs, 84% were classified as preventable
EX: Many of the patients studied with permanent disabilities directly resulting from ADEs received higher than usual drug dosage
The average settlement cost in the resulting litigations was $4.3 million!
Why is HIT Useful/Necessary?
Improving Quality of Care Patient Safety Decreasing Medical Errors
IT solutions can help with clinical decision support: Medication conflicts Clinical knowledge – differential diagnoses etc. Latest lab and test results Medication Lists List of appointments Clinic notes and consult recommendations
Why is HIT Useful/Necessary?
Reducing Health Disparities Research results and evidence based guidelines
Facilitates the Medical Home Improved access to and more “personalized” care
for the patient and caregivers Patient centered care for high-risk patients – i.e.
better monitoring
Why is HIT Useful/Necessary?
Timely Payment for Services
Increasing Efficiency in Care
Delivery
Makes Pay For Performance
Obtainable
What is the Ultimate Goal of Using HIT?
To improve the Quality of Health
Services and Outcomes for All Patients
Not Only to Collect Data
Data Used to Track, Alert & Manage Individual Patient Outcomes Population Health Outcomes, and Improve Overall Care of All Patients
What is the Ultimate Goal of Using HIT?Developed by Alliance of Chicago Health Services, LLC
Where Do We Start? How Do We Know if We are Ready?
Assessments
Organizational Commitment Board CEO Clinical Leadership Financial
Where Do We Start? How Do We Know if We are Ready?
Assessments
Staff Computer Knowledge Basic Keyboard Skills Basic Mouse Skills Readiness to Change
Readiness to Change Readiness to Change
Readiness to Change
Where Do We Start? How Do We Know if We are Ready?
Assessment
Infrastructure Current Computer Hardware High Bandwidth Capability Offices Wired for Computers Examination Rooms Wired for Computers
Change Management & Workflow Processes
Opportunities
Improved Communication
Redesigned Workflows to meet Organization Goals Opportunity to Think “Out of the Box”
80% of Implementation is in Workflow/Process Change
Management
20% in Hardware/Software Implementation
Improved Teamwork
Change Management & Workflow Processes
Implementation Team MUST include ALL Levels of Staff
Project/Champion/Manager Should be selected Not Necessarily the IT Guy Clinical Champion is Necessary
Implementation is an Overall Review of the Current
Status Quo with Opportunities for
Improvement/Revitalization
How Do We Go About Selecting a Vendor/System?
Start with CCHIT http://www.cchit.org
Speak to other Centers Similar to Yours Regarding Their
Experience with Vendors
NACHC can Help Determine your Most Important Requirements Request References from Vendors (5 – 10) Schedule Site Visits that You Choose
Include Representatives from Your Implementation Team Determine Hidden Costs Engage Legal for Contract Review
Implementation of any HIT Solution is a System-Wide Process Identify Goals for Success Monitor the Goals Encourage Input and Recommendations for Improvement Manage the Process of Continuous Improvement Implement Recommendations to Continually Improve Your
Operations and Services
Helpful Resources
Agency for Healthcare Research and Quality – HIThttp://healthit.ahrq.org
Health Information Management and Systems Society http://www.himss.orgCalifornia Healthcare Foundation
http://www.chcf.org Certification Commission for Healthcare Information Technology
http://www.cchit.org Robert Wood Johnson
http://www.rwjf.orgeHealth Initiative http://www.ehealthinitiative.orgNACHC
www.nachc.com
Michael Lardiere, LCSW
National Association of Community Health Centers
Director, HIT
Sr. Advisor, Behavioral Health
7200 Wisconsin Ave, Ste 210
Bethesda, MD 20814
301-347-0400
301-347-0459 (fax)
www.nachc.com