iht² health it summit in new york city 2012 - keynote presentation: "clinicians' role in...

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Lecture, University of Lille (7 December 1854)

Louis Pasteur 1822-1895

In the field of observation, chance favors the prepared mind.

Dans les champs de l'observation le hasard ne favorise que les esprits préparés.

David R. Hunt, MD, FACSMedical Director, Health IT Adoption & Patient Safety ONC, Office of the Chief Medical Officer

Clinicians' Role in IT

David R. Hunt, MD, FACS has no real or apparent conflicts of interest to report

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Take Home Messages

• Clinicians must lead

• Success is wholly dependent on partnership

• The path forward requires a system, resources, and courage

Where

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Adverb: (‘)hwe(Ə)r1. at, in, or to what place < ~ is the house>2. at, in, or to what situation, position,

direction, circumstances, or respect <shows ~ the plan leads>

3. archaic : here, there < <lo, ~ it comes again – Shak. >

Health care should be:

Safe Efficient

Effective Timely

PatientCentered

EquitableCrossing the Quality Chasm: A New Health System for the 21st Century (2001) Institute of Medicine (IOM) ; pg. 39

How

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Adverb: (‘)haῢ

1. in what manner or way2. with what meaning: to what effect3. by what name or title < ~ art thou called> 4. for what reason: why5. to what degree or extent6. in what state or condition <~ are you>7. at what price <~ a score of ewes now>

William Osler, M.D. (1849 – 1919)

HHS Priorities & Clinical Quality Measures Alignment

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All providers must select CQMs from at least 3 of the 6 HHS National Quality Strategy domains:

• Patient and Family Engagement• Patient Safety• Care Coordination• Population and Public Health• Efficient Use of Healthcare Resources• Clinical Processes/Effectiveness

“Quality, however, is so very disputable a matter that I look upon all information of this kind as somewhat uncertain.”

An Inquiry into the Nature And Causes of the Wealth of NationsBook One, Chapter 11

1776

Dr. Adam Smith

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“…health care reform must focus on improvinghealth and health care value for patients…

…Physicians can lead this change and return the practice of medicine to its appropriate focus: enabling health and effective

care.”

March 14, 2007—Vol 297, No. 10, pg. 1103

Clinical Quality Measures

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• Conditions that contribute to the morbidity and mortality of the most Medicare & Medicaid beneficiaries

• Conditions that represent national public/population health priorities

• Conditions that are common to health disparities

EHR Adoption Office-based Providers

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ONC, Health IT Dashboard (July 2012)Data from the CDC National Ambulatory Medical Care Survey (NAMCS)

Meaningful Use Eligible Provider Registrations

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Source: CMS EHR Incentive Program Data as of 7/31/2012

Total = 267,221

Payments to Eligible Professionals and Hospitals Under EHR Incentive Programs

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Source: CMS EHR Incentive Program Data as of 7/31/2012

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Number of students who successfully completed the Community College Consortia Program by state:

Health IT Workforce Training

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Quality of Diabetes Care: EHR vs. Paper Medical Records

Source: Cebul, R. D., M.D.; et al. (2011). Electronic Health Records and Quality of Diabetes Care. New England Journal of Medicine, 365:825-833. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMsa1102519#t=article

* Even after adjusting for patient demographic characteristics and insurance type, differences remain significant; p<0.001

% of Patients Receiving Care

A significantly higher proportion of patients being treated by

physicians with EHRs received care that aligns with accepted

treatment standards *

Health Outcomes : EHR vs. Paper Medical Records

A significantly higher proportion of patients being treated by physicians with

EHRs obtained better outcomes*

* Even after adjusting for patient demographic characteristics and insurance type, differences remain significant; p<0.005

% of Patients Obtaining Outcome Standards

Source: Cebul, R. D., M.D.; et al. (2011). Electronic Health Records and Quality of Diabetes Care. New England Journal of Medicine, 365:825-833. Retrieved from http://www.nejm.org/doi/full/10.1056/NEJMsa1102519#t=article

“There are two diagnoses you will never make: the one you don’t know about and the one you don’t think about.”

LaSalle D. Leffall, Jr., M.D.

Malpractice Claims and EHRs

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The relationship between electronic health records and malpractice claims.Quinn MA, Kats AM, Kleinman K, Bates DW, Simon SR.Arch Intern Med. 2012 Aug 13;172(15):1187-9.

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2011 Nov 10;365(19):1758-9. Epub 2011 Nov 2.

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“…in the light of experience as guided by intelligence.”

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Men at some time are masters of their fates; The fault, dear Brutus, is not in our stars, but in ourselves

Julius Caesar I. ii

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Lecture, University of Lille (7 December 1854)

Louis Pasteur 1822-1895

Dans les champs de l'observation le hasard ne favorise que les esprits préparés.

Thank You

Contact Information

davidr.hunt@hhs.gov

www.healthit.gov