arra - rhitec
DESCRIPTION
ARRA and WVRHITEC discussion for WV HIMSS conferenceTRANSCRIPT
ARRA & Regional ARRA & Regional HIT Extension HIT Extension
CentersCenters
Jack L. Shaffer, Jr.CIO – Community Health Network of West Virginia
A quick word about the Community Health Network of West Virginia
The Network is a tax-exempt, non-profit health center-controlled West Virginia corporation – formed in 2000.
The Network is primarily an application service provider (ASP) delivering centralized practice management, electronic medical records (EMR), and technology services for its members.
Currently with 50 clinical locations in production using the Indian Health Services RPMS-EHR system (CCHIT-Certified, public domain / open source EHR derivation of the VA’s VistA system) 70 FTE providers – 300+ concurrent users. 10 More clinics to implement over the next year.
Our focus is health improvement through the strategic use of health information technology along with workflow modifications to improve health outcomes.
ARRA... A Massive Stimulus for
Health IT Adoption & HIE Expansion
Appropriations for Health IT New Incentives for Adoption
$2 billion for loans, grants & technical assistance for:
• National Resource Center and Regional Extension Centers
• EHR State Loan Fund
• Workforce Training
• Research and Demonstrations
New Medicare and Medicaid payment incentives for HIT adoption
• $20 billion in expected payments through Medicare to hospitals & physicians
• $14 billion in expected payments through Medicaid
• ~$34 billion expected outlays, 2011-2016
At least $300 million of the total at HHS Secretary’s discretion for HIE development
• Funneled largely through States or qualified State-designated entities
• For planning and/or implementation
Appropriations for HIE
$4.3 billion for broadband & $2.5 billion for distance learning/ telehealth grants
Broadband and Telehealth
$1.5 billion in grants through HRSA for construction, renovation and equipment, including acquisition of HIT systems
Community Health Centers
ARRA – HITECH Funding Streams $17.2 billion in incentives for EMR adoption
Paid via Medicare OR Medicaid Estimated $234 million+ could go to WV
ambulatory providers over 4 years Estimated $500+ million could go to WV
acute hospitals over 4 years Avg. hospital with 7,550 discharges and 50%
Medicare share will receive $4 million over 4 years. Must meet “meaningful use” criteria to
achieve 100% of ARRA funds $2 billion for the Office of the National Coordinator
Health Information Exchange Creation of Regional HIT Extension Centers
Extension Center? Regional health IT extension centers will aim to help health care
providers become "meaningful users" of health IT by 2011 so they can qualify for federal health IT stimulus funding.
Blumenthal noted that the federal economic stimulus package allocated nearly $700 million to form a nationwide network of "local health care geek squads.“
The health IT extension center program is patterned after the federal agriculture extension service created nearly a century ago. Similar to how the agricultural extension centers help farmers address pesticide, crop and land use issues, the new health IT extension centers would help health care providers "not just get computers, not just store the information, but use the information," Blumenthal said.
Each State will be served by a RHITEC (some states may have more than one and some states will be served by a multi-state RHITEC)
Federal support for the first two years Services to include
Assistance selecting a system Assistance negotiating fair pricing Project implementation assistance Workflow Redesign Functional interoperability Privacy and Security Support Training and support on using technology and
demonstrating medical use Progression to “meaningful use”
Regional HIT Extension Center - Regional HIT Extension Center - FAQFAQ
Not a grant. It is a cooperative agreement between the RHITEC and the ONC for specific services.
90/10 match first 2 years then 10/90 for next 2 years.
Focus is primary care providers. Funding capped at 10 providers per
organization. Capped at ~$5K per provider.
Regional HIT Extension Center - Regional HIT Extension Center - FAQFAQ
In West Virginia……..In West Virginia……..
Applied for ~9M in Federal funding over a 4 year period.
The WV-RHITEC is a consortium comprised of the Health Improvement Institute; the Community Health Network of West Virginia and West Virginia Medical Institute.
The Consortium will have strategic partners throughout the State assisting with executing its mission.
Targeted Groups for WV-RHITECWe have the opportunity to help more than
1,800 providers adopt and use health-IT over the next 4 years. Assuming a 90% success rate in progressing to meaningful use, these providers could receive over $80 million to support HIT adoption and use efforts.
Targeted Groups for WV-RHITECThe following table reflects the commitments received by the
Extension Center by category:
Category Paper to M-use
EHR to M-use
Total
Priority PC
Providers118 342 460
Total PC Providers
142 361 503
Non PC Providers
0 411 411
Total Providers
142 772 914
PC designates Primary Care Providers; M-use means meaningful use.
What Does this Mean to All What Does this Mean to All of You?of You? Need to move forward with implementation and meaningful use of
technology The environment is heating up and the tipping point is near Meaningful Use -
Evidence based decision support tools Computerized order entry and results reporting E-prescribing Care opportunity reports based on age appropriate and disease
based guidelines Engagement of patients and families-Patient Health Records Care coordination across the boundaries of the clinic Reporting and sharing data for quality improvement purposes
Meaningful Use? Blumenthal emphasized that the meaningful use
of electronic health records is not just about introducing technology to collect and share information. It's also about physicians and hospitals changing how they operate and the sequence of their work. "We are involved in a vast social project of change management," he noted.
Providing better information is the foundation for change, he said. Beyond that, physicians and hospitals will need help and training to understand what improvements to make.
Bending the Curve Towards Transformed Health
Achieving Meaningful Use of Health Data
2009 2011 2013 2015
HIT-Enabled Health ReformAchieving Meaningful Use
2009 2011 2013 2015
HIT-Enabled Health Reform
HITECH Policies 2011 Meaningful
Use Criteria (Capture/share
data)2013 Meaningful
Use Criteria(Advanced care processes with
decision support)
2015 Meaningful Use Criteria (Improved Outcomes)
Meaningful Use - Examples
Extension Centers are key for M-use
"I know this from my own experience as a physician," he said. "You can show me that my results are not up to those of my colleagues. That didn't mean I knew how to improve them."
He cited activities, such as workflow redesign, workforce education and rearranging offices and nurses' stations so that the right information is more accessible.
ONC will help providers adopt these techniques in their own practices through its regional extension center program, which will assist providers in deploying and operating electronic health records.
Questions?