community meeting 101 october 16, 2012 houston. healthcare in houston healthcare is the largest...
TRANSCRIPT
Healthcare in Houston
Healthcare is the largest industry in the US.
Houston is home to the the largest medical complex in the world.
Workers are well-educated, with income that is higher than average.
People from around the world seek care from area facilities.
Healthcare helps drive the IT, biotechnology, and education clusters.
Continues to be a crucial component of the area economy.
60% of all new commercial construction in Houston is Healthcare.
Obama Administration Directive
All U.S. medical records to be computerized within five years; standards created
cut waste, eliminate red tape and reduce the need to repeat expensive medical tests
2d largest Spending item in 2009 Stimulus Package; $40 Billion
National Health Information Network
501c3 non-profit corporation governed by a board appointed by Governor
to serve as a catalyst for the development of a seamless electronic health information infrastructure
Funding – No state funds were ever appropriated to the THSA
Texas Health Services Authority
Problems:• Mix of paper and electronic
• No standardization
• Unmanageable
• Incomplete
• Expensive
Current State ofHealthcare Connectivity
iHealth Trust Vision
Trusted third party, non governmental, non stakeholder, neutral community information infrastructure provider
High quality, cost-effective health care for all Houstonians
Interoperable health information to support effective decision making and risk management at all levels
Patient care Population health Administration Performance monitoring and evaluation Policy development
iHealth Trust Vision
iHealth Trust is not controlled by any single entity or segment of the healthcare marketplace
iHealth Trust is a cooperative relationship of entities from across the healthcare provider and insurance spectrum.
iHealth Trust will act as a legal fiduciary of the consumer’s personal healthcare information and will act in the best interests of the community
Potential Benefits:• Portable lifetime health record
• Improved healthcare delivery
iHealth Trust Vision
“Data Liquidity”
Making it easy for the data to move around and do some good for us all
Nobody can make good decisions without good data
Industry uses data 'lock-in' as a tactic to keep their customers captive.
This is NOT a technology problem, it is a sociology problem.
Consumer is effectively “barefoot, pregnant and in the kitchen”; information is power who represents consumer?
Conflicting institutional missions; self interest
Perception of lack of trust Data rights and permissions issues Financing, “why should I pay?” Vendors have silver bullet I’m from the Government……
1863, President Lincoln designated 4ft 8.5inches as the gauge of the transcontinental railroad.
1865, the “golden age” of railroads began.
Community Infrastructure; Utility
Step 1: Set up account; authorize deposits and withdrawals; get ID card to facilitate registration process & ID
Step 2: Deposit. With your permission, caregivers deposit copies of your medical information into your electronic lockbox
Step 3: Verify & Update your PHR. You verify your information through the Internet or with your physician. You can also add updates or comments.
Step 4: Withdrawals. With your permission, doctors withdraw a copy of your information from your lockbox to take better care of you and your family.
How does the iHealth Trust work?
5209 people 1948 (1st generation)
Every 2 years:
Detailed Medical History, Physical, Labs
5124 offspring 1971 (2nd generation)
Every 2 years:
Detailed Medical History, Physical, Labs
3500 offspring 2002 (3rd generation)
Every 2 years:
Detailed Medical History, Physical, Labs
Consider the Boston University Framingham Heart Study…
What will the value be for appropriate access to large-sample, electronically collected, clinical information in the future?
Imagine the shear volume ofpatient medical information withinthe facilities of the Texas Medical Center.
Consider Houston…
Dr. Ernest Bertner,January 30, 1949 - Houston
“As a time saver, a pneumatic tube system will be included that will connect all institutions in the center.”
Why? This was for the purpose of distributing histories of patients and other information that might be needed, as well as a means of communication between departments in the teaching institutions.
Challenges to this initiative.
Conflicting institutional missions; self interest
Perception of lack of trust Data rights and permissions issues Houston iHealth Trust financing Legal issues
Reasons to do this……. Better Healthcare for community & system to manage
uninsured Supports accountability – measuring results Decreases duplication of services Attacks fragmentation – coordinating care Provides aggregate data for community health measurement Helps patients learn self-management strategies. Serves to position Houston as national health leader
Creates Economic Cluster for HIT & Research Provides bridge for genetic research
Leverage HIT arms race happening now Going to happen anyway…….
What we know……
Huge amounts of digital data exist, already formatted electronically, but scattered across many proprietary systems
Huge amounts of digital data is coming
Software and the Internet will make this possible
An integration “big bang” -- getting everybody all of a sudden onto one, single, structured and standard format—can’t and won’t happen.
The doctors MUST participate
Collaboration in Community will be required
What have we done? Business Structure: IRS approved 501 c3 Award by THSA: B&O Plan approved
iHealth Physicians, LLC: Operating Entity Sustainable business model - revenue
Valuable technology offerings Plan not contingent on Stimulus
funding Nimble and market driven
Where do we start?ID the users.
Identify all providers once Centralized identity credentials Centralized clinical credential information Texas sets National Standard
Identify consumers f/k/a patients Providers issue branded credentials Get rid of registration clipboard Put patient at center of system