Health IT Through your Customers’ Eyes: what meaningful use and the federal Health IT

Strategic Plan say about the changing health care market

iHT2 HIT Summit

March 3, 2015

David Lansky, PhD

President and CEO

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PBGH Members

Apple Facebook Google Hewlett Packard Microsoft Oracle ….

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We’re in a race…

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The rationale for EHR incentives

HIT Policy Committee

Meaningful Use Workgroup Presentation

Paul Tang

Palo Alto Medical Foundation

Farzad Mostashari,

New York City Health Department

June 16, 2009

Health IT and Transformed Health Care

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• Ultimate vision is to enable significant and measurable improvements in population health through a transformed health care delivery system.

• Key goals*: – Improve quality, safety, & efficiency

– Engage patients & their families

– Improve care coordination

– Improve population and public health; reduce disparities

– Ensure privacy and security protections

*Adapted from National Priorities Partnership. National Priorities and Goals:

Aligning Our Efforts to Transform America’s Healthcare. Washington, DC: National Quality Forum; 2008.

Achievable Vision for 2015

• Prevention, and management, of chronic diseases

– A million heart attacks and strokes prevented

– Heart disease no longer the leading cause of death in the US

• Medical errors

– 50% fewer preventable medication errors

• Health disparities

– The racial/ ethnic gap in diabetes control halved

• Care Coordination

– Preventable hospitalizations and re-admissions cut by 50%

• Patients and families

– All patients have access to their own health information

– Patient preferences for end of life care are followed more often

• Public health

– All health departments have real-time situational awareness of

outbreaks

HIT-Enabled Health Reform Achieving Meaningful Use

2009 2011 2013 2015

HIT-Enabled Health Reform

Meanin

gfu

l U

se C

rite

ria

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)

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Federal HIT – what it’s not…

• Not about more EHRs

• Not about clinical decision support

• Not about improved documentation

• Not about more HIE

It’s about transforming care to deliver value to the

public – and addressing the national debt.

Payments are conditional upon making progress

towards that goal.

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The shift to “value”

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Where are we now – with MU3?

• Far behind intended pace of functional advancement, quality measurement, and interoperability

• Significant provider opposition and slow uptake

• Perception of “burden”, cost, and low value

• CMS making modest accommodations

• Congress proposing legislative curtailment of pace and scope

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Reactions to MU3

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Entering a fundamentally new era

• Incentives for system redesign are escalating

• Market pressure will reward those who leverage

HIT and punish those who don’t

• MU incentives and penalties becoming less

important than market forces

• New federal planning to support desired payment

and delivery system environment • New policy workgroups – like accountable care

• Interoperability roadmap

• Federal Health IT Strategic Plan

Vision

Accountable health models:

• Optimal patient/consumer and community health

• Aligned accountability for patient and community health that bridges employers, health plans, hospitals, providers, communities, and patients

• Aligned financial incentives that encourage market competition to optimize patient and community health

• Seamless integration of required clinical, financial, administrative, and operational information across the entire continuum of care to eliminate information gaps as a root cause of inefficient and ineffective patient care.

• Promotion of innovations and improvements to continuously discover, test, and evaluate better ways to achieve health and healthcare outcomes

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DRAFT Shared Nationwide Interoperability Roadmap - Version 0.5 The Vision

2021 - 2024

Broad-scale learning health

system

2018 - 2020

Expand interoperable data, users,

sophistication, scale

2015 - 2017

Nationwide ability to send, receive, find,

use a common clinical data set

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Federal HIT Strategic Plan: 2015-2020

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Reactions to Strategic Plan

• Strategic Plan should better integrate its focus on individuals/consumers as a Health Improvement Plan, rather than emphasizing data in a “Collect, Share, Use” framework

• The Plan’s focus should be how to build a culture of shared, person-centered health and care goals, and how federal policies, programs, and regulations will support individuals, providers, and community partners to meet these goals

• Federal actions should unambiguously show how they facilitate and reinforce the Triple Aim

• The end state is not a health IT infrastructure – it is the widespread, effective use of digitized information to support improved health and health care. The Plan should use language to emphasize the end, not the means.

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Joint Recommendations for Refinement

• Articulate a pathway to evolve toward a new paradigm: More dynamic, interactive learning system

Health equity for consumers and providers

Improved patient/family caregiver experience, as well as improved empowerment and engagement through consumer participation

Accommodate a pluralistic data and care delivery environment

• Integrate public health and social determinants of health into the health IT ecosystem and into health improvement efforts

• Provide clear guidance on privacy framework

• Plan must hold federal partners accountable, with regular, transparent reporting on progress toward goals

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A critical juncture…

• We are six years into a journey to transform the

health care system.

• We have new commitments to accelerate the

changes in incentives – but they can’t succeed

without modern information flows.

• The health IT sector has to embrace and lead the

change.