Quality Matters: Optimizing Health IT Adoption in Puerto Rico

Fadesola Adetosoye, M.S.Project Officer, Regional Extension Center ProgramOffice of the National Coordinator for Health IT

June 16, 2011

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HITECH: Catalyst for Transformation

Pre 2009 2009 2014

A system plagued by inefficiencies

EHR Incentive Program and 62 Regional Extension Centers

Widespread adoption & meaningful use of EHRs

HITECH: Supported Programs

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• Regional Extension Center Program

• Community College Workforce Program

• Beacon Community Programs

• State Health Information Exchange Programs

• Standards and Certification Framework

• Privacy and Security Framework

HITECH: How the Pieces Fit Together

Medicare and Medicaid Incentives and Penalties

Health IT Practice Research

Improved Individual & Population HealthOutcomes

IncreasedTransparency & Efficiency

ImprovedAbility to Study &Improve Care Delivery

ADOPTIONADOPTION

EXCHANGEEXCHANGE

State Grants forHealth Information Exchange

Standards & Certification Framework

Privacy & Security Framework

Regional Extension Centers

Workforce Training

MEANINGFUL USEMEANINGFUL USE

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The Healthcare system today…

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System plagued by inefficiencies

Inconsistent and inadequate health care delivery

Increasing costs at exponential rates

Eroding health care coverage

The Healthcare system of “tomorrow”…

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Big Picture Goal…

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• Regional Extension Center

• Community College Workforce

• Communities of Practice• Health Information

Technology Research Center (HITRC)

Paper-Based Practice

Support Network

REC-Provider Partnership

Fully Functional EHR

Education and Outreach • Workforce • Vendor Relations • Implementation • Workflow Redesign • Functional Interoperability • Privacy and Security • Meaningful Use

Population HealthHealth Care EfficiencyPatient Health Outcomes

How do we Improve Clinical Outcomes How do we Improve Clinical Outcomes for ALL Puerto Ricans?for ALL Puerto Ricans?

Building a case for:Health Information Technology

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Making the case for Health IT in PR

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1. 12.9% of the Puerto Rican population is diabetic (2nd Highest prevalence rate in the Country)

2. Over 4,500 cases of Dengue (2005)

3. Less than 30% of adults have received their influenza (flu) or pneumococcal vaccinations (the U.S. average for both is over 65%)

4. Information not readily available on Puerto Rico providers

We need to….

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1. Optimize electronic health record adoption

2. Achieve quality standards to produce desired health outcomes

3. Increase patient education on the opportunities and benefits available to them via health information technology (the patient-centric approach)

So that we can…..

Improve Health Improve Health Outcomes for AllOutcomes for All

In Puerto Rico Today…

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• 625 out of 930 Pharmacies have the capability of accepting electronic prescriptions from the electronic health record

• Less than 1% of physicians in Puerto Rico are actively e-prescribing

• Less than 10% of providers in Puerto Rico have adopted an electronic health record

• Limited patient engagement in managing their health care

Opportunities for Puerto Rico…

• Meaningful Use Incentive Program• Patient-Center Medical Homes• Accountable Care Organizations• State Health Information Exchange• Regional Extension Center ProgramRegional Extension Center Program

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62 Regional Extension Centerscover 100% of the U.S. and its territories

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Goal: 100,000 priority primary care providers

achieve meaningful use (MU) by 2012

RECs assist providers with:• Education• EHR vendor selection• EHR implementation• Project Management• Workflow redesign• Achieving Meaningful Use

Ponce School of Medicine is the Regional Extension Center for Puerto Rico and the U.S. Virgin Islands

Ponce School of Medicine:Regional Extension Center of PR and USVI

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MISSION

VISION

To Provide accessible and effective solutions, technical resources and educational programs to facilitate the transformation of 4,038 primary care practices in PR and USVI through the adoption of certified EHRs and meaningful use of health information technology.

To establish an information-driven health care delivery system where providers and patients participate in decisions which result in improved health status, healthcare quality and service access.

GOALTo assist more than 4,000

providers meaningfully use their electronic health

record

Service Area Profile

• Total # PCPs: 7,000• Total # PPCPs: 6,000• Total # providers: 12,750

PSM h

as c

omm

itted

to

assis

ting

over

30%

of

prov

ider

s in

PR w

ith E

HR

adop

tion

and

MU!

2,300 Providers and counting…

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Provider make-up by Practice Setting

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Follow the Money….While Meaningful Use is one incentive, Health IT providesnumerous cost-saving opportunities!

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Reduce Administrative cost

Billing system and payments

Meaningful Use

Patient-Centered Medical Homes

↓ Medication errors↑ Medical Reconciliation

Save time

Public HealthImproved care coordination

Challenging, but possible…

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Dr. Aida Blasini pictured with Michelle Piatek (Office Manager)

Dr. Blasini is the first provider in PR and one of the first in United States to successfully attest to Meaningful Use!

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¡ ¡ Puerto Rico, SI SE PUEDE!SI SE PUEDE!

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Visit the ONC Web site: www.HealthIT.hhs.gov/programs/REC/

Fadesola AdetosoyeFadesola.adetosoye@hhs.gov