Connecting Communities – CMS’ Role

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Presentation transcript:

Connecting Communities – CMS’ Role William Rollow, MD MPH Deputy Director, Quality Improvement Group June 24, 2004

CMS Supports Healthcare Information Exchange Crucial to IOM goals of safety, timeliness, effectiveness, patient-centeredness, efficiency, and equitableness Must develop within privacy policy framework Communities are the appropriate locus of development

LHIIs – With or Without EHRs Information exchange does not require providers to have EHRs, but it is facilitated when they do CMS can help LHII development by stimulating EHR adoption and effective use

DOQ-IT: Doctors Office Quality – Information Technology Premise: substantial improvement in physician office quality cannot be achieved without adoption of health information technology and process redesign

DOQ-IT Make high quality, affordable systems more available Provide assistance to physician offices IT adoption decision Implementation and workflow efficiencies Care management/patient self-management Financial incentives: MCMP demonstration (MMA Sec 649)

MCMP Four states Expected payment methodology Expect to require adoption and use of systems which meet selected HL7 functional and CHI data standards, and at specified point, contribution of data to PHR and data exchange through available LHIIs Expect to require submission to QIO data warehouse of cardiac and diabetes measure results, based on DOQ/AMA set, with performance at target levels QIO assistance to physician offices in improving process and infrastructure for data collection

QIO Data Warehouse HIPAA oversight authority gives QIOs ability to collect quality data without need for the physician to obtain patient consent Avoids multiple slices and small numbers Single collection process Data can be used for multiple purposes Confidential assistance Public reporting, pay-for-performance: with consent Warehouse and secure data exchange exist Is being populated with hospital data Physician office data later this year

What You Can Expect Enhanced VistA product expected to be available by year end Four state (CA, MA, AR, UT) pilot project underway; national pilot in fall; full implementation in August 2005 via 8th SOW MCMP demonstration expected to be available to physicians in fall of this year

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