Health Information Technology (“HIT”) Bobby Gladd. M.A., HealthInsight Regional Extension Center HIT Project Coordinator This material was prepared by HealthInsight as part of our work as the Regional Extension Center for Nevada and Utah, under grant #90RC0033/01 from the Office of the National Coordinator, Department of Health and Human Services.

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HITECH Act HITECH Act The Health Information Technology for Economic and Clinical Health Act (HITECH) Act ARRA Components—January 6, 2009 The Health Information Technology for Economic and Clinical Health Act (“HITECH”) is part of the American Recovery and Reinvestment Act of 2009 (ARRA). ARRA contains incentives related to health care information technology in general (e.g. creation of a national health care infrastructure) and contains specific incentives designed to accelerate the adoption of electronic health record (EHR) systems among providers. Because this legislation anticipates a massive expansion in the exchange of electronic protected health information (ePHI), the HITECH Act also widens the scope of privacy and security protections available under HIPAA; it increases the potential legal liability for non-compliance; and it provides for more enforcement.

“The widespread use [of computers]… in hospitals and physicians’ offices will instantaneously give a doctor or a nurse a patient’s entire medical history, eliminating both guesswork and bad recollection, and sometimes making a difference between life and death.” Who said this?

“The widespread use [of computers]… in hospitals and physicians’ offices will instantaneously give a doctor or a nurse a patient’s entire medical history, eliminating both guesswork and bad recollection, and sometimes making a difference between life and death.” Who said this? IBM CEO Thomas J. Watson, Jr., 1965

24 years later…

The (near) future: widespread mobile HIT

ACRONYMANIA 2011: HIT alphabet soup

This will no longer do, particularly in a world where we take e-Commerce (incl. online banking), ATMs, Google, and iPads, smart phones, etc as givens.

This is also why it will no longer do. Tracking health data on paper is [1] too expensive, and [2] potentially dangerous to patients.

Universal access Improved quality Reduced cost Can we do all of these, at once? Or is that naïve? The long-sought national goal

The now-sought national goal

2010 U.S. National Health expenditure, ~$2.7 trillion (17% of GDP), 2010 U.S. population, ~309,000,000 people, ~$8,738 per capita! U.S. population and NHE data

We could do healthcare for half of what it costs today. “We could do healthcare, at markedly higher quality, for everyone in this country, without rationing or denying anybody the care that they need, without having the government dictate how doctors practice or whether hospitals could expand, at half the cost we do it now...” - Health care “Futurist” Joe Flower

The aging U.S. Population

How Are U.S. Health Care Expenses Distributed? A Small Proportion of the Total Population Accounts for Half of All U.S. Medical Spending Five percent of the population accounts for almost half (49 percent) of total health care expenses. The 15 most expensive health conditions account for 44 percent of total health care expenses. Patients with multiple chronic conditions cost up to seven times as much as patients with only one chronic condition. Source: AHRQ

2010 HEDIS Quality Report

The history of U.S. healthcare: “FFS” (“Fee for Service”) The future of U.S. healthcare: “P4P” (“Pay for Performance”) a.k.a. “No outcomes, no income.” HIT will be critical to P4P success.

Before EHR Source: California Healthcare Foundation

After EHR Source: California Healthcare Foundation

Adopting HIT effectively: HealthInsight REC services Initial readiness assessment Workflow analysis Tailored selection tools Referrals to mentor clinics Contract negotiation tools Project management and implementation Privacy and security best practice Health information exchange assistance Getting to “Meaningful Use”

“Health care is fundamentally an information science, and, more importantly, the clinical information at its core is information about science – the science of treatment, healing, and wellness. Consequently, it is expensive to accurately acquire (given the considerable breadth of data to be usefully captured) and expensive to effectively interpret and act upon – in light of the extensive expertise required for quality health care. The labor time of everyone involved in the delivery of care is an invaluable resource, a precious, finite resource whose effectiveness can only be enhanced by improving the way we deliver its information lifeblood to the point of care.” - Bobby Gladd

Source: Executive Healthcare blog The BIG picture

Thank you! Questions? Bobby Gladd, HealthInsight REC