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The 17th WorldVistA Community Meeting June 27, 2008

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Presentation on theme: "The 17th WorldVistA Community Meeting June 27, 2008"— Presentation transcript:

1 Federal Government’s Perspective for the Future of Health Information Technology
The 17th WorldVistA Community Meeting June 27, 2008 Robert M. Kolodner, MD National Coordinator Office of the National Coordinator for Health Information Technology (ONC)

2 17th WorldVistA Community Meeting
Today’s Agenda Health IT Vision The Tipping Point Federal Health IT Strategic Plan: 2008 – 2012 Critical Components Necessary for Nationwide Interoperable Health Information AHIC Successor “A2” June 27, 2008 17th WorldVistA Community Meeting

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Health IT: A Vision for 300 Million We know that we have achieved success when we have: Universal use of Health IT by all involved in health care Seamless, secure availability of a person’s health information Information available to make informed choices Widespread trust of that our privacy is protected Universal use of Health IT by all involved in health care Health IT becomes common and expected in health care delivery nationwide for all communities, including those caring for underserved or disadvantaged populations Seamless, secure availability of a person’s health information Your health information is available to you and those caring for you so that you receive safe, high quality, and efficient care Information available to make informed choices You will be able to use information to better determine what choices are right for you with respect to your health and care Widespread trust of that our privacy is protected You trust your health information can be used, in a secure environment, without compromising your privacy, to assess and improve the health in your community, measure and make available the quality of care being provided, and support advances in medical knowledge through research June 27, 2008 17th WorldVistA Community Meeting

4 Health and Care Transformation “Through” Health IT
Individual and Population Health & Well-being Health Care Transformation (Higher Quality, More Efficient, Patient-Focused) Population Health (PH, R&D, Quality Improvement, Emergency Preparedness) Goal 1. Patient-focused Health Care Goal 2. Population Health Health IT solutions must support the needs of BOTH “perspectives”

5 Moving Toward the Tipping Point: How Transformational Change Occurs
Past (?) EHR Adoption Transformational Change in Health Care Delivery & Health Health IT Tipping Point TIME June 27, 2008 17th WorldVistA Community Meeting

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ONC-sponsored Federal Collaborations and National Health IT Initiatives AHRQ HRSA IHS CDC CMS FDA ONC ASPR ASPE OMH OCR DOA FCC NSF DOJ DOE NASA OAS PHEP DOT DoJ/ BoP NIST SSA OPM EPA DHS DOD VA OMB DOS NIH SAMHSA Individual State’s HIE HISPC State Alliance for eHealth Direct Participants 13 Operational and Staff Divisions of DHHS 5 federal departments and agencies outside DHHS LEGEND AHIC HITSP CCHIT NHIN HHS Initiatives Other Federal Agency Initiatives State Initiatives AHIC 2.0 Public/Private Initiatives June 27, 2008 17th WorldVistA Community Meeting

7 The ONC-Coordinated Federal Health IT Strategic Plan: 2008 - 2012
Lays out the health IT agenda: the Collaboration 5-year plan: Two goals, eight objectives, 43 strategies Measure for each objective Milestone for each strategy Details current activities of Federal agencies June 27, 2008 17th WorldVistA Community Meeting

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“The Plan” – Goal One Enable Patient-focused Health Care Enable the transformation to higher-quality, more cost-efficient, patient-focused health care through electronic health information access and use by care providers, and by patients and their designees. June 27, 2008 17th WorldVistA Community Meeting

9 Improve Population Health
“The Plan” – Goal Two Improve Population Health Enable the appropriate, authorized, and timely access and use of electronic health information to benefit public health, biomedical research, quality improvement, and emergency preparedness. June 27, 2008 17th WorldVistA Community Meeting

10 Summary of Health IT Strategic Goals and Objectives: 2008-2012
Five Critical Components Necessary For Nationwide Interoperable Health Information Summary of Health IT Strategic Goals and Objectives: Privacy and Security Interoperability Adoption Collaborative Governance Objective 1.1: Facilitate electronic exchange, access, and use of electronic health information, while protecting the privacy and security of patients’ health information. Objective 1.2: Enable the movement of electronic health information to support patients’ health and care needs. Objective 1.3: Promote nationwide deployment of electronic health records (EHRs) and personal health records (PHRs) and other consumer health IT tools. Objective 1.4: Establish mechanisms for multi-stakeholder priority-setting and decision-making. Standards in Health IT Products Goal 1. Patient-focused Health Care Privacy, Security and Other Heath IT Policies Adoption of Interoperable Health IT Objective 2.1: Advance privacy and security policies, principles, procedures, and protections for information access in population health. Objective 2.2: Enable exchange of health information to support population-oriented uses. Objective 2.3: Promote nationwide adoption of technologies to improve population and individual health. Objective 2.4: Establish coordinated organizational processes supporting information use for population health. Nationwide Health Information Network Goal 2. Population Health Governance June 27, 2008 17th WorldVistA Community Meeting

11 Current State Ambulatory EHR Adoption
Adoption of Interoperable Health IT Current State Ambulatory EHR Adoption Level of EHR Function Size of Practice 25 20 15 10 5 100 80 60 40 20 Basic System > 50 physicians 13% 50% Percentage Percentage Fully Functional 1 - 3 physicians 4% 9% DesRoches CM et al., N Engl J Med 2008;359:50-60. June 27, 2008 17th WorldVistA Community Meeting

12 Adoption of Health IT Solutions
Interoperable Health IT Adoption of Health IT Solutions Standardized, repeatable method developed to measure EHR adoption Multiple financial barriers addressed Conflict of interest regulations (“Stark” and “Anti-Kickback”) modified to facilitate donations of certified EHRs Malpractice insurers offering premium discounts for use of EHRs CMS EHR Demonstration to be started in June June 27, 2008 17th WorldVistA Community Meeting

13 Standards in Health IT Products Interoperability Standards into Products – Summary of the Cyclical Process Health-related Priorities Established American Health Information Community (AHIC) Certification Commission for Healthcare IT (CCHIT) Describe Health-related Scenarios Incorporated in Health IT Products Used in Health IT Product Certification Required in Federal Systems and Healthcare Contracts (Executive Order 13410) “Stark” exceptions and Anti- Kickback safe harbor Identify Health IT Standards Healthcare IT Standards Panel (HITSP) Acceptance by Secretary of HHS Recognition by Secretary of HHS Testing and Implementation (1 year gap) June 27, 2008 17th WorldVistA Community Meeting

14 Interoperability Standards in Products
Health IT Products Interoperability Standards in Products STANDARDS 4 “cycles” of standards harmonization 1st set recognized by HHS Secretary in January 2008 2nd set accepted by HHS Secretary in January 2008 3rd set in process of being harmonized 4th set priority areas selected In PRODUCTS Over 150 EHR products certified in 2 years since program launch Ambulatory EHRs >75% of new installations Inpatient EHRs 9 certified in first 6 months 4 more pending (total >50% of U.S. market) Network and specialty EHRs certifications imminent PHR certification being planned June 27, 2008 17th WorldVistA Community Meeting

15 Different Network Models
Nationwide Health Information Network Different Network Models Network Type Examples Benefit Challenge Organizational Integrated delivery systems, hospital chains Effort of exchanging data internally is aligned with business outcomes Extra-organizational exchange Geographic RHIOs, geographic HIEs Support non-proprietary exchange Achieving sustainable business models Personally Controlled Personally Controlled Health Record Support Organizations Consumer access to, and control of, health information Consumer and provider acceptance June 27, 2008 17th WorldVistA Community Meeting

16 Mobilizing Health Information Nationwide
The Nationwide Health Information Network State and Local Gov Health Bank or PHR Support Organization Community Health Centers Community #1 CDC VA CMS DoD SSA Mobilizing Health Information Nationwide Labs Integrated Delivery System Community #2 Exchange of electronic health information to: improve the quality / efficiency of health care empower the individual patient support public health, emergency preparedness, and research Requires common elements: minimum set of detailed standards - a shared network “dial tone” support for consumer / inter-organizational trust value of exchanging data exceeds the cost Pharmacies The Internet Standards, Specifications and Agreements for Secure Connections June 27, 2008 17th WorldVistA Community Meeting

17 Privacy and Security: Policy Development in Progress
Privacy, Security and Other Heath IT Policies Privacy and Security: Policy Development in Progress Authentication Authorization Patient Identify Proofing and Linkage Privacy and Security Framework Principles and Policies for Secondary Uses of Information developed by HHS Federal Advisory Committee (NCVHS) Privacy Act 1970s - CFR Title 42 – Confidentiality of Alcohol & Drug Abuse Patient Records Health Information Portability and Accountability Act (HIPAA) Genetic Information Nondiscrimination Act (GINA) Robust privacy and security protections will be the underpinning of a successful network for health information exchange. Secretary Michael Leavitt, HIMSS 2008 Keynote Address June 27, 2008 17th WorldVistA Community Meeting

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Governance American Health Information Community 2.0 (AHIC Successor) (AHIC 2.0) (“A2”) - Principles for Governance The entity should exist for the purpose of individual/ consumer benefit The entity should establish and enhance trust among stakeholders The entity should have broad participation across the health care industry stakeholders The governing bodies of the entity should have necessary authority to make decisions, but only the authority that is necessary to do this The entity should be feasible to establish and operate, and sustainable into the future The entity should be adaptable over time and across future circumstances June 27, 2008 17th WorldVistA Community Meeting

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Governance Membership Segmentation Ensures Appropriate Outreach and Representation of all Stakeholders Consumers Employers Government and Public Health Health Care Providers Health Informatics, Research, Academia Health Information Exchanges and Regional/State-Level Public-Private Partnerships Health Plans and Other Players Infrastructure and Standards (Technical) Other Health Entities (Pharma, Labs, Device Manufacturers…) Quality Vendors, Consultants (Supply Chain) The entity should exist for the purpose of individual/ consumer benefit The entity should establish and enhance trust among stakeholders The entity should have broad participation across the health care industry stakeholders The governing bodies of the entity should have necessary authority to make decisions, but only the authority that is necessary to do this The entity should be feasible to establish and operate, and sustainable into the future The entity should be adaptable over time and across future circumstances The role of membership within the Successor’s governance structure must still be determined – Comments on this subject are welcome June 27, 2008 17th WorldVistA Community Meeting

20 For More Information on AHIC 2.0 (“A2”)
Governance For More Information on AHIC 2.0 (“A2”) The entity should exist for the purpose of individual/ consumer benefit The entity should establish and enhance trust among stakeholders The entity should have broad participation across the health care industry stakeholders The governing bodies of the entity should have necessary authority to make decisions, but only the authority that is necessary to do this The entity should be feasible to establish and operate, and sustainable into the future The entity should be adaptable over time and across future circumstances June 27, 2008 17th WorldVistA Community Meeting

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2008 – A Banner Year Adoption Ambulatory adoption up another 50% in one year Interoperability Standards 79 health IT standards recognized by Secretary Leavitt Nationwide Network Nationwide network “dial-tone” demonstrated for health data mobility Privacy & Security & Other Health IT Policies Privacy and security framework leads to common ground States collaborate to implement similar policy solutions Governance Health IT Strategic Plan released AHIC 2.0 launched June 27, 2008 17th WorldVistA Community Meeting

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June 27, 2008 17th WorldVistA Community Meeting

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William Stead, M.D.* “Try, fail. Try, fail. Try, succeed, deploy.” *Associate Vice Chancellor for Health Affairs & Professor of Medicine and Biomedical Informatics Vanderbilt University ` June 27, 2008 17th WorldVistA Community Meeting

24 17th WorldVistA Community Meeting
For More Information: June 27, 2008 17th WorldVistA Community Meeting

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