1. Quality Matters: Optimizing Health IT Adoption in Puerto Rico Fadesola Adetosoye, M.S. Project Officer, Regional Extension Center Program Office of the National Coordinator for Health IT June 16, 2011

2. 1 HITECH: Catalyst for Transformation Pre 200920092014 A system plagued by inefficiencies EHR Incentive Program and 62 Regional Extension Centers Widespread adoption & meaningful use of EHRs

3. HITECH: Supported Programs 8/7/2015 Office of the National Coordinator for Health Information Technology 2 Regional Extension Center Program Community College Workforce Program Beacon Community Programs State Health Information Exchange Programs Standards and Certification Framework Privacy and Security Framework

4. HITECH: How the Pieces Fit Together Medicare and Medicaid Incentives and Penalties Health IT Practice Research Improved Individual & Population Health Outcomes Increased Transparency & Efficiency Improved Ability to Study & Improve Care Delivery ADOPTION EXCHANGE State Grants for Health Information Exchange Standards & Certification Framework Privacy & Security Framework Regional Extension Centers Workforce Training MEANINGFUL USE 3

5. The Healthcare system today… 8/7/20154 System plagued by inefficiencies Inconsistent and inadequate health care delivery Increasing costs at exponential rates Eroding health care coverage

6. The Healthcare system of “tomorrow”… 8/7/2015 Office of the National Coordinator for Health Information Technology 5

7. Big Picture Goal… 8/7/2015 Office of the National Coordinator for Health Information Technology 6 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 Health Health Care Efficiency Patient Health Outcomes

8. How do we Improve Clinical Outcomes for ALL Puerto Ricans? Building a case for: Health Information Technology 8/7/2015 Office of the National Coordinator for Health Information Technology 7

9. Making the case for Health IT in PR 8/7/2015 Office of the National Coordinator for Health Information Technology 8 1.12.9% of the Puerto Rican population is diabetic (2 nd 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

10. We need to…. 8/7/2015 Office of the National Coordinator for Health Information Technology 9 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…..

11. Improve Health Outcomes for All

12. In Puerto Rico Today… 8/7/2015 Office of the National Coordinator for Health Information Technology 11 625 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

13. Opportunities for Puerto Rico… Meaningful Use Incentive Program Patient-Center Medical Homes Accountable Care Organizations State Health Information Exchange Regional Extension Center Program Regional Extension Center Program 8/7/2015 Office of the National Coordinator for Health Information Technology 12

14. 62 Regional Extension Centers cover 100% of the U.S. and its territories 8/7/2015 Office of the National Coordinator for Health Information Technology 13 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

15. Ponce School of Medicine: Regional Extension Center of PR and USVI 8/7/2015 Office of the National Coordinator for Health Information Technology 14 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. GOAL To 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 Service Area Profile Total # PCPs: 7,000 Total # PPCPs: 6,000 Total # providers: 12,750 PSM has committed to assisting over 30% of providers in PR with EHR adoption and MU!

16. 2,300 Providers and counting… 8/7/2015 Office of the National Coordinator for Health Information Technology 15

17. Provider make-up by Practice Setting 8/7/2015 Office of the National Coordinator for Health Information Technology 16

18. Follow the Money…. While Meaningful Use is one incentive, Health IT provides numerous cost-saving opportunities! 8/7/2015 Office of the National Coordinator for Health Information Technology 17 Reduce Administrative cost Billing system and payments Meaningful Use Patient-Centered Medical Homes ↓ Medication errors ↑ Medical Reconciliation Save time Public Health Improved care coordination

19. Challenging, but possible… 8/7/2015 Office of the National Coordinator for Health Information Technology 18 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!

20. 8/7/2015 Office of the National Coordinator for Health Information Technology 19 ¡ SI SE PUEDE! ¡ Puerto Rico, SI SE PUEDE!

21. 8/7/2015 Office of the National Coordinator for Health Information Technology 20 Visit the ONC Web site: www.HealthIT.hhs.gov/programs/REC/ Fadesola Adetosoye Fadesola.adetosoye@hhs.gov