1. Quality of Care A Group VI

2. Public Policy Problem The lack of ability to generate population-based data/information from individual practices or health care providers impedes effective communication and quality care.

3. Dimensions of the Problem ONCHIT credentialing process incomplete and expensive. Inpatient E.H.R. requirements lack population- based relational database capabilities. Lack of capital funding for providers for IT. Medical Home criteria seems to be changing in relation to the above problems. Lack of Medicare direction/funding for population-based health initiatives.

4. Rationale for Pursuing this Problem Current state of electronic medical records integration in physician practices and hospitals or community agencies is a mess. Lack standards of data collection. Use for quality improvement – link interventions to outcomes. Improved health outcomes.

5. Stakeholders - Supporters Certified VendorsNew revenue opportunity Public Health agencies (State and local) Connectivity to patient information to improve continuity of care Community assessment data FQHC ResearchersRelational databases Disease advocacy groups Cancer, Heart, Asthma, etc. Help illustrate the relationship between treatment and outcomes

6. Stakeholders - Supporters LegislatorsMore information about my voters. Vendors of health care products HIPPAContinuity of care/secured tracking

7. Stakeholders - Opponents Small providersCosts, lack of staff/support/resources Non-certified ONCHIT vendors Loss of revenue HIPPAConfidentiality breach. Payers

8. Action Plan Require the Office of the National Coordinator for Health Information Technology (ONCHIT) to ensure the inclusion of relational database technology in both inpatient and outpatient certified vendor products and services. Require physician and outpatient practices over a certain size (i.e., 4 licensed independent practitioners) that participate in the Medicare program to use an ONCHIT-certified vendor, using Medicare reimbursement as leverage. Recommend that the criteria for Medical Home include an ONCHIT-certified vendor.