1. PINNACLE, HIT and Informatics The paradigm of the EHR is changing … to include the delivery of interoperable, interchangeable information leveraging and extending existing workflows – including “automatic” data capture & data reuse Meaningful Use requires BOTH technical enhancement (i.e., enabling software) and operational governance (i.e., documentation approach / philosophy, workflow changes) FUNCTION + USE = EFFECT

2. PINNACLE, HIT and Informatics Shortcomings … – Registries such as PINNACLE not in (Stage 1) MU – Informatics principles not central to PINNACLE Data standards and terminology Information-enabled workflow Semantic interoperability, HIE EHR Vendor Disincentives … – CDS, quality modules required for MU certification – Lack of standard vocabulary – Cost of standardization and interoperability Where’s the Beef … – Advanced CDS? Advanced quality endorsement? MOC / lifelong learning / self-assessment? AUC?

3. PINNACLE, HIT and Informatics Do we have alignment of 1.What we can do (technology, workflow) 2.What we need to do (PQRI, MU) 3.What we should do (Guidelines, ACO) 4.What we can afford to do (value – not just cost) Relative to HIT / informatics: – What do you see as the barriers and costs for practices to participate in PINNACLE? – What should (must?) the College do to reduce the cost of participation? – What is the opportunity cost (should other alternatives be pursued)?