HITECH Health IT Legislation: Opportunities for the DMAA Community September 2009 • San Diego, CA Vince Kuraitis JD, MBA Better Health Technologies, LLC http://e-CareManagement.com blog (208) 395-1197 • [email protected]Don Storey, MD RMD Networks www.rmdnetworks.com (303) 789-1188 • [email protected]
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HITECH Health IT Legislation: Opportunities for the DMAA Community
HITECH Health IT Legislation: Opportunities for the DMAA Community
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HITECH Health IT Legislation:Opportunities for the DMAA Community
1. Recap: DM Community as Leaders or Laggards in HIT Interoperability?
2. Changing Environment
3. ARRA HITECH Act Stimulus Legislation
4. Implications/Opportunities for DMAA Community
1. Recap: DM Community as Leaders or Laggards in HIT Interoperability?
HIT Strategy on Autopilot for the Past Decade
Health Information Technology (HIT) is the Backbone of Prevention and Care Management
• Provides easy access to comprehensive patient records electronically, thus making it easier to see a patient’s medical history
• Helps providers track patient care in order to reduce duplication of services, address patient issues, and coordinate care with care managers
• Offers providers access to reference materials during a patient visit
• Provides clinicians real-time guidance on standards of care• Sends reminders and prompts to patients about visits, tests, and
recommendations and prescriptions
DM Community Pivot Points
• Several industry sectors are uniquely positioned to promote interoperability and liquidity
• Leverage!
– DM is a central role with many touch points
– Knowhow, tools, & technology to improve care processes and create new interventions
– Trust with patients creates opportunity to get patient permission to gather and use data on patients’ behalves
• Interoperability can be disruptive!
Two Scenarios for the DM Community
• Laggards
– Maintain proprietary IT
– Maintain closed business models and proprietary processes
• Leaders
– Embrace interoperable health information exchange
– Embrace open (collaborative) business models and shared care management processes
2. Changing Environment
Challenges With EMR 1.0
• Usability/design– Created to replicate individual paper charts in e-format,
not to manage a panel of patients for optimal health• Implementation
– Changes clinician workflow– Loss of productivity for physicians– Risk of failure/de-install
• Proprietary business model– Lack of interoperability– Dependent on customer lock-in and switching costs
→Result: very low penetration
Proprietary & Confidential Slide # 9
EMR 1.0 (Circa 1990 – 2009)
Proprietary & Confidential Slide # 10
Modularity: Dis-integration Of The Computer Industry
Proprietary & Confidential Slide # 11
EHR 2.0 – (2009 - ?)High value, integrated applications facilitating higher quality, coordinated care
Proprietary & Confidential Slide # 12
EMR 1.0 to Clinical Groupware
EMR 1.0
– Client-server based– Proprietary– Non-interoperable– No connectivity to patients – Monolithic– High capex and operating
expense– MD workflow must adapt
to rigid design
Clinical Groupware
– Web-based– Open– Interoperable– Networked – Platform/application– No capex, low
subscription cost– Flexible design adapts
to MD workflow
Proprietary & Confidential Slide # 13
How is Value Created in a Network Economy? PHR Case Study
• Examine PHR adoption
– Typical 2- 5%
– Best Practice » Kaiser: 30%
» Group Health Cooperative (GHC): 50%
• Why?
Proprietary & Confidential Slide # 14
Features/Functionality Of Kaiser and GHC PHR System (As of Mid-2008)
Proprietary & Confidential Slide # 15
Explanation of Increased PHR Adoption
• Kaiser/GHC PHR platform adoption = early network effects• What’s the killer app? – Wrong question.• How is value created?
» An integrated bundle of apps » Delivered on a unified platform with broad data exchange» Providing high value to patients and doctors » Thereby driving adoption and usage
• How can un-integrated doctors, health plans, and hospitals work together toward a “Virtual-Kaiser”?
Proprietary & Confidential Slide # 16
3. ARRA HITECH Act Stimulus Legislation
ARRA HITECH Act
• Incentives between 2011 & 2015 = $36 billion.
• Providers must use a “Certified EHR”
• Providers must demonstrate “Meaningful Use” of the EHR
• Penalties for non-adoption after 2015
• Key question: How can DMAA community participate?
Recommendations – Certification/Adoption Workgroup of HIT Policy Committee, August 2009
• Focus Certification on Meaningful Use
• Leverage Certification process to improve progress on Security, Privacy, and Interoperability
• Improve objectivity and transparency of the certification process
• Expand Certification to include a range of software sources: Open source, self-developed, etc.
• Develop a Short-Term Certification Transition plan
Achieving Meaningful UseMeaningful Use Workgroup of HIT Policy Committee, July 2009
“Meaningful Use” Framework Becoming a Focal Point that Links Previously Disparate Initiatives
Proprietary & Confidential Slide # 21
4. Implications/Opportunities for the DMAA Community
Care Collaboration is a “Must Have”
Source: Michael R. Nelson, Georgetown Center for Culture, Communication, and Technology, 2009
...Enabled by Clinical Groupware PlatformEMR 1.0 supports limited care delivery transformation; clinical groupware provides greater adaptability, multi-purposing to accelerate transformative care delivery changes.
Healthcare Enters the Network Economy:A Fundamental Strategic Shift
Source: Venkatraman, N., Winning in a Network Era: Opportunities & Challenges, 2006