Interoperable EHRs Proposed Vision for HIE in Southern Illinois Stakeholder Meeting April 23, 2009 Nick Bonvino Executive Consultant Connect SI *NB Consulting,

Interoperable EHRs

Proposed Vision for HIE

in Southern Illinois

Stakeholder Meeting April 23, 2009

Nick BonvinoExecutive Consultant

Connect SI*NB Consulting, Inc. 2008 All rights reserved

Reproduction or use without permission is prohibited

Agenda

Brief review of national, state, and local initiatives…the Ultimate Objective

Sustainability Model Administration and Operations Technology Architecture Project Work Plan and Budget Stakeholder Consortium

Executive Order, April 2004: The President created the National Coordinator position

To advance the vision of developing a nationwide interoperable health information technology infrastructure

To achieve the President’s goal of widespread adoption of interoperable electronic health records (EHR) by 2014

Key Role for ONC: Provide leadership for the development and nationwide implementation of an interoperable health information technology infrastructure to improve the quality and efficiency of health care

K

e

y

R

o

l

e

f

o

r

O

N

C

:

Provide leadership for the development and nationwide implementation of an interoperable health information technology infrastructure to improve

The quality and efficiency of health care and

The ability of consumers to manage their health

National Health IT AgendaOffice of the National Coordinator (ONC)

Nationwide Health Information Network

Five Critical Components Necessary For Nationwide Interoperable Health Information

Five Critical Components Necessary For Nationwide Interoperable Health Information

The complexity of modern medicine exceeds theinherent limitations of the unaided human mind.— David M. Eddy (1990)Source: CBO Evidence on the Costs and Benefits of Health Information Technology May 2008

4%14%

Per

cen

t o

f P

hys

icia

ns

100

80

60

40

20

03%

23%

Size of Hospital

> 500 beds

Hospital*

Per

cent

age

< 50 beds

*Rate of hospital use does not represent physician use; only ¼ of implemented hospitals report 50% MD use (or more)

100

80

60

40

20

0

68%

11%

Level of Function

Full or partial adoption

Minimally Functional EHRs

Hospital*

Per

cent

age

Current HOSPITAL EHR Adoption Rate (2007)

Physician Office rate of EHR Adoption varies by definition

43%

Source: MGH Institute for Health Policy, George Washington University and RTI, A National Survey of Health Record Keeping among Physicians & Group Practices in the United States, Preliminary Data

20%

4%14%

23%

0%

25%

50%

75%

Historical NAMCSEHR

MinimallyFunctional EHR

Functional EHR

All electronic

Part paper, part electronic

Per

cen

t o

f P

hys

icia

ns

2007 AMBULATORY results

Full-Function EHRs- The Ultimate

Objective EHRs used interactively at the point

of care delivery interoperable with all relevant data

sources complimenting the caregiver with a body of

knowledge and clinical tools accessible by patients and other providers

Enabling the practice of Evidence Based Medicine and Quality Measures

Managing Patient Behavior & Care Delivery

Reducing the variation of treatment thru alerts and reminders at the point of care(45% of care is either under or over utilized)

Providing Quality measures and reporting against evidence based medicine (EBM) standards

Managing and influencing patient behavior by increased communications with caregivers and patient health information

Sustainability Model

Create a Sustainable Business Model that funds the initial investment and ongoing support of this future state vision with all stakeholders contributing their pro-rata share based upon the accrual of benefits.

Administration and Operations

Determine the appropriate neutral entity to serve as the focal point for collaboration representing all stakeholders. This will be the actual provider of shared services to support the governance and operations of the HIE.

Technology Architecture

Identify the appropriate Technology Architecture consistent with standards outlined by the Office of the National Coordinator (ONC) and as a component of a state-level HIE, including:

Certification Privacy & Security Interoperability Governance

Project Work Plan and Budget

Produce a Project Work Plan and Budget that plans a program for the mass deployment of EHRs and an HIE. This will take advantage of economies of scale and shared services to most efficiently and effectively transform healthcare in Southern Illinois.

Stakeholders

Connect SI will coordinate and facilitate HIE planning with a Consortium that represents a minimum of 50% of the covered lives, 75% of medical transactions, 50% of Stakeholder groups including FQHCs & Public Health Departments in our MTA.