Meaningful Use and Certification: Are the EHR Incentives Worth the Effort?

Transcription

1 Meaningful Use and Certification: Are the EHR Incentives Worth the Effort? Wes Rishel and Tom Handler Notes accompany this presentation. Please select Notes Page view. These materials can be reproduced only with written approval from Gartner. Such approvals must be requested via Gartner is a registered trademark of Gartner, Inc. or its affiliates.

2 EHR Incentive Money? Fahgeddaboutit!! Payment-Driven Changes? Youbetcha!!

3 Key Issues Meaningful Use 1. Why should the U.S. invest in EHR incentives? Societal Good Useful Use Institutional Good 2. How will certification and meaningful use work? 3. How should a care delivery organization pursue incentives or not?

4 Key Issue: Why the U.S. Should Invest in Incentives Societal Good Meaningful Use Useful Use Institutional Good 1. Why should the U.S. invest in EHR incentives?

5 Ambulatory EHR Penetration: Effects of Stark Relaxation and Stimulus Incentives EMR Penetration 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Stimulus + Stark (prior projection) Physican Practice Size

6 Fixing Healthcare: EHR Generation Effect on Meaningful Use Generation 2: The Documentor Generation 1: The Collector Generation 3: The Helper Year Generation 4: The Colleague Generation 5: The Mentor

7 Coordinating Care: No Practice or Hospital Is an Island

8 Balancing Interoperability and EHR Sophistication Reliance on Interoperability Passive Error Prevention Clinical Data Availability Administrative Data Exchange Error Intervention PFP Population Data Re-Engineering for Quality Knowledge Propagation Evidenced-Based Medicine EHR Sophistication

9 Key Issue: Certification and Meaningful Use 1. Why should the U.S. invest in EHR incentives? 2. How will certification and meaningful use work? Rorschach inkblot test, Psychodiagnostik, 1921 Menelaus Blue Morpho Butterfly

10 Defining "Meaningful Use" Initially and Definitively HIT PC HIT SC Meaningful Use Criteria Recommendation Notice of Proposed Rulemaking (Incentives) ONC Estimated Dec CMS CMS Centers for Medicare and Medicaid Services CMS ONC HIT PC Health IT Policy Committee HIT SC ONC Health IT Standards Committee Office of the National Coordinator for Health IT Final Rule (Incentives) Estimated April 2010 Federal Regulation

11 Criteria for Meaningful Use: The Matrix Policy Priority Care Goal Objective: 2011, 2013, 2015 Yearly Measures

12 Meaningful Use: Representative Objectives and Measures for 2011 Compute and display body mass index Report aspirin prophylaxis CPOE* Give patients their clinical data electronically* Problem list based on ICD-9 or SNOMED* Capability to exchange lab, patient summary, med list Insurance eligibility confirmed Capability to submit immunization data to registries Implemented health information exchange with external clinical entity Security risk assessment and corrections High-cost imaging orders with structured indications *significant ramp-up in 2013

13 Two Channels for Certification: Product and Project Certification Regulation: Process Certification Regulation: Requirements and Standards NIST: Accreditor Third-Party Certifier Applicants EHR Vendor Product Accredited Third-Party Certifier Orgs. Self-Dev. Project* User Org. Certified Product Certified Project User Org. Federal Regulation User Org. Meets Cert. Rqmts. * This approach may be used for some opensource EHRs

14 Key Issue: Pursue the Incentives? 1. Why should the U.S. invest in EHR incentives? 2. How will certification and meaningful use work? 3. How should a care delivery organization pursue incentives or not?

15 The Long Road to Quality and Performance Measures Hospital EHR Measure Receiver Clinic EHR Enterprise Data Aggregation Measure Data Measure Receiver Acquired Clinic EHR Non-HER Data Source

16 Eight Questions to Ask Yourselves Before Pursuing Incentive Funds Strategic Alignment Gap Analysis 1. Are we thinking of incentive funds as an IT problem? 2. Is clinical leadership ready to mandate problem list, CPOE and structured documentation? 3. How do we add practices or hospitals without disrupting compliance? 4. Use a common coded problem list by 2013? 5. Have clinicians enter 100% of orders by 2015? 6. Report quality measures across our multiple EHRs? 7. Adapt quickly as meaningful use measures come online and change? 8. Install necessary releases to vendor software?

17 Recommendations Don't let the rush to incentive funds lead to hasty choices and implementation. Multihospital systems should not consider qualifying before 2015 unless they have already started to install an EHR. If you already have an EHR, you may qualify in 2011; review the draft meaningful use criteria to see if you can qualify. CDOs that have been holding off on upgrading EHR software will have to determine if they must schedule an upgrade in order to meet certification requirements. The smallest practices must be helped to avoid rushing to implement an EHR in a way that is counterproductive.

18 Your Action Plan CIOs, CMOs, CMIOs and other C-level executives Monday Morning - Review draft meaningful use criteria - Establish a hardnosed process that can look past the dollar signs to a realistic assessment of short-term risks versus long-term benefits Your Next 90 Days - Execute the hardnosed process - Update the outcome based on NPRM - Comment effectively on NPRM Your Next 12 Months - Review current EHR and make changes for meaningful use - Establish a realistic plan for acquisition or not

19 Related Gartner Research "Meaningful Use and Certification of EHRs: Tracking Evolving Targets" Wes Rishel (G ) "Magic Quadrant for U.S. Enterprise CPR Systems" Thomas J. Handler, M.D. (G ) "Requirements for Helping U.S. Physicians to Adopt EHRs Wes Rishel (G ) "Without Profiler-Enforcers, Healthcare IT Standards Cannot Enable Interoperability" Wes Rishel, Jonathan Edwards (G ) "Early Analysis of the Impact of the ARRA on U.S. Healthcare IT" Wes Rishel (G )

20 Meaningful Use and Certification: Are the EHR Incentives Worth the Effort? Wes Rishel and Tom Handler Notes accompany this presentation. Please select Notes Page view. These materials can be reproduced only with written approval from Gartner. Such approvals must be requested via Gartner is a registered trademark of Gartner, Inc. or its affiliates.

21 Meaningful Use and Certification: Are the EHR Incentives Worth the Effort? Wes Rishel and Tom Handler Notes accompany this presentation. Please select Notes Page view. These materials can be reproduced only with written approval from Gartner. Such approvals must be requested via Gartner is a registered trademark of Gartner, Inc. or its affiliates.