Meaningful Use & Meaningful Results from Electronic Health Records

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1 Meaningful Use & Meaningful Results from Electronic Health Records Judy Hanover, Research Manager November 4, 2009

2 ARRA Timeline: Key Dates for HIT Adoption Date February 17, 2009 April 3, 2009 June 16, July 16, August 14 and Sept 18, 2009 Oct 27 and December 15, 2009 December 31, 2009 February 2010 October 1, 2010 September 30, 2015 October 1, 2015 Event ARRA Enacted, $20+B in funding begins flowing in 2011, paid directly to providers who receive incentive payments after demonstrating meaningful use $2B for ONCHIT will fund infrastructure investments and state grants for HIEs, promote electronic exchange / use of health information, create regional and national HIT resource centers to support the nationwide electronic exchange of health information, e.g. NHIN; $7.2 billion for broadband access will help to fund the requisite technology investments to establish HIE networks. HIT Policy Committee appointed HIT Policy Committee makes recommendations to ONC regarding standards, implementation specifications, and certification criteria. Published outcomes are several sets of recommendations from committees and a final meaningful use matrix published July 16, Additional meetings of the HIT Policy Committee in 2009 Meaningful Use Definition Finalized; initial standards, implementation specification, and certification criteria approved by the Secretary Final Privacy Rule Adopted Incentive Payments Penalties begin 1% a year for 3 years Source: Health Industry Insights Health Industry Insights, an IDC company Page 2

for ONCHIT will fund infrastructure investments and state grants for HIEs, promote electronic exchange / use of health information, create regional and national HIT resource centers to support the

3 Incentive Payment Eligibility & Timeline Incentive payments to offset the cost of EMR and EHR technology acquisition are: Specifically limited to hospitals and physicians in private practice Full-time, hospital-based physicians are not eligible (e.g., pathologists, anesthesiologists) Eligible Provider EMR Incentive Payment Schedule Under ARRA 45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 0 Implement by Q Prior to Q4 Q4 '10 - Q3 Q4 '11 - Q3 Q4 '12 - Q3 Q4 '13 - Q3 After Q4 '14 Health Industry Insights, an IDC company Page 3

4 Attempting to Define Meaningful Use Meaningful Use of EHR Technology eprescribing Information Exchange Electronic exchange of health information to improve the quality of health care, such as promoting care coordination Reporting on Measures Using EHR Clinical quality measures and such other measures as selected by the Secretary Care goals include improving quality, safety efficiency and reducing care disparaties, engaging patients and families, improving care coordination, and driving better population and public health "Meaningful use is a destination and a journey." Carolyn Clancy, director of the Agency for Healthcare Research and Quality Health Industry Insights, an IDC company Page 4

include improving quality, safety efficiency and reducing care disparaties, engaging patients and families, improving care coordination, and driving better population and

5 The Current State of EMR Functionality EMR/EHR vendors need to provide functionality, providers need to implement and use Gaps between vendor-supplied functionality, meaningful use & meaningful results in the adoption and execution by the provider Key variables include: Provider organization politics, readiness for change, adoption Ease-of-use Intuitiveness of functionality for providers Fit to practice patterns Configurability of workflow Ease-of-integration Ability to set up and maintain integration for meaningful use criteria requiring interoperability Ordering e-prescribing, labs, radiology Focus areas include: electronic charting, electronic ordering (CPOE), eprescribing, decision support, implementation and architecture Health Industry Insights, an IDC company Page 5

providers Fit to practice patterns Configurability of workflow Ease-of-integration Ability to set up and maintain integration for meaningful use criteria requiring interoperability Ordering

6 Best Practices: Considerations Pre-ARRA Selection, implementation, adoption and ongoing use Benefits to efficiency of ongoing operations Improvements to the quality of care Return on investment for the EMR system Cost savings Efficiencies With the advent of ARRA Certification of application for federal stimulus funding Staging and planning of projects to prioritize functionality and demonstration of meaningful use according to timelines Consider accelerators like hosting and outsourcing to get to meaningful use deadlines Health Industry Insights, an IDC company Page 6

application for federal stimulus funding Staging and planning of projects to prioritize functionality and demonstration of meaningful use

7 Future Outlook: Now That Money Is Less of An Issue, Is the Road Ahead Truly Clear? Timing implications of incentives payments Can certifying organizations, likely CCHIT, gear up in time for the onslaught of certification and recertification requests? Can the EMR/EHR vendors accommodate the demand? Can vendors supply functionality and can providers fill gaps to demonstrate meaningful use in time? Can HIE partners accept and exchange data? Health Industry Insights, an IDC company Page 7

of certification and recertification requests? Can the EMR/EHR vendors accommodate the demand?

8 Upcoming Research and Events Complimentary IDC-HI Webinar Nov 12: What s on Your EMR Short List? Sign up at Forthcoming Reports: Vendor Assessment: The Short List of Electronic Health and Medical Records for Small and Mid-Sized Ambulatory Practices (IDC HI#220502, November 2009) Vendor Assessment: The Short List of Electronic Health and Medical Records for Large Ambulatory Practices (IDC HI#220600, November 2009) Available on November 9, 2009 Current Reports: Best Practices: Getting to Meaningful Use with Ambulatory EMR, online at View additional research at Health Industry Insights, an IDC company Page 8

2009) Vendor Assessment: The Short List of Electronic Health and Medical Records for Large Ambulatory Practices (IDC HI#220600, November 2009) Available on November 9, 2009

9 Questions? Judy Hanover Research Manager, IDC Health Insights Please feel free to me at: Follow me on Twitter at Or join me and your peers and the conversations in our IDC Health Insights Community Health Industry Insights, an IDC company Page 9

Jhanover@idc.com Follow me on Twitter at http://twitter.

10 Resource Links Government Websites ARRA: The Office of the National Coordinator for Health Information Technology (ONC): de=2&in_hi_userid=10741&cached=true Health and Human Services: Health Information Technology ARRA Implementation Plan ONCHIT: Meaningful Use of Certified Technology AMDIS: AHIMA Statement of Meaningful Use: Certification Commission for Health Information Technology: HIMSS definition: HIMSS Adoption Model: AHA Hospital Demographics: State loans and grants Universal Health Coverage Health Industry Insights, an IDC company Page 10

gov/ Health Information Technology ARRA Implementation Plan ONCHIT: http://www.hhs.gov/recovery/reports/plans/onc_hit.pdf Meaningful Use of Certified Technology AMDIS: www.meaningfuluse.

11 Terms of Use Policy Except as otherwise noted, the information enclosed is the intellectual property of Health Industry Insights, an IDC company. Copyright Reproduction is forbidden unless authorized. All rights reserved. Please refer to Health Industry Insights Terms of Use policy at for more information about our terms and conditions. If you have any questions regarding permissions and restrictions regarding our brand and content, please contact Sandi Collins at Health Industry Insights, an IDC company Page 11

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Vendor Assessment: The Industry Short List of Electronic Health and Medical Records for Small and Midsize Ambulatory Practices

Global Headquarters: 5 Speen Street Framingham, MA 01701 USA P.508.935.4445 F.508.988.7881 www.healthindustry-insights.com Vendor Assessment: The Industry Short List of Electronic Health and Medical Records