SELECTED PROJECTS: HEALTH INFORMATION TECHNOLOGY

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1 SELECTED PROJECTS: HEALTH INFORMATION TECHNOLOGY

2 Personal Health Information Management and the Design of Consumer Health Information Technology Client: U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality The overall goals of this contract were to characterize the methods that individuals use to manage their health information; establish an action agenda about how personal health information management (PHIM) practices can be supported by health IT; and to propose recommendations for moving the agenda forward. The research informed the design of effective consumer health IT systems by identifying key design principles that are appropriate for different types of health information and for different types of consumers. This project included 3 phases: 1. A literature and evidence review relating to consumers' personal information management (PIM) and PHIM needs and goals; practices used for PIM and PHIM; tools and technologies available to date; and significant gaps in current understanding of PHIM; 2. An analysis of the Medical Expenditure Panel Survey (MEPS) to better understand individuals health management techniques (e.g., relying on memory, recording information on a calendar or in a checkbook, or referring to consult documentation) as well as some influencing factors such as demographics, socioeconomic characteristics, and volume of health information; and 3. A multidisciplinary expert workshop to facilitate the design of health IT systems that are based on a solid understanding of individuals and families health information management practices resulting in recommendations for ongoing research, industry, and policy work in this field. Stakeholder, Advisory Committee, and Technical Expert Panels; Complex Survey Data Analysis and Modeling; Literature Reviews and Environmental Scans; Policy Analysis and Assessment; Report Development and Presentation Three reports were developed for this project. Personal Health Information and the Design of Consumer Health Information Technology: Background Report. (June 2009) Personal Health Information and the Design of Consumer Health Information Technology: Secondary Analysis of Data from the Medical Expenditure Panel Survey. (July 2009) Managing Personal Health Information: An Action Agenda. (March 2010) The project was featured in the AHRQ Spotlight report entitled Success Stories From the AHRQ Funded Health IT Portfolio (2009). (November 2010)

3 Self Contained Health IT Training Modules Client: U.S. Department of Health and Human Services, Health Resources and Services Administration In order to successfully implement health information technology, each medical setting must have a clinician champion as well as a team of healthcare professionals with training in informatics in order to support the workflow redesign and challenges of selecting and migrating to an electronic system. Various studies have shown that at least 50,000 additional qualified health IT workers are needed to assist hospitals, Community Health Centers (CHCs) and physicians as they move to adopt and meaningfully use electronic health records. This study will provide an assessment of the need among CHCs with respect to training for their current staff in informatics. The assessment will include: Site visits with CHCs within the Alliance; Interviews with Health Center Controlled Network staff; and Site visit interviews at prototype sites live on EMR representing variation in size, complexity, geography, and services/service population The study will consolidate these findings into profiles of current staff to which training would be targeted. The roles and skills matrix will be reviewed to identify applicability, need for adaption, and gaps to meet the CHC models. The end product will be a set of training curricula along with sustainability models based on these pilot studies. Insight serves as a subcontractor to Alliance of Chicago for this project to design and provide prepared, self-contained, health IT training modules. Literature review and Environmental Scans; Data Collection; Qualitative Research; Technical Assistance; Data Analysis and Simulations; Advisory Committees and Technical Expert Panel Meetings; Report Development and Presentation The final training materials are expected in December 2012.

4 Federal Efforts to Encourage the Adoption of Health Information Technology and Electronic Health Records Client: U.S. Department of Health and Human Services, Health Resources and Services Administration Insight worked with the Advisory Committee on Interdisciplinary, Community-Based Linkages (ACICBL) to develop a Congressional Report on the interdisciplinary challenges and opportunities for further utilization of Health Information Technology (HIT) and the Electronic Health Record (EHR). The ACICBL consists of member representatives from AHECs, HETCs, GECs, GTPDs, GACAs, Allied Health, Chiropractic, Podiatry, Psychology, and Rural Interdisciplinary programs and provides advice to the Congress and the Secretary of the U.S. Department of Health and Human Services on issues under the domain of Title VII, Section 756 programs. Federal Efforts to Encourage the Adoption of Health Information Technology and Electronic Health Records, the ACICBL s Seventh Report, addresses the use of information technology for interdisciplinary team care, specifically focusing on HIT and EHRs. From expert testimony, white papers, and direct research, this report analyzes the utilization of health information technology, including specific user experiences, and relates those to the challenges and needs of health care practitioners. The report focuses on 1) how various aspects of the Nation s health care system can best move forward in preparation for the increasing utilization of HIT and EHR, and 2) how HRSA can encourage the adoption of HIT and EHR through training and development of the nation s health care workforce. The ACICBL provided a series of recommendations in support of their findings, including recommendations related to workforce training, curricula development, service delivery, financing, pilot project development, and dissemination and implementation of best practice models. Stakeholder, Advisory Committee, and Technical Expert Panels; Literature Reviews and Environmental Scans; Policy Analysis and Assessment; Report Development and Presentation The final report is entitled Federal Efforts to Encourage Adoption of Health Information Technology and Electronic Health Records, (September 2007) and is available at

5 The Future of Primary Care: The Critical Role of Title VII Education and Training Client: U.S. Department of Health and Human Services, Health Resources and Services Administration Insight worked with the Health Resources and Services Administration s (HRSA) Advisory Committee on Training and Primary Care Medicine and Dentistry (ACTPCMD) to develop a Congressional Report on preparing future primary care providers to meet the changing challenges of the U.S. population. For the past 13 years, ACTPCMD has advised the Congress and the Secretary of the Department of Health and Human Services on issues under the domain of Title VII, Section 747 programs, including the undergraduate and graduate-level training of primary care providers, the recruitment of underrepresented minorities and disadvantaged populations, and the provision of quality health care to underserved communities. The Future of Primary Care: The Critical Role of Title VII Education and Training, the ACTPCMD s Fourth Report to Congress, provides an overview of the challenges facing primary care providers, and lays out a roadmap for preparing the primary care disciplines to meet these challenges. Drawing from expert testimony, white papers, and direct research, this report outlines the challenges facing primary care providers, including the aging of the population, racial and ethnic diversity, chronic care management, disparities in care, costs of care, access to care, provider supply and demand, underserved populations, information technology, quality of care, and patient safety. The report then delves into what is needed for the primary care workforce to meet these rapidly changing challenges and provides specific recommendations for consideration. The ACTPCMD made 6 recommendations in support of their findings, including 1) developing and disseminating educational innovations in the use of information technology; 2) the integration of interdisciplinary team models; 3) the development of interdisciplinary faculty team models; 4) the encouragement of cultural competencies; 5) community collaboration and outreach; and 6) emphasis on emerging populations needs, including patient safety, prevention, chronic disease management, genomics, and first response strategies to public health hazards. Stakeholder, Advisory Committee, and Technical Expert Panels; Policy Analysis and Assessment; Report Development and Presentation The final report is entitled Preparing Primary Healthcare Providers to Meet America s Future Healthcare Needs, (November 2004) and is available at ftp://ftp.hrsa.gov/bhpr/actpcmd/4thannual.pdf.

6 Evaluation of the Multistate Nursing Licensure Compact Client: The National Council of State Boards of Nursing This project was designed to evaluate the effects of the Nurse Licensure Compact (NLC) on each of the States and on actively practicing nurses. The NLC began in 2000 when it was passed into law by the first 5 participating States. The NLC is an agreement between participating States to mutually recognize each other s RN, LPN, and LVN licenses. This agreement allows nurses to hold a single license and be eligible to practice in the licensing State as well as other States participating in the NLC, subject to each State's practice laws and regulations. At the time of this study, 18 States had entered the NLC with a goal of removing regulatory barriers to increase access to safe nursing care throughout the U.S. As a subcontractor to Gallup, Insight assessed the NLC s outcomes through: A literature search and synthesis of the history of the NLC; each State s position on the NLC (including groups of proponents and opponents within the State); progress toward full implementation; and perceived barriers and benefits to participation. In-depth, semi-structured interviews with Nurse Licensure Compact Administrators in participating States and Executive Directors of State Boards of Nursing in non-participating States. The interviews focused on the State s actual and perceived barriers to participation, perceived benefits of participation, as well as perceptions of the NLC s effectiveness in meeting its goals. A survey of 2,000 nurses across the U.S. to measure nurses awareness, attitudes, knowledge, and experiences with the NLC and assess preliminary impacts on nurses. Results of this research helped the NCSBN to develop effective communication strategies for communicating with States, addressing State concerns, and recommending ways to break down barriers to full implementation. It also helped States to share information on implementation challenges and best practices with other States. Program Evaluation; Literature Reviews and Environmental Scans; Qualitative Research; Survey Design and Implementation; Policy Analysis and Assessment; Report Development and Presentation The final report is entitled Evaluation of the Nurse Licensure Compact: Report of Findings. (June 2006)

7 Global Assessment of the HITECH Program Client: U.S. Department of Health and Human Services, Office of the National Coordinator for Health Information Technology Insight is partnering with Mathematica Policy Research and the Urban Institute on this global assessment of programs funded under the Health Information Technology for Economic and Clinical Health Act (HITECH). The evaluation will help the Office of the National Coordinator for Health Information Technology (ONC) ensure that vital connections are made across HITECH initiatives by examining the critical linkages among those initiatives and between the initiatives and meaningful use (MU) of health information technology (HIT). The global assessment also will provide ONC with a vehicle for assessing the effect of increased MU on health care quality and costs. The study will provide insights into what features are working best, how success varies across geographic areas (for example, regions, States, local markets) and target populations (for example, Medicare beneficiaries), and what future steps would best facilitate the fulfillment of ONC s goals. The global assessment is meant to complement evaluations of individual HITECH programs, providing a means to integrate and interpret findings on individual programs and to support an expanded analysis that takes into account the broader range of factors that are likely to determine the successes of HITECH. For this project, Insight convened a Technical Expert Panel (TEP) comprising a select group of experts in HIT, EHR adoption, clinical care, health services research, health economics, and public policy to advise ONC on the Global Assessment of HITECH. Insight coordinated the first in-person meeting of the TEP and prepared a comprehensive report documenting the panel s recommendations for ensuring that the evaluation plan and analyses reflect the current state of knowledge about technology, medical practice, and policy issues. Based on our ongoing work with the TEP, which is scheduled to meet annually over the course of this 5-year contract, the Insight team is providing key contributions to the evaluation plan and annual reports. Program Evaluation; Technical Expert Panels; Policy Analysis and Assessment; Report Development and Presentation A report, Global Assessment of the HITECH Program Technical Expert Panel: Summary and Recommendations. (October 2010) Anticipated products: Annual reports in 2011, 2012, 2013, and 2014, and a final report in 2015.

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