Progress in Health Information Technology

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1 Progress in Health Information Technology 2011 Annual HIT Survey by The American Hospital Association Hospitals Ability to Meet Meaningful Use Requirements of the Medicare and Medicaid EHR Incentive Programs Pennsylvania Findings January 2012

2 State E-Health Activities in 2011 Virtually all hospitals and health systems are engaged in e-health strategies that support the adoption of information technology to improve the effectiveness of the health care delivery system while providing greater value, quality, and safety for patients. Pennsylvania sees e-health initiatives as a very high-priority, however, hospitals and health systems face significant challenges that accompany these initiatives, including the costs and time required for implementation and for realizing a return on their investment. Findings from this year s AHA HIT Survey demonstrate Pennsylvania hospitals and health systems commitment to progress in the implementation of health information technology across a broad range of functions. 2

3 Does Your Hospital Use an EMR/EHR System? Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

4 In what year did you first deploy an EMR/EHR? % of respondents (cumulative) Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

5 Do you currently have an electronic system that allows you to... % of respondents indicating YES Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

6 Is your current system capable of providing patients with an electronic copy of their health information that includes ALL of the following: diagnostic test results, problem lists, medication lists, allergies, and discharge summaries within 3 business days? IF YES, through what mechanism(s) are you currently providing this electronic information? *Or other physical device. Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

7 Meaningful Use: EHR Functionality Criteria CORE CRITERIA: ALL 14 MUST BE MET Providers may claim certain objective(s)/measure(s) is inapplicable to them, if they meet CMS criteria of such an exception. CPOE (Computerized Physician Order Entry) Drug-drug and drug-allergy interaction checks Maintain current problem list of active diagnoses Maintain active medication list Maintain active medication allergy list Record demographics Record and chart changes in vital signs Record smoking status for patients 13 and older Report hospital/ambulatory clinic measures to CMS/states Implement one clinical decision support rule Provide patients with an e-copy of their health information upon request Capability to exchange key clinical information among providers of care and patient-authorized entities electronically Protect electronic health information Provide patients with an e-copy of their discharge instructions at time of discharge upon request 7

8 Meaningful Use: EHR Functionality Criteria MENU CRITERIA: HOSPITALS MUST MEET 5 OF THE 10 OBJECTIVES, INCLUDING ONE PUBLIC HEALTH OBJECTIVE Drug-formulary checks Incorporate clinical lab test results as structured data Generate lists of patients by specific conditions Use certified EHR technology to identify patient-specific education resources and provide to patient, if appropriate Medication reconciliation Summary of care record for each transition of care/referrals Record advanced directives for patients 65 years or older (EH only) Capability to provide electronic submission of reportable lab results to public health agencies Capability to submit electronic data to immunization registries/systems Capability to provide electronic syndromic surveillance data to public health agencies Providers may claim certain objective(s)/measure(s) is inapplicable to them, if they meet CMS criteria of such an exception. Public Health Objective 8

9 Do you plan to apply for a first-year Medicaid EHR incentive payment 1? % of respondents 1 To support adoption, implementation, or upgrading of certified EHR technology. Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

10 Do you plan to attest as a Meaningful User of certified EHR technology, and if yes, in what year will you achieve meaningful use for the first time? % of respondents 1 To support adoption, implementation, or upgrading of certified EHR technology. Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

11 Do you possess an EMR/EHR system that has been certified as meeting the federal requirements for each of the 24 hospital objectives of Meaningful Use? Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

12 What is the primary challenge in implementing an EMR/EHR system that meets each of the federal requirements for meaningful use? NOTE: Respondents instructed to check all that applied. % of respondents Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

13 What is the single largest barrier to reaching meaningful use? NOTE: Respondents instructed to identify ONE. % of respondents Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

14 Which specific proposed meaningful use criteria were or would be the most challenging to achieve? NOTE: Respondents instructed to identify TWO. % of respondents *To state/other entities, including reportable lab results, immunizations, or syndromic surveillance. Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

15 Computerized Systems for Electronic Clinical Documentation Patient Demographics Physician Notes Nursing Notes Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

16 Computerized Systems for Electronic Clinical Documentation Problem Lists Medication Lists Discharge Summaries Advanced Directives Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

17 Computerized Systems for Results Viewing Lab Reports Radiology Reports Radiology Images Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

18 Computerized Systems for Results Viewing Diagnostic Test Results Diagnostic Test Images Consultant Reports Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

19 Computerized System for Provider Order Entry (CPOE) Lab Results Radiology Tests Medications Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

20 Computerized System for Provider Order Entry (CPOE) Consultation Requests Nursing Orders Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

21 Computerized System for Decision Support Clinical Guidelines Clinical Reminders Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

22 Computerized System for Decision Support Drug Allergy Alerts Drug-Drug Interaction Alerts Drug-Lab Interaction Alerts Drug Dosing Support Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

23 Computerized System for Barcoding Lab Specimens Tracking Pharmaceuticals Pharmaceutical Administration Patient I.D. Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

24 Computerized Systems for Other Functions Telemedicine Radio Frequency I.D. Physician Use of PDA/Smart Phone Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

25 Additional Meaningful Use Functionality Electronic Clinical Documentation Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

26 Electronic System Functionality Patient / Medication Lists % of respondents indicating Yes Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

27 Electronic System Functionality Public Health Reporting % of respondents indicating Yes Submit electronic data per MU standards... Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

28 Electronic System Functionality Quality Reporting % of respondents indicating Yes Automatically generate... Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

29 Current arrangements to share patient-level clinical data through an electronic health information exchange (HIE) or a regional health information organization (RHIO) % of respondents Level of Participation NA Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

30 Electronic Data Exchange with Hospitals In Health System % of respondents indicating Yes NA Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

31 Electronically Data Exchange with Hospitals Outside Health System % of respondents indicating Yes NA Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

32 Electronic Data Exchange with Ambulatory Providers Inside Health System % of respondents indicating Yes NA Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

33 Electronic Data Exchange with Ambulatory Providers Outside Health System % of respondents indicating Yes NA Source: AHA HIT Surveys, Results for Pennsylvania acute care hospitals,

34 Does your IT department currently support an infrastructure for two factor authentication (e.g., tokens or biometrics)? Percent (%) of Respondents Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

35 How would you describe your EHR system? Percent (%) of Respondents Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

36 Primary 1 Vendors of EHR/EMR Systems to Pennsylvania Hospitals Percent (%) of Respondents Top Vendors INPATIENT Systems 1 Siemens 20.7% 2 Meditech 19.6% 3 Cerner 16.3% 4 McKesson 10.9% 5 Allscripts/Eclipsys 7.6% 6 Healthland 4.3% 7 CPSI 4.3% 8 Epic 4.3% Top Vendors INPATIENT Systems 9 GE 3.3% 10 Self-developed 1.1% 11 HMS 1.1% Other* 2.2% *Other: Keane 1 Primary is defined as the system that handles the largest number of patients or the system in which you have made the single largest investment. Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

37 Primary 1 Vendors of EHR Systems to Pennsylvania Hospitals Percent (%) of Respondents Top Vendors OUTPATIENT Systems 1 Epic 15.2% 2 Siemens 13.0% 3 Allscripts/Eclipsys 12.0% 4 Meditech 9.8% 5 Cerner 7.6% 6 McKesson 7.6% 7 eclinical Works 5.4% 8 GE 4.3% Top Vendors OUTPATIENT Systems 9 Healthland 4.3% 10 CPSI 4.3% 11 HMS 1.1% 12 Self-developed 1.1% Other* 12.0% *Other: Keane, ProMed, NextGen, Wellsoft, Greenway, 1 Primary is defined as the system that handles the largest number of patients or the system in which you have made the single largest investment. Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

38 What changes, if any, are you planning for your EHR system within the next 18 months? Percent (%) of Respondents Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals,

39 Data Source The AHA s Annual HIT survey was fielded to 6,700 hospitals nationwide in Fall Nearly 3,600 hospitals nationwide participated (54%). In Pennsylvania, 101 general acute care (GAC) hospitals participated in the survey (63% response rate). Sample is broadly representative of the Pennsylvania-licensed general acute care hospitals. An additional 20 non-acute, specialty, and Veterans Affairs hospitals in Pennsylvania also participated in the survey; however, for the purposes of this analysis, their responses have been excluded. 39

40 Pennsylvania Region Med. Educ. MSA Location Tax Status Ownership Bed Size Distribution of Pennsylvania Hospital Respondents, 2011 Source: AHA HIT Survey, Results for Pennsylvania acute care hospitals N (#) 2011 Acute Respondents Total Acute Hospitals Less than % 33% 101 to % 41% % 12% % 14% Unaffiliated 41% 38% System-Owned 59% 62% NFP 92% 89% For Profit 8% 11% Large Urban 1 36% 41% Urban 33% 29% Rural 32% 29% Non-Teaching 45% 46% Teaching 55% 54% West 36% 37% Central 24% 20% Northeast 18% 18% Southeast 23% 25% TOTAL PA 1 Denotes Philadelphia and Pittsburgh 63% 100% 40

41 The Hospital & Healthsystem Association of Pennsylvania January 2012

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