Transforming Healthcare Delivery: Care Coordination and Population Health. September 29, 2009

Transcription

1 Transforming Healthcare Delivery: Care Coordination and Population Health September 29, 2009

2 Meaningful Use of Healthcare IT for Population Health--- a Physician s View

3 SIDE BAR: CULTURE AND COMPANY BACKGROUND

4 Culture Education Organization Chart Information Technology

5 Population health the health outcomes of a group of individuals, including the distribution of such outcomes within the group. It is an approach to health that aims to improve the health of an entire population Population health seeks to step beyond the individual-level focus of mainstream medicine and public health by addressing a broad range of factors that impact health on a population-level, such as environment, social structure, resource distribution, etc. Physician Perspective Hippocratic Oath: To teach medicine to the sons of my teacher. :Guild Oath Of Maimonides: May I never see in the patient anything but a fellow creature in pain. Sun Si-Miao: Act as if he were thinking of his close relatives. Declaration of Geneva: The health of my patient will be my first consideration.

6 Context MIE heritage Med-Web Statistics: -Accessible by 90+% of NE IN physicians -1.5 million monthly HL7 The messages Med-Web is one of the first (and one of the few) -More commercially than 225,000viable HIEs in the United States monthly diagnostic reports -Nearly 15,000 monthly radiology studies NE IN EHR Adoption: -65% of NE IN physicians have some form of EHR Lessons Learned

7 Natively Integrated Architecture EMR m.i.emr Document Management RIS/PACS PHR Minimally Invasive EHR Platform Med Web heritage

8 Markets and domains Physicians Employers Hospitals Universities Government Health Plans RHIOs/HIEs Safety Net Consumers Clinical Care Occupational Health Consumer Engagement Disease Management EMR m.i.emr Enterprise Health PHR Minimally Invasive EHR Platform

9 NOW TO THE PHR

10 PHR A Consumer Product A Healthcare Tool A legal instrument: HIPAA

11 John Moore: Chilmark Research Time to get rid of the term PHR

28 Bar-coded fax-back form Physicians can send paper results and correspondence back to their patients. NoMoreClipboard.com provides fax cover pages that send information directly into the patient account. Copyright 2009 NoMoreClipboard.com 28

32 NoMoreClipboard practice portal

33 ARRA (Am.Recovery & Reinvestment Act) MEANINGFUL USE NEW TOOLS NEEDED

34 Meaningful Use of Healthcare IT for Population Health---

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36 ARRA, meaningful use and PHRs Provide patients with an electronic copy of their health information - Provide patients with timely electronic access to their health information - Provide patients with an electronic copy of their discharge instructions and procedures at time of discharge, upon request - Provide access to patient-specific education resources - Provide clinical summaries for patients for each encounter Access for all patients to PHR populated in real time with health data - Offer secure patient-provider messaging capability - Provide access to patient-specific educational resources in common primary languages - Record patient preferences - Documentation of family medical history, in compliance with GINA - Update data from home monitoring device

37 Context new opportunity Stimulus Package Physician Incentives for Meaningful EHR Use TOTAL 2011 $18,000 $12,000 $8,000 $4,000 $2,000 $0 $44, $18,000 $12,000 $8,000 $4,000 $2,000 $44, $15,000 $12,000 $8,000 $4,000 $39, $15,000 $12,000 $8,000 $35, $0- Fee reductions: Providers who do not demonstrate meaningful use in 2014 will see, in their 2015 fee schedules from Medicare, a decrease of 1%. An additional decrease will be affected in 2016 and 2017 down to a total of 97% of the regular fee schedule; it can further be reduced to 95% if the Secretary determines that total adoption is below 75% in Tackles cost, ignores practice upheaval For the 85% of physicians who have not adopted EHR what is the least I must do to qualify?

38 The MIE platform WebChart EMR: -Configured for the workflow preferences of each practice/physician -Implementation-intense approach = minimally invasive practice impact -ARRA incentives/steep adoption curve demand high-growth, scalable model EMR m.i.emr Enterprise Health PHR Minimally Invasive EHR Platform

39 EHR Roadmap 600,000 Anticipated EMR Market Adoption 400, , EMR m.i.emr Enterprise Health PHR Minimally Invasive EHR Platform

40 m.i.emr modules Functionality Base m.i.emr Current 2011 Meaningful Use Criteria Patient Demographics/Insurance/Health Preferences > Record patient demographics (language, insurance, race, gender, ethnicity, etc.) > Check insurance eligibility electronically where possible > Record advance directives Patient History > Record vital signs (height, weight, BP, BMI) > Record smoking status Patient Encounters > Maintenance of current SNOMED-CT coded problem list > Maintenance of active medication list > Maintenance of active medication allergy list > Incorporation of structured data lab-test results > CPOE > Progress note documentation > Clinical decision rule support eprescribing/medication Management > Generate and transmit permissible prescriptions > Conduct drug-drug, drug-allergy, drug-formulary checks > Perform medication reconciliation Patient Communication > Provide patients w/electronic copies of health information > Provide patients w/timely electronic access to health information > Provide access to patient-specific education resources > Provide patients w/clinical summaries for each encounter > Send reminders to patients for preventive/follow-up care Reporting > Report ambulatory quality measures to CMS > Generate lists of specific patients for quality improvement, reduction of disparities and outreach > Submit claims electronically Interoperability > Exchange key clinical information among providers of care and patient authorized entities electronically > Submit electronic data to immunization registries where required and accepted > Provide electronic syndromic surveillance data to public health agencies according to applicable law/practice Security/Privacy > Compliance with HIPAA Privacy and Security Rules > Compliance with Nationwide Privacy and Security Framework fair data sharing practices

41 Web-based on-boarding

42 EXAMPLES

43 Example Populations 1. Indigent Population 2. University Population 3. Hospital-Physician Portals (Medical home, diabetes, etc.)

44 Our clients Physicians Employers Hospitals Universities Government Health Plans RHIOs/HIEs Safety Net Consumers Over 15+ Specialties Cardiology OB/GYN Neurology Pediatrics Primary Care Radiology Dermatology Surgery ENT Psychiatry Gastro Nephrology Ophthalmology Internal Med Urology Urgent Care Orthopedics

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46 Indiana University portal

47 From Free PHR a Hit at Indiana University HDM Breaking News, September 25, 2009 Just weeks into the new semester, 3,100 of 7,200 incoming students--40% of the class--have activated a PHR and entered some data, says Pete Grogg, associate director at the health center. And half of those with a PHR are sharing data with the center as they start seeking treating. "We're very happy, we weren't quite sure what to expect," Grogg says. The university this fall expects to complete integration work and populate PHRs with pertinent patient data from the center's electronic health records systemand other means, Grogg says. --Joseph Goedert

48 What this means Physicians Employers Hospitals Universities Government Health Plans RHIOs/HIEs Safety Net Consumers Clinical Care Occupational Health Consumer Engagement Disease Management m.i.emr Hospital Market Enterprise Health -Significant demand for patient portal solutions that integrate with hospital IT systems Minimally Invasive EHR Platform PHR

49 NoMoreClipboard hospital portal

50 CMS PHR pilot

51 NoMoreClipboard PHR NoMoreClipboard.com Value Proposition NoMoreClipboard interoperability expertise, embedded EHR functionality, and workflow integration capabilities enable sponsoring organizations to offer a branded PHR that helps consumers compile, manage and share their personal health records in a physician-friendly and appropriate format. This approach improves value perceptions of the sponsoring organization, and can contribute to improved communication, care coordination and clinical outcomes while reducing errors, duplicated services and costs. m.i.emr NoMoreClipboard Vision Enterprise Health NoMoreClipboard will be perceived as a must consider PHR option by target customers and a premium-value acquisition target by the healthcare IT community. Minimally Invasive EHR Platform PHR

56 CONNECTING MODULES CORPORATE WELLNESS

57 The enterprise challenge Escalating healthcare costs adversely affect enterprise bottom lines Increasing compliance requirements demand vigilant management Chronic conditions impair productivity and multiply the economic impact of medical expenditures

58 The enterprise response Employers are opening on-site employee health clinics that: Provide clinical diagnosis and treatment Ensure compliance with occupational health requirements Engage employees in improving health and wellness

59 MIE value proposition MIE Enterprise Health Value Proposition The MIE Enterprise Health solution: -Combines EHR and PHR modules designed to meet the clinical, occupational health & safety and employee engagement needs of Fortune 500 organizations -Integrates with HR systems, corporate legacy applications, diagnostic devices, health and wellness programs and external data sources including labs and health plans -Gives each stakeholder a robust set of online tools designed to increase productivity, improve clinical outcomes and reduce healthcare costs.

60 Enterprise Health modules

61 Questions?

62 Our clients Physicians Employers Hospitals Universities Government Health Plans RHIOs/HIEs Safety Net Consumers Over 15+ Specialties Cardiology OB/GYN Neurology Pediatrics Primary Care Radiology Dermatology Surgery ENT Psychiatry Gastro Nephrology Ophthalmology Internal Med Urology Urgent Care Orthopedics