Health Information Technology: A tool for optimizing health



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Health Information Technology: A tool for optimizing health December 2014 Susan Otter, Director of Health Information Technology, OHA Gina Bianco, Executive Director, Jefferson Health Information Exchange Robert Dannenhoffer, M.D., CEO, Umpqua Health Alliance Homer Chin, M.D., Board Chair, We Can Do Better Amy Fellows, Executive Director, We Can Do Better

Goals for this session Learn how Oregon is ensuring the coordinated care model is optimized and supported by the right health information technology. Learn how health information technology enables providers and care teams to share critical patient information, allows CCOs and health systems to manage care across populations and ensure quality of care, can be used by Oregonians to access their own health information and better engage in their care. 2

Health Information Technology What does Health IT refer to? Technology that stores, retrieves, or shares health information and data Hardware (computers, smart devices) Software (computer programs, apps) Examples: An electronic health record (EHR) Data registry for clinical information (e.g., immunization registry)

Other Useful Definitions Health Information Exchange (HIE) the electronic transfer of health information between two or more health IT systems Sometimes HIE can also refer to an organization that provides this service Interoperability the ability of different health IT systems to communicate and exchange data between them, and make use of that data

Vision of an HIT-optimized health care system The vision for the State is a transformed health system where statewide HIT/HIE efforts ensures that all Oregonians have access to HIT-optimized health care. Oregon HIT Business Plan Framework (2013-2017): http://healthit.oregon.gov/initiatives/documents/hit_fin al_businessplanframework_2014-05-30.pdf

Goals for HIT-optimized health care: Providers have access to meaningful, timely, relevant and actionable patient information at the point of care. Information is about the whole person including physical, behavioral, social and other needs Systems (Health plans, CCOs, health systems and providers) have the ability to effectively and efficiently use aggregated clinical data for quality improvement, population management and to incentivize value and outcomes. Individuals, and their families, have access to their clinical information and are able to use it as a tool to improve their health and engage with their providers. 6

How does Health IT support CCOs and the coordinated care model? Selected characteristics of the coordinated care model: Care coordination, population management throughout the system Integration of physical, behavioral, oral health Accountability, quality improvement and metrics Alternative payment methodologies Patient engagement Coordinated care model relies on access to patient information and the Health IT infrastructure to share and analyze data 7

EHR Adoption and Meaningful Use in Oregon Oregon providers have been early adopters of EHR technology Currently, Oregon is in the top tier of states for providers receiving EHR incentive payments, with more than $300 million in federal funds coming to: nearly all Oregon hospitals and nearly 6,000 Oregon providers However, More than 100 different EHRs are in use in Oregon Many providers are not eligible for EHR incentives

EHR Vendor Systems purchased by Oregon Eligible Professionals (top 10) N=4,912 out of 6,007 total Medical Informatics Engineering 1% McKesson* 2% Greenway* 6% NextGen 10% Allscripts 9% athenahealth* 3% Cerner 1% eclinicalworks LLC* 4% GE Healthcare 19% Epic* 45% Count of unique providers that received a payment in either the Medicare or Medicaid EHR Incentive Programs from 2011 August 2014.

EHR Vendor Systems in use by Oregon Hospitals (56 out of 59 total hospitals) MEDITECH* 12% CPSI 3% Healthland 11% Cerner* 11% Healthwise Incorporated 7% MEDHOST 2% Siemens Medical Solutions USA Inc 2% McKesson* 11% Epic* 41% Count of unique hospitals, that received a payment in either the Medicare or Medicaid EHR Incentive Programs from 2011 Aug 2014

Health Information Exchange in Oregon Several community HIEs: Gorge Health Connect mid-columbia River Gorge region Jefferson HIE Southern Oregon Central Oregon HIE Central Oregon Coos Bay, Corvallis, others in development Epic Care Everywhere Functionality for viewing among participating Epic users Direct secure messaging within EHRs is beginning CareAccord, Oregon s statewide HIE Other organizational efforts by CCOs, health plans, health systems, independent physician associations, and others including HIE and HIT tools, hosted EHRs, etc. that support sharing information across users

HIT/HIE exists in Oregon, but gaps remain Many providers, plans, and patients do not have the HIT/HIE tools available to support a transformed health care system, including new expectations for care coordination, accountability, quality improvement, and new models of payment. 12

State-Level Health IT Services Why provide some health IT services at the state-level? Connecting and supporting local HIT efforts across the state Administrative simplification and efficiencies where multiple systems would be duplicative and burdensome Fill gaps where there are no services available Services for sharing health information to support care coordination Foundational HIT services to support HIE and organizations using aggregated health data 13

Statewide Hospital Notifications, EDIE Hospital notifications systems (2015) Provide real-time alerts to providers and the care team when their patient has a hospital event (emergency department, inpatient, discharge) Subscribers can only access information for their patients CCOs, health plans, providers, HIEs, etc. Emergency Department Information Exchange (EDIE) Identify frequent users of emergency department care Provide ED care history, treatment plans for frequent ED users 54 of 59 Oregon hospitals are using EDIE today http://www.orhealthleadershipcouncil.org/our-currentinitiatives/emergency-department-information-exchange-edie 14

For more information on Oregon s HIT/HIE developments, please visit us at http://healthit.oregon.gov CareAccord, Oregon s state HIE: www.careaccord.org Susan Otter, Director of Health Information Technology Susan.Otter@state.or.us