1. Implications of IT on Health Systems and Physicians Amy Walker MS, RN, CPHQ, FACHE, NEA-BC

2. HITECH Act? hmm, sounds familiar…  Signed into law February 2009 as part of ARRA  Goal  90% of U.S. physicians and 70% of hospitals using EHR by 2019  How?  Provide $19 Billion to doctors and hospitals through DHS to implement EHR by 2011

3. How did we get here?  Greater use of EHR is pragmatic  Improve patient care  Enhance records management  Easier to enforce compliance with standards  Improve productivity and performance  Cut costs over the long haul  Next: The Path to Public Policy

4. Creating Public Policy (simplified) Bill goes to floor for vote No: dropped or sent back for modification Yes: sent to other house, for same process Various interest groups and experts asked for input Bill goes to committee Bill sponsored and introduced by legislator Vetoed Signed into law Sent to highest ranking official (President or Governor)

5. Demonstrating Meaningful Use Matters  Summary of Meaningful Use Criteria  http://healthpolicyandreform.nejm.org/?attachment_id=3742 http://healthpolicyandreform.nejm.org/?attachment_id=3742  Examples  Record patient demographics  >50% structured data  Report clinical quality measures to CMS or states  2011: aggregate, 2012: submit electronically  Use EHR to identify patient-specific education resources  Provide to >10% of patients  Provide patients with e-health data upon request  >50% within 3 days of request

6. What does it mean to CIS & Providers?  Increased reliance on IT  Greater need for informatics professionals  SWOT analysis should come sooner rather than later  Suddenly, certifications matters more than ever  More governance / new regulatory and reimbursement guidelines  Meaningful Use

7. Where’s the money going to come from?  Grants  Loans  Penalties  Incentive payments based on three criteria: 1. Use of EHR meets HHS standards. 2. Connectivity to other providers to share a patient’s health history in a secure electronic environment. 3. Capability to provide regular reports on the use of technology to the HHS.

8. But, money is a two-way street…  There will be penalties for those who fail to adopt HIT by the year 2015.  Program depends on some providers not meeting Meaningful Use in order to pump money back into regulation/enforcement system  Additional civil penalties (enforced by state attorney general) may be imposed for collecting the wrong patient data  With 5 levels of severity, penalties start at $100 and top out at $50,000 per violation with a cap of $1.5 million!

9. Meaningful Use Timeline Image Credit: managemypractice.com

10. How do I get there from here?  Office of the National Coordinator for Health Information Technology has approved two entities as able to review and certify EHRs  Certification Commission for Health Information Technology (CCHIT)  Drummond Group Inc.  Unless your current system is homegrown, piecemeal or older, your EHR vendor is likely already pursuing certification  (and/or trying to sell you a new or upgraded system – which they promise will be certifiable)

11. Things you need to know… 1. Systems only need to be certified once. 2. All required functionality must be present in order to obtain certification.  True even if you have no use for a particular functionality. 3. If the vendor isn’t seeking certification, you can – but you have to pay. 4. However, if others have the same system, you can share the costs.  Good Source for FAQ and Answers:  http://healthit.hhs.gov/portal/server.pt/community/onc_regulations_faqs/3163 http://healthit.hhs.gov/portal/server.pt/community/onc_regulations_faqs/3163

12. Impact on Care Delivery  Easier to share patient information  Therefore, easier to coordinate patient care across multiple providers  E-health records can help improve patient/caregiver relations  Yes, we have an aging population…but a greater percentage of the population is tech savvy, more informed and expects immediacy  There’s really no other option than to make records readily accessible (and secure).  Greater efficiency.  Enhances ability to document at the point of care

13. Questions? Thank you!