1. Connecting Communities – CMS’ Role
William Rollow, MD MPH
Deputy Director,
Quality Improvement Group
June 24, 2004

2. CMS Supports Healthcare Information Exchange
Crucial to IOM goals of safety, timeliness, effectiveness, patient-centeredness, efficiency, and equitableness
Must develop within privacy policy framework
Communities are the appropriate locus of development

3. LHIIs – With or Without EHRs
Information exchange does not require providers to have EHRs, but it is facilitated when they do
CMS can help LHII development by stimulating EHR adoption and effective use

4. DOQ-IT: Doctors Office Quality – Information Technology
Premise: substantial improvement in physician office quality cannot be achieved without adoption of health information technology and process redesign

5. DOQ-IT Make high quality, affordable systems more available
Provide assistance to physician offices
IT adoption decision
Implementation and workflow efficiencies
Care management/patient self-management
Financial incentives: MCMP demonstration (MMA Sec 649)

6. MCMP Four states Expected payment methodology
Expect to require adoption and use of systems which meet selected HL7 functional and CHI data standards, and at specified point, contribution of data to PHR and data exchange through available LHIIs
Expect to require submission to QIO data warehouse of cardiac and diabetes measure results, based on DOQ/AMA set, with performance at target levels
QIO assistance to physician offices in improving process and infrastructure for data collection

7. QIO Data Warehouse
HIPAA oversight authority gives QIOs ability to collect quality data without need for the physician to obtain patient consent
Avoids multiple slices and small numbers
Single collection process
Data can be used for multiple purposes
Confidential assistance
Public reporting, pay-for-performance: with consent
Warehouse and secure data exchange exist
Is being populated with hospital data
Physician office data later this year

8. What You Can Expect
Enhanced VistA product expected to be available by year end
Four state (CA, MA, AR, UT) pilot project underway; national pilot in fall; full implementation in August via 8th SOW
MCMP demonstration expected to be available to physicians in fall of this year