1. HEALTH INFORMATION TECHNOLOGY OVERVIEW Amy Cooper, MPHFebruary 28, 2013

2. 2 My Background  Formal training: MPH: HMP, Instructor at PCC, PSU  Areas of experience  HIT Project Management Practice Management and EHR installation Health Information Exchange  HIT Consulting HIT strategic planning –safety net clinics Quality Corp-Environmental Scan

3. What is Health Informatics?  Health informatics (HI) is the development and assessment of methods and systems for the acquisition, processing, and interpretation of patient data with the help of knowledge from scientific research and computers  Essentially – health IT (HIT) provides tools to health professionals and health care organizations to better manage data and utilize information

4. Why HIT is so Important  Quality  Safety  Cost  Goal for health information managers is to identify and ensure that IT is best used in various health care settings  However, there are numerous barriers to the use of IT in health care

5. Examples of Administrative Applications  Patient administration systems  Admission, discharge, and transfer (ADT)  Registration  Scheduling  Patient billing or accounts receivable  Utilization management (e.g. appropriateness of care)  Financial management systems  Accounts payable  General ledger  Personnel management  Materials management  Payroll  Staff Scheduling

6. Examples of Clinical Applications  Ancillary information systems  Laboratory  Radiology  Pharmacy  Other clinical information systems  Nursing documentation  Electronic medical record (EMR)  Computerized provider order entry  Telemedicine and telehealth  Medication administration

7. Health Care Information Systems Financial management systems Accounts payable: monitors debts incurred and outgoing costs General ledger: monitors financial management and reporting to feds, state and other key financial stakeholders Personnel management: manages HR information for staff (e.g. salaries, payroll, benefits, education, training, among other HR issues)

8. Health Care Information Systems Best of Breed vs. Integrated HCIS Historical development Piecemeal factor in development of HCIS Therefore need to build interfaces or integrate data amongst various silo or stand alone systems System integration remains a primary challenge for many HCOs Enterprise-wide system from single vendor Any advantages? Any disadvantages?

9. Numerous Health IT Systems  EHR  E-prescribing  Disease Management Registries  Computerized Physician Order Entry (CPOE)  Clinical Decision Support System (CDSS)  Picture Archiving and Communication Systems (PACS)  Telemedicine and Telehealth

10. Access and Authentication  Paper-based MR system relies on sign-in sheets, ID badges, and copies of handwritten signature  EHR requires account management, password management, and signature code management  Auditing capabilities greatly enhanced with use of an EHR system  However, passwords and log-in access are continuously being changed

11. Value of EHR Improved quality, outcomes and safety Computerized reminders and alerts Improved compliance with practice guidelines Reduction in medical errors Improved efficiency, productivity, and cost reduction Readily available test results Prompting physicians to use generic and formulary drugs Savings from elimination of transcription services Improved coding practices (or higher reimbursements) Improved service and satisfaction Patient satisfaction User satisfaction Less stress Improved job satisfaction Quality of documentation

12. HITECH Act  The Health Information Technology for Economic and Clinical Health Act (HITECH)  Medicare Incentives ($44K per eligible provider)  Medicaid Incentive programs (State run- $63,750 per eligible provider)  Regional Extension Centers O-HITEC (www.ohitec.org)  HIT Workforce programs OHSU Curriculum Dissemination Center Community College Consortiums

14. Meaningful Use of EHR  EHRs use by providers to achieve significant improvements in care. The legislation ties payments specifically to the achievement of advances in health care processes and outcomes.  Stage 1 (July 2010 rules out- 2012 reporting)  Electronic reporting of data for quality of care  Stage 2 (2014)  Adds Health Information Exchange (HIE)  Stage 3

15. Meaningful Use as a Building Block (From Nov 8, 2012 Trailblazers National Strategy Webinar) Stage 2 MU ACOs Stage 3 MU Robust CDS (evidenced based medicine & practice goals) Patient centered, team based care Structured data utilized Care coordination Structured data utilized Case management & longitudinal viewing Robust CDS (evidenced based medicine & practice goals) Patient centered, team based care CQM data utilized to improve delivery and outcomes Structured data utilized Case management & longitudinal viewing Utilization of clinical decision support Performance and population management Patient engagement Stage 1 MU Basic EHR functionality, structured data Patient informed Utilize technology Access to information Transformation Improved population health CQM data utilized to improve delivery and outcomes Performance and population management Improved population health Enhanced access and continuity

16. Questions? Amy Cooper, MPH Cooper and Associates, LLC 503-887-9395 amy_cooper@comcast.net