1. 1 VistA-Office EHR CAPT Cynthia Wark Deputy Director, Information Systems Group Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services July 15, 2005

2. 2 Session Topics Project Background VistA-Office EHR: Where We Are Today and Where We’re Headed Tomorrow

3. 3 Framework for Strategic Action Released July 21, 2004. 10-year plan to build a national health information infrastructure including electronic health records for all Americans. IT in health care lags behind IT in other industries – Use of EHRs reported to be 14-28 percent in physician offices Plan identified needed actions including federal leadership, accelerated efforts by Federal Agencies, and incentivizing EHR adoption VistA-Office EHR listed in the CMS project inventory

4. 4 Certification Commission for Health Information Technology The mission of CCHIT is to accelerate the adoption of robust, interoperable HIT throughout the US healthcare system, by creating an efficient, credible, sustainable mechanism for the certification of HIT products. CMS plans to pursue certification of the VistA- Office EHR when ambulatory standards are published.

5. 5 Quality Improvement Organizations The Office of Clinical Standards and Quality (OCSQ) administers the Health Care Quality Improvement Program (HCQIP) and provides data for analysis to individual QIOs to facilitate quality improvement for Medicare beneficiaries.

6. 6 QIO IT Infrastructure As part of CMS' mission to ensure the provision of quality care to Medicare beneficiaries, CMS has sponsored the development of various systems to collect clinical, cost and other beneficiary and provider information to determine and assess the quality of care provided. As part of this effort, the QIO community uses the Standard Data Processing System (SDPS).

7. 7 QualityNet Exchange Designed and developed by CMS and entered production in August, 2002 CMS-approved site for secure communications and data exchange between Quality Improvement Organizations (QIOs), Hospitals, Performance Measurement System vendors, End Stage Renal Disease (ESRD) networks, ESRD facilities, and CMS Provides tools to perform data exchange and import of data to the QIO Clinical Warehouse

8. 8 Doctor’s Office Setting: Quality Improvement Efforts The Doctor’s Office Quality Information Technology (DOQ- IT) is a “special study” in the QIO 7 th SOW that includes four participating states: California, Utah, Arkansas, Massachusetts. –The DOQ-IT work is aimed at promoting information technology to improve care in small-to-medium sized physician offices. –QIOs are providing assistance to physician offices by educating offices on EHR system solutions and providing implementation assistance. DOQ-IT does not endorse any particular product or service. VistA-Office EHR is one option that offices may consider using.

9. 9 The DOQ-IT Model Practice EHR VendorQIO

10. 10 Vista-Office EHR will… Promote health information technology adoption in the ambulatory care setting by providing government developed software that is publicly available at low cost by August 1, 2005 Support quality of health care services by enabling the exchange of clinical quality data Be based upon and stay in alignment with the current Veteran’s Health Administration VistA spending government resources wisely to produce software which will be compatible with future system updates

11. 11 Partners The Centers for Medicare and Medicaid Services (CMS) in the Department of Health and Human Services (DHHS) –Iowa Foundation for Medical Care Daou Systems, Inc. WorldVista The Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) The Indian Health Service (DHHS/IHS) The Health Resources and Services Administration (DHHS/HRSA)

12. 12 VistA-Office EHR Development Approach Modular approach to modifications with 3 phased releases in February, April and June Usability Testing Field Testing Independent Testing Acceptance Testing Class I Testing

13. 13 Modifications to VistA Registration changes to support general practice in non-VA environment Templates added for pediatric and OB/GYN care Addition of printing and faxing of prescriptions Laboratory interface training package and implementation guide Measure reporting to QIO clinical warehouse Disease management reminders Interface to accept data from practice management/billing application(s) Improved installation procedures

14. 14 VistA-Office EHR Vendor Support Organization (VVSO) VVSO will provide training to vendors Contract awarded to WorldVistA May 6, 2005 Training sessions to be held in locations across the country Website to be launched July 22 Will post list of Qualified VOE Vendors Tests will include successful completion of scenarios (installing the system, configuring the system, entering data, building templates, etc.) Conference late September in DC area

15. 15 VistA-Office EHR Applied to the DOQ-IT Model Practice EHR VendorQIO IFMC/Daou WorldVistA CMS/VHA

16. 16 Communication Channels Change Control Board Feedback and suggestion box at: vista@ifmc.org Information posted on the CMS website at: http://www.cms.hhs.gov/quality/pfqi.asp http://www.cms.hhs.gov/quality/pfqi.asp –VistA-Office EHR Information Sheet –Version 1.0 Requirements –Fact Sheet –Questions and Answers –VistA-Office EHR Presentation Software distribution will be available through VistA-Office.org List of qualified VOE vendors available at WorldVistA.org

17. 17 Questions??