• Save
2011 CMIO Summit | David Cochran
Upcoming SlideShare
Loading in...5
×
 

2011 CMIO Summit | David Cochran

on

  • 869 views

 

Statistics

Views

Total Views
869
Views on SlideShare
869
Embed Views
0

Actions

Likes
0
Downloads
1
Comments
0

0 Embeds 0

No embeds

Accessibility

Categories

Upload Details

Uploaded via as Adobe PDF

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    2011 CMIO Summit | David Cochran 2011 CMIO Summit | David Cochran Presentation Transcript

    • HIE:The Vermont Version David Cochran, MD President and CEOVermont Information Technology Leaders, Inc.
    • Topics• VITL Overview• Vermont Health Reform• Blueprint for Health• Health Information Exchange
    • Snapshot of Vermont637,000 population9615 square miles13 Health Service Areas Few large employers (IBM, State Government, University of Vermont) Little industry Dairy and Tourism
    • VITL Background• Started as a project within the Vermont Association of Hospitals and Health Systems• Spun off as independent entity in July 2005• Received 501(c)(3) non-profit status in March 2009• A public-private partnership with participation from health care providers, government, employers, consumers, and health plans• Shared public investment supporting IT requirements of Vermont’s health care reform efforts 4
    • VITL ProgramsVermont RECStatewide HIEBlueprint SupportePrescribing 5
    • Support Based on Practice’s Technology Maturity Meaningful Advanced Paper EHR Labs Blueprint HIE UsePaper EHR Lab Patient Clinical, Clinical(clinical) installed results demo- structured datapractice Standard update graphics data sharingMay have workflows EHR and captured witha PMS Data May also clinical Quality consent entry is have summary measures manual immun- sent to are ization Registry automatic 6
    • Vermont Health Care Reform60+ Discrete, Active Initiatives which combine to… Improve Quality • Provider Access, Transparency Increase Coverage • Promote Wellness / Prevention • New Coverage Options • Blueprint for Health • Premium Assistance integrated Medical Home & • H202 – Roadmap to Single Payer Community Health Team • Health Information Technology • Accountable Care Organizations Contain Cost Growth All of Above PLUS • Cost Transparency • Statewide Health Resource Planning and Review • Prescription Drug Cost Containment • Administrative Simplification 7
    • HIT & HIE Fully Integrated in Health Care Reform from start• In 2005, VT authorized and funded a single statewide Health Information Exchange• VITL (Vermont Information Technology Leaders), a 501(c)3 public/private partnership, developed standards based architecture for statewide HIE and began operations.• Investment in EHR adoption and deployment included in HCR legislation, starting with a primary care EHR pilot, expanded through creation of HIT Fund (fee of 0.199 of 1% on each health care claim) in 2008 8
    • Blueprint for HealthAdvanced Primary Care PracticesCommunity Health TeamsPayment ReformsHealth Information InfrastructureExpansion & Quality Improvement Program (EQuIP)
    • Advanced Primary Care Practice Doc Site Centralized Registry Community Health Team Medical Home
    • NCQA Score & Payment $3.00 $2.50$ PPPM per provider $2.00 $1.50 $1.00 $0.50 $0.00 0 10 20 30 40 50 60 70 80 90 100 NCQA PCMH Score
    • Continuum of Health Services - General Specialized & Targeted Services Higher Community Health • Specialty Care Acuity & Teams • Advanced Assessments Complexity • Advanced Treatments • Support Patients & Families • Advanced Case Management • Support Practices • Social ServicesLevel of Need Advanced Primary • Coordinate Care • Economic Services • Coordinate Services • Community Programs Care Practice • Referrals & Transitions • Self Management Support • Health Maintenance • Case Management • Public Health Programs o DVHA Care Coordinators • Prevention o SASH Coordinators • Access • Self Management Support • Communication • Counseling • Self Management Support • Population Management • Guideline Based Care Lower • Coordinate Referrals Acuity & • Coordinate Assessments Complexity • Panel Management 6/15/2011 12 Level of Service & Support
    • Blueprint for Health: Practice Transformation EngineBlueprint for Health’s integrated platform: – web-based registry, – clinical data repository, – population-based management toolPopulated through the HIE for bi-directional feeds from practice and hospital EHR systems, labs, public health registries, other sources to support: – clinical messaging, – care coordination, – patient and panel management functions 13
    • Hospitals Medical Self-Help Recovery Home Communities Medical Social, Economic, & Community Health Team Home Community Services Nurse Coordinator Social Workers Nutrition Specialists SASH Coordinator Medical Mental Health & MCAID Care Coordinators Home Substance Abuse Programs Medical Home Long Term Care Public Health Programs & Services Health IT Framework Evaluation Framework6/15/2011 14
    • Federal HIT/HIE Policy, Oversight, & Standards - Office of the National Coordinator (ONC)State HIT/HIE Policy, Oversight, & Standards – OVHA/HCRState Government & Public Health Vermont Health Care Providers & Institutions NHIN ConnectivityPublic Health surveillance, Tertiary and Community Hospitalsregistries, & other publichealth functions Primary Care & Specialty Providers Health InformationMedicaid health programscase management Exchange “Cloud” Federally Qualified Health Centers & Rural Health Clinicsfunctionality and connectivity for secure, privacy protected interchange of health records, Free ClinicsOther Medicaid & AHS casemanagement functionality demographic data, image files, Mental Health/BH/SA Providersand connectivity clinical messaging, & other digitized health information Long Term Care ProvidersOther state agency & dept. Statewide HIE Operated by VITLcase management Home Health & Hospice Providersfunctionality and connectivity Community Human ServiceLaw Enforcement, Agencies (Family Centers, AreaCorrections, & Court System Individual Vermonters: connectivity to EHR Agencies on Aging, etc.) Portals, Personal Health Records (PHR), Health 2.0 applications and Ix Services 15
    • Blueprint Integrated Pilots Health Information Infrastructure Medical Home • Visit planners for individual patients • Reporting for panel management & outreach (Medical Homes, CHTs) Medical Hospital data warehouse • Clinical information for care coordination (CHTs, OVHA CCs) Home (hosted EMR) • Tracking for public health services (e.g. cessation counselors) • Reporting for public health planning • Reporting & comparative benchmarks to support program evaluation Medical Core data elements Home Medical VITL Home HIE Core data elements Core data elements CentralMedical FQHCHome (hosted EMR) Registry Medical Home Medical Home EMR Core data Medical elements Home EMR Access Medical Community Access Web Web Home Health Team No EMR
    • Blueprint Integrated Pilots Health Information Infrastructure Medical Home • Visit planners for individual patients • Reporting for panel management & outreach (PCMHs, CHTs) Medical Hospital data warehouse • Clinical information for care coordination (CHTs, OVHA CCs) Home (hosted EMR) • Tracking for public health services (e.g. cessation counselors) • Reporting for public health planning • Reporting & comparative benchmarks to support program evaluation Medical Home Medical VITL Home HIEMedical FQHC CentralHome (hosted EMR) Registry Medical Home Medical Home EMR Medical Home EMR Access Community Access Web Web Medical Health Team Home
    • Blueprint Integrated Pilots Evidence Based Quality Improvement Data Data Data Data Source Processing & Storage Analysis Reports & Uses EMRs used for EMR Databases Data transmission & EMR Clinical Individual Patient Individual Patient transformation Reporting Tool or Process Care & Support Care VITL / GE Analyst Measures Services DocSite used for DocSite Database DocSite Health Population Individual Patient Reporting Status Management Care Tool Measures Contracted Healthcare Quality Quality Analysis Measures & Standards Improvement ServicesMedical Claims from BISCHA BISCHA Healthcare Provider PaymentCommercial Insurers Multipayer Reports Patterns & Resource for Quality & Medicaid Database Utilization VCHIP VCHIP VCHIP Healthcare Program Chart Review & Databases Analysis & Report Expenditures & Evaluation & NCQA Scoring Generation Financial Impact SustainabilityPublic Health Surveys Public Health VDH Health VDH Health Population Indicators Community & Data Collection Registries & Surveillance Analytic Surveillance Analyst & Prevention Databases Database Risk Factors Planning
    • Blueprint Integrated Pilots Evidence Based Quality Improvement Data Data Data Data Source Processing & Storage Analysis Reports & Uses EMRs used for EMR Databases Data transmission & EMR Clinical Individual Patient Individual Patient transformation Reporting Tool or Process Care & Support Care VITL / GE Analyst Measures Services DocSite used for DocSite Database DocSite Health Population Individual Patient Reporting Status Management Care Tool Measures Contracted Healthcare Quality Quality Analysis Measures & Standards Improvement ServicesMedical Claims from BISCHA BISCHA Healthcare Provider PaymentCommercial Insurers Multipayer Reports Patterns & Resource for Quality & Medicaid Database Utilization VCHIP VCHIP VCHIP Healthcare Program Chart Review & Databases Analysis & Report Expenditures & Evaluation & NCQA Scoring Generation Financial Impact SustainabilityPublic Health Surveys Public Health VDH Health VDH Health Population Indicators Community & Data Collection Registries & Surveillance Analytic Surveillance Analyst & Prevention Databases Database Risk Factors Planning
    • Blueprint Integrated Pilots Evidence Based Quality Improvement Data Data Data Data Source Processing & Storage Analysis Reports & Uses EMRs used for EMR Databases Data transmission & EMR Clinical Individual Patient Individual Patient transformation Reporting Tool or Process Care & Support Care VITL / GE Analyst Measures Services DocSite used for DocSite Database DocSite Health Population Individual Patient Reporting Status Management Care Tool Measures UVM CCTS Healthcare Quality Quality Health Informatics Measures & Standards Improvement PlatformMedical Claims from BISCHA BISCHA Healthcare Provider PaymentCommercial Insurers Multipayer Reports Patterns & Resource for Quality & Medicaid Database Utilization VCHIP VCHIP VCHIP Healthcare Program Chart Review & Databases Analysis & Report Expenditures & Evaluation & NCQA Scoring Generation Financial Impact SustainabilityPublic Health Surveys Public Health VDH Health VDH Health Population Indicators Community & Data Collection Registries & Surveillance Analytic Surveillance Analyst & Prevention Databases Database Risk Factors Planning
    • Intermittent Academic Analyses•Outcomes & Effectiveness Reporting & Studies•Guide Health Reform Policies & Programs Advanced analysis New analytic models Routine Analytic data sets Supportive reporting HIPAA Compliant DocSite Environment Clinical Data Analytic models Central Multipayor Repository High Performance Claims Data Computing Center De-  Storage Identified Public Health Normalization Data Processing Data De-identification Re-identification Query for experiments Analytics (Routine) Other Data Analytics (Exploratory) Sources Workbench Reporting Data Sources UVM CCTS Health Informatics Platform
    • HIE Current State• Infrastructure• Connectivity – Nine hospitals – 54 practices – 1 commercial lab• Blueprint -- 34 practices• Meaningful Use
    • Learnings and Issues• Vendor Challenges – Capabilities – Business model – Focus• “Interoperability” – State of the standards• Sustainability – Beyond the public utility model – Preparing for reimbursement reform
    • Questions?David Cochran, MDVermont Information Technology Leaders, Inc. (VITL)dcochran@vitl.net802.839.1935