iHT² Health IT Summit in New York City 2012 - Keynote Presentation: "Clinicians' Role in IT: ONC Guidance for Optimizing Quality, Safety and Efficiency"
 

iHT² Health IT Summit in New York City 2012 - Keynote Presentation: "Clinicians' Role in IT: ONC Guidance for Optimizing Quality, Safety and Efficiency"

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While American healthcare has been at the confluence of pressures to improve the quality and safety of care, the HITECH and Affordable Care Acts offer a renewed call for the integration of information ...

While American healthcare has been at the confluence of pressures to improve the quality and safety of care, the HITECH and Affordable Care Acts offer a renewed call for the integration of information technology in all aspects of health care delivery. Many clinicians are uncertain about the relationship of these HHS initiatives—to improve quality and promote the adoption, and meaningful use, of health information technology. As we prepare for the second stage of Meaningful Use this discussion will examine our current state, our trajectory, and practical opportunities for clinicians and providers to leverage information technology to improve the quality and efficiency of the care they provide—part of this discussion must include the clear challenges on this path. When viewed in this context, we will better understand the inextricable relationship between the meaningful use of electronic health records, our national healthcare quality agenda, healthcare reform, and the individual capacity of each physician to improve the quality and efficiency of the care delivered through his/her practice.

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iHT² Health IT Summit in New York City 2012 - Keynote Presentation: "Clinicians' Role in IT: ONC Guidance for Optimizing Quality, Safety and Efficiency" iHT² Health IT Summit in New York City 2012 - Keynote Presentation: "Clinicians' Role in IT: ONC Guidance for Optimizing Quality, Safety and Efficiency" Presentation Transcript

  • Louis Pasteur 1822-1895 In the field of Dans les champs de observation, chance lobservation le favors the prepared hasard ne favorise mind. esprits que les préparés. Lecture, University of Lille (7 December 1854) Office of the National Coordinator for 09/21/12 1 Health Information Technology
  • Clinicians Role in ITDavid R. Hunt, MD, FACSMedical Director, Health IT Adoption & Patient SafetyONC, Office of the Chief Medical Officer
  • David R. Hunt, MD, FACS has no realor apparent conflicts of interest toreport
  • Take Home Messages • Clinicians must lead • Success is wholly dependent on partnership • The path forward requires a system, resources, and courage 4
  • WhereAdverb: (‘)hwe(Ə)r 1. at, in, or to what place < ~ is the house> 2. at, in, or to what situation, position, direction, circumstances, or respect <shows ~ the plan leads> 3. archaic : here, there < <lo, ~ it comes again – Shak. > Office of the National Coordinator for 09/21/12 5 Health Information Technology
  • Health care should be: Safe Efficient Effective Timely Patient Equitable Centered Crossing the Quality Chasm: A New Health System for the 21st Century (2001) Institute of Medicine (IOM) ; pg. 39
  • HowAdverb: (‘)haῢ 1. in what manner or way 2. with what meaning: to what effect 3. by what name or title < ~ art thou called> 4. for what reason: why 5. to what degree or extent 6. in what state or condition <~ are you> 7. at what price <~ a score of ewes now> Office of the National Coordinator for 09/21/12 7 Health Information Technology
  • William Osler, M.D.(1849 – 1919)
  • HHS Priorities & ClinicalQuality Measures Alignment All providers must select CQMs from at least 3 of the 6 HHS National Quality Strategy domains: • Patient and Family Engagement • Patient Safety • Care Coordination • Population and Public Health • Efficient Use of Healthcare Resources • Clinical Processes/Effectiveness Office of the National Coordinator for 09/21/12 9 Health Information Technology
  • Dr. Adam Smith“Quality, however, is so verydisputable a matter that I lookupon all information of this kindas somewhat uncertain.” An Inquiry into the Nature And Causes of the Wealth of Nations Book One, Chapter 11 1776
  • March 14, 2007—Vol 297, No. 10, pg. 1103 “…health care reform must focus on improving health and health care value for patients… …Physicians can lead this change and return the practice of medicine to its appropriate focus: enabling health and effective care.”11 09/21/12
  • Clinical Quality Measures • Conditions that contribute to the morbidity and mortality of the most Medicare & Medicaid beneficiaries • Conditions that represent national public/population health priorities • Conditions that are common to health disparities Office of the National Coordinator for 09/21/12 12 Health Information Technology
  • EHR AdoptionOffice-based Providers ONC, Health IT Dashboard (July 2012) Data from the CDC National Ambulatory Medical Care Survey (NAMCS) Office of the National Coordinator for 09/21/12 13 Health Information Technology
  • Meaningful UseEligible Provider Registrations Total = 267,221 Source: CMS EHR Incentive Program Data as of 7/31/2012 Office of the National Coordinator for 09/21/12 14 Health Information Technology
  • Payments to Eligible Professionals andHospitals Under EHR Incentive Programs Source: CMS EHR Incentive Program Office of the National Coordinator for Data as of 7/31/2012 09/21/12 15 Health Information Technology
  • Health IT Workforce Training Number of students who successfully completed the Community College Consortia Program by state: Office of the National Coordinator for 09/21/12 16 Health Information Technology
  • Office of the National Coordinator for09/21/12 17 Health Information Technology
  • Quality of Diabetes Care:EHR vs. Paper Medical Records % of Patients Receiving Care A significantly higher proportion of patients being treated by physicians with EHRs received care that aligns with accepted treatment standards *Source: Cebul, R. D., M.D.; et al. (2011). Electronic Health Records and Quality ofDiabetes Care. New England Journal of Medicine, 365:825-833. Retrieved from * Even after adjusting for patient demographic characteristics and insurance type,http://www.nejm.org/doi/full/10.1056/NEJMsa1102519#t=article differences remain significant; p<0.001
  • Health Outcomes :EHR vs. Paper Medical Records % of Patients Obtaining Outcome Standards A significantly higher proportion of patients being treated by physicians with EHRs obtained better outcomes*Source: Cebul, R. D., M.D.; et al. (2011). Electronic Health Records and Quality ofDiabetes Care. New England Journal of Medicine, 365:825-833. Retrieved from * Even after adjusting for patient demographic characteristics and insurance type,http://www.nejm.org/doi/full/10.1056/NEJMsa1102519#t=article differences remain significant; p<0.005
  • LaSalle D. Leffall, Jr., M.D. “There are two diagnoses you will never make: the one you don’t know about and the one you don’t think about.”
  • Malpractice Claims and EHRs The relationship between electronic health records and malpractice claims. Quinn MA, Kats AM, Kleinman K, Bates DW, Simon SR. Arch Intern Med. 2012 Aug 13;172(15):1187-9. Office of the National Coordinator for 09/21/12 21 Health Information Technology
  • 2011 Nov 10;365(19):1758-9. Epub 2011 Nov 2. Office of the National Coordinator for 09/21/12 22 Health Information Technology
  • “…in the light of experience asguided by intelligence.” Office of the National Coordinator for 09/21/12 23 Health Information Technology
  • Men at some time aremasters of their fates; Thefault, dear Brutus, is not inour stars, but in ourselves Julius Caesar I. ii 24
  • Louis Pasteur 1822-1895 Dans les champs de lobservation le hasard ne favorise que les esprits préparés. Lecture, University of Lille (7 December 1854) Office of the National Coordinator for 09/21/12 25 Health Information Technology
  • Thank YouContact Informationdavidr.hunt@hhs.gov www.healthit.gov