What Lies Ahead for ONCMeaningful Use and Beyond                              Farzad Mostashari, MD ScM             Nation...
Last Year’s Notable Heath IT Trends•  Policy Ú Implementation of HITECH    –  MU and certification    –  Regional Extensi...
Health IT and Data are Foundational forHealth Reform                                       Sustainable	  	                ...
Payment Reforms will Motivate and RewardInnovation at a Whole New Level   Pa0ent	         •  Organized	  outpa0ent	  care,...
HITECH and Meaningful Use Regional	  Extension	  Centers	                                                        ADOPTION	...
Conceptual Approach toMeaningful Use                                                 2015	                            2013...
Meaningful Use Regulation•  “Stage	  1”	  regula0on	  (2011-­‐2012)	       –  July	  2010:	  Final	  rule	  published	    ...
Fewer Premature Deaths (CV) •    Demographics     •  Quality Measurement •    Blood Pressure   •  CDSS •    Smoking       ...
Safer Care    •    Demographics                       •       Quality Measurement    •    Blood Pressure                  ...
Patient-Centered Care    •    Demographics                       •      Quality Measurement    •    Blood Pressure        ...
More Coordinated Care  •    Demographics                                        •    Quality Measurement  •    Blood Press...
Next Steps: Meaningful Use Stage 2•  Incorporate HITPC feedback and hearing findings into   final MU WG recommendations fo...
Expert Panel Projections:Office-based Physicians’ Adoption of EHRs
Regional Extension CenterRegional Extension Center Provider Registration   Total	  Priority	  Primary	  Care	       Total	...
Health Information Exchange Portfolio                                        15	  
Rising Health Data Liquidity       The	  Direct	  Project	  	                          “Blue	  Bu^on”	                    ...
…while	  protec0ng	  privacy	  and	  security:	  	  	  Federal Government’s Actions To Date                               ...
What Comes Next?•  Accountable care rewarded (ACO, bundled   payment, PCMH, shared savings, VBP, etc)•  Virtuous Cycle (in...
ONC Health IT Strategy (What’s Next?)   BeGer	   Technology	         Achieve Adoption and Information Exchange        ↑ Tr...
…	  to Make this Vision, At Long Last, a Reality
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What Lies Ahead for ONC: Meaningful Use and Beyond

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Farzad Mostashari, MD, ScM serves as Deputy National Coordinator for Programs and Policy within the Office of the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services.

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What Lies Ahead for ONC: Meaningful Use and Beyond

  1. 1. What Lies Ahead for ONCMeaningful Use and Beyond Farzad Mostashari, MD ScM National Coordinator for Health Information Technology
  2. 2. Last Year’s Notable Heath IT Trends•  Policy Ú Implementation of HITECH –  MU and certification –  Regional Extension Centers THE TIME IS –  State HIEs and Beacons –  Workforce programs•  Direct Project & Blue Button•  Anticipation of delivery reform –  Hospital consolidation, ACO service providers –  National Quality Strategy, Partnership for Patients –  getting the music out of the piano (tribute to Duke)
  3. 3. Health IT and Data are Foundational forHealth Reform Sustainable     health,  quality  &  efficiency   improvements   Care   Measurement   Consumer   &     Payment   Delivery   Engagement   Reform   Innova0ons   Provider   Feedback     Health  IT,  Informa0on  Exchange,  and  Data    
  4. 4. Payment Reforms will Motivate and RewardInnovation at a Whole New Level Pa0ent   •  Organized  outpa0ent  care,   IT  Innova0ons  Needed:   Centered   coordina0on  and  team-­‐based  Medical  Homes   approaches   Timely  Clinical  Data,   Decision  Support   Accountable   •  Shared  savings;  redesigned  care     Care   processes  for  high  quality,  efficient   Care  Integra0on  Tools   Organiza0ons   delivery     Technology  to  Extend   Bundled   •  Pilot  program  for  episodes  of  care;   Physician  Reach     incen0vizes  reduced  costs  around     Payments   eight  condi0ons   Consumer  Engagement   Tools/PlaIorms/Apps   Readmission   •  Mo0vates  hospitals  to  engage  with     Reduc0on   care  coordinators  and  beGer   Data  Mining/Analy0cs   Programs   organize  delivery  systems      
  5. 5. HITECH and Meaningful Use Regional  Extension  Centers   ADOPTION   Improved  Individual  &   Workforce  Training    Popula0on  Health   Outcomes     Medicare  and  Medicaid     Increased   Incen0ves  and  Penal0es   MEANINGFUL  USE   Transparency  &    Efficiency     Improved   State  Grants  for   Ability  to  Study  &  Health  Informa0on  Exchange   EXCHANGE   Improve  Care  Delivery   Standards  &  Cer0fica0on     Privacy  &  Security  Framework   5  
  6. 6. Conceptual Approach toMeaningful Use 2015   2013   Improved   Outcomes   Advanced   2011   care   processes   Capture  /   with  decision   share  data   support   6  
  7. 7. Meaningful Use Regulation•  “Stage  1”  regula0on  (2011-­‐2012)   –  July  2010:  Final  rule  published   –  Jan  2011:  Registra0on  began   –  May  2011:  First  Medicare  payments  •  65%  of  non-­‐federal  acute  care   hospitals  and  32%  of  office-­‐based   physician  prac0ces  planning  to  apply   in  2011  or  2012     Source:  American  Hospital  Associa0on  Informa0on  Technology  Survey,  2010;  Na0onal  Center  for  Health  Sta0s0cs,  Na0onal  Ambulatory  Medical   Center  Survey,  2010.     7  
  8. 8. Fewer Premature Deaths (CV) •  Demographics •  Quality Measurement •  Blood Pressure •  CDSS •  Smoking •  Registry •  BMI •  Problem List •  Med List •  Lab Data
  9. 9. Safer Care •  Demographics •  Quality Measurement •  Blood Pressure •  CDSS •  Smoking •  Registry •  BMI •  CPOE •  Problem List •  Drug-Drug, Drug-Allergy •  Med List •  eRx •  Allergy •           eMAR*   •  Lab Data* Recommendation of the Meaningful Use Workgroup of the Health IT Policy Committee
  10. 10. Patient-Centered Care •  Demographics •  Quality Measurement •  Blood Pressure •  CDSS •  Smoking •  Registry •  BMI •  CPOE •  Problem List •  Drug-Drug, Drug-Allergy •  Med List •  eRx •  Allergy •  After Visit Summary •  Lab Data •  Reminders •  Patient Education •           Pa0ent  Copy   View  &   •           Online  Access   Download*   •           Secure  Messaging*  * Recommendations of the Meaningful Use Workgroup of the Health IT Policy Committee
  11. 11. More Coordinated Care •  Demographics •  Quality Measurement •  Blood Pressure •  CDSS •  Smoking •  Registry •  BMI •  CPOE •  Problem List •  Drug-Drug, Drug-Allergy •  Med List •  eRx •  Allergy •  After Visit Summary •  Lab Data •  Reminders •  Patient Education •  Patient Copy •  Online Access •           List  of  care team members* •  Medication Rec Longitudinal •  Share Care Summary care plan* •           Electronic progress notes** Recommendations of the Meaningful Use Workgroup of the Health IT Policy Committee
  12. 12. Next Steps: Meaningful Use Stage 2•  Incorporate HITPC feedback and hearing findings into final MU WG recommendations for stage 2•  June 8: Present final draft recommendations to HITPC for approval•  June 2011: Submit final HITPC stage 2 Meaningful Use recommendations to ONC and CMS•  End-2011: anticipate HHS MU NPRM•  Mid-2012: anticipate HHS MU Final Rule 12  
  13. 13. Expert Panel Projections:Office-based Physicians’ Adoption of EHRs
  14. 14. Regional Extension CenterRegional Extension Center Provider Registration Total  Priority  Primary  Care   Total  Priority  Primary  Care   Providers  Enrolled   Providers  Enrolled  By  Specialty   14  
  15. 15. Health Information Exchange Portfolio 15  
  16. 16. Rising Health Data Liquidity The  Direct  Project     “Blue  Bu^on”   •  The  ability  for  any  veteran  or  • Collabora0ve  project  to  develop  a   Medicare  beneficiary  to  download   simple  method  for  enabling  secure   an  electronic  copy  of  their  own   transmission  of  health  care   personal  health  or  claims   informa0on  over  the  Internet   informa0on    • Launched  3/10,  specs  posted  6/10,   •  Launched  10/10,  u0lized  by  over   first  produc0on  transac0on  1/11,  now   310,000  unique  users  thus  far   being  implemented  by  65+  vendors  
  17. 17. …while  protec0ng  privacy  and  security:      Federal Government’s Actions To Date •  Prevent  sharing  of  health   informa0on  without  consent     •  Strengthen  communica0ons   about  breaches     •  More  enforcement   •  Expand  pa0ent  rights  to   access  their  informa0on   17  
  18. 18. What Comes Next?•  Accountable care rewarded (ACO, bundled payment, PCMH, shared savings, VBP, etc)•  Virtuous Cycle (information, payment, redesign)•  Tipping point for health IT (business case)•  Beyond EHRs – Business intelligence, hot spotting, population management, patient engagement, Consumer eHealth-PCHR
  19. 19. ONC Health IT Strategy (What’s Next?) BeGer   Technology   Achieve Adoption and Information Exchange ↑ Transparency through Meaningful Use of Health IT ↑ Data Liquidity Improve Care, Improve Population Health, and Reduce Health Care Costs through the QM 2.0 Use of Health IT Beacon Lessons BeGer   Informa0on   NwHIN Inspire Confidence and Trust in Health IT Governance Empower Individuals with Health IT to Improve their Health and the Health Care System PCHRs Arrive? Achieve Rapid Learning and Technological Meta Data Tagging Transform   Advancement Distributed Query Health  Care   19  
  20. 20. …  to Make this Vision, At Long Last, a Reality

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