600 East Superior Street, Suite 404  I Duluth, MN 55802  I Ph. 800.997.6685 or 218.727.9390  I  www.ruralcenter.org  <br /...
Mission<br /><ul><li>To provide technical assistance, information, tools and resources for the improvement of rural health...
To serve as a national rural health knowledge center and strive to build state and local capacity.</li></li></ul><li>v<br ...
Delta Rural Hospital Performance Improvement
National Rural HIT Coalition
Federally funded Technical Assistance and Services Center (TASC)
Regional Extension Center – MN/ND</li></li></ul><li>The HITECH Act’s Framework for Meaningful Use of Electronic Health Rec...
Broad Goals for Meaningful Use<br />Vision<br />Enable significant and measurable improvements in<br />population health t...
Engage patients and families
Improve care coordination
Ensure adequate privacy and security protections for personal</li></ul>health information<br /><ul><li>Improve population ...
2011<br />2013<br />2015<br />Bending the Curve Towards Transformed Health; <br />Achieving Meaningful Use of Health Data<...
National HIT Policy and Funding for Rural Health<br /><ul><li> Is there an adoption gap?
 For hospitals, yes
 AHA survey and Flex survey
 For other rural providers</li></li></ul><li>AHA Survey<br />Rural hospitals less likely to be investing<br />
AHA Survey<br />Urban hospitals using IT more than rural hospitals<br />
TASC HIT Survey Conclusions<br /><ul><li>Medicare cost-based reimbursement has permitted many CAHs to make initial investm...
CAHs have high use rates for administrative and financial IT application, but much lower rates for clinical applications
CAH HIT use rates are lower than overall rates for hospitals
Future efforts need to focus on increasing use of clinical applications and interconnectivity of CAHs and other health car...
Lack of support for HIT systems, programs, software, etc… is also an issue
Because of isolation, small rural hospitals probably cannot design and implement HIT strategies alone</li></li></ul><li>Ru...
It is difficult for rural providers to make an informed decision about vendors
New national “interoperability” requirements for HIT implementation might disadvantage rural</li></li></ul><li> Additional...
Hard to find physician or administrative leaders/change agents
Other business priorities i.e. “surviving”
No business case for connectivity/linkages to other institutions (stand-alone EHRs?)</li></li></ul><li> Additional Rural &...
Need to address critical referral pattern issues, disruptions, patient flows, etc.
Rural health care organizations will need special legislative consideration</li></li></ul><li>Valley of Despair<br />Imple...
HIT Theme Strategy Map<br />Increased cost efficiency<br />Increased market share<br />Increased revenue<br />Clinical pro...
A Quick Lesson in Physics <br />There are six types of simple machines: <br /><ul><li> Levers
 Pulleys
 Wheels & axles
Ramps
 Wedges
Screws</li></li></ul><li>Simple Machines<br />A simple machine is a device that can provide one of the two following benef...
A Network as a Simple Machine<br />It increases the effort that is applied to issues affecting your members, so that the b...
On to the Network Summit<br />December 15-16, 2009, Minnesota<br />Sponsored by the National Rural Health Resource Center ...
On to the Summit<br />
Who Attended?	<br />Montana Rural Health Care Performance Improvement Network<br />Western Healthcare Alliance<br />The Ho...
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Health information technology networks presentation

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Health information technology networks presentation

  1. 1. 600 East Superior Street, Suite 404 I Duluth, MN 55802 I Ph. 800.997.6685 or 218.727.9390 I www.ruralcenter.org <br />Health Information Technology<br />Meaningful Use and the Role for Networks<br />Terry Hill<br />National Rural Health Resource Center <br />Executive Director<br />May 2010 <br />
  2. 2. Mission<br /><ul><li>To provide technical assistance, information, tools and resources for the improvement of rural health care.
  3. 3. To serve as a national rural health knowledge center and strive to build state and local capacity.</li></li></ul><li>v<br />About the Center<br /><ul><li>Non-Profit Located in Duluth, Minnesota
  4. 4. Delta Rural Hospital Performance Improvement
  5. 5. National Rural HIT Coalition
  6. 6. Federally funded Technical Assistance and Services Center (TASC)
  7. 7. Regional Extension Center – MN/ND</li></li></ul><li>The HITECH Act’s Framework for Meaningful Use of Electronic Health Records (EHRs)<br />
  8. 8. Broad Goals for Meaningful Use<br />Vision<br />Enable significant and measurable improvements in<br />population health through a transformed health care <br />delivery system<br />Goals<br /><ul><li>Improve quality, safety, efficiency and reduce health disparities
  9. 9. Engage patients and families
  10. 10. Improve care coordination
  11. 11. Ensure adequate privacy and security protections for personal</li></ul>health information<br /><ul><li>Improve population and public health</li></li></ul><li>Meaningful Use Evolution<br />The proposed rule lays out three stages to be applied<br />to providers and hospitals seeking to receive incentive payments: <br /><ul><li>The first stage will be applied to all those seeking to</li></ul>meet the requirements when the program launches in <br />FY 2011 (hospitals) and CY 2011 (providers). <br /><ul><li>The second and third stages, which will be proposed </li></ul>in late 2011 and late 2013, will apply to providers and hospitals as they progress in their meaningful use of<br />EHRs.<br />
  12. 12. 2011<br />2013<br />2015<br />Bending the Curve Towards Transformed Health; <br />Achieving Meaningful Use of Health Data<br />“Phased-in series of improved clinical data capture supporting more rigorous and robust quality measurement and improvement.”<br />Source: Connecting for Health, Markle Foundation “Achieving the Health IT Objectives of the American Recovery and Reinvestment Act” April 2009<br />
  13. 13. National HIT Policy and Funding for Rural Health<br /><ul><li> Is there an adoption gap?
  14. 14. For hospitals, yes
  15. 15. AHA survey and Flex survey
  16. 16. For other rural providers</li></li></ul><li>AHA Survey<br />Rural hospitals less likely to be investing<br />
  17. 17. AHA Survey<br />Urban hospitals using IT more than rural hospitals<br />
  18. 18. TASC HIT Survey Conclusions<br /><ul><li>Medicare cost-based reimbursement has permitted many CAHs to make initial investments in HIT infrastructure
  19. 19. CAHs have high use rates for administrative and financial IT application, but much lower rates for clinical applications
  20. 20. CAH HIT use rates are lower than overall rates for hospitals
  21. 21. Future efforts need to focus on increasing use of clinical applications and interconnectivity of CAHs and other health care providers</li></li></ul><li>Rural Health in the Digital Age<br /><ul><li>Important Health information technologies (HIT) issues remain:
  22. 22. Lack of support for HIT systems, programs, software, etc… is also an issue
  23. 23. Because of isolation, small rural hospitals probably cannot design and implement HIT strategies alone</li></li></ul><li>Rural Health in the Digital Age<br /><ul><li>Important Health information technologies (HIT) issues remain:
  24. 24. It is difficult for rural providers to make an informed decision about vendors
  25. 25. New national “interoperability” requirements for HIT implementation might disadvantage rural</li></li></ul><li> Additional Rural & Practice Challenges<br /><ul><li>Small rural hospitals may have no IT support let alone an IT Department
  26. 26. Hard to find physician or administrative leaders/change agents
  27. 27. Other business priorities i.e. “surviving”
  28. 28. No business case for connectivity/linkages to other institutions (stand-alone EHRs?)</li></li></ul><li> Additional Rural & Practice Challenges<br /><ul><li>No aggregate buying power (hence pooled vendor selection processes)
  29. 29. Need to address critical referral pattern issues, disruptions, patient flows, etc.
  30. 30. Rural health care organizations will need special legislative consideration</li></li></ul><li>Valley of Despair<br />Implemented and Supported<br />Implement EHR<br />Good Choices and management determines level of productivity and satisfaction<br />Preferred Future<br />Leadership and Management Determines how long you’re in the valley of despair.<br />Productivity<br />Little or No HIT<br />Choices, Planning, Execution Determines extent of Slide<br />Possible Future<br />Time<br />
  31. 31. HIT Theme Strategy Map<br />Increased cost efficiency<br />Increased market share<br />Increased revenue<br />Clinical processes<br />Acquire HIT expertise<br />Ensure a skilled workforce<br />Business processes<br />Operational processes<br />Establish an empowering work culture<br />Leadership<br />Instill change management<br />Acquire needed HIT systems<br />Ongoing education<br />Patient safety outcomes<br />Patient satisfaction<br />Increased margin to fund mission<br />Community health outcomes<br />Physician satisfaction<br />Finance<br />As financial stakeholders, how do we intend to meet the goals and objectives in the hospital’s Mission Statement?<br />Customers & Community<br />As customers of the hospital’s services, what do we want, need or expect?<br />Internal Processes<br />As members of the hospital staff, what do we need to do to meet the needs of the patients and healthcare community?<br />Learning & Growth<br />As an organization, what type of culture, skills, training and technology are we going to develop to support our processes?<br />
  32. 32. A Quick Lesson in Physics <br />There are six types of simple machines: <br /><ul><li> Levers
  33. 33. Pulleys
  34. 34. Wheels & axles
  35. 35. Ramps
  36. 36. Wedges
  37. 37. Screws</li></li></ul><li>Simple Machines<br />A simple machine is a device that can provide one of the two following benefits:<br />1. It can increase the force that is applied, so that the output (resistance) force is bigger than the input (effort) force.<br />OR<br />2. It can increase the speed at which a task is performed.<br />
  38. 38. A Network as a Simple Machine<br />It increases the effort that is applied to issues affecting your members, so that the benefits are larger than what individual members could reasonably accomplish on their own.<br />It can increase the speed at which these benefits are accomplished.<br />Best of all, you can achieve both of these things at once and so much more.<br />
  39. 39. On to the Network Summit<br />December 15-16, 2009, Minnesota<br />Sponsored by the National Rural Health Resource Center and the National Cooperative of Health Networks <br />Funding from the Health Resources and Services Administration, Office of Rural Health Policy<br />
  40. 40. On to the Summit<br />
  41. 41. Who Attended? <br />Montana Rural Health Care Performance Improvement Network<br />Western Healthcare Alliance<br />The Hospital Cooperative<br />National Cooperative of Health Networks<br />Oregon Rural Healthcare Quality Network<br />Montana AHEC and Office of Rural Health<br />Rural Healthcare Quality Network<br />University of Minnesota, Rural Health Research Center<br />Upper Peninsula Michigan Network<br />Federal Office of Rural Health and Policy<br />Texas Organization of Rural Community Hospitals<br />Illinois Critical Access Hospital Network<br />Rural Wisconsin Health Cooperative<br />
  42. 42. Goal of the Summit<br />To tap into the collective wisdom of these experienced network leaders. <br /><ul><li>Productive network activities
  43. 43. Critical success factors
  44. 44. Lessons learned
  45. 45. National knowledge center
  46. 46. National learning community</li></li></ul><li>Goal of the summit<br />Facilitated meeting of network leaders<br />Questions were sent in advance<br />While on site participants were asked to<br />Relate experiences<br />Share perspectives<br />Offered opinions<br />Topics: Quality, HIT, finances, work force, governance & leadership and more<br />
  47. 47. Why Do Networks Form?<br />Economies of scale and access to funds<br />Advocacy at the regional, state and national level<br />Develop new products and services<br />Increased manpower and technical expertise<br />Address common needs<br />Share education, information and other resources<br />Networking and peer support<br />Enable benchmarking and improvement<br />Meet future challenges and create opportunities<br />
  48. 48. Health Information Technology<br />Challenges included:<br />Agreeing on a common system/ownership of data<br />Achieving interoperability/exchange<br />Shortage of skilled professionals<br />Lack of capital funding to purchase EMR systems<br />
  49. 49. Health Information Technology<br />Lessons learned: <br />Networks must be involved in state/regional HIT policy and activities<br />Networks should help formulate a vision for how HIT improves quality, safety, efficiency and productivity<br />Recruit, train and share qualified HIT staff and consultants<br />Seek capital funding, discount pricing and shared services<br />
  50. 50. Rural Wisconsin Health Cooperative<br />Members:<br /><ul><li> Thirty-five, rural acute, general medical-surgical hospitals
  51. 51. In 1996, RWHC created a non-voting Affiliate Membership for</li></ul> specialty provider based systems<br />RWHC:<br /><ul><li>Is the “rural advocate of choice” for its members
  52. 52. Develops and manages a variety of products and services
  53. 53. Assists members to offer high quality, cost effective healthcare
  54. 54. Assists Members to partner with others to make their communities healthier
  55. 55. Generates additional revenue by services to non-members
  56. 56. Actively uses strategic alliances in pursuit of its vision</li></li></ul><li>Illinois Critical Access Hospital Network<br />Members: 50 CAH members<br />ICAHN Core Network Activities include:<br /><ul><li>Ensuring appropriate funding and financial resources
  57. 57. Promoting efficient use of information technology services
  58. 58. Maintaining and further developing specific-type user groups, activities and list serves that promote hospital operational efficiencies and connectivity
  59. 59. Offering on-going educational opportunities and resources
  60. 60. Developing and offering projects that are self-sustaining and add value
  61. 61. Developing and offering shared services that offer value</li></li></ul><li>SISU Medical Systems<br />Members:<br />17 members including CAHs, rural and urban hospitals and nursing homes <br />Also have 4 Associate Members<br />Purpose:<br />Consortium of medical centers located throughout greater Minnesota that work together to share information technology resources<br />SISU members maintain their independence while collaboratively investing in cutting-edge technology<br />
  62. 62. Western Colorado Health Alliance<br />27 Hospital members<br />Since 1989<br />Numerous business products and services (e.g. collections)<br />Returns cash dividends to members<br />Shared IT staff<br />
  63. 63. Upper Peninsula Health Network<br />All 14 hospitals in UP of Michigan<br />Since 1997<br />Telehealth network<br />Also have a health insurance product<br />Various business products<br />
  64. 64. Northern Montana Healthcare Alliance<br />Since 2003<br />15 hospitals<br />Coordinated fundraising and implementation of EHRs<br />Ongoing education<br />Administer the regional telehealth network<br />Clinical services<br />Conferencing<br />
  65. 65. Nevada Rural Hospital Partners<br />14 hospitals<br />Since 1987<br />Group purchasing of equipment and support<br />Standardize practices and processes<br />Negotiate discounts<br />Dedicated CIO and IT staff<br />Developing a Health Information Exchange<br />
  66. 66. Other HIT Networks<br />Integrated Health System of Alabama (2004)<br />Guadalupe Valley Healthcare Network (1995)<br />Minnesota Rural Health Coop (1995)<br />Lake Okeechobee Rural Health Network (1994)<br />Community Health Network of West Virginia (2000)<br />Ohio State Health Network (2001)<br />Appalachian Health Information Exchange (2008)<br />Susquehanna Valley Rural Health Partnership (2002)<br />St. John’s River Rural Health Network (1994)<br />
  67. 67. HIT Critical Success Factors<br /><ul><li>Sense of urgency
  68. 68. Strong team/coalition
  69. 69. Clear vision and planning framework
  70. 70. Ongoing communication
  71. 71. Empowerment and engagement of staff
  72. 72. Short-term wins
  73. 73. Anchor change in culture</li></li></ul><li>Develop a <br />What Hospitals Should Do Now…<br /><ul><li>Begin with the end in mind—develop a plan
  74. 74. Network with other hospitals
  75. 75. Seek out the experience of others who have done it already
  76. 76. Raise awareness that HIT implementation will be difficult but necessary
  77. 77. Involve employees and medical staff throughout the hospital
  78. 78. Begin to to clean up/document hospital processes now
  79. 79. Seek assistance from HIT Regional Extension Centers and other state and national resources </li></li></ul><li>
  80. 80.
  81. 81. Terry Hill<br />Executive Director<br />National Rural Health Resource Center<br />600 East Superior Street, Suite 404<br />Duluth, MN 55808<br />(218) 727-9390 ext. 232<br />thill@ruralcenter.org<br />

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