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State of Michigan HIE Update (without Tina Scott)

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Connecting Michigan for Health 2013 http://mihin.org/

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State of Michigan HIE Update (without Tina Scott)

  1. 1. HIT AND HIE IN THE STATEHIT AND HIE IN THE STATE OF MICHIGANOF MICHIGAN Meghan Sifuentes Vanderstelt HIT Manager Michigan Department of Community Health 1
  2. 2. 2 DEPARTMENT OF COMMUNITY HEALTH 2013 STRATEGIC PRIORITIES MISSION MDCH will protect, preserve, and promote the health and safety of the people of Michigan with particular attention to providing for the needs of vulnerable and under-served populations. VISION Improving the experience of care, improving the health of populations, and reducing per capita costs of health care. STRATEGIC PRIORITIES Improve Population Health Transform the System of Care Reform the Health Care System Transform the Department of Community Health
  3. 3. THE SIM OPPORTUNITY (State Innovation Model) •Collaborating to create meaningful system change in order to Improve Care Improve Health Outcomes Reduce Costs •Create a State Healthcare Innovation Plan (SHIP) • Funding to bring together a broad base of stakeholders to plan an innovative, multi-payer and multi-sector health care delivery system transformation •Testing and implementation funding anticipated 3 Center for Medicare and Medicaid Innovation- CMS
  4. 4. State Innovation Model (SIM) & The State Healthcare Innovation Plan (SHIP) • Major deliverable – done by September • SIM Advisory Committee asked to provide input: • Consider Michigan’s health system, payment models, performance metrics “as is” and “to be” • Develop a roadmap for health system transformation 4
  5. 5. Michigan’s Plan • Multi-payer, multi-stakeholder, multi-system approach to develop and test comprehensive system reform • Invest in a lifetime of good health for people and communities 5
  6. 6. Innovations being tested • MiPCT • Value Partnerships • Care Bridge • Health Information Exchange • Trailblazers • Community Linkages • Strengthen Public Health Infrastructure for Improved Health Outcomes • Maternal and Child Health Initiatives • MI Healthcare Workforce Planning Team 6
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  8. 8. The Health Information Technology Commission (HITC) The Health Information Technology Commission is created within the department to facilitate and promote the design, implementation, operation, and maintenance of an interoperable health care information infrastructure in this state. HIT Commission Public Act 137-2006 8
  9. 9. HITC Job Description • Develop and maintain a strategic plan to guide implementation of an interoperable health information technology system • Perform activities within HIT scope as directed by MDCH and DTMB • ID strategies to improve ability to monitor health status • Provide recommendations on policy to achieve HIT adoption • ID critical issues that affect private/public adoption • Technical • Scientific • Economic • Governance • Other • Increase public’s understanding of HIT • Promote effective and efficient communication among health care providers: • Hospital, physicians, payers, employers, pharmacies, labs, and other health care entities 9
  10. 10. 2013 HITC Objectives Objective: To recommend and advise the Michigan Department of Community Health on Policy decisions, business and technical needs, and general oversight for the following HIT activities essential to the State of Michigan HIT and HIE landscape during 2013. 10
  11. 11. Role of HIT and HIE Stakeholders • Identify new and emerging best practices • Provide input for evolving policy framework • Collaborate and identify potential crossover opportunities • Coordinate and further advance HIT and HIE in Michigan 11
  12. 12. Vision beyond HIT and HIE • Research • Quality improvement • Inspire confidence and trust in health IT • Empower the consumer to be more actively involved in their health care • Improve population health 12
  13. 13. Roadmap For Reforming The Healthcare System 13
  14. 14. 14
  15. 15. Michigan Medicaid EHRMichigan Medicaid EHR Incentive Program UpdateIncentive Program Update June 5, 2013June 5, 2013 Jason Werner, MDCHJason Werner, MDCH
  16. 16. Program Summary This ARRA funded program provides financial incentives (100% Federal) to eligible Medicaid professionals and hospitals to meaningfully use (MU) a certified EHR technology. Program administration (90% Federal) is the responsibility of DCH.
  17. 17. Eligible Professionals: (Non-hospital based with at least 30% Medicaid volume) • Physicians/Pediatricians (20%) • Optometrists • Dentists • Certified Nurse Mid-wives • Nurse Practitioners • Physician Assistants (PA) practicing in a PA-led FQHC or Rural Health Clinic Hospitals: • Acute care -- at least 10% Medicaid volume • Children’s hospitals • Critical access hospitals Who Is Eligible to Receive the Medicaid Incentive Payments?
  18. 18. Certified EHR Technology Office of National Coordinator (ONC) maintains the list of complete EHRs and EHR modules that have been tested and certified. There are now 6 certifying bodies and over 3,000 certified products. Certified = Capable of meeting Meaningful Use (MU).
  19. 19. Meaningful Use Timeline   Meaningful Use Stage 1st year 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2011 AIU 1 1 2 2 3 TBD TBD TBD TBD TBD 2012   AIU 1 1 2 2 3 TBD TBD TBD TBD 2013     AIU 1 1 2 2 3 TBD TBD TBD 2014       AIU 1 1 2 2 3 TBD TBD 2015         AIU 1 1 2 2 3 TBD 2016           AIU 1 1 2 2 3
  20. 20. Stage 1 vs. Stage 2 *Regardless of the stage of MU, all providers will complete this number of CQMs in 2014 Stage I 15 Core 5 of 10 Menu 6 of 44 CQM’s Total of 26 Objectives Stage II 17 Core 3 of 6 Menu *9 of 64 CQM’s Total of 29 Objectives Effective 4/20/2012 Effective 1/1/2014
  21. 21. Core Objectives Comparison Core Objective Stage 1 Stage 2 1 CPOE Use CPOE for >30% of medications Use CPOE for > 60% of medications, 30% of laboratory and 30% of radiology 2 e-Rx e-Rx for >40% e-Rx for >50% 3 Demographics Record demographics for >50% Record demographics for >80% 4 Vital Signs Record vital signs for >50% Record vital signs for >80% 5 Smoking Status Record smoking status for >50% Record smoking status for >80% 6 CDS Interventions Implement 1 clinical decision support rule. Drug/drug and drug/allergy is separate Core Objective in Stage 1 Implement 5 clinical decision support interventions and drug/drug and drug/allergy 7 Labs Menu Objective in Stage 1; Incorporate lab results for >40% Incorporate lab results for >55% 8 Patient List Menu Objective in Stage 1; Must generate one report Generate patient list by specific condition
  22. 22. Core Objectives Comparison Core Objective Stage 1 Stage 2 9 Preventive Measures Menu Objective in Stage 1; Reminders for follow up care for >20% of patients ≤ 5 or ≥ 65 years of age Reminders for follow up care for >10% of patients with two or more office visits in the last 2 years 10 Patient Access Menu Objective in Stage 1; Provide online access to health information for >10% within 4 business days of EHR update Provide online access to health information for >50% with >5% actually accessing 11 Visit Summaries Provide summaries for >50% of office visits within 3 business days Provide summaries for >50% of office visits within 1 business day 12 Education Resources Menu Objective in Stage 1; Provide education resources for >10% of all unique patients Provide education resources for >10% of all unique patients 13 Secure Messages New for Stage 2 More than 5% of patients send secure messages to their EP
  23. 23. Core Objectives Comparison Core Objective Stage 1 Stage 2 14 Medication Reconciliation Menu Objective in Stage 1; Medication Reconciliation for >50% of transitions of care Medication Reconciliation for >50% of transitions of care 15 Summary of Care Menu Objective in Stage 1; Provide documents for >50% of transitions of care/referrals Provide documents for >50% of transitions of care/referrals with 10% sent electronically. At least one is sent to a recipient with a different EHR vendor or successfully testing with CMS test EHR 16 Immunizations Menu Objective in Stage 1; Perform one successful test transmission of immunization data Successful ongoing transmission of immunization data 17 Security Analysis Conduct or review security analysis and incorporate in risk management process Conduct or review security analysis and incorporate in risk management process
  24. 24. Stage 2 – EPs must select 3 our of 6 Menu Menu Objective Stage 1 Stage 2 1 Imaging Results New for Stage 2 More than 20% of imaging results are accessible through CEHRT 2 Family History New for Stage 2 Record Family History for >20% 3 Syndromic Surveillance Successful ongoing transmission of syndromic surveillance data Successful ongoing transmission of syndromic surveillance data 4 Cancer New for Stage 2 Successful ongoing transmission of cancer case information 5 Specialized Registry New for Stage 2 Successful ongoing transmission of data to specialized registry 6 Progress Notes New for Stage 2 Enter an electronic progress note for >30% of unique patients
  25. 25. CQMs in 2014 and Beyond CQM Changes in 2014 Provider Prior to 2014 2014 and Beyond* EPs Complete 6 out of 44 •3 Core or 3 Alternate core •3 Additional CQMs Complete 9 out of 64 Choose at least 1 measure from 3 of 6 NQS domains *Regardless of the stage of MU, all providers will complete this number of CQMs in 2014
  26. 26. Auditing MDCH is responsible for the auditing function including Meaningful Use (MU) To help with the audit function related to MU Public Health testing, MDCH has created a MU repository
  27. 27. What is this MU Repository? Tool used by the Michigan Department of Community Health (MDCH) to track providers in the State of Michigan that wish to meet electronic public health reporting meaningful use requirements.
  28. 28. Medicare? CMS is running a similar program for Medicare providers. Professionals can only claim one incentive program (either Medicaid or Medicare). Very similar eligibility criteria. 10,991 Medicare providers have registered with 8,121 having received a payment.
  29. 29. Incentive Payment for Eligible Professionals First Calendar Year in which the EP receives an Incentive Payment Calendar Year CY 2011 CY 2012 CY 2013 CY 2014 CY 2015 CY 2016 2011 $21,250 2012 $8,500 $21,250 2013 $8,500 $8,500 $21,250 2014 $8,500 $8,500 $8,500 $21,250 2015 $8,500 $8,500 $8,500 $8,500 $21,250 2016 $8,500 $8,500 $8,500 $8,500 $8,500 $21,250 2017 $8,500 $8,500 $8,500 $8,500 $8,500 2018 $8,500 $8,500 $8,500 $8,500 2019 $8,500 $8,500 $8,500 2020 $8,500 $8,500 2021 $8,500 Total $63,750 $63,750 $63,750 $63,750 $63,750 $63,750
  30. 30. Incentive Payment for Eligible Hospitals Payments are formula driven and will vary per hospital. Most hospitals will receive between $1-$3 million. Payments are made over 3 years at a 50%, 40%, 10% ratio. MDCH will utilize cost report data in deriving the incentive amount.
  31. 31. Registrations/Payments As of 5/29/2013   Registered Paid Under AIU Paid Under MU Total Payments Dollars Paid (In Millions) EP 3,756 2,516 431 2,947 $55.6 EH 117 93 50 143 $108.6 Totals 3,873 2,609 481 3,090 $164.2
  32. 32. What the rest of 2013 holds? Launching Stage II of MU Getting Registration System Ready Getting Public Health Registries Ready Getting MU Repository Ready (MSSS, Cancer, CDR) Increasing MU Adoption Rates Electronic Clinical Quality Reporting
  33. 33. www.MichiganHealthIT.org Questions?

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