The document discusses advancements in health information technology (IT) and electronic medical records (EMRs). It notes that while the US spends over $1.7 trillion annually on healthcare, Americans still face quality issues. EMRs and health IT can help by improving care coordination, monitoring guidelines, and measuring performance. The document outlines recent legislation promoting health IT adoption and the benefits of EMRs, such as reduced costs and errors. It explains what EMRs are and their role in supplementing technologies like e-prescribing. Finally, it discusses the concept of "meaningful use" to ensure EMRs improve care, safety, efficiency and engage patients rather than just being adopted.

1. Shaping a brighter
Future:
Advancements in Health IT
February 16-18, 2012 | Philadelphia, PA
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2. Understanding Health IT and how it relates to you
• What does Health IT mean to you?
• Do you know what an EMR is?
• How do you see Health IT playing a role in your personal life?
• How do you see it affecting your business, if at all?
• How do you feel overall about the health care system?
• What opportunities do you foresee taking place with technology in health care?
• Are there any particular advancements you would like to see?
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3. Despite the current U.S health care investment of over $1.7 trillion
annually, Americans are still plagued by quality care concerns
• Per capita health care expenditure in the United States far outstrips expenditure in other nations,
yet Americans suffer from the burden of chronic disease at a higher rate than their counterparts in
other nations
• Most providers lack the information systems necessary to:
– Coordinate a patient’s care with other providers and share needed information
– Monitor compliance with prevention and disease-management guidelines
– Measure and improve performance
• Incentives within the U.S. health care system are misaligned, contributing to the high costs of care
Demand Side Incentives Supply Side Incentives
Health Care Costs
• Insured patients, who are largely • Physicians and hospitals are still largely
insulated from the costs of care, paid under a fee-for-service model that
demand the most/best treatment, provides additional payment for each
including interventions, prescriptions, visit/procedure, offering little incentive
etc. that may have little efficacy to control utilization
• The media intensifies this feeling of • Liability concerns fuel the tendency to
entitlement and highlights “miracle provide all possible interventions
cures”
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4. Over the last 10 years, recent and aggressive legislation has helped
guide the development of Health IT in an effort to improve health care
Legislation Impact on HIT
President’s Health Information • Executive Order signed by President Bush in 2004
Technology Plan • Outlined a broad ten year plan to increase the reach of Health IT (HIT) with a
focus on patients’ needs, values, and education
• Established the Office of the National Coordinator for Health Information
Technology
Health Information Technology for • A component of the American Recovery and Reinvestment Act of 2009, signed
Economic and Clinical Health into law by President Obama in 2009
• Serves as the guiding framework for expansion of HIT
(HITECH) Act
• Defines “meaningful use” and provides incentives and support to providers who
adopt “meaningful use” of HIT into their practices
• Addresses privacy and security concerns and implemented new rules regarding
the accounting of disclosure of patient health information
Patient Protection and Affordable • Signed into law by President Obama in March 2010, the ACA includes
Care Act (ACA) requirements that the federal and state governments establish new electronic
systems for enrolling individuals in health insurance plans
• The ACA emphasizes:
— Transparency of the online process
— Guidance for consumers to make informed decisions
— Accommodations for a range of users
— Privacy and security
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5. By adopting Health IT solutions, standards, and best practices,
health care providers will be able to offer superior care
• Health IT is the comprehensive management of health information across computerized systems
and its secure exchange between consumers, providers, government and quality entities, and
insurers and includes:
• Implementing Health IT solutions would: Estimated Annual Benefits from Inpatient Computerized
Physician Order Entry Systems, After Full Adoption
– Improve care quality and reduce errors
– Reduce overall health care cost by an estimated
$77B per year*
– Increase patient involvement and collaboration
– Increase administrative efficiency, reducing cost,
effort, and time to complete tasks
• Current Health IT solutions include:
– Electronic Medical records (EMRs)
– Computerized provider order entry (CPOE)
– E-Prescribing (eRx)
– Electronic data immunization
– Electronic syndromic surveillance data Source: Rand Corporation Study, Can HIT Lower Costs and Improve Quality?
– E-copies of health info to patients
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6. To enable a smooth adoption of Health IT, the industry must
understand EMRs and the role it plays in future health services
8 Information Technologies
Electronic Medical Record (EMR) is a computerized to Supplement EMRs
medical record created in an organization that delivers  Electronic Transcribing – automated clinical
care, i.e. hospital or physician's office note taking that creates document-sharing
among multiple locations
• Usage– only 10% of hospitals have integrated their  Electronic Lab Reporting (ELR) – automated
systems web-based lab reporting, that helps timeliness,
• Legal Status– EMRs must be kept in its unaltered form, reduction of manual data entry errors, and
by the health facility more complete reports
• Tech Feature – EMRs enables patient records to be  E-Prescribing – automated prescribing
read & created on workstations and mobile devices;  Clinical Content Repository – clinical content
and access to Personal Health records to consumers management that offer users flexibility to
• Event Monitoring – EMR systems monitor clinical change and manage content on their own
events such as, predicting, preventing adverse events  Document Imaging – scanning and paper
i.e. discharges, transfers, lab results and others digitalization to assist with “medical grade”
• Role in electronic Research network– connects medical documentation and productivity
practitioners to researchers , promotes practice based  Patient Registry and CRR Bulletin Board –
basic patient population management, proven
research networks and facilitates clinical research
to improve chronic disease care
 Clinical Groupware – software that helps
streamline work and automatically prioritizes
the most time-consuming or needy patients
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7. When utilizing Health IT, especially EMRs, it’s important to understand
“Meaningful Use” and its impact on provider and patient services
“Meaningful Use” seeks to drive clinicians toward improved decision-making, acknowledging that
adoption of EMRs alone is insufficient to transform care
“Meaningful Use” of EMRs is an effort to:
• Improve quality, safety, and efficiency • Ensure privacy and security
• Reduce health disparities • Control costs
• Engage patients and families • Improve public health
• Improve care coordination • Facilitate research
Furthermore:
• Health information must be exchanged and used to inform clinical decisions at point of care
• EMRs must provide a minimum set of required functionality and should be certified as such
Ultimately, EMRS are just a vehicle, not the end goal; and it’s up to doctors,
not technology, to help patients make the right decisions.
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8. A phased implementation approach of “Meaningful Use” will guide the
development of Health IT into the coming years
• Electronic health data in a coded format
• Tracking of key clinical conditions
Stage 1 – Data Capture and • Communication of care outcomes & care coordination
Sharing (Current state) • Implementation of clinical decision support tools for disease/
medication management
• Reporting outcomes for public health purposes
• Increase SSA’s capacity to hear and decide cases
• Improve workload management practices of the hearings process
Stage 2 – Advanced Clinical • Encourages health IT use to enhance computerized provider order entry
Processes (2013) • Transitions of care
• Electronic transmission of diagnostic test results and research
• Promotes improvements to quality and safety
Stage 3 – Improved
Outcomes (2015) • Focus on clinical decision support
• encourages patient access and involvement to enhance health data

9. Despite tremendous adoption efforts, challenges to implementing
and adapting to Health IT are inevitable
• Laws prohibiting advancement, such as
HIPPA
• Paper based records are the most common
method of recording patient information,
and as such, a majority of doctors still use
paper records compared to digital records
• State requirements mandate that physical
records be held for a minimum of seven
years
• Portability and Security vulnerabilities are
incredibly concerning to many patients, as it
is uncertain who will see what information,
and how that information will be used
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10. Opportunities for the advancement of Health IT------Update
• Managing and improving
Mayo Clinic
your own health
• Mobile app development
• Systems development
Cleveland
• Change management
Clinic
• Medical device innovation
• Cyber security needs
• Hardware and software Johns
innovation and migration Hopkins
Can you identify other
areas for opportunity, Clinic
personally or professionally?
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11. Understanding the health care environment will help you navigate your
personal health, and your business, in the years to come
Be proactive in
seeking new information
Identify a source, be it a
Update and manage your
journal or online news
personal medical records
column, to stay current
Be inventive, and flag any Staying up to date in Build a network of
opportunities that may the health care field, diverse professions, one
relate to your business and making it being in the health field
relevant to you
Anticipate change in IT Get to know your health
and be ready to environment, i.e., your
react quickly physician and office
Stay current on your work
environment trends
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12. Questions and Contact Information
Kristine Martin Anderson
Vice President
Booz Allen Hamilton Inc.
1101 Wootton Pkwy
Rockville, MD 20852
Tel (240) 314-5790
anderson_kristine@bah.com
Chris Foster
Principal
Booz Allen Hamilton Inc.
8283 Greensboro Drive
Mclean, VA 22102
Tel (703) 377-0870
foster_chris@bah.com
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13. Additional Resources
• 10 Technologies to Embrace before EMRs (http://www.healthcareitnews.com/news/10-
technologies-embrace-emrs)
• Five ways health IT will reduce the cost of care (healthcareitnews.com/news/five-ways-
health-it-will-reduce-cost-care)
• Information Exchanges Let Doctors Share Patient Data Efficiently
(http://www.informationweek.com/news/healthcare/EMR/221601130)
• Kaiser Health Information Background brief (http://www.kaiseredu.org/Issue-
Modules/Health-Information-Technology/Background-Brief.aspx)
• Rand Corporation Study, Can HIT Lower Costs and Improve Quality?
(http://www.rand.org/pubs/research_briefs/RB9136/index1.html)
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