1) The document discusses recent trends in health IT policy and implementation including Meaningful Use and regional extension centers.
2) It outlines upcoming payment reforms like accountable care organizations and bundled payments that will further incentivize health IT innovation.
3) The document proposes next steps for advancing health IT through the proposed Stage 2 of Meaningful Use regulations to promote improved health outcomes, care coordination, and patient engagement through 2015.
Davin Lundquist, MD
CMIO
Dignity Health Medical Foundation
Case Study: "Leveraging technology to build an organizational strategy fostering staff competency & physician satisfaction"
Health IT systems will never please all users however providers are employing strategies that can significantly improve user satisfaction. Staff re-education and continually measuring the effectiveness of initiatives can make a positive impact on an organization’s ability to realize gains with IT. This presentation will explore Dignity Health’s lessons learned and organizational strategy to ensure staff competency levels and physician satisfaction.
Dignity Health is a family of more than 60,000 caregivers and staff delivering excellent care to diverse communities across 17 states. Founded in 1986 and headquartered in San Francisco Dignity Health is the fifth largest hospital provider in the nation and the largest hospital system in California.
Clinical Integration: The Foundation for Accountable Care - Presentation delivered by Keynote Speaker Marvin O’Quinn, Senior Executive Vice President and Chief Operating Officer, Dignity Health at the National Healthcare CXO Summit held in Las Vegas Oct 19-21, 2014.
Case Study "Dignity Health: Implementation of an EHR Alliance Bridging Acute and Ambulatory Care"
This session will provide a unique learning opportunity focusing on the Dignity Health $1.8B implementation program to meet horizon 2020 as we transform healthcare. The initiative encompassed a 42 hospital health IT implementation in the acute care setting. Mr. Lowe will also review the challenges associated with governance and review lessons Learned from the project.
Learning Objectives:
∙ Key implementation points
∙ Integration with Ambulatory strategies for a full market approach
∙ What’s next – business intelligence
Davin Lundquist, MD
CMIO
Dignity Health Medical Foundation
Case Study: "Leveraging technology to build an organizational strategy fostering staff competency & physician satisfaction"
Health IT systems will never please all users however providers are employing strategies that can significantly improve user satisfaction. Staff re-education and continually measuring the effectiveness of initiatives can make a positive impact on an organization’s ability to realize gains with IT. This presentation will explore Dignity Health’s lessons learned and organizational strategy to ensure staff competency levels and physician satisfaction.
Dignity Health is a family of more than 60,000 caregivers and staff delivering excellent care to diverse communities across 17 states. Founded in 1986 and headquartered in San Francisco Dignity Health is the fifth largest hospital provider in the nation and the largest hospital system in California.
Clinical Integration: The Foundation for Accountable Care - Presentation delivered by Keynote Speaker Marvin O’Quinn, Senior Executive Vice President and Chief Operating Officer, Dignity Health at the National Healthcare CXO Summit held in Las Vegas Oct 19-21, 2014.
Case Study "Dignity Health: Implementation of an EHR Alliance Bridging Acute and Ambulatory Care"
This session will provide a unique learning opportunity focusing on the Dignity Health $1.8B implementation program to meet horizon 2020 as we transform healthcare. The initiative encompassed a 42 hospital health IT implementation in the acute care setting. Mr. Lowe will also review the challenges associated with governance and review lessons Learned from the project.
Learning Objectives:
∙ Key implementation points
∙ Integration with Ambulatory strategies for a full market approach
∙ What’s next – business intelligence
Soccnx III - Using Social for social good - the case for Social Business in H...LetsConnect
Speakers: Bill Looby
"Social Business for Healthcare Social is everywhere. Patients and providers are living in a socially networked world. Healthcare is a social business. Are you ready? Social businesses leverage collaboration capabilities to connect people and break down traditional boundaries. They activate networks of people that apply relevant content and expertise to improve and accelerate how work gets done. This is a demonstration of social business capabilities applied to healthcare for improved patient outcomes and efficiency of care delivery. See examples of connecting providers across acute and ambulatory care settings in new ways via social business technologies and open standards. Featured technologies include IBM Connections social business software for healthcare and IBM InfoSphere® HC solutions built on Initiate® technology.
What eHealth strategies work and do not work, and what should be implemented to effectively meet these healthcare “transformational” imperatives?. Crawford J. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)
Presentation by Dr Aaron McKethan, who's running the Beacon Communities project at ONC. This was the presentation he gave to the Health 2.0 Community in the webinar on July 21
This PPT explains about how Singapore is using IT in healthcare, Integrated Health Information Systems, Singapore's Shifting Demographics and 2020 Master Plan. For more information visit: http://www.transformhealth-it.org/
Soccnx III - Using Social for social good - the case for Social Business in H...LetsConnect
Speakers: Bill Looby
"Social Business for Healthcare Social is everywhere. Patients and providers are living in a socially networked world. Healthcare is a social business. Are you ready? Social businesses leverage collaboration capabilities to connect people and break down traditional boundaries. They activate networks of people that apply relevant content and expertise to improve and accelerate how work gets done. This is a demonstration of social business capabilities applied to healthcare for improved patient outcomes and efficiency of care delivery. See examples of connecting providers across acute and ambulatory care settings in new ways via social business technologies and open standards. Featured technologies include IBM Connections social business software for healthcare and IBM InfoSphere® HC solutions built on Initiate® technology.
What eHealth strategies work and do not work, and what should be implemented to effectively meet these healthcare “transformational” imperatives?. Crawford J. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)
Presentation by Dr Aaron McKethan, who's running the Beacon Communities project at ONC. This was the presentation he gave to the Health 2.0 Community in the webinar on July 21
This PPT explains about how Singapore is using IT in healthcare, Integrated Health Information Systems, Singapore's Shifting Demographics and 2020 Master Plan. For more information visit: http://www.transformhealth-it.org/
The 10th Annual Utah Health Services Research Conference: Data: What's available and how we are use it is changing. By: Danielle A. Lloyd, MPH - Premier
Health Services Research Conference: March 16, 2015
Patient Centered Research Methods Core, University of Utah, CCTS
A Vision for U.S. Healthcare's Radical MakeoverCognizant
The healthcare industry is on the verge of a disruptive change that will significantly reshape our experiences and reorient our expectations across the provider and payer value chain.
Delivered by Craig Brammer at CITIH 2011. Focus on discussion of regional and national initiatives and opportunities for regional partners to leverage them for driving healthcare improvements, public health and research.
This session will provide a broad perspective on the many initiatives related to HIT. Experts from the regional and national level will discuss data models, privacy concerns and adoption strategies from their different perspectives. Also addressed will be planning for NHIN direct adoption as a complimentary strategic to full HIEs.
Paperless Hospitals Dr Dev Taneja 3rd June2012DrDevTaneja
The Indian Hospital industry is growing at 15% per annum.Due to Low industry maturity, the Health IT applications are still at basal level. Though there is lot of hype around Paperless hospitals, the presentation attempts to understand challenges of implenting a True Paperless Hospital
Health IT Summit Houston 2014 - Case Study "EHR Optimization for Organizational Value in a Changing Healthcare Environment"
Luis Saldana, MD, MBA, FACEP
CMIO
Texas Health Resources
iHT2 case studies and presentations illustrate challenges, successes and various factors in the outcomes of numerous types of health IT implementations. They are interactive and dynamic sessions providing opportunity for dialogue, debate and exchanging ideas and best practices. This session will be presented by a thought leader in the provider, payer or government space.
Examination of the value of data analytics and integration to support new care models such as ACOs and Patient-Centered Medical Homes. The EHR is necessary but not sufficient!
This White Paper discusses the intersection of the corporate onus of performance measurement data collection and reporting with that of health information technology. KSA shares its thoughts on the planning for the future-state architecture for efficient and effective performance measurement.
This KSA White Paper by Jason Oliveira, a Principal with KSA, discusses the intersection between the corporate onus of performance measurement and healthcare information technology. Planning towards and efficient and efffective performance measurement architecture.
What are some challenges in adopting HIT to CQISolutionAssump.pdfkellenaowardstrigl34
What are some challenges in adopting HIT to CQI?
Solution
Assumption
HIT means healthcare in information technology
CQI means Clinical Quality Improvement.
Clinical Quality Improvement (CQI): Ensures a comprehensive approach to integrating clinical
knowledge into health IT. Provides subject matter expertise on policies, standards, and tools that
give providers and consumers the information and tools needed to identify high risk
conditions,assist in decision making, and measure care quality.
All industries are besieged by claims that Internet-based content, services, and applications can
solve a wide range of problems that have plagued prior efforts to implement other information
technologies. In health care, these problems include the difficulty of integrating a diverse,
heterogeneous set of legacy systems; a lack of data standards; the complexity of medical
practice; and complex, politicized health care organizational structures.
It is not clear whether the traditional hurdles to implementation of complex clinical information
systems, such as the electronic medical record, are significantly lowered by the use of the
Internet and related technologies. For example, although the capability to provide access to a set
of services, content, and applications through a wide array of workstations and other devices
might reduce the support costs for an application, it is not clear that the aggregate cost of the
application infrastructure is reduced.
Some of the challenges are
Standards Development and Harmonization- This is important for interoperability of various
systems, testing of features and for intergrity of data. This is yet to be done.
Health Information Exchange- This includes engaging HIE participants and assisting them to
implement HIE services, and providing a focus on the right set of standards, protocols, legal
agreements, specifications, and services needed to manage the exchange of health information.
Certification and Accreditation: Provides vendors and developers with clear criteria for
developing their products by issuing certification criteria for the Certification Program.
Awarness among patients or end user: This will help in engaging consumers directly with IT
system to empower them to meaningfully use their health information and actively participate in
their health care through improved access to health information.
The proposed Trusted Exchange Framework supports ONC’s goals of achieving nationwide interoperability:
Patient Access - Patients must be able to access their health information electronically without any special effort;
Population-level Data Exchange - Providers and payer organizations accountable for managing benefits can receive population level health information allowing them to analyze population health trends, outcomes, and costs; identify at-risk populations; and track progress on quality improvement initiatives; and
Open and Accessible APIs – The health information technology (health IT) community should have open and accessible application programming interfaces (APIs) to encourage entrepreneurial, user-focused innovation to make health information more accessible and to improve electronic health record (EHR) usability.
2015 Edition Proposed RuleModifications to the ONC Health IT Certification ...Brian Ahier
Presentation to April 7, 2015 Health IT Policy Committee:
2015 Edition Proposed RuleModifications to the ONC Health IT Certification Program and 2015 Edition Health IT Certification Criteria
Remarks to Public Forum on National Health IT PolicyBrian Ahier
On February 4, 2010 there was a public forum on the rollout of national HIT policy under HITECH, including "meaningful use," EHR certification, and HIE. Aneesh Chopra, at the time serving as Chief Technology Office (CTO) of the United States made some remarks.
FTC Spring Privacy Series: Consumer Generated and Controlled Health DataBrian Ahier
Increasingly, consumers are taking a more active role in managing and generating their own health data. For example, consumers are researching their health conditions and diagnosing themselves online. Consumers are also uploading their information into personal health records and apps that allow them to manage and analyze their data, and utilizing connected health and fitness devices that regularly collect information about them and transmit this information to other entities.
The movement of health data outside the traditional medical provider context has many potential benefits; however, it also raises potential privacy concerns. The seminar will address questions such as:
What types of websites, products, and services are consumers using to generate and control their health data, and how are consumers using them?
Who are the companies behind these websites, products, and services, what are their business models, and what does the current marketplace look like?
How can consumers benefit from these companies’ websites, products, and services?
What actions are these companies taking to protect consumers’ privacy and security?
What do consumers expect from these companies regarding privacy and security protections?
Do consumers differentiate between these companies and those that offer traditional medical products and services that are covered by HIPAA?
What restrictions, if any, do advertising networks and others impose on tracking of health data?
On February 19, 2014, the Federal Trade Commission staff hosted a seminar on Mobile Device Tracking.
The speakers discussed how retailers and other businesses have been tracking consumers’ movements throughout and around retail stores and other attractions using technologies that identify signals emitted by their mobile devices. While the technologies differ, many work by identifying and collecting the MAC address – which is unique to a particular device – broadcast when a mobile device searches for Wi-Fi networks. Companies can use these technologies to reveal information about consumers including the path taken throughout a location, length of time in one location, whether a visitor is new or returning, and the frequency of visits to a location. According to media reports, major retailers in the United States are using or have tested the technology in their stores in order to gain insights into the behavior of their customers.
In most cases, this tracking is invisible to consumers and occurs with no consumer interaction. As a result, the use of these technologies raises a number of potential privacy concerns and questions.
Big Data and VistA Evolution, Theresa A. Cullen, MD, MSBrian Ahier
Presentation to Open Source Electronic Health Record Alliance (OSEHRA) Architecture Work Group by Theresa A. Cullen, MD, MS
Chief Medical Information Officer
Director, Health Informatics
Office of Informatics and Analytics
Veterans Health Administration
Department of Veterans Affairs
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
What Lies Ahead for ONC: Meaningful Use and Beyond
1. What Lies Ahead for ONC
Meaningful Use and Beyond
Farzad Mostashari, MD ScM
National Coordinator for Health Information Technology
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. Health IT and Data are Foundational for
Health Reform
Sustainable
health,
quality
&
efficiency
improvements
Care
Measurement
Consumer
&
Payment
Delivery
Engagement
Reform
Innova0ons
Provider
Feedback
Health
IT,
Informa0on
Exchange,
and
Data
4. Payment Reforms will Motivate and Reward
Innovation 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. 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. Conceptual Approach to
Meaningful Use
2015
2013
Improved
Outcomes
Advanced
2011
care
processes
Capture
/
with
decision
share
data
support
6
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. Fewer Premature Deaths (CV)
• Demographics • Quality Measurement
• Blood Pressure • CDSS
• Smoking • Registry
• BMI
• Problem List
• Med List
• Lab Data
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. 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. 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. 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
14. Regional Extension Center
Regional Extension Center Provider Registration
Total
Priority
Primary
Care
Total
Priority
Primary
Care
Providers
Enrolled
Providers
Enrolled
By
Specialty
14
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. …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. 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. 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. …
to Make this Vision, At Long Last, a Reality