HITECH Health IT Legislation: Opportunities for the DMAA Community   September 2009 • San Diego, CA Vince Kuraitis JD, MBA...
Overview <ul><li>Recap: DM Community as Leaders or Laggards in HIT Interoperability? </li></ul><ul><li>Changing Environmen...
1. Recap: DM Community as Leaders or Laggards in HIT Interoperability?
HIT Strategy on Autopilot for the Past Decade
Health Information Technology (HIT) is the Backbone of Prevention and Care Management <ul><li>Provides easy access to comp...
DM Community Pivot Points <ul><li>Several industry sectors are uniquely positioned to promote interoperability and liquidi...
Two Scenarios for the DM Community <ul><li>Laggards  </li></ul><ul><ul><li>Maintain proprietary IT </li></ul></ul><ul><ul>...
2. Changing Environment
Challenges With EMR 1.0 <ul><li>Usability/design </li></ul><ul><ul><li>Created to replicate individual paper charts in e-f...
EMR 1.0 (Circa 1990 – 2009) Proprietary & Confidential   Slide #
Modularity: Dis-integration Of The Computer Industry Proprietary & Confidential   Slide #
EHR 2.0 – (2009 - ?) High value, integrated applications facilitating higher quality, coordinated care Proprietary & Confi...
EMR 1.0 to Clinical Groupware <ul><li>EMR 1.0 </li></ul><ul><ul><li>Client-server based </li></ul></ul><ul><ul><li>Proprie...
How is Value Created in a Network Economy?  PHR Case Study <ul><li>Examine PHR adoption </li></ul><ul><ul><li>Typical 2- 5...
Features/Functionality Of Kaiser and GHC PHR System  (As of Mid-2008) Proprietary & Confidential   Slide #
Explanation of Increased PHR Adoption <ul><li>Kaiser/GHC PHR platform adoption = early network effects </li></ul><ul><li>W...
3. ARRA HITECH Act Stimulus Legislation
ARRA HITECH Act <ul><li>Incentives between 2011 & 2015 = $36 billion. </li></ul><ul><li>Providers must use a “Certified EH...
Recommendations – Certification/Adoption Workgroup of HIT Policy Committee, August 2009 <ul><li>Focus Certification on Mea...
Achieving Meaningful Use Meaningful Use Workgroup of HIT Policy Committee, July 2009
“ Meaningful Use” Framework Becoming a Focal Point that Links Previously Disparate Initiatives Proprietary & Confidential ...
4. Implications/Opportunities  for the DMAA Community
Care Collaboration is a “Must Have” Source: Michael R. Nelson, Georgetown Center for Culture, Communication, and Technolog...
...Enabled by Clinical Groupware Platform EMR 1.0 supports limited care delivery transformation; clinical groupware provid...
Healthcare Enters the Network Economy: A Fundamental Strategic Shift Source: Venkatraman, N.,  Winning in a Network Era: O...
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HITECH Health IT Legislation: Opportunities for the DMAA Community

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HITECH Health IT Legislation: Opportunities for the DMAA Community

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  • Sectors: Retail clinics Ambulatory EHRs PHRs Personal health information platforms (Google, Microsoft, Dossia) The DM community
  • HITECH Health IT Legislation: Opportunities for the DMAA Community

    1. 1. HITECH Health IT Legislation: Opportunities for the DMAA Community September 2009 • San Diego, CA Vince Kuraitis JD, MBA Better Health Technologies, LLC http://e-CareManagement.com blog (208) 395-1197 • vincek@bhtinfo.com Don Storey, MD RMD Networks www.rmdnetworks.com (303) 789-1188 • dstorey@rmdnetworks.com
    2. 2. Overview <ul><li>Recap: DM Community as Leaders or Laggards in HIT Interoperability? </li></ul><ul><li>Changing Environment </li></ul><ul><li>ARRA HITECH Act Stimulus Legislation </li></ul><ul><li>Implications/Opportunities for DMAA Community </li></ul>
    3. 3. 1. Recap: DM Community as Leaders or Laggards in HIT Interoperability?
    4. 4. HIT Strategy on Autopilot for the Past Decade
    5. 5. Health Information Technology (HIT) is the Backbone of Prevention and Care Management <ul><li>Provides easy access to comprehensive patient records electronically, thus making it easier to see a patient’s medical history </li></ul><ul><li>Helps providers track patient care in order to reduce duplication of services, address patient issues, and coordinate care with care managers </li></ul><ul><li>Offers providers access to reference materials during a patient visit </li></ul><ul><li>Provides clinicians real-time guidance on standards of care </li></ul><ul><li>Sends reminders and prompts to patients about visits, tests, and recommendations and prescriptions </li></ul>
    6. 6. DM Community Pivot Points <ul><li>Several industry sectors are uniquely positioned to promote interoperability and liquidity </li></ul><ul><li>Leverage! </li></ul><ul><ul><li>DM is a central role with many touch points </li></ul></ul><ul><ul><li>Knowhow, tools, & technology to improve care processes and create new interventions </li></ul></ul><ul><ul><li>Trust with patients creates opportunity to get patient permission to gather and use data on patients’ behalves </li></ul></ul><ul><li>Interoperability can be disruptive! </li></ul>
    7. 7. Two Scenarios for the DM Community <ul><li>Laggards </li></ul><ul><ul><li>Maintain proprietary IT </li></ul></ul><ul><ul><li>Maintain closed business models and proprietary processes </li></ul></ul><ul><li>Leaders </li></ul><ul><ul><li>Embrace interoperable health information exchange </li></ul></ul><ul><ul><li>Embrace open (collaborative) business models and shared care management processes </li></ul></ul>
    8. 8. 2. Changing Environment
    9. 9. Challenges With EMR 1.0 <ul><li>Usability/design </li></ul><ul><ul><li>Created to replicate individual paper charts in e-format, not to manage a panel of patients for optimal health </li></ul></ul><ul><li>Implementation </li></ul><ul><ul><li>Changes clinician workflow </li></ul></ul><ul><ul><li>Loss of productivity for physicians </li></ul></ul><ul><ul><li>Risk of failure/de-install </li></ul></ul><ul><li>Proprietary business model </li></ul><ul><ul><li>Lack of interoperability </li></ul></ul><ul><ul><li>Dependent on customer lock-in and switching costs </li></ul></ul><ul><li>Result: very low penetration </li></ul>Proprietary & Confidential Slide #
    10. 10. EMR 1.0 (Circa 1990 – 2009) Proprietary & Confidential Slide #
    11. 11. Modularity: Dis-integration Of The Computer Industry Proprietary & Confidential Slide #
    12. 12. EHR 2.0 – (2009 - ?) High value, integrated applications facilitating higher quality, coordinated care Proprietary & Confidential Slide #
    13. 13. EMR 1.0 to Clinical Groupware <ul><li>EMR 1.0 </li></ul><ul><ul><li>Client-server based </li></ul></ul><ul><ul><li>Proprietary </li></ul></ul><ul><ul><li>Non-interoperable </li></ul></ul><ul><ul><li>No connectivity to patients </li></ul></ul><ul><ul><li>Monolithic </li></ul></ul><ul><ul><li>High capex and operating expense </li></ul></ul><ul><ul><li>MD workflow must adapt to rigid design </li></ul></ul><ul><li>Clinical Groupware </li></ul><ul><ul><li>Web-based </li></ul></ul><ul><ul><li>Open </li></ul></ul><ul><ul><li>Interoperable </li></ul></ul><ul><ul><li>Networked </li></ul></ul><ul><ul><li>Platform/application </li></ul></ul><ul><ul><li>No capex, low subscription cost </li></ul></ul><ul><ul><li>Flexible design adapts to MD workflow </li></ul></ul>Proprietary & Confidential Slide #
    14. 14. How is Value Created in a Network Economy? PHR Case Study <ul><li>Examine PHR adoption </li></ul><ul><ul><li>Typical 2- 5% </li></ul></ul><ul><ul><li>Best Practice </li></ul></ul><ul><ul><ul><li>Kaiser: 30% </li></ul></ul></ul><ul><ul><ul><li>Group Health Cooperative (GHC): 50% </li></ul></ul></ul><ul><li>Why? </li></ul>Proprietary & Confidential Slide #
    15. 15. Features/Functionality Of Kaiser and GHC PHR System (As of Mid-2008) Proprietary & Confidential Slide #
    16. 16. Explanation of Increased PHR Adoption <ul><li>Kaiser/GHC PHR platform adoption = early network effects </li></ul><ul><li>What’s the killer app ? – Wrong question. </li></ul><ul><li>How is value created? </li></ul><ul><ul><ul><li>An integrated bundle of apps </li></ul></ul></ul><ul><ul><ul><li>Delivered on a unified platform with broad data exchange </li></ul></ul></ul><ul><ul><ul><li>Providing high value to patients and doctors </li></ul></ul></ul><ul><ul><ul><li>Thereby driving adoption and usage </li></ul></ul></ul><ul><li>How can un-integrated doctors, health plans, and hospitals work together toward a “Virtual-Kaiser”? </li></ul>Proprietary & Confidential Slide #
    17. 17. 3. ARRA HITECH Act Stimulus Legislation
    18. 18. ARRA HITECH Act <ul><li>Incentives between 2011 & 2015 = $36 billion. </li></ul><ul><li>Providers must use a “Certified EHR” </li></ul><ul><li>Providers must demonstrate “Meaningful Use” of the EHR </li></ul><ul><li>Penalties for non-adoption after 2015 </li></ul><ul><li>Key question: How can DMAA community participate? </li></ul>
    19. 19. Recommendations – Certification/Adoption Workgroup of HIT Policy Committee, August 2009 <ul><li>Focus Certification on Meaningful Use </li></ul><ul><li>Leverage Certification process to improve progress on Security, Privacy, and Interoperability </li></ul><ul><li>Improve objectivity and transparency of the certification process </li></ul><ul><li>Expand Certification to include a range of software sources: Open source, self-developed, etc. </li></ul><ul><li>Develop a Short-Term Certification Transition plan </li></ul>
    20. 20. Achieving Meaningful Use Meaningful Use Workgroup of HIT Policy Committee, July 2009
    21. 21. “ Meaningful Use” Framework Becoming a Focal Point that Links Previously Disparate Initiatives Proprietary & Confidential Slide #
    22. 22. 4. Implications/Opportunities for the DMAA Community
    23. 23. Care Collaboration is a “Must Have” Source: Michael R. Nelson, Georgetown Center for Culture, Communication, and Technology, 2009
    24. 24. ...Enabled by Clinical Groupware Platform EMR 1.0 supports limited care delivery transformation; clinical groupware provides greater adaptability, multi-purposing to accelerate transformative care delivery changes.
    25. 25. Healthcare Enters the Network Economy: A Fundamental Strategic Shift Source: Venkatraman, N., Winning in a Network Era: Opportunities & Challenges , 2006
    26. 26. Thank you!

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