February 16-18, 2012 | Philadelphia, PA 1

Shaping a brighter

Future: Advancements in Health IT

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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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

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• Insured patients, who are largely insulated from the costs of care, demand the most/best treatment, including interventions, prescriptions, etc. that may have little efficacy

• The media intensifies this feeling of entitlement and highlights “miracle cures”

Demand Side Incentives Supply Side Incentives

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• Physicians and hospitals are still largely paid under a fee-for-service model that provides additional payment for each visit/procedure, offering little incentive to control utilization

• Liability concerns fuel the tendency to provide all possible interventions

Over the last 10 years, recent and aggressive legislation has helped guide the development of Health IT in an effort to improve health care

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Legislation Impact on HIT

President’s Health Information Technology Plan

• Executive Order signed by President Bush in 2004 • 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 Economic and Clinical Health (HITECH) Act

• A component of the American Recovery and Reinvestment Act of 2009, signed into law by President Obama in 2009

• Serves as the guiding framework for expansion of HIT • 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 Care Act (ACA)

• Signed into law by President Obama in March 2010, the ACA includes 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

• 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:

– 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

– E-copies of health info to patients

By adopting Health IT solutions, standards, and best practices, health care providers will be able to offer superior care

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Estimated Annual Benefits from Inpatient Computerized Physician Order Entry Systems, After Full Adoption

Source: Rand Corporation Study, Can HIT Lower Costs and Improve Quality?

To enable a smooth adoption of Health IT, the industry must understand EMRs and the role it plays in future health services

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8 Information Technologies to Supplement EMRs

Electronic Transcribing – automated clinical note taking that creates document-sharing among multiple locations

Electronic Lab Reporting (ELR) – automated web-based lab reporting, that helps timeliness, reduction of manual data entry errors, and more complete reports

E-Prescribing – automated prescribing Clinical Content Repository – clinical content

management that offer users flexibility to change and manage content on their own

Document Imaging – scanning and paper digitalization to assist with “medical grade” documentation and productivity

Patient Registry and CRR Bulletin Board – basic patient population management, proven to improve chronic disease care

Clinical Groupware – software that helps streamline work and automatically prioritizes the most time-consuming or needy patients

Electronic Medical Record (EMR) is a computerized medical record created in an organization that delivers care, i.e. hospital or physician's office

• Usage– only 10% of hospitals have integrated their systems

• Legal Status– EMRs must be kept in its unaltered form, by the health facility

• Tech Feature – EMRs enables patient records to be read & created on workstations and mobile devices; and access to Personal Health records to consumers

• Event Monitoring – EMR systems monitor clinical events such as, predicting, preventing adverse events i.e. discharges, transfers, lab results and others

• Role in electronic Research network– connects medical practitioners to researchers , promotes practice based research networks and facilitates clinical research

“Meaningful Use” seeks to drive clinicians toward improved decision-making, acknowledging that adoption of EMRs alone is insufficient to transform care

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When utilizing Health IT, especially EMRs, it’s important to understand “Meaningful Use” and its impact on provider and patient services

“Meaningful Use” of EMRs is an effort to:

• Improve quality, safety, and efficiency

• Reduce health disparities

• Engage patients and families

• Improve care coordination

• Ensure privacy and security

• Control costs

• Improve public health

• 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.

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

• Communication of care outcomes & care coordination

• 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 1 – Data Capture and Sharing (Current state)

Stage 2 – Advanced Clinical Processes (2013)

• Encourages health IT use to enhance computerized provider order entry

• Transitions of care

• Electronic transmission of diagnostic test results and research

Stage 3 – Improved Outcomes (2015)

• Promotes improvements to quality and safety

• Focus on clinical decision support

• encourages patient access and involvement to enhance health data

Despite tremendous adoption efforts, challenges to implementing and adapting to Health IT are inevitable

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• 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

Opportunities for the advancement of Health IT------Update

Mayo Clinic

Cleveland Clinic

Johns Hopkins

Clinic

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• Managing and improving your own health

• Mobile app development

• Systems development

• Change management

• Medical device innovation

• Cyber security needs

• Hardware and software innovation and migration

Can you identify other

areas for opportunity, personally or professionally?

Understanding the health care environment will help you navigate your personal health, and your business, in the years to come

Update and manage your

personal medical records

Identify a source, be it a

journal or online news

column, to stay current

Be proactive in

seeking new information

Build a network of

diverse professions, one

being in the health field

Be inventive, and flag any

opportunities that may

relate to your business

Staying up to date in

the health care field,

and making it

relevant to you

Anticipate change in IT

and be ready to

react quickly

Get to know your health

environment, i.e., your

physician and office

Stay current on your work

environment trends

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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

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Chris Foster

Principal

Booz Allen Hamilton Inc.

8283 Greensboro Drive

Mclean, VA 22102

Tel (703) 377-0870

foster_chris@bah.com

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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