Connecting Technology: Achieving Better Health for Patients and Pharmacy

Marsha K. Millonig, MBA, BSPharmCatalyst Enterprises, LLC

1

American Society for Automation in Pharmacy492 Norristown Road, Suite 160

Blue Bell, PA 19422http://www.asapnet.org

Today’s Objectives

• Describe the HIT infrastructure in the United States.

• Discuss how priorities for HIT funding are being set in the United States.

• Describe implications of the HIT priorities for pharmacy and pharmacy system vendors.

• Data sharing: What is state of HIEs?

• Lake Wobegon: Minnesota as a case study

Technology and health…

…Alan has noted the reasons why the push toward HIT…

But it remains a challenging undertaking…

President Obama and Vice President Biden understand the immense transformative power of technology and innovation and how they can improve the lives of Americans. They will work to ensure the full and free exchange of information through an open Internet and use technology to create a more transparent and connected democracy.

www.whitehouse.govInauguration Day

The Health IT Infrastructure

Increasingly government-driven (but not forever…)

First IT Czar: David Brailer 5/2004(Who was the second? The third?)

Office of the National Coordinator for Health IThttp://healthit.hhs.gov, formed 8/2005

"We will make wider use of electronic records and other health information technology to help control costs and reduce dangerous medical errors."-- President Bush, January 31, 2006

Common Language and Terms

Terms

EHREMRPHRHI exchangeHealth information organizationRegional health information organizationNHIN

HIT Terms

Electronic Medical Record (EMR) –a digital record that is managed, shared, and consulted by health care clinicians and staff within one health care organization

•Electronic Health Record (EHR) –a digital record that is managed, shared, and consulted by authorized health care clinicians and staff across more than one health care organization.

•Personal Health Record (PHR) –a digital record that is managed, shared, and controlled by or primarily for the individual.

•Health Information Exchange (HIE) –the movement of health-related information among health care organizations according to nationally recognized standards.

HIT

Interoperability is common theme

National standards are needed to enable information flow

Principle difference EMR and EHR is interoperable exchange

Control of information distinguishes EHR from PHR

HIE is process; HIO is oversight, RHIO is type of HIO

Released June 2008

Second plan

Lays out the health IT agenda: the Collaboration

5-year plan: 2008 - 2012

Two goals, eight objectives, 43 strategiesMeasure for each objectiveMilestone for each strategy

Details current activities of Federal agencies

The ONC-Coordinated Federal Health IT Strategic Plan: 2008 - 2012

Summary of Health IT Strategic Goals and Objectives: 2008-2012

Objective 1.1: Facilitate electronic exchange, access, and use of electronic health information, while protecting the privacy and security of patients’ health information.

Objective 2.1: Advance privacy and security policies, principles, procedures, and protections for information access in population health.

Objective 1.2: Enable the movement of electronic health information to support patients’ health and care needs.

Objective 2.2: Enable exchange of health information to support population-oriented uses.

Objective 1.3: Promote nationwide deployment of electronic health records (EHRs) and personal health records (PHRs) and other consumer health IT tools.

Objective 2.3: Promote nationwide adoption of technologies to improve population and individual health.

Objective 1.4: Establish mechanisms for multi-stakeholder priority-setting and decision-making.

Objective 2.4: Establish coordinated organizational processes supporting information use for population health.

Goal 1. Patient-focused Health Care

Goal 2. Population Health

Privacy and Security

Interoperability AdoptionCollaborative Governance

Interoperability Standards into Products –Summary of the Cyclical Process

Describe Health-related Scenarios

Recognition by Secretary of HHS

Identify Health IT Standards

Acceptance by Secretary of HHS

Testing and Implementation(1 year gap)

Health-related Priorities Established

• Incorporated in Health IT Products

• Used in Health IT Product Certification

• Required in

• Federal Systems and Healthcare Contracts (Executive Order 13410)

• “Stark” exceptionsand Anti- Kickback safe harbor

American Health Information Community (AHIC)

Healthcare IT Standards Panel

(HITSP)

Certification Commission for Healthcare IT

(CCHIT)

Stimulus Bill: A Big Boost

Alan noted highlights

Money for EHR systems if “Meaningful Use”

Definition due year-end 2009, final 2010

Matrix Alan alluded too

My point: cannot be accomplished without pharmacists, MTM whether in/out of a medical home model (Ed will discuss)

Overview of Recovery Act HIT Programs

Dr. David Bluementhal, article (10.1056/NEJMp0912825) published on December 30, 2009, at NEJM.org