Kickoff Meeting

Cris Ross, co-chairAnita Somplasky, co-chair

November 17, 2015

Certified Technology Comparison (CTC) Task Force

2

• Welcome, Opening Remarks & Membership Introduction

• Review of charge• Review of environmental scan• Review draft workplan and hearing outline• Public Comment• Adjourn

Agenda

3

Membership

First Name Last name Title OrganizationCris Ross CIO Mayo ClinicAnita Somplasky Director Quality InsightsChristopher Tashjian Partner/Physician Vibrant Health Family Clinics

Christine Kennedy Nursing Informatics Coordinator

Lawrence and Memorial Hospital

David Schlossman Hematologist/Oncologist Missouri Cancer Associates

John Travis Vice President, Solution Strategist - Regulatory Compliance

Cerner Corporation

Joe Wivoda Chief Information Officer National Rural Health Resource Center

Liz Johnson VP, Applied Clinical Informatics

Tenet Healthcare

Steven Stack President American Medical Association

Dawn Heisey-Grove Staff Lead ONC

Task Force Charge

• The taskforce is charged with providing recommendations on the most feasible public-private approaches that could be used to create and maintain a tool that will compare certified technology products. This taskforce may address:– The different health IT needs for providers across the adoption

and implementation spectrum – The development and maintenance of the tool, taking into

account feedback from providers and vendors • Recommendations from the taskforce may include policy,

technical, or other considerations that arise during the course of its work.

4

5

MACRA Language

(3) STUDY AND REPORT ON THE FEASIBILITY OF ESTABLISHING A MECHANISM TO COMPARE CERTIFIED EHR TECHNOLOGY PRODUCTS.—

(A) STUDY.—The Secretary shall conduct a study to examine the feasibility of establishing one or more mechanisms to assist providers in comparing and selecting certified EHR technology products. Such mechanisms may include—

(i) a website with aggregated results of surveys of meaningful EHR users on the functionality of certified EHR technology products to enable such users to directly compare the functionality and other features of such products; and

(ii) information from vendors of certified products that is made publicly available in a standardized format. The aggregated results of the surveys described in clause (i) may be made available through contracts with physicians, hospitals, or other organizations that maintain such comparative information described in such clause.

(B) REPORT.—Not later than 1 year after the date of the enactment of this Act, the Secretary shall submit to Congress a report on mechanisms that would assist providers in comparing and selecting certified EHR technology products. The report shall include information on the benefits of, and resources needed to develop and maintain, such mechanisms.

6

Questions that need to be addressed in the report

• Feasibility: Is such a tool necessary?– Who could benefit from this tool?– What resources are necessary to develop and maintain such a

tool?– What are the gaps in existing tools?– What role (if any) should the federal government take in

implementing this tool?

• Tool function: to help health care providers compare and select certified health IT products– How might the tool be implemented?– What data is necessary to make the tool useful?

ADOPTION AND USE OF CERTIFIED HEALTH ITWho could benefit from the tool?

7

8

Physician specialty

Practice size

Practice ownership

Participation in EHR Incentive

Program

0 10 20 30 40 50 60 70 80 90 100

70

55

71

70

78

76

47

79

81

83

90

86

87

Percent of physicians

Overall adoption of certified EHR: 74%

Based on data brief that summarized findings from the 2014 National Electronic Health Record Survey of ambulatory care physicians: http://dashboard.healthit.gov/evaluations/data-briefs/quantifying-physician-ehr-adoption.php

Participating in, or planning to participateNot participating

11+ physicians6-10 physicians2-5 physiciansSolo physician

HMO/other health care corp.Medical/academic health centerCommunity health centerPhysician/group practice

Primary careMedical specialistsSurgical specialists

Disparities in certified EHR adoption among physicians in 2014

9

Adoption and use of certified health IT is not equal across all provider types

All elig

ible hospita

ls

Small rural &

Critica

l Acce

ss Hosp

itals

Physicians

Nurse practi

tioners*

Physician assi

stants*

0

20

40

60

80

100 95 91

54

131.3

Rate of meaningful use achievement by provider type, among providers reg-istered with the Medicare or Medicaid EHR Incentive Programs, 2014

Perc

ent o

f pro

vide

rs

Data represent meaningful use achievement among eligible professionals and hospitals registered for the Medicare & Medicaid EHR Incentive Programs through September, 2015. Maps and additional meaningful use achievement data available here: http://dashboard.healthit.gov/quickstats*Physician assistants and nurse practitioners are only eligible for the Medicaid EHR Incentive Program.

10

Different stages of health IT adoption and use

Stage Description In scope for task force?

Resources needed to support comparison and selection of products

New adoption Consumer is completely new to health IT and needs to select a certified health IT product for the first time

Yes • Identification of health IT functionalities necessary for basic adoption

• Consumer satisfaction reports• Product costs

Implementation Consumer has certified health IT and needs to modify workflow to maximize health IT potential

No N/A

Upgrading or supplementing existing technology

Consumer is considering upgrading or supplementing existing certified health IT for meaningful use, patient engagement, population health management, medical home functionality, and/or delivery system reform.

Yes • Identification of certified health IT functionalities applicable for advanced use

• Consumer satisfaction reports• Product costs• Compatibility/interoperability with

consumer’s existing systems

Replacing existing technology

Consumer is considering replacing existing health IT due to dissatisfaction with current product(s)

Yes • Health IT functionality • Consumer satisfaction reports• Product costs• Compatibility or interoperability

concerns necessary to address data migration

Tool function: to help health care providers compare and select certified health IT products

EXISTING TOOLS

11

12

Tool Types

• Comparison tools: allow consumers to select products from a list and compare features, with detailed information about each product for the selected features

• Informational tools: provide consumers with information about product; these tools do not provide comparison functionality

• Selection tools: checklists, sample contracts, questions, requests for proposals, etc. that may help the provider during the selection process; these tools do not provide specific information regarding products (out of scope)

13

Sample of existing comparison tools

Organization Description Tool Cost & Accessibility

Data source

Includes consumer reviews

Includes product costs

Software Insiderehr.softwareinsider.com

Allows for comparison of EHR products on basis of many characteristics

FreeOnline access to all

Highlights sponsored products

Yes, limited

Free quote comparison guide after you provide personal information

AmericanEHRhttp://www.americanehr.com/ratings/ehr_ratings/EHR-Product-Comparison.aspx

Compare up to 2 vendor products at a time by selecting one EHR product from a drop-down and comparing to another product side-by-side.

FreeAccessible to all once provide demographic information

Yes, limited

Some

14

Sample of existing informational tools

Organization Description Information cost & accessibility

Includes consumer reviews

Includes product costs

BlackBookhttp://www.blackbookrankings.com/healthcare/

Product ranking list and loyalty index reports (consumer research)

Between $2,00-$5,000 Yes Unk

California Healthcare Foundationhttp://www.chcf.org

Toolkit provides a list of functional criteria that should be considered when evaluating vendors that sell EHR systems to CHCs.

FreeAccessible to all online

No No

CHPL 2.0 List of certified health IT products FreeAccessible to all online

No No

KLAS In-depth analysis and ranking of health IT products

Cost to access information

Yes Unk

15

Sample of existing selection tools(out of scope)

Organization Description Information cost & accessibility

Includes consumer reviews

Includes product costs

HIMSS Sample vendor scenarios, questionnaire, and other specialty-specific information when choosing EHR vendor. HIMSS Model for EHR vendor captures specific requirements needed for key electronic health technology (PACS, Patient Portals, Lab, etc.).

FreeAccessible to all online

No No

HealthIT.gov Sample contracts, questionnaires for vendors and practices to consider during selection process, RFP templates, pricing template

FreeAccessible to all online

No No

HealthInfoNet Practice assessment tool, behavioral health EHR toolkit, Workflow process mapping for EHR Implementation guide

FreeAccessible to all online

No No

Virtual Hearing Overview: Proposed Panels

The Task Force will hold two virtual hearings in January to hear from experts in the field. Their feedback will help to inform final recommendations to the HITPC and HITSC.

Panel I Physicians• Inclusive of both primary care and specialists, non-adopters and experienced users

Panel II Non-Physician health care providers• Health care providers who use certified health IT who are not physicians , non-

adopters and experienced users

Panel III Certified health IT developers• Developers of certified EHRs and other health IT

Panel IV Health IT comparison and informational tool vendors• Vendors who currently provide comparison and/or informational health IT selection

tools

Panel V Clinical Quality Measures (CQMs) and Advanced Payment Model (APMs) Capabilities• Providers and/or vendors who can speak on the challenges of finding certified

health IT products that have the applicable CQMs or advanced health IT functionalities necessary to meet APM and quality reporting needs

Task Force Workplan

17

Meeting Goals Meeting Tasks

Tue, Nov 17, 2015 9:00am • Overview of charge and plan• Initial considerations from committee• Overview of market research to date

Tues, Dec 1, 2015 12:30pm Potential Topic: Provider/vendor needs• How might a tool address different health IT needs for different stages of adoption or

implementation? (maturity model) • Does a tool need to address different provider types’ health IT? If so, how might that be

implemented?• Does a tool need to address different forms of patient care? If so, how might that be

implemented?• Does a tool need to provide resources to compare base EHR vs. modular health IT needs?

Dec – Admin Call (non-public) • Refine the virtual hearing format

December 8, 2015 - Draft Recommendations to HITPC

• Status of current TF work• Expectations for what will be learned from the virtual hearing

December 10, 2015 - Draft Recommendations to HITSC

• Status of current TF work• Expectations for what will be learned from the virtual hearing

Thu, Jan 7, 2016 10:00am –Hearing • Hear from additional expertise to inform final recommendations

Fri, Jan 8, 2016 12:00pm • Refine recommendations

Fri, Jan, 15 2016 - Hearing • Hear from additional expertise to inform final recommendations

Tue, Jan, 19, 2016 12:00pm • Finalize recommendations

January 20, 2016 - Final Recs • Joint HITPC/HITSC Presentation