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ONC Program Update
NCVHS MeetingJune 19, 2013
Judy Murphy, RN, FACMI, FHIMSS, FAAN Deputy National Coordinator for Programs and Policies, ONC
Meaningful Use –Eligible Professionals Registered and Paid
0
100,000
200,000
300,000
400,000
500,000
Total Professionals Paid: 291,325
(56%)
Total Professionals Registered: 390,469
(75%)
2012 Goal
521,600 Total Eligible Professionals
2013 Goal
Source: CMS EHR Incentive Program Data as of 4/30/2013
Share of Physicians, PA’s and NP’s that received CMS EHR Incentive Program Payment (Feb 2013)
14%15%
16%18% 20%
22%
25%
28%
0%
5%
10%
15%
20%
25%
30%
35%
40%
Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13
National Trend
Source: Office of the National Coordinator for Health IT, Health IT DashboardMeaningful Use State Acceleration Challenge
http://dashboard.healthit.gov/data/
Meaningful Use –Eligible Hospitals Registered and Paid
0
1,000
2,000
3,000
4,000
5,000
Total Hospitals Paid: 3,880(77%)
Total Hospitals Registered: 4,371
(87%)
5,011 Total Eligible Hospitals
2013 Goal
2012 Goal
Source: CMS EHR Incentive Program Data as of 4/30/2013
Share of Hospitals that received CMS EHR Incentive Program Payment (Feb 2013)
32% 34%36%
39%43%
49%
63%
72%74%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13
National Trend
Source: Office of the National Coordinator for Health IT, Health IT DashboardMeaningful Use State Acceleration Challenge
http://dashboard.healthit.gov/data/
$22 $16 $26 $31
$109 $81
$116
$276 $237
$387
$607
$837
$564
$629 $662
$623 $587
$442 $408
$534 $579
$716
$907
$1,402
$1,109
$809
$1,022
$896
Cumulative Total$14,635
$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
$14,000
$16,000
$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
Jan
-11
Feb
-…
Mar
-…
Ap
r-…
May…
Jun
-11
Jul-
11
Au
g-…
Sep
-…
Oct
-11
No
v-…
Dec
-…
Jan
-12
Feb
-…
Mar
-…
Ap
r-…
May…
Jun
-12
Jul-
12
Au
g-…
Sep
-…
Oct
-12
No
v-…
Dec
-…
Jan
-13
Feb
-…
Mar
-…
Ap
r-…
Cu
mu
lati
ve A
mo
un
t P
aid
(M
illio
ns)
Am
ou
nt
Pai
d p
er
Mo
nth
(M
illio
ns)
Source: CMS EHR Incentive Program Data as of 4/30/2013
Total EHR Incentive Payments to All Eligible Providers and Hospitals
Scorecard Reports for MU AccelerationState Challenge Results
Hospitals Providers
dashboard.healthit.gov/data/data/2013January_MUScorecard
Changes to HIMSS EMRAM
2011 Q1 & 2
42% 23%
36% 45%
22% 32%
Exchange is growing
• Three EHR vendors (Cerner, eCW and EPIC) are each exchanging millions of patient records a month
• New England Healthcare Exchange Network has 200,000 directed exchanges a month
• HealthBridge in Ohio has 3.2 million directed exchanges a month
• Lots of IDNs and hospitals are spearheading exchange
• Rapid growth in exchange supported by the State HIE program
State HIE Directed Exchange Transactions
75,209,61879,957,695
150,406,044
Q2 2012 Q3 2012 Q4 2012
State HIE Query-Based Exchange Transactions
1,753,202
2,794,705
5,407,271
Q2 2012 Q3 2012 Q4 2012
Focus on INTEROPERABILITY in the Stage 2 Meaningful Use Criteria
• E-prescribing (ambulatory and inpatient discharge)
• Transition of Care summary exchange:
• Create & transmit from EHR
• Receive & incorporate into EHR
• Lab tests & results from inpatient to ambulatory
• Public health reporting – transmission to:
• Immunization Registries
• Public Health Agencies for syndromic surveillance
• Public health Agencies for reportable lab results
• Cancer Registries
• Patient ability to View, Download and Transmit their health data to a 3rd Party
• Create an export summary of patient data, in order to enable data portability
Four other Interoperability Modules
Four additional modules that cover the Meaningful Use Stage 2 interoperability data exchange criteria have been released:
1. Transitions of care between care providers and care venues
2. Lab interoperability between hospitals and ambulatory providers
3. View, download, and transmit of information between patients and providers
4. Transmission of information to public health agencies
Beacon Community Update
• As of March 31, 2013, two Beacon Communities are in their grant close-down period
– Indiana
– Rhode Island
• The remaining 15 Beacon Communities have 6-month no-cost extensions on their grants (April 1 – Sept 30, 2013)
• Beacon Nation Learning Guides
– A common set of materials describing a promising IT-enabled intervention that can be deployed in a community to accelerate change
– Sponsored by the Hawaii Island Beacon Community
12
3,904
2,460
4,461 4,076 3,944
185
1,255147
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
Northwest(8 Colleges)
Southwest(13 Colleges )
Midwest(17 Colleges)
South(20 Colleges)
Northeast(22 Colleges)
Community College Students May 2013
Successfully Completed* Actively Enrolled
Students Enrolled or Completed: 20,432Attrition Rate: 36.4%
Workforce Training – Community CollegeProgram Enrollment & Graduation
Community College Programstudents have diverse characteristics
Demographic characteristics for students who successfully
completed the Community College Consortia Program: May 2013
Student AgeMinority
Consortium Status Mean Min Max
Northwest 15.9% 43.7 18 78
Southwest 45.3%45.1
19 79
Midwest 35.8%45.9
19 75
South 44.8%45.3
19 79
Northeast 35.3%45.8
18 79
National 36.9%45.3
18 79
205
66
200
50
127 116
262
87
145
11
41
54
40
87
17
99
69
76
0
50
100
150
200
250
300
350
400
Columbia Duke George Washington
Indiana Johns Hopkins
OHSU Texas State Colorado Minnesota
Graduated Enrolled Target
Workforce Training - University-BasedProgram Enrollment & Graduation
As of May 22, 2013
Policy and Planning
• Health IT Patient Safety Action & Surveillance Plan
• HIE Governance
– 2 cooperative agreements:Direct Trust and NeYC Collaborative
• HIE Acceleration RFI
17
S&I Framework Operating Metrics
Timing
Framework Launch Date Jan 7, 2011
First Initiative Launch Date Jan 31, 2011
Elapsed Time (as-of today) 28 months
Participation & Process
# Wiki Registrants 2284
# Committed Members 707
# Committed Organizations 538
# Working Sessions Held 1,492
S&I Face to Face meetings 3
Standards Organizations 35
engaged
SDS Newsletter Subscribers 201
Outputs
# Consensus Approved Use Cases 16
# Pilots Committed 33
# Pilot Vendors 42
Total Ballots 11
# Total HL7 Ballot Comments 3,128
Received
# HL7 Ballot Comments Resolved 2,494
As of 5/2/201318
Status Key:Active
Maintenance
On hold19
S&I Framework Initiatives List
Initiative (chronological) Initiative (chronological)
Transitions of Care Public Health Reporting (Community-led)
Laboratory Results Interface Longitudinal Coordination of Care
Provider Directories Lab Orders Interface
Certificate Interoperability Health eDecisions
Query Health Automate Blue Button
Data Segmentation for Privacy Structured Data Capture
Electronic Submission of Medical Prescription Drug Management Program
Documentation
S&I Initiative Portfolio Snapshot
S&I Initiative Portfolio Snapshot Pre-Discovery Use Case Harmonization RI, Test & Pilot Evaluation
Direct Project(S&I Archetype)
In production
Transitions of CareCompanion Guide Completed
Lab Results Interface IG/Errata Published, 2014 CEHRT In Progress
Query Health Pilots Underway, QRDA III Published, HQMF in Comment
Data Segmentation for Privacy
ReconciliationPilots in Evaluation, IG in preparation for balloting
Public Health ReportingCommunity-Led; Consensus for Data Harmonization profiles closed on 1/20/13; community will be meeting on a monthly basis
esMD esMD AoR Level 1 IG is now in E2E review; AoR Level 2 UC achieved consensus; IG consensus closed for UC 1, UC 2, and Prov. Dirs. Guidance IG’s
Longitudinal Coordination of Care
Community-Led initiative; 1st UC Complete; PAS SWG Complete; Created 'Care Plan' Glossary for HITPC & HL7; Use Case 2: Care Plan Exchange is in development. Transition of Care Implementation Guide(s) being developed for HL7 Fall Ballot.
Laboratory Orders Interface
LOI IG ballot ended on 1/7/13 and ballot reconciliation conts; Lab pilot efforts include LOI, and eDOS
Health eDecisions Use Case 1: Knowledge Artifact Sharing Model, Schema and IG was approved by HL7, UC 1 now in Pilots. Use Case 2: CDS Guidance Service achieved consensus
Blue Button Plus Two WGs complete (Payer & Clinical Content); Two WGs (Push & Pull) in progress, at various stages of IG development
Structure Data Capture Project Charter Consensus complete; Use Case in final review with planned completion in May; Standards Development and Harmonization kicked off 5/2 20
21
S & I Framework Pilots
• S&I Pilots website indicates geographically where all pilots are located
Certified Health IT Product List (CHPL) Summary Data 06/12/13
• 3303 Certified EHR Products
• 977 EHR Vendors/Developers
Ambulatory Inpatient Total
Complete EHR 1349 311 1660
Modular EHR 874 769 1643
Total 2223 1080 3303
This table shows the total count of products. All product versions are
included.
