Meaningful Use The Catalyst for Connected Health
Sameer BadeStrategic Product Planner
One Year Ago…. American Recovery and Reinvestment Act (ARRA)
– Total: $787 Billion– Healthcare (total): $59 Billion
Health Information Technology for Economic and Clinical Health (HITECH) Act– $20 Billion net investment to drive adoption of electronic health record (EHR)
technology– Payments beginning October 1, 2011 (hospitals) and January 1, 2012 (eligible
providers or EPs)
– Stimulus turns to penalties after 2015
Meaningful Use Calendar of Events
Dec Jan Feb Mar Apr May June 2011 2012 2013 2014
Regulations Released
Regulations published in Federal Register.
60-day comment period begins.
Comment period closed. CMS finalizes and publishes Final Rule in Spring of 2010.
Incentive payments released.
Stage 2 criteria proposed.
Stage 3 criteria proposed.
CMS Timeline
TodayReview public comments and develop further
recommendations
Interim final rule from ONCHIT with initial set of standards, certification criteria, and implementation specifications for Stage 1 of the EHR incentive program
Refine Stage 2 meaningful use
criteria.
ONC publishes the Certification Process rules
Certification Aimed at vendors
– Criteria and specifications defined in Interim Final Rule
– Process document not yet published
Can be done in two ways:– “Complete EHR Certification” certifies that the
vendor’s entire system meets the full set of requirements.
• Integration burden falls to vendor.
– “Modular EHR Certification” certifies that the vendor’s system meets one or more of the capabilities required.
• Integration burden fall to buyer
Certification is required to permit the buyer to get stimulus funds.
Microsoft will pursue Modular Certification for HealthVault Community Connect
Meaningful Use Reporting Aimed at hospitals and EPs.
Have to demonstrate meaningful use of certified electronic medical record (EMR) systems by reporting specific measures tied to a set of objectives.
The criteria for meaningful use are defined in three stages
– Stage 1 requirements for reporting in 2011 are the only ones presently defined.
– Stage 2 requirements will soon be defined and will be required beginning in 2013 and finally
– Stage 3 requirements will be required beginning in 2015.
Meaningful use is organized around broad themes referred to as Health Outcome Policy Priorities.
One-Two Punch
6© 2009 Microsoft Corporation. All rights reserved. Microsoft Confidential
Health Outcome Priorities and Care Goals – Stage 1
Engage patients and families in their health care
Improve care coordination
Patient e-copy Patient Discharge Instructions Patient AccessPatient Visit
Summary
Meds ReconcileExchange w/other providers
Summary of care to other providers
At least 80% of all patients who request an electronic copy of their health information are provided it within 48 hours
At least 80% of all patients who are discharged from an eligible hospital and who request an electronic copy of their discharge instructions and procedures are provided it
At least 10% of all unique patients seen by the EP are provided timely electronic access to their health information
Clinical summaries are provided for at least 80% of all office visits
Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information
Provide summary of care record for at least 80% of transitions of care and referrals
Perform medication reconciliation for at least 80% of relevant encounters and transitions of care
A Closer look at Objectives and Measures
Data capture and sharing
Advanced clinical processes
Improved outcomes
Long-term Approach to Meaningful Use
9
o Stage 1 – 2011
Stage 2 – 2013
Stage 3 – 2015
The longer term purpose of this entire Act is to drive improvements in care quality and cost performance.
Healthcare organizations should be looking at technologies and vendors that are addressing the longer term goals:
– Providing a comprehensive patient view, – Allowing for real-time patient cohorting, – Seeing real-time performance against quality measures. – Connecting beyond the health system walls – Engaging patients in their health and wellness, – Assisting in coordinated care, and – Allowing early detection and reporting of key public health indicators.
Finally, all these capabilities have to be grounded in a commitment to secure data exchange and patient privacy.
Stage 1 is the beginning….
Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning.
Sir Winston Churchill, 1942
Meaningful Use Outcomes Care Goals Microsoft
Improve Quality, Safety and Efficiency • Incorporate lab-test results
• Generate lists of patients by condition to use for quality improvement
• Report ambulatory and hospital quality measures
• Send reminders to patients
Engage Patients and Families • Provide clinical summaries for patients
• Provide patients timely electronic access to their health record
Improve Care Coordination • Capability to exchange key clinical information
• Perform medication reconciliation
• Provide summary care record
Improve Population and Public Health • Capability to submit electronic data to immunization registries
• Capability to provide electronic submission of reportable lab results
• Capability to provide electronic syndromic surveillance data
Ensure adequate privacy and security • Protect health information maintained by a certified EHR
Meaningful Use Reporting • Quality measures and reporting
Microsoft Amalga UIS and HealthVault Your Bridge to Meaningful Use
Existing Electronic Health Record(s)
• Enables clinicians to exchange key clinical information and provides data supporting medication reconciliation
• Working toward integration of Amalga UIS with HealthVault to provide a Summary of Care Record for every patient
Meaningful Use
“Every time we look at data from another source, we save $400 because we are not duplicating what has been done”
Dr. John WhitcombMedical Director
Aurora Healthcare
Meaningful Use
Engage Patients & Families
Improve Care Coordination
Improve Population & Public Health
• Improve Quality and Availability of information at the point of admission
• Consistent Delivery of Summarized Patient Information to Interested Physicians with every Discharge
• Direct Access & Ownership of Health Data for all NYP Patients
Connected Community
“The vision for what myNYP.org could be is a place where you, in a very trusting way, can store information, enter it in,own it, control it,understand it, and share it.”
Dr. Mehmet OzVice Chairman & Professor of Surgery, NYP Columbia University
Meaningful Use
Meaningful Use
• General Health Information
• Health History• Discharge Instructions• Lab & Test Results• Medications• EKGs & Images
myNYP.org
Engage Patients & Families
Improve Care Coordination
Improve Population & Public Health
Delivering Beyond Meaningful Use
Engage Patients & Families
Improve Care Coordination
Improve Population & Public Health
Improve Quality, Safety & EfficiencyEnsure Privacy & Security Protections
ARRA HITECH 5 Policy Priorities
Mea
sure
Rep
ortin
gProvide patients
with access to their health
information Provide patients with an
electronic copy of their
health information
Exchange key clinical
info. among providers w/patient authorized
entitiesRecord smoking status for patients
Generate lists of
patients by specific
conditions to use for
quality improvemen
t
Send reminders to
patients
Empower People
Liberate Data
Connect Care
16© 2009 Microsoft Corporation. All rights reserved. Microsoft Confidential
Key Points
We believe we have strong offering aimed squarely at two of the broader areas of Meaningful Use.
Microsoft will pursue Modular Certification for HealthVault Community Connect.
Our roadmap will continue to build out capabilities needed to maintain certification over Stage 2 and 3.
Meaningful use is really about the “use” – so focus on customer readiness and getting to production fast.
Payments cannot be collected until the customer gets system into use for at least 3 months (initially) and then is able to report against the required measures
This material is provided for informational purposes only. Microsoft makes no warranties, express or implied. ©2010 Microsoft Corporation