us perspectives on hit adoption and assessment under meaningful use blackford middleton, md, mph,...
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US Perspectives on HIT Adoption and Assessment
under Meaningful Use
Blackford Middleton, MD, MPH, MScPartners HealthCare System, Inc.
Harvard Medical SchoolEU-US ARGOS Meetings
Budapest, 2011
Overview
Overview HITECH -> Meaningful UseHealth IT (ICT) Measurement: NCVHS… NQF… HITReview MU attestation process and procedureReflections on ARGOS Benefits White PaperOpportunities for Collaboration between US and EU
Bending the Curve Towards Transformed Health
Achieving Meaningful Use of Health Data
Data capture and sharing
Advanced clinical processes
Improved outcomes
“Phased-in series of improved clinical data capture supporting more rigorous and robust quality measurement and improvement.”
“These goals can be achieved only through the effective use of information to support better decision-making and more effective care processes that improve health outcomes and reduce cost growth”
Connecting for Health, Markle Foundation “Achieving the Health IT Objectives of the American Recovery and Reinvestment Act” April 2009
Adoption
Get an EMRand use it
Effective Use
Use key EMRfeatures fully
Smart Use
Leverage EMR
decision support
We are here
How can an EHR make a difference?
Meaningful Use
Structure Process Outcome
Overview of National Strategy
Adoption
Meaningful Use
Outcomes
Meaningful Use definition and incentivesEHR certification criteria and process
Data, exchange, and quality measure standards and processPrivacy and security standards, practices and policies
Provider implementation support (extension centers) $643MExchange implementation support (State HIE/NHIN) $564MWorkforce development $118M
Structure
Beacon Communities $235M
HIT Research Centers (SHARP $60M, NHIN $54.3M)
Process
$2B net
Entitlement Funds $27B
Appropriated Funds
HealthcareInformationExchange
EHR Adoption Loans
HIT Extension Programs
Workforce Training
New TechnologiesR&D Grants
Medicare Payments
Medicaid Payments
Meaningful Use Stage 1
Required 15 core measuresChoose 5 of 10 menu measuresNote that 1 core measure is actually 6 quality
measuresChoose 3 of 3 core or 3 alternate core quality
measuresChoose 3 of 38 additional quality measures
MeasureAuthoring
Tool registry
EHR
PHR
QualityDataModel
eMeasure
standards setting
(e.g. HL7)
eMeasure standard+
measure developers
reporting
implementationevolution
NQF Quality Data Model Use
Relationship between quality measures, CDS, and the NQF Quality
Data Model
