Health Information Technology and the Transformation of Care Delivery

1
Health Information Technology and the
Transformation of Care Delivery

• California Council on Science and Technology
• February 1, 2006

2
CMA Activity in Health IT

• Patient Safety Institute in full operation
  today, exchanging health information between
  hospitals and doctors in Seattle.
• Participation at the national level
• Physicians Foundations activity
• Resource development
• Research and action

3
Patient Safety Institute

• Record
• Locator approach

• Hospitals and Physicians
  exchanging data today. PSIs technology is
  open and available for use as a public benefit.

4
National Level Participation

• Working With
• ONC
• Connecting for Health
• eHealth Initiative
• CCHIT
• Physicians Foundations
• Quality Performance Measures development

• Focused On
• Technology
• Clinical Quality
• Standardization
• Practice Redesign
• Incentives
• Knowledge
• Resources
• Regulations

5
Physicians Foundations

• Finding meritorious tools that enable migration
  from paper to technology
• Information to empower physicians in technology
  selection
• Strategies to create market forces
• Engaging leaders in the profession to embrace the
  transformation

6
Challenges
7
Improving, an Access Gap Remains
Access to Computer Access to Internet
8
EHR Market Has No Leader

• Recent CMA survey 72 practices using 49
  commercial and 9 home grown EMR systems
• 48 of respondents plan to purchase EMR within 4
  years
• Expense, selection risk and implementation
  challenges are serious obstacles

9
Beleagured Physicians

• Innovation Desire X Capacity

• National 75th percentile of productivity is 5,035
  visits per year. In California, the first 3,810
  are necessary to just cover overhead.
• When running that hard, will you
• Outlay 10-20K for uncertain technology?
• Lose productivity while learning new processes?
• Embrace innovation?

Average primary care practice overhead 60-62
of revenue Average revenue outstanding
62 Average allowed amount Medicare - 51
Medi-Cal - 24 WC - 48 Commercial ?
10
Extreme Makeover of the Solo and Small Group
Practice

• Bring together
• Physicians and staff
• Subject matter experts
• Well designed technology
• Organizational design leadership
• Redesign office flows and pilot these designs
• Measure pre and post
• Can we eliminate non value added activity and
  improve access, satisfaction and capacity?
• Can we replicate these results?

11
Opportunities for California

• Explore PSI technology as a potential resource
• Wire the state
• Boost skill development at basic levels of
  computer use
• Increase resources to help safety net providers
  to acquire and implement technology
• Remember this is a care delivery problem, not
  just a technology problem. Investment is needed
  in people and process as much or more than
  software and servers.
• Design solutions to address diverse needs,
  populations and challenges one size will not
  fit all.