Iowa Foundation for Medical Care

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Iowa Foundation for Medical Care
Health Information Technology in Iowa A Time
of Change
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HIT National Focus

• The widespread adoption of EHRs is clearly a
  national agenda item.
• President Bush has called for widespread adoption
  of interoperable electronic health records within
  10 years and has selected David J. Brailer, MD,
  PhD, as National Coordinator for Health
  Information Technology.

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Office of the National Health Information
Technology Coordinator

• (David Brailer, MD)
• Goal 1 Inform Clinical Practice
• Efforts to bring EHRs directly into clinical
  practice
• Goal 2 Interconnect Clinicians
• Portable information that moves across care
  continuum

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Office of the National Health Information
Technology Coordinator, cont.

• Goal 3 Personalize Care
• Helps individuals manage their own wellness
• Goal 4 Improve Population Health
• Requires timely, accurate data to allow for
  evaluation of healthcare delivery

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CMS Information Technology Initiatives

• Medicare Care Management Performance (MCMP)
  demonstration
• AHRQ evaluation of CMS Medicare Care Management
  Performance (MCMP) demonstration project
• Physician self-referral exception phase II
• E-prescribing hearings to develop, adopt,
  recognize, or modify initial e-prescribing
  standards

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CMS Information Technology Initiatives

• EMR focus groups
• VistA office EHR
• CMS virtual call center
• CMS/ASPE partnership
• conforming the nursing home MDS v.3 to
  CHI-endorsed standards
• Doctors Office Quality Information Technology
  (DOQ-IT)

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IMS Health Information Technology Initiative

• Mission
• To advance an innovative healthcare environment
  in Iowa that employs the electronic health record
  as a tool for improving quality, safety and value.

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Participating Organizations

• Iowa Medical Society
• Iowa Foundation for Medical Care
• University of Iowa Hospitals Clinics
• Iowa Chapter, American College of Physicians
• Iowa Health Information Management Association
• Iowa Health Care Collaborative
• Iowa Health Systems
• Iowa Osteopathic Medical Association

• Iowa Hospital Association
• Iowa Medical Group Managers Association
• Iowa Health Physicians
• Mercy Health Network
• Iowa Academy of Family Physicians
• Iowa Health Information and Management Systems
  Society
• IMS Health Care Executives
• Iowa Heart Center

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Action Plan2005 Build the Case for Change

• Educate providers regarding benefits of an IT
  environment
• Educate providers regarding the clinical value of
  IT
• Identify EHR adoption barriers and potential
  solutions
• Engage providers
• Change the culture and measure the results
• Develop tool to assess extent of IT usage across
  all clinics in Iowa

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HIT Survey Tool

• Information captured
• Demographics
• HIT Implementations Status
• Barriers to HIT Implementation
• Future HIT Plans
• Disease Management
• Culture

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HIT Survey Tool, cont.

• Assess status of HIT in Iowa
• Assess assistance needed
• Identify barrier interventions and education
  needed
• Identify extent of data being used to improve
  care
• Inform state government

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Action Plan2006 Enlist Widespread Participation

• Demonstrate Microsystem Value in Iowa
• Reassess extent of IT saturation

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Action Plan, cont.2007 Tipping Point

• Demonstrate Macrosystem Value in Iowa
• Reassess extent of IT saturation

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Why is this important?

• Fundamentally transform the way health care is
  delivered in the physician office setting

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Four Strategies for Transformational Change

• Adopt HIT and use it effectively
• HIT Adoption within the identified participant
  group
• Redesign care process
• Process redesign which includes care management
  and patient self management

K. Bell , J. Sorace, K. Winchester. Success in
the physician office setting. AHQA Technical
Meeting. San Francisco, February 23, 2005.
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Four Strategies for Transformational Change, cont.

• Measure and report performance
• Quality performance measurement, reporting and
  improvement
• Transform organizational culture
• Adopt and effective use of EHR that will create a
  more reliable delivery system that focus on
  patient safety and effective management of
  patients with chronic conditions

K. Bell , J. Sorace, K. Winchester. Success in
the physician office setting. AHQA Technical
Meeting. San Francisco, February 23, 2005.
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Care Management In Practice
Population Management

• ID population of individuals
• Performance feedback
• Planning services for subpopulations

Delivery System Redesign
Self Management
Electronic Health Records and Information
Technology

• Personalized care plan
• Personal health record
• Online goal setting tools

• Set goals for optimal health
• Primary care team
• Open access
• Care coordination

Decision Support

• Alert and reminders
• Guidelines
• Clinical knowledge
• Templates

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The DOQ-IT Charter

• Improve physician office care management of
  chronic illness and preventive services using
  workflow redesign, evidence-based guidelines,
  best practices and data reporting through the use
  of EHR systems.

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National DOQ-IT Pilot

• Goal Identify four to eight physician office
  practices to participate in the initiative
• Small-to-medium-sized (up to nine MDs per
  practice site)
• Primary family medicine physicians/clinicians
  provide primary care to Medicare beneficiaries
  with chronic illnesses
• Practice has the intent to purchase an electronic
  system within the next 12 months

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Iowa DOQ-IT Pilot

• Recruited eight physician offices to participate
• Completed readiness assessments for all eight
  offices
• Assisting with vendor selection activities

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Iowa DOQ-IT Pilot, cont.

• Next Phase
• Begin office redesign efforts

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8TH SoW DOQ-IT Initiative

• Beginning August 2005
• Recruit 10 percent of small-to-medium practices
  in state to implement EHR
• Practices will subsequently submit clinical
  quality measure data to data warehouse data will
  be used as feedback mechanism

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How Can HIMSS Help?

• ?

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HIMSS

• Vision
• Advancing the best use of information and
  management systems for the betterment of health
  care.
• Mission
• To lead change in the healthcare information and
  management systems field through knowledge
  sharing, advocacy, collaboration, innovation and
  community affiliations.

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HIMSS Can Help By

• Leverage expertise of your organization
• Support a statewide effort to move HIT forward
• Promote survey tool
• Serve as a resource for physician offices
• Utilize IFMC resources
• Continue engagement in the IMS/HIT Initiative

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Upcoming Events

• April 15, 2005 IMS HIT Initiative Meeting
• In conjunction with IMS Annual Meeting
• 900-1100 a.m.
• Hotel Fort Des Moines
• August 25, 2005 IMS HIT Summit
• Keynote Speaker David Kibbe, MD Director, AAFP
  Center for Health Information Technology (CHiT)
• 800 a.m. - 430 p.m.
• Sheraton West Des Moines
• November 2, 2005 IMS HIT Initiative Meeting
• In conjunction with the Iowa Health Care
  Collaborative Meeting
• Time TBD
• HyVee Hall

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Conclusion

• A well-planned and coordinated effort, sustained
  over a number of years, can deliver results that
  will better support Iowas healthcare
  professionals and better serve the public.

Executive Summary of the Framework for Strategic
Action, David J. Brailer, MD, November 2004
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IFMC DOQ-IT Contacts

• For more information, call 1-800-383-2856
• Tim Gutshall, MD, ext. 2153
• tgutshall_at_iaqio.sdps.org
• Branko Strok, MD, MS, ext. 8849
• bstrok_at_iaqio.sdps.org
• Crystal Kallem, ext. 2116
• ckallem_at_iaqio.sdps.org