Title: Electronic Health Records and Health Information Exchange: Implications for Rural Hospitals
1Electronic Health Records and Health Information
ExchangeImplications for Rural Hospitals
- Rick Snyder
- Vice President, Finance Information Services
- Oklahoma Hospital Association
- Brian Yeaman, MD
- Director, Physician Informatics
- Norman Regional Health System
- Greater Oklahoma City Hospital Council
2American Recovery and Reinvestment Act of 2009
(ARRA)
- Incentive payments for meaningful use of
certified Electronic Health Records - Hospitals and Eligible Professionals
- Medicare incentives
- Medicaid incentives
3Hospital Incentive Payments
- Qualify as early as Oct 1, 2010
- Range for OK PPS 2 million - 8 million
- Median 3.7 million
- State potential 311 million
- Qualifying after FFY 2013 reduces amount
- CAH Medicare share of capital 20
- FFY 2015 Incentives end penalties begin
4Hospital Incentive Payments Medicaid
- Requires 10 Medicaid inpatient volume
- CAHs can qualify not based on costs
- 500,000 to 1,200,000
- 108 million potential for OK hospitals
- State has some discretion in design
5Eligible Professionals
- Medicare incentives capped at 44,000 (plus 10
in HPSAs) OR - Medicaid incentives capped at 63,750 (if 30 of
practice is Medicaid (Peds 20)) - Paid over 5 years beginning Jan. 2011
- Penalties for non-adoption begin Jan. 2015
- Hospital-based professionals ineligible
6EHR Adoption Rates
- 2008 RWJF study of 2,952 hospitals
- Comprehensive EHR1.5 of US hospitals
- Basic EHR (physician, nursing notes) 7.6
- Rural hospitals
- 0.6 comprehensive EHR
- 4.0 basic EHR
7OHA members tell us
8OHA members tell usPotential obstacles to your
hospital adopting EHR
- Insufficient IT staff
- Incentive payments will likely not cover EHR
costs - Medical Staff is not supportive
- Cannot find a suitable EHR
9OHA members tell us OHA can help most by
- Providing education on incentives
- Providing education on EHRs
- Offering a group deal
- Helping arrange financing
- Helping select EHR
10EHR Certification
- Certification Commission for Health Information
Technology (CCHIT) - CCHIT Certified
- Preliminary ARRA certification
- Site certification
- HHS Health IT Policy Committee recommendation
- Allow multiple Certification organizations
- Accreditation process for certifying
organizations - HHS will propose rules
11Meaningful Use
- HIT Policy Committee
- HIT Standards Committee
- Public input
- Policy Committees August 19 matrix
- Proposed rule due by December 31
- 60 day comment period
- Final rule middle or end of spring 2010
12- NE Oklahoma origins
- Oklahoma City exchange
- Projects around the state
- Attractive pricing for hospitals and their
physicians
13Regional Extension Centers ARRA Section 3012
- National HIT Research Center
- Develop or recognize best practices to support
and accelerate efforts to - Adopt, implement, and effectively utilize HIT for
- Electronic exchange and
- Use of information
- Regional Extension Centers
- Provide technical Assistance
- Disseminate best practices and other information
- Support and accelerate efforts to adopt,
implement, and utilize HIT
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15Regional Extension Centers
- ARRA law
- Hospitals (public, NFP, CAH)
- Federally Qualified Health Centers
- Entities serving uninsured, medically underserved
- Individual and small group practices in primary
care - Funding opportunity
- Primary care providers in small group practices,
public hospitals CAHs, CHCs and RHCs, other
settings for the uninsured/medically underserved
16Regional Extension Centers
- OFMQ selected by stakeholders
- Three waves of funding
- 6.5 million potential for Oklahoma
- Substantial matching required in years 3 and 4
17State Loan Program
- 51 federal match for loans to providers
- Administered through Medicaid agencies
- OHCA will apply has requested state match in SFY
2011 budget - Projected availability October 2010
18SHIECAP
- State Health Information Exchange Cooperative
Agreement Program - Planning and Implementation grants
- State funding required
- 2011 1/10
- 2012 1/7
- 2013 1/3
19SHIECAP
20SHIECAP Oklahoma Health Information Exchange
- Network of networks
- Planning phase beginning Jan. 2010
- TBD Governance, financing,
- ONC approval of State plan required before
implementation is funded - OHA participating in planning volunteers?
21OHA Trade Show HIT vendors
- Spectron Corp McKesson products more booth
320 - CPSI booth 800
- Phoenix Health Systems booth 111
- Meditech, CPSI, others, including MedSphere
OpenVista
22Resources
- http//healthit.ahrq.gov/RuralHITtoolbox
- http//www.cchit.org/
- http//www.okoha.com/ARRA