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Beyond the EMR – Exchanging Health Information Outside of Your Organization John W. Loonsk, MD, FACMI Office of the Nati

Beyond the EMR – Exchanging Health Information Outside of Your Organization John W. Loonsk, MD, FACMI Office of the National Coordinator for Health Information Technology. Some Critical Health Needs. Avoidance of medical errors Up to 98,000 avoidable annual deaths due to medical errors

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Beyond the EMR – Exchanging Health Information Outside of Your Organization John W. Loonsk, MD, FACMI Office of the Nati

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  1. Beyond the EMR – Exchanging Health Information Outside of Your Organization John W. Loonsk, MD, FACMI Office of the National Coordinator for Health Information Technology

  2. Some Critical Health Needs • Avoidance of medical errors • Up to 98,000 avoidable annual deaths due to medical errors • Improvement of resource utilization • Up to $300B spent annually on treatments with no health yield • Acceleration of knowledge diffusion • 17 years for evidence to be integrated into practice • Reduction of variability in healthcare delivery and access • Access to specialty care highly dependent on geography • Empowerment of the consumer • Capitalize on growing consumer trend of active health management • Strengthening of data privacy and protection • HIPAA becomes reality • Promotion of public health and preparedness • Surveillance is fragmented, and importance to homeland security brings heightened awareness

  3. Information Exchange Needs During Anthrax Attacks

  4. Level of Function Size of Practice 25% 25 25 Using some functions 20.8% 20 20 11 or more in practice 15 15 Percentage Percentage 10% 10 10 With (1) electronic note keeping,(2) lab order, (3) med orders, & (4) ability to obtain lab results 4.4% 5 5 1 or 2 in practice 0 0 Physicians* Physicians* Current State EHR Adoption: US Physicians (2005) *3 times more prevalent in metropolitan areas

  5. The National Health IT Agenda • Priorities • American Health Information Community • Business needs and priorities • Use Cases • Certification • Certification Commission For Healthcare Information Technology • Criteria development • Testing • Networking • NHIN - network of networks • Architecture specifications Agenda • Business Deployment • Sustainable business models • Software • State / regional partnerships • Evaluation • Standards • Healthcare Information Technology Standards Panel • Recognized standards • Policies • State laws and regulations – State Alliance • Health Information Security and Policy Collaboration

  6. AHIC Priorities and Use Case Roadmap

  7. Standards in the National HIT Agenda Certification Commission for Healthcare Information Technology (CCHIT) Secretary and recognition • January, 2008 - 52 standards • January 2009 - 60 standards Stark and Anti-kickback American Health Information Community Priorities (AHIC) Healthcare Information Technology Standards Panel (HITSP) Interoperability Use Cases Specifications Federal Systems and Healthcare Contracts (Executive Order 13410) Nationwide Health Information Network (NHIN)

  8. HIE SSA VA CMS DoD CDC FDA PHR HIE Fed HIE IDS HIE Geo HIE RHIO The Nationwide Health Information Network State and Local Gov HealthBank PCHR Support Organization Community Health Centers Common “dial tone” and “chain of trust” Labs Pharmacies

  9. Common Network “Dial Tone” Functions and specifications: • Patient look-up and information retrieval • Information routing and delivery • The exchange of consumer preferences • Support for population data uses • Provider has a patient but not their record • Updating health data where it is needed • Patient wants / doesn’t want information to be electronically released • Providing the best care and protecting the population

  10. Enabling Information Exchange Trust Issues • Tacit “ownership” • HIPAA and other legal angst • Propriety business needs • Patient confidentiality issues Enablers • Value of exchanging data • Patient choice x 2 • Support trusted users • High level access controls • Minimize identifying information

  11. HIE SSA VA CMS DoD CDC FDA PHR HIE Fed HIE IDS HIE Geo HIE RHIO The Nationwide Health Information Network State and Local Gov HealthBank PCHR Support Organization Community Health Centers Common “dial tone” and “chain of trust” Labs Pharmacies

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