Transcript U.S. Department of Health and Human Services Health Resources and Services Administration HRSA’s Office of Health Information Technology Maryland Community Health Resources Commission April 23, 2007 Cheryl.

U.S. Department of Health and Human Services
Health Resources and Services Administration
HRSA’s Office of
Health Information Technology
Maryland
Community Health Resources Commission
April 23, 2007
Cheryl Austein Casnoff, MPH
Associate Administrator
US Department of Health and Human Services
Health Resources and Services Administration
Office of Health Information Technology
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Health Resources and Services
Administration (HRSA)
• Budget of approximately $6.6 billion (FY 2006)
• Programs reach into every corner of America, providing
a safety net of direct health care services to 20 million
people each year (about 1 in every 15 Americans).
• In Maryland there are 97 HRSA grants for a wide variety
of programs including research, workforce development,
support for scholarships and residencies, maternal and
child health, Ryan White as well as primary care and oral
health programs.
• 2004 Health Center Data
• 1,000 Health Centers funded
• About 13.1 million patients served
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Support the Participation of Safety-Net
Providers and EHRs
• HRSA recognizes that Health Centers want to invest in:
• Electronic Health Records
• Telehealth
• E-prescribing
• HRSA is developing tools to help Health Centers make
informed decisions
• HRSA HIT Community Web Portal
• HIT Adoption Tool Kit
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HIT Goals for the Safety Net Providers
Bring HIT to America’s safety net providers which will:
• Improve quality of care
• Reduce health disparities
• Increase efficiency in care delivery systems
• Increase patient safety
• Decrease medical errors
• Prevent a digital divide
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HRSA HIT Quality Strategy
• In May 2006, HRSA reconfirmed its goal to improve the
quality of health service and outcomes for all patients
served by HRSA grantees:
Quality
Measures
HIT
Performance
Measures
Data
Reporting
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HRSA HIT Quality Strategy
• HRSA's goal is not simply to collect data; it is also
important that the data be used to track individual and
population health outcomes and improve patient care.
The long-term vision of HRSA and OHIT is to transform
systems of care for safety-net populations through the
effective use of HIT.
Data
Reporting
HIT
Performance Quality
Measures
Measures
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Office of Health
Information Technology
• Formed in December 2005, as the principal advisor to the
HRSA Administrator in developing an agency wide HIT
strategy.
Mission:
The Office of Health Information Technology (OHIT)
promotes the adoption and effective use of health
information technology (HIT) in the safety net community.
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Office of Health
Information Technology - Goals
• Develop a nationwide HIT and telehealth strategy for HRSA
that focuses on helping to meet the needs of the uninsured,
underserved, and vulnerable populations.
• Ensure successful dissemination of appropriate information
technology advances, such as electronic medical records
systems or provider networks, in community health centers
and other HRSA programs by providing technical
assistance and identifying and disseminating model
practices.
• Promote the HIT advances of HRSA grantees and promote
innovative grantees as models for the private sector and
other public programs.
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Office of Health
Information Technology - Goals
• Work collaboratively with foundations, national & state
organizations, the private sector, as well other Federal
agencies to promote the adoption of HIT by HRSA’s
grantees.
• Ensure that HRSA HIT policy and programs are
coordinated with those of other HHS components.
• Serve as the Administrator’s principal advisor on the
impact of HIT initiatives in the uninsured, underserved,
and vulnerable populations.
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Safety Net Challenges
• According to National Association of Community Health
Centers (NACHC) 2006 survey:
• Health Centers frequently lack the capital dollars to invest in
health IT to help them provide more improved and efficient
care.
• Only 8% of health centers currently report using a full
Electronic Medical Record (EMR).
• 60% of health centers report plans for installing a new EMR
system or replacing the current system within the next 3
years.
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Safety Net Challenges
• According to a Commonwealth Fund 2006 survey:
• 23.9% of physicians providing care to non-hospitalized
patients use electronic health records in some form
• Reimbursement issues must be addressed in order to
promote health IT adoption
• There is no evidence yet of a “digital divide.” However
doctors who treat large numbers of Medicaid patients are
half as likely to have electronic health records
• Doctors in cities are more likely to have EHRs than those
in rural areas, as are doctors in larger practices and in
larger health care facilities
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Advancing HIT through Networks
• Why Networks?
• Collaboration of health centers and other safety net
providers
• Economies of scale/cost efficiencies/volume
• Enhanced efficiencies in business and clinical core
areas
• Higher performance and value
• Sharing of expertise and staff among collaborators
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Networks and HIT
• FY 2003 – HRSA funded 6 Health Center Controlled
Networks to focus on Clinical Data, Care Model, and
Electronic Health Records (EHR) though the Integrated
Information and Communication (ICT) Initiative.
• Statewide efforts: Maine, West Virginia
• Multi-state efforts: Oregon
• Marketplace efforts: Florida, North Carolina, Illinois
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Networks and HIT Continued …
• As of 2006, six networks were installing EMR/EHR in 64
health centers with 379 CHC sites
• Maine: 4 Health Centers = 19 sites
• Oregon: 15 Health Centers = 59, 3 FQHCLA, and 5 ‘other’
sites
• West Virginia: 19 Health Centers – 67 sites and 1
FQHCLA
• Florida: 11 Health Centers – 99 sites
• Illinois: 4 Health Centers – 98 sites and 1 FQHCLA
• North Carolina: 7 Health Centers – 37 sites
FQHCLA - Federally Qualified Health Center Look Alike
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HRSA Health IT Community
• In partnership with the Agency for Health Care Quality
and Research (AHQR), HRSA has established a Health IT
Community for HRSA grantees.
• The ‘Community’:
• Serves as a virtual community for health centers, networks
and PCAs to collaborate around the adoption of
technologies promoting patient safety and higher quality of
care.
• Creates a central hub for communication across
geographically disparate sites, allows team members to
view important announcements, documents, tasks, events,
and discussions related to their initiative.
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HRSA Health IT Community
• The ‘Community’:
• Includes a repository of information on IT targeted to the
health center population members.
• Facilitates collaboration among health centers via
discussion forums where health centers facing similar
challenges can share thoughts and lessons from
experiences with a variety of IT systems and scenarios.
• Provides access documents, tools and resources on
issues related to planning for and implementing health IT
in the community provider setting.
• Will include tabs for maternal and child health, rural health,
HIV/AIDS grantees, and telehealth grantees.
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Health Center HIT Toolbox
• Development of an interactive Toolbox that will assist
health centers, maternal and child health, rural health,
and HIV/AIDS grantees in HIT planning, implementation,
and sustainability.
• Focus:
•
•
•
•
Collaborative solutions
Module based
Interactive
Questions and answers
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When would providers use the toolbox?
 Starting out with health IT
 What problems are we trying to address?
 How can health IT help?
 Assessing current health IT environment
 How do we assess our software and hardware infrastructure?
 How do we set priorities for health IT?
 How do we develop a plan
 Procurement and implementation
 Why is collaboration important? (why should we join a network?)
 How should we select vendors?
 What are best practices for involving providers and training?
 How do we build on our existing health IT efforts?
 Evaluating health IT
 Using health IT for continuous health care quality improvement
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Strategic Plan/
HIT Technical Assistance Center
• OHIT is developing a strategic plan that will define:
• OHIT office
• Relationships with offices within HRSA
• Relationships with its grantees
• Relationships with other constituents
• How OHIT addresses its mission to promote the adoption and
effective use of HIT in the safety net community
• In FY 2007, OHIT will initiate a health IT technical assistance (TA)
center that will identify and organize the HIT TA efforts across HRSA
• EHR implementation, network development, procurement,
workforce, training, disaster recovery
• Our goal is to provide consistent HIT TA to HRSA grantees
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Potential Funding Opportunities for FY 2007
Health Center Controlled Networks
•
HIT Planning Grants
•
E H R Implementation Grants
•
HIT Innovation Grants
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Potential Funding Opportunities
HIT PLANNING GRANTS
LEGISLATIVE INFORMATION: PHS Act, Title III, Section 330(c)1D
PURPOSE: To support health centers in structured planning
activities that will prepare them to adopt E H R or other HIT
innovations including: readiness assessment, workflow analysis,
due diligence in selecting vendor, business planning, determining
specific network HIT functions, marketplace assessment, initial
stages of collaboration with partners, and business planning.
ELIGIBILITY: Health centers acting on behalf of the member health
centers and the network.
ESTIMATED OR AVERAGE SIZE OF EACH AWARD: $125,000
ESTIMATED PROJECT PERIOD: 1 year
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Potential Funding Opportunities
EHR IMPLEMENTATION INITIATIVE
LEGISLATIVE INFORMATION: PHS Act, Section 330(e)(1)©
PURPOSE: Funding for implementation of an electronic health
record (EHR) in support of the President's goal of universal
adoption of electronic health records by 2014.
ELIGIBILITY:
-A health center applying on behalf of a managed care network; or
-A health center applying on behalf of a practice management
network; or
-Operational networks, controlled by and acting on behalf of the
health center(s).
ESTIMATED OR AVERAGE SIZE OF EACH AWARD: $550,000
ESTIMATED PROJECT PERIOD: 3 years
•
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Potential Funding Opportunities
HIT INNOVATION INITIATIVE
LEGISLATIVE INFORMATION: PHS Act, Title III, Section
330(e)(1)(C)
PURPOSE: To implement HIT other than EHRs including, but not
limited to: e-prescribing, physician order entry, personal health
records, community health records, health information exchanges,
smart cards, using telehealth to advance previous investments
(e.g., using e-prescribing to build a telepharmacy), and creating
interoperability with outside partners such as health departments
and other HRSA grantees.
ELIGIBILITY:
--a health center applying on behalf of a managed care network or
plan; or
-a health center applying on behalf of a practice management
network; or
-operational networks, controlled by and acting on behalf of the
health center(s).
ESTIMATED PROJECT PERIOD: 3 years.
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STATES
•
•
HRSA is providing funding for a small number of networks (competitive).
Some states are providing financial support to network HIT systems.
•
According to the National Conference of State Legislatures (NCSL), state
health reform initiatives in 2006 have focused on:
• Ensuring affordability of insurance for small employers and individuals
(AR, KY, MO, OK, RI, TN)
• Incremental or comprehensive approaches towards universal coverage
(VT, MA)
• Coverage expansion for State Children’s Health Insurance Program (IL,
PA)
• Other coverage expansion and reform (IL, CO, LA, MA, MD, NM and
WA)
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According to eHealth Initiative*, a majority of states have introduced HIT
related legislation
•
20% of nation’s governors have issued executive orders for state action to
improve health care through HIT
*eHealth Initiative, 3rd Annual Survey of Health Information Exchange Activities at the
State, Regional, and Local levels
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STATES
• According to the NCSL, state roles in HIT planning include:
• Start-up Funding
• At least 17 state governments are funding programs to
examine how HIT may be used or implemented
• Building infrastructure
• At least 10 states are facilitating RHIO development
• Studies
• At least 6 states have initiated planning projects but
have not taken legislative action
• HRSA is looking to states, foundations, and the private sector
to partner with networks to provide additional financial support
to close the funding gap to implement and sustain HIT.
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Contact Information
Cheryl Austein Casnoff, MPH
Associate Administrator
DHHS/HRSA/OHIT
5600 Fishers Lane, 7C-22
Rockville, MD 20857
Phone: 301-443-0210
Fax: 301-443-1330
[email protected]
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