A COLLABORATIVE JOURNEY FOR HEALTHCARE TRANSFORMATION ... FOR HEALTHCARE TRANSFORMATION THROUGH HEALTH

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  • A COLLABORATIVE JOURNEY FOR HEALTHCARE TRANSFORMATION THROUGH HEALTH IT

    Antonio Fernández Director

    Regional Extension Center Ponce School of Medicine and Health Science

  • The CMS “Three-Part Aim”

  • ARRA & High Tech Act

  • Stage I: Where are We in PR? (Physicians)

  • )

    Primary Care

    Physicians  

    Dentists &

    Specialists  Hospitals   Totals  

    Selected & Contracted CEHRs   4,524   1103   42   5,446  

    Implementing CEHRs 3,659   683   20   4,362  

    Meaningful Users   820   182   1   1003  

  • The federal government’s approach to addressing the “three part aim” centers on developing a National Quality Strategy. Justification for pursuing this strategy includes the federal role in addressing health disparities, population health, and quality of care for underserved groups. Among other activities, the strategy calls for an alignment of quality measures that can be used to assess national progress, including those appropriate for monitoring progress related to reducing health disparities.

    National Quality Strategy

  • “The National Coordinator shall assess and publish the impact of health information technology in communities with health disparities and in areas with a high proportion of individuals who are uninsured, underinsured, and medically underserved individuals (including urban and rural areas) and identify practices to increase the adoption of such technology by health care providers in such communities, and the use of health information technology to reduce and better manage chronic diseases.” American Recovery and Reinvestment Act of 2009, Pub. L. No. 111-5, § 13101, 123 Stat. 232 - 233 (2009) (adding § 3001(c)(6) (C) of the Public Health Service Act).

    ARRA & HITECH

  • Aligning CQMs Across Programs • CMS’s commitment to alignment includes finalizing the same CQMs used in multiple quality reporting programs for reporting beginning in 2014

    •  Other programs include Hospital IQR Program, PQRS, CHIPRA, and Medicare SSP and Pioneer ACOs

  • Implications *Changes in MU Goals & Metrics, Alignment of Clinical Quality Measures (HEDIS, CMS 5 Stars) *Health IT Essential for Practice Transformation •  Accountable Care Organizations (ACO) •  Patient Centered Medical Homes (PCMH) *Care Coordination & Care Transitions *Patient-Family Engagement *Privacy and Security Protection

  • Medicare ACO Requirements

  • TOOLS FOR BUILDING THE PATIENT – CENTERED MEDICAL HOME

  • Costly Readmission Rates

  • AVOIDING (RE) ADMISSIONS

  • Building HIT Bridges to Serve the Underserved

  • PR AS A SOURCE OF INNOVATION IN HEALTH IT

  • PATIENT ENGAGEMENT FOR COLLABORATIVE, PERSONALIZED CARE

    POPULATION HEALTH

    MANAGEMENT

    PAYER- PROVIDER

    MANAGED CARE

    PROVIDER- MANAGED CARE

  • Collaborative Service Model

  • “Where there is a Will, there is Way.

    Modern Science and Technology show us the Way.

    The issue is do we have the Will to follow the Way.”

    Sir Jonas Salk

  • Ponce School of Medicine Regional Extension Center

    Call center: (787) 651-4070 Website: http://psmrec.org

    Antonio I. Fernandez afernandez@psm.edu

    Contact Information:

  • Gracias