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How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

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Page 1: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

How Future-Proof HIT Infrastructure

Supports Data Sharing

March 1, 2016John D. Halamka, MD, MS

Jonathan Bush

Page 2: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

Learning Objectives

• Define the stages of interoperability, and where and how eachof them are operating today

• Clarify how a healthcare system that continually “learns” through interoperable data advances accountable care

• Explore the role of record locator services, provider directories,and quality registries in the advancement of interoperability

Page 3: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

THE DISCONNECT

Page 4: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 5: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 6: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 7: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

THE INFORMATION SUPERHIGHWAY

Page 8: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 9: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

Connected Care and the Patient Experience survey; Surescripts, 2015

of patients report that

their medical history

is missing or incompletewhen they visit their doctor

55%

Page 10: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 11: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 12: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 13: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 14: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

HOW WE GOT HERE

Page 15: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 16: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 17: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 18: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 19: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 20: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 21: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

WHERE WE ARE NOW

Page 22: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

% A1C

% HEMOGLOBIN A1C

% HGB A1C

% HGBA1C

%A1C

%HBA1C

A1C

A1C %

A1C (FOR HGB A1C CALCULATION)

A1C - LAV

A1C CALC

A1C CONCENTRATION

A1C HEMOGLOBIN

A1C HPLC

A1C TODAY 5.9

A1C%

A1C-%HBA1C

A1C-2

A1C-2*

A1C2

HA1C

HA1C (GLYCOHEMOGLOBIN)

HA1CB

HB A1C

HB A1C DIABETIC ASSESSMENT

HB A1C, %

HBA1C

HBA1C (HEMOGLOBIN A1C), BLOOD

HBA1C ESTIMATED AVERAGE GLUCOSE

HBA1C II.

HBA1C-

HBG A1C

HBG A1C%

HBGA1C

HEAMOGLOBIN A1C

HEMA1C

HEMAGLOBIN A1C

HEMO A1C

HEMOA1C

HEMOBLOBIN A1C

HEMOGLOBIN (FOR A1C CALCULATION)

HEMOGLOBIN (HGB)

HEMOGLOBIN (HGB) SOLUBILITY

HEMOGLOBIN A1C

HEMOGLOBIN A1C%

HEMOGLOBIN A1C, POC

HEMOGLOBIN A1C.

HEMOGLOBIN A1C:

HGA1C

HGB A

HGB A %

HGB A1

HGB A1C

HGB A1C %

HGB A1C (GLYCO-HGB)

HGB A1C GLYCOHB

HGBA1

HGBA1C

HGBA1C - DIABETES MELLITUS

HGBA1C - DIABETIC MONITORING

HGBA1C - DIABETIC MONITORING -65 YRS OR

GREATER

HGBA1C - PRE-DIABETES MELLITUS

HGBA1C - SCREENING OR PREDIABETIC MONITORING

HGBA1C POC

HGBA1C-T

…

Page 23: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 24: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey, Electronic Health Records Survey.

18.2 17.3 17.320.8

23.9

29.2

34.8

42

48.351

57

71.8

78.4

0

20

40

60

80

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

EHR Adoption

Page 25: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

As of October 30, 2015

2,825 Vendors

Page 26: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 27: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 28: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 29: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 30: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 31: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

CONNECTING THE DISCONNECT

Page 32: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 33: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

2018:

90% of Medicare payments

tied to quality

2020:

75% of commercial plans will be

value-based

Jan 2015. http://www.hhs.gov/news/press/2015pres/01/20150126a.html

Page 34: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

Number of Americans with high-

deductible plans:

RISING DEDUCTIBLES ARE DRIVING CONSUMERIZATION IN HEALTH CARE

SOURCE: athenaNet data

Page 35: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

The Growth of Retail Clinics

Source: Merchant Medicine LLC.

-

500

1,000

1,500

2,000

2007 2008 2009 2010 2011 2012 2013 2014 2015

Re

tail

Clin

ics

at

Sta

rt o

f Y

ea

r

Year

Page 36: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 37: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 38: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

VIRTUAL HEALTH CARE WILL

REVOLUTIONIZE THE INDUSTRYIF WE LET IT

“

- FORBES TECH

”

Page 39: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 40: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 41: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

of pediatric

scans are read

by the correct

sub-specialist

50%

ONLY

Page 42: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

CHEYENNE

WYOMING

Page 43: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

CHEYENNEWYOMING

AMC W/BONE

EXPERTAMC W/

BRAINEXPERT

CLINIC W/LUNG

EXPERT

AMCGENERALIST

COMMUNITYHOSPITAL

Page 44: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

CHEYENNEWYOMING

AMC W/BONE

EXPERTAMC W/

BRAINEXPERT

CLINIC W/LUNG

EXPERT

AMCGENERALIST

COMMUNITYHOSPITAL

Page 45: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 46: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

EpicCerner

NextGen eClinicalWorksathenahealth

Meditech

Page 47: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

WHAT IF HEALTH CARE

WORKED AS IT SHOULD?

Page 48: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush
Page 49: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

She would get a text

reminder to schedule

a mammogram

Page 50: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

Scan routed to

sub-specialist

via cloud

Page 51: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

Complete view of

history, genomics,

care preferences

Page 52: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

Images are shared in the

cloud with specialists

via secure text

Page 53: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

Care team coordinates

and shares care plan

with patients and

families

Page 54: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

Clinical trial data made

available to all

Page 55: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

“Post-cure” care

done close to or

in the home

Page 56: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

PRIMARY CARE

PHYSICIAN

CARE

MANAGER

RADIATION

ONCOLOGISTSURGEON

ONCOLOGIST

Page 57: How Future-Proof HIT Infrastructure Supports Data Sharing ......How Future-Proof HIT Infrastructure Supports Data Sharing March 1, 2016 John D. Halamka, MD, MS Jonathan Bush

It’s now possible to connect the entire health ecosystem.

It’s time to replace compliance with conviction.

It’s happening… with or without you!

1

2

3


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