ARRA & Regional ARRA & Regional HIT Extension HIT Extension

CentersCenters

Jack L. Shaffer, Jr.CIO – Community Health Network of West Virginia

A quick word about the Community Health Network of West Virginia

The Network is a tax-exempt, non-profit health center-controlled West Virginia corporation – formed in 2000.

The Network is primarily an application service provider (ASP) delivering centralized practice management, electronic medical records (EMR), and technology services for its members.

Currently with 50 clinical locations in production using the Indian Health Services RPMS-EHR system (CCHIT-Certified, public domain / open source EHR derivation of the VA’s VistA system) 70 FTE providers – 300+ concurrent users. 10 More clinics to implement over the next year.

Our focus is health improvement through the strategic use of health information technology along with workflow modifications to improve health outcomes.

ARRA... A Massive Stimulus for

Health IT Adoption & HIE Expansion

Appropriations for Health IT New Incentives for Adoption

$2 billion for loans, grants & technical assistance for:

• National Resource Center and Regional Extension Centers

• EHR State Loan Fund

• Workforce Training

• Research and Demonstrations

New Medicare and Medicaid payment incentives for HIT adoption

• $20 billion in expected payments through Medicare to hospitals & physicians

• $14 billion in expected payments through Medicaid

• ~$34 billion expected outlays, 2011-2016

At least $300 million of the total at HHS Secretary’s discretion for HIE development

• Funneled largely through States or qualified State-designated entities

• For planning and/or implementation

Appropriations for HIE

$4.3 billion for broadband & $2.5 billion for distance learning/ telehealth grants

Broadband and Telehealth

$1.5 billion in grants through HRSA for construction, renovation and equipment, including acquisition of HIT systems

Community Health Centers

ARRA – HITECH Funding Streams $17.2 billion in incentives for EMR adoption

Paid via Medicare OR Medicaid Estimated $234 million+ could go to WV

ambulatory providers over 4 years Estimated $500+ million could go to WV

acute hospitals over 4 years Avg. hospital with 7,550 discharges and 50%

Medicare share will receive $4 million over 4 years. Must meet “meaningful use” criteria to

achieve 100% of ARRA funds $2 billion for the Office of the National Coordinator

Health Information Exchange Creation of Regional HIT Extension Centers

Extension Center? Regional health IT extension centers will aim to help health care

providers become "meaningful users" of health IT by 2011 so they can qualify for federal health IT stimulus funding.

Blumenthal noted that the federal economic stimulus package allocated nearly $700 million to form a nationwide network of "local health care geek squads.“

The health IT extension center program is patterned after the federal agriculture extension service created nearly a century ago. Similar to how the agricultural extension centers help farmers address pesticide, crop and land use issues, the new health IT extension centers would help health care providers "not just get computers, not just store the information, but use the information," Blumenthal said.

Each State will be served by a RHITEC (some states may have more than one and some states will be served by a multi-state RHITEC)

Federal support for the first two years Services to include

Assistance selecting a system Assistance negotiating fair pricing Project implementation assistance Workflow Redesign Functional interoperability Privacy and Security Support Training and support on using technology and

demonstrating medical use Progression to “meaningful use”

Regional HIT Extension Center - Regional HIT Extension Center - FAQFAQ

Not a grant. It is a cooperative agreement between the RHITEC and the ONC for specific services.

90/10 match first 2 years then 10/90 for next 2 years.

Focus is primary care providers. Funding capped at 10 providers per

organization. Capped at ~$5K per provider.

Regional HIT Extension Center - Regional HIT Extension Center - FAQFAQ

In West Virginia……..In West Virginia……..

Applied for ~9M in Federal funding over a 4 year period.

The WV-RHITEC is a consortium comprised of the Health Improvement Institute; the Community Health Network of West Virginia and West Virginia Medical Institute.

The Consortium will have strategic partners throughout the State assisting with executing its mission.

Targeted Groups for WV-RHITECWe have the opportunity to help more than

1,800 providers adopt and use health-IT over the next 4 years.  Assuming a 90% success rate in progressing to meaningful use, these providers could receive over $80 million to support HIT adoption and use efforts.

Targeted Groups for WV-RHITECThe following table reflects the commitments received by the

Extension Center by category:

Category Paper to M-use

EHR to M-use

Total

Priority PC

Providers118 342 460

Total PC Providers

142 361 503

Non PC Providers

0 411 411

Total Providers

142 772 914

PC designates Primary Care Providers; M-use means meaningful use.

What Does this Mean to All What Does this Mean to All of You?of You? Need to move forward with implementation and meaningful use of

technology The environment is heating up and the tipping point is near Meaningful Use -

Evidence based decision support tools Computerized order entry and results reporting E-prescribing Care opportunity reports based on age appropriate and disease

based guidelines Engagement of patients and families-Patient Health Records Care coordination across the boundaries of the clinic Reporting and sharing data for quality improvement purposes

Meaningful Use? Blumenthal emphasized that the meaningful use

of electronic health records is not just about introducing technology to collect and share information. It's also about physicians and hospitals changing how they operate and the sequence of their work. "We are involved in a vast social project of change management," he noted.

Providing better information is the foundation for change, he said. Beyond that, physicians and hospitals will need help and training to understand what improvements to make.

Bending the Curve Towards Transformed Health

Achieving Meaningful Use of Health Data

2009 2011 2013 2015

HIT-Enabled Health ReformAchieving Meaningful Use

2009 2011 2013 2015

HIT-Enabled Health Reform

HITECH Policies 2011 Meaningful

Use Criteria (Capture/share

data)2013 Meaningful

Use Criteria(Advanced care processes with

decision support)

2015 Meaningful Use Criteria (Improved Outcomes)

Meaningful Use - Examples

Extension Centers are key for M-use

"I know this from my own experience as a physician," he said. "You can show me that my results are not up to those of my colleagues. That didn't mean I knew how to improve them."

He cited activities, such as workflow redesign, workforce education and rearranging offices and nurses' stations so that the right information is more accessible.

ONC will help providers adopt these techniques in their own practices through its regional extension center program, which will assist providers in deploying and operating electronic health records.

Questions?