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Key Elements - Transforming Care

Strategies & Actions

Key Initiatives

Key Elements: Transforming Care at the Point of Care

Transforming Care Key Initiatives

Source/Reference	Initiative:	Summary:
American Academy of Family Physicians (AAFP)	Center for Health Information Technology	An arm of the AAFP that promotes and facilitates the adoption and optimal use of health IT by AAFP members and other office-based clinicians.
	Goals:	Strategies / Principles / Tools:
	To increase the availability and use of low-cost, standards-based information technology among family physicians.	Principles: Affordability Compatibility Interoperability Data stewardship

Source/Reference	Initiative:	Summary:
AAFP	TransforMED	An AAFP-sponsored initiative focused on redesign of care delivery to a patient-centered model of care.
	Goals:	Strategies / Principles / Tools:
	Develop high-performance family medicine practices through a transformative process of practice redesign focused on patient care and practice team satisfaction Generate transportable new knowledge about the practice transformation process Generate means to allow for the continued financial viability of the organization	Core Components of the TransforMED Model of Care: Team approach Comprehensive practice offering (e.g., DM, wellness) Open access to care Advanced, data-based information systems (compliant w/ AAFP ChiT guidelines) Redesigned, more functional and efficient offices Patient access to information Emphasis on quality and safety Enhanced practice management

Source/Reference	Initiative:	Summary:
Agency for Health Research and Quality (AHRQ)	AHRQ National Resource Center for Health IT	AHRQ's National Resource Center includes more than $166 million in grants and contracts in 41 states to support and stimulate investment in health IT, especially in rural and underserved areas. AHRQ and its partners identify challenges to health IT adoption and use, solutions and best practices for making health IT work, and tools that will help hospitals and clinicians successfully incorporate new IT.
	Goals:	Strategies / Principles / Tools:
	Help the health care community make the leap into the Information Age. In addition to providing technical assistance, the National Resource Center shares new knowledge and findings that have the potential to transform everyday clinical practice. AHRQ's National Resource Center is committed to advancing our national goal of modernizing health care through the best and most effective use of IT.	As new findings and data become available to the health IT community from both the AHRQ portfolio of projects and other sources, they will be shared through future releases of the National Resource Center Health IT Knowledge Repository.

Source/Reference	Initiative:	Summary:
American College of Physicians (ACP)	I Adoption Road Map and Tools	A road map and tools to assist College members at each stage in the I adoption process.
	Goals:	Strategies / Principles / Tools:
	Integration of EHRs into clinical practice will provide the tools for improving practice efficiency and clinical quality over time.	Tools for each stage of adoption: I investigation Selection and Purchase Installation – Getting the I up and running Basic implementation – Achieving base I functionality Enhanced implementation – Exploiting I into the future

Source/Reference	Initiative:	Summary:
Bridges to Excellence (BTE)	Physician Office Link	An employer-based incentive program that promotes physician office use of health IT.
	Goals:	Strategies / Principles / Tools:
	Physician practices implement information systems to improve communications and reduce medical errors.	Assess the use of evidence-based standards of care, maintenance of patient registries for the purpose of identifying and following-up with at-risk patients and provision of educational resources to patients. Assess whether practices use electronic systems to maintain patient records, provide decision support, enter orders for prescriptions and lab tests and provide patient reminders. Assess whether a practice’s electronic systems interconnect and whether they are interoperable with other systems, whether they use nationally accepted medical code sets and whether they can automatically send, receive and integrate data such as lab results and medical histories from other organizations’ systems.

Source/Reference	Initiative:	Summary:
Centers for Medicare & Medicaid Services (CMS)	Doctor’s Office Quality – IT (DOQ-IT)	A national initiative that promotes the adoption of EHRs and health IT in small adult primary care practices
	Goals:	Strategies / Principles / Tools:
	Support I adoption, improved care management processes and electronic reporting of quality data in 5% of small practices in each state.	Provide hands-on technical assistance to support I adoption Using a QI framework, support care process and workflow redesign for effective use of EHRs Enable ongoing provider management of patient-population health

Source/Reference	Initiative:	Summary:
Certification Commission for Health Information Technology (CCHIT)	Certification of health IT products	The Certification Commission for Healthcare Information Technology (CCHIT) is a recognized certification body (RCB) for electronic health records and their networks, and an independent, voluntary, private-sector initiative.
	Goals:	Strategies / Principles / Tools:
	To accelerate the adoption of health information technology by creating an efficient, credible and sustainable certification program.

Source/Reference	Initiative:	Summary:
Connecting for Health – Markle Foundation	The Common Framework	A framework consisting of a set of mutually-reinforcing technical documents and specifications, testing interfaces, code, privacy and security policies, and model contract language intended to help health information systems share information.
	Goals:	Strategies / Principles / Tools:
	A new infrastructure for health information sharing will provide the foundation for a transformed, 21st century healthcare system in which patients and families can better understand their own health and engage more fully in their care through direct access to their own health information.	Policy Principles: Openness and transparency Purpose specification and minimization Collection limitation Use limitation Individual participation and control Data integrity and quality Security safeguards and controls Accountability and oversight Legal and financial remedies Technology Principles: Make it “Thin” Avoid “Rip and Replace” Separate Applications from the Network Decentralization Federation Flexibility Privacy and Security Accuracy

Source/Reference	Initiative:	Summary:
Department of Health and Human Services - Office of the National Coordinator for Health IT	National Health Information Network (NHIN) Phases I & II	A critical portion of the health IT agenda intended to provide a secure, nationwide, interoperable health information infrastructure.
	Goals:	Strategies / Principles / Tools:
	Developing capabilities for standards-based, secure data exchange nationally Improving the coordination of care among providers Ensuring appropriate information is available at the point of care Ensuring consumers' health information is secure and confidential Giving consumers new capabilities for managing and controlling their personal health records Reducing risks from medical errors and supporting the delivery of appropriate, evidence-based medical care Lowering healthcare costs resulting from inefficiencies, medical errors, and incomplete patient information Promoting a more effective marketplace	The four NHIN Prototype Architectures (Phase I) included core services and three AHIC priority areas/use cases: Consumer Empowerment - Registration and Medication History Electronic Health Record - Laboratory Result Reporting Biosurveillance - Connecting Clinical Care to Public Health The NHIN Trial Implementations (Phase II) will implement the core services and several new AHIC priority areas/use cases: Emergency Responder-Electronic Health Record Consumer Empowerment-Consumer Access to Clinical Information Medication Management Quality Personalized Healthcare Public Health Case Reporting Response Management Remote Consultation Remote Monitoring Referrals and Transfer of Care

Source/Reference	Initiative:	Summary:
The Dossia Founders Group (including large employers such as Wal-Mart, Intel, BP America)	Dossia Network	An infrastructure designed to gather and store personal health information for employees of participating employers.
	Goals:	Strategies / Principles / Tools:
	To empower individuals to manage their own health care, improve communications with their doctors, and ensure more complete and accurate information for health care providers.	Dossia’s framework will possess the following features: Customizable – allowing consumers to organize and summarize their information in ways they find useful Privacy and security – accessible to the individual only Portability – consumers can access their information despite changing employers, health plans or doctors

Source/Reference	Initiative:	Summary:
Health Information Technology Standards Panel (HITSP)	Health Information Technology Standards Panel (HITSP)	Comprised of a wide range of stakeholders, the Panel supports the development of the Nationwide Health Information Network (NHIN) by harmonizing existing standards and recommending a single set to HHS for specific use cases related to health information sharing.
	Goals:	Strategies / Principles / Tools:
	The mission of the Healthcare Information Technology Standards Panel is to serve as a cooperative partnership between the public and private sectors for the purpose of achieving a widely accepted and useful set of standards specifically to enable and support widespread interoperability among healthcare software applications, as they will interact in a local, regional and national health information network for the United States.

Source/Reference	Initiative:	Summary:
The Leapfrog Group	Computer Physician Order Entry (CPOE) Standard	Adopted as a hospital safety standard to leverage major improvements in patient safety.
	Goals:	Strategies / Principles / Tools:
	Leapfrog’s CPOE standard requires hospitals to: Assure that physicians enter at least 75% of medication orders via a computer system that includes prescribing-error prevention software; Demonstrate that their inpatient CPOE system can alert physicians of at least 50% of common, serious prescribing errors, using a testing protocol now under development by First Consulting Group and the Institute for Safe Medication Practices (this criterion for the Leap will not count towards the hospital’s publicly reported status on this Leap until the test is available). Require that physicians electronically document a reason for overriding an interception prior to doing so.

Source/Reference	Initiative:	Summary:
National Committee for Quality Assurance (NCQA)	Physician Practice Connections	A standards-based evaluation program that recognizes physician practices that use information systematically to enhance the quality of patient care.
	Goals:	Strategies / Principles / Tools:
	Encourage physicians to adopt HIT for the following purposes: Monitor patients’ medical histories Work with patients over time, not just during office visits Follow up with patients and with other providers Manage populations, not just individuals, using evidence-based care Assist patients to manage their own health better Avoid medical errors	PPC standards evaluate the following: Enabling patients to communicate with and access the practice easily Using systems to track patients, their treatments and conditions Managing patients’ care proactively over time Supporting patients’ self-management of their health Using electronic prescribing tools Tracking and following up lab and imaging tests Tracking and following up referrals Measuring performance and working to improve Updating to interoperable electronic systems