Transforming Care Delivery at the Point of Care

STRATEGY

1.
Understand provider purchase motivations regarding HIT adoption

ACTIONS

1.1

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations, Quality Organizations (QIOs) and NGOs, with support from Federal Agencies (such as AHRQ and/or ONC) should examine adoption motivations among providers, including lessons from failed and successful models of HIT implementations and participation in HIE, as well as the impact of providing free technology, and make recommendations regarding best practices. (2007-2008, and ongoing)

STAKEHOLDERS Federal Agencies NGOs Providers/Provider Organizations Quality Organizations

1.2

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations and NGOs, in partnership with Federal Agencies, should communicate findings regarding best practices for moving providers to adopt HIT systems, use them effectively and participate in HIE. (2008-2009, and ongoing)

STAKEHOLDERS Federal Agencies NGOs Providers/Provider Organizations

1.3

2007		2008		2009		2010		2011		ONGOING >>

ACTION NGOs (such as foundations) and the Federal Agencies should fund research conducted among State and Community HIE Collaboratives to examine HIEs that are currently operational, as well as defunct organizations, to identify best practices and lessons learned for how HIEs can play a role in supporting HIT adoption among providers. (2008-2010, and ongoing)

STAKEHOLDERS Federal Agencies NGOs State and Community HIE Collaboratives

STRATEGY

2.
Educate and motivate providers to adopt HIT and use it effectively.

ACTIONS

2.1

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations should continue to help prepare providers for the increased focus on performance reporting, accountability and transparency in the healthcare marketplace through educational events, online resources, and other communications. In addition, NGOs and Federal Agencies (especially CMS) should also undertake similar education efforts to prepare providers. (2007-2009)

STAKEHOLDERS Federal Agencies NGOs Providers/Provider Organizations

2.2

2007		2008		2009		2010		2011		ONGOING >>

ACTION Vendor Organizations, Quality Organizations, Provider Organizations and Federal Agencies (through ONC and the AHRQ Resource Center for HIT) should help educate providers about resources available before, during and after adoption (including tools developed below) to support adoption and effective use of HIT. (2007-ongoing)

STAKEHOLDERS Federal Agencies Health IT Vendors Providers/Provider Organizations Quality Organizations

2.3

2007		2008		2009		2010		2011		ONGOING >>

ACTION Quality Organizations (QIOs) through DOQ-IT and the hospital HIT projects, as well as Provider Organizations, NGOs and researchers, should help providers set realistic expectations regarding adoption of HIT – its benefits, uses, etc. (2007-ongoing)

STAKEHOLDERS NGOs Providers/Provider Organizations Public Health, Researchers, Etc. Quality Organizations

2.4

2007		2008		2009		2010		2011		ONGOING >>

ACTION NGOs, Employers, Provider Organizations and Consumer Organizations should collaborate to undertake a comprehensive study of the value proposition and business case for HIT adoption among providers based on objective, vender-neutral case studies. (2007-2008, and ongoing)

STAKEHOLDERS Consumer Organizations NGOs Payers (Employers/Purchasers) Providers/Provider Organizations

2.5

2007		2008		2009		2010		2011		ONGOING >>

ACTION NGOs should collaborate with Health Plans and Employers to undertake a comprehensive, objective study of the value proposition and business case for health plans to provide financial or other incentives in support of HIT adoption. (2008)

STAKEHOLDERS Consumer Organizations NGOs Payers (Employers/Purchasers) Providers/Provider Organizations

2.6

2007		2008		2009		2010		2011		ONGOING >>

ACTION NGOs, Health Plans, Employers, Provider Organizations, HIT Vendors, Federal Agencies and Consumer Organizations should communicate the value proposition of HIT adoption and effective use to their respective stakeholder groups. (2009-2012)

STAKEHOLDERS Consumer Organizations Federal Agencies Health IT Vendors Health Plans NGOs Payers (Employers/Purchasers) Providers/Provider Organizations

2.7

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations, NGOs, Consumer Organizations, HIT Vendors, State and Community HIE Collaboratives, Public Health stakeholders, Quality Organizations and Federal Agencies should examine and create awareness of the benefits of sharing and using electronic health information across care settings and at the point of care. (2008-ongoing)

STAKEHOLDERS Consumer Organizations Federal Agencies Health IT Vendors NGOs Providers/Provider Organizations Public Health, Researchers, Etc. Quality Organizations State and Community HIE Collaboratives

2.8

2007		2008		2009		2010		2011		ONGOING >>

ACTION HIT Vendors should focus their products and future enhancements on enabling providers to improve the quality of care, the efficiency of how care is delivered and the effectiveness of data capture. Vendors should develop work flow and change management competencies, both in sales and implementation, that contribute to the optimal use of their technology to achieve those improvements and with guidance on how to adapt current processes to those optimal work flows. (2007-2009)

STAKEHOLDERS Health IT Vendors

2.9

2007		2008		2009		2010		2011		ONGOING >>

ACTION Federal Agencies (CMS), Employers, and Health Plans should increase the transparency of the quality reporting and pay for performance program development processes, strategies and timelines, with clear explanation of the benefits of using technology to participate in current and upcoming quality improvement programs. (2007-ongoing)

STAKEHOLDERS Federal Agencies Health Plans Payers (Employers/Purchasers)

STRATEGY

3.
Educate providers regarding the availability of incentives and financing options to support adoption and effective use of HIT.

ACTIONS

3.1

2007		2008		2009		2010		2011		ONGOING >>

ACTION Federal Agencies and NGOs should work with Health Plans, Employers, HIT Vendors and others to create and maintain a centralized resource center of grants, loans, insurance savings opportunities, incentive programs and other financing options for HIT for providers. (2008-ongoing)

STAKEHOLDERS Federal Agencies Health IT Vendors Health Plans NGOs Payers (Employers/Purchasers)

3.2

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations (at the national and state levels) should leverage the resource center (above) and their own knowledge of local options and programs to communicate information about funding sources for HIT adoption. (2008-ongoing)

STAKEHOLDERS Providers/Provider Organizations

3.3

2007		2008		2009		2010		2011		ONGOING >>

ACTION HIT Vendors, Quality Organizations (QIOs) and NGOs should provide increased support for small and rural healthcare organizations that need assistance with the grant writing process to complete applications for HIT funding support. (2008-2010)

STAKEHOLDERS Health IT Vendors NGOs Quality Organizations

3.4

2007		2008		2009		2010		2011		ONGOING >>

ACTION Providers (especially Integrated Delivery Networks, health systems and hospitals) should communicate to physicians the availability and related criteria for funding under the Stark and anti-kickback relaxation. (2007-ongoing)

STAKEHOLDERS Providers/Provider Organizations

STRATEGY

4.
Monitor adoption rates based on agreed upon methodology. Report on rates to all healthcare stakeholders, including the government, in order to continue to incentivize and support adoption and effective use.

ACTIONS

4.1

2007		2008		2009		2010		2011		ONGOING >>

ACTION Federal Agencies, in partnership with Provider Organizations and NGOs, should establish a consistent methodology for measuring adoption and effective use, and analyzing and reporting data. (2007)

STAKEHOLDERS Federal Agencies NGOs Providers/Provider Organizations

4.2

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations, with federal funding, should promote the survey instrument to their members, assist with follow up to ensure survey completion, and communicate results back to members, Federal Agencies, and the public. (2008-ongoing)

STAKEHOLDERS Providers/Provider Organizations

4.3

2007		2008		2009		2010		2011		ONGOING >>

ACTION Using the agreed upon methodology, NGOs, the Federal Agencies, Congress, Health Plans, HIT Vendors and Employers should utilize annual survey results at the national and local level as a feedback loop that informs national and local strategies to boost adoption rates and encourage effective use. (2008-ongoing)

STAKEHOLDERS Congress Federal Agencies Health IT Vendors Health Plans NGOs Payers (Employers/Purchasers)

STRATEGY

5.
Increase the availability of incentives and financing options to support adoption and effective use.

ACTIONS

5.1

2007		2008		2009		2010		2011		ONGOING >>

ACTION Providers (especially hospitals) should utilize the recent Stark and anti-kickback relaxation to help provide hardware, software and training to physician practices. (2008-2009)

STAKEHOLDERS Providers/Provider Organizations

5.2

2007		2008		2009		2010		2011		ONGOING >>

ACTION HIT and HIE vendors on a broader scale should provide more flexible contract options, reducing upfront costs through monthly fees. (2008)

STAKEHOLDERS Health IT Vendors

5.3

2007		2008		2009		2010		2011		ONGOING >>

ACTION HIT Vendors should provide software that maximizes the current and future value propositions for providers based on the studies outlined in 2.5 regarding value proposition to providers. (2008-ongoing)

STAKEHOLDERS Health IT Vendors

5.4

2007		2008		2009		2010		2011		ONGOING >>

ACTION Existing group purchasing organizations should increase their focus on providing HIT and HIE solutions for providers. (2008)

STAKEHOLDERS Payers (Employers/Purchasers)

STRATEGY

6.
Provide education, tools and technical and other assistance to prepare and assist providers for selection, implementation and effective use of HIT. Education, tools and assistance should be tailored to provider size and specialty.

ACTIONS

6.1

2007		2008		2009		2010		2011		ONGOING >>

ACTION HIT Vendors, Provider Organizations, and Quality Organizations should work together to provide adaptable tools to help providers understand and assess the business case for HIT adoption, as well as the requirements for HIT implementation and effective use, including current workflow and redesign of care processes, technical requirements, current operational and business rules, staff capacity and skills and change management requirements. (2007-2009)

STAKEHOLDERS Federal Agencies Health IT Vendors Quality Organizations

6.2

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations, NGOs, HIT Vendors and Quality Organizations should leverage conferences, online tools and other communication vehicles to educate providers about (2007-ongoing): The overall process and steps to adopt – selection, acquisition, implementation, and effective use. Internal interoperability among all applications, services and products within a practice or provider organization, including practice management systems (existing and new) to facilitate efficient data entry (e.g., one-time, within the workflow, etc). Ongoing maintenance requirements, such as back-up and recovery, technical support, upgrades, compliance with future new standards.

STAKEHOLDERS Health IT Vendors NGOs Providers/Provider Organizations Quality Organizations

6.3

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations, Quality Organizations, HIT Vendors and NGOs should collaborate to create and make available model/standard approaches and guidelines for RFPs, vendor contracts, requirements checklist, model workflows, etc. (2007-2010, and ongoing)

STAKEHOLDERS Health IT Vendors NGOs Providers/Provider Organizations Quality Organizations

6.4

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations, Quality Organizations, HIT Vendors and NGOs should develop and make available how-to guides regarding selection, acquisition and implementation, tailored to provider size and specialty. (2008-2011)

STAKEHOLDERS Health IT Vendors NGOs Providers/Provider Organizations Quality Organizations

6.5

2007		2008		2009		2010		2011		ONGOING >>

ACTION Provider Organizations, NGOs (such as commercial product research organizations) and Quality Organizations, should provide peer experience information regarding HIT products and applications. (2007-ongoing)

STAKEHOLDERS NGOs Providers/Provider Organizations Quality Organizations

6.6

2007		2008		2009		2010		2011		ONGOING >>

ACTION Federal Agencies, through the AHRQ HIT Resource Center should help providers navigate the tools and assistance available to them (including how-to guides, model approaches, workflow and other support, etc). Provider Organizations, NGOs and Quality Organizations should contribute tools and resources to the AHRQ HIT Resource Center. (2008-ongoing)

STAKEHOLDERS Federal Agencies NGOs Providers/Provider Organizations Quality Organizations

6.7

2007		2008		2009		2010		2011		ONGOING >>

ACTION Quality Organizations should provide engagement and hands-on support regarding practice redesign, workflow techniques, etc. to an increased number and type of provider organizations, including hospitals, small primary and specialty physician practices, and long term care providers. (2008-ongoing)

STAKEHOLDERS Providers/Provider Organizations Quality Organizations

6.8

2007		2008		2009		2010		2011		ONGOING >>

ACTION Quality Organizations and HIT Vendors (and consultants) should provide support to providers during and after implementation to ensure effective use of all EHR functions. (2007-ongoing)

STAKEHOLDERS Health IT Vendors Providers/Provider Organizations Quality Organizations

6.9

2007		2008		2009		2010		2011		ONGOING >>