Lecture 1 Intro to Healthcare informatics (2) PDF

03/17/2024 HCMT 2001 Hospital Functions and Management Topic 1: Introduction to Healthcare management www.udst.edu.qa What is healthcare informatics? 1 03/17/2024 What is healthcare informatics? Interdisciplinary, scientific field that studies and pursues the effective uses of biomedical data, infor...

03/17/2024 HCMT 2001 Hospital Functions and Management Topic 1: Introduction to Healthcare management www.udst.edu.qa What is healthcare informatics? 1 03/17/2024 What is healthcare informatics? Interdisciplinary, scientific field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving and decision making, motivated by efforts to improve human health (American Medical Informatics Association) Informatics is more about information than technology (with the technology acting as a tool) Friedman has defined a “fundamental theorem” of informatics, which states that informatics is more about using technology to help people do cognitive tasks better than about building systems to mimic or replace human expertise Source: Hersh W, Advice to a Young Person Considering a Career in HI. July 3, 2014. Blog(Informatics Professor). Recommendation Of The International Medical Informatics Association (IMIA) 4 2 03/17/2024 What is Health Informatics? “ Patient/Person/Human Centered Digital Health 5 What is Health Informatics? Hersh W, A stimulus to define informatics and health information technology. BMC Medical Informatics & Decision Making, 2009. 9: 24. http://www.biomedcentral.com/1472-6947/9/24/. 6 3 03/17/2024 What are the competencies required? Hersh W, A stimulus to define informatics and health information technology. BMC Medical Informatics & Decision Making, 2009. 9: 24. http://www.biomedcentral.com/1472-6947/9/24/. 7 What is Health Informatics? Hersh W, A stimulus to define informatics and health information technology. BMC Medical Informatics & Decision Making 2009. 9: 24. http://www.biomedcentral.com/1472-6947/9/24/. 8 4 03/17/2024 Qatar’s E-Health Program Mission & Goals “Ministry of Public Health.” Ministry of Public Health , www.moph.gov.qa/english/strategies/Supporting-Strategies-andFrameworks/NationalEHealthAndDataManagementStrategy/Pages/default.aspx. 9 Learning objectives Define what healthcare informatics is Discuss some of the most significant influences shaping the current and future health information technology landscapes in the United States Understand the roles national private sector and government initiatives have played in the advancement of health information technology in the United States Describe major events since the 1990’s that have influenced the adoption of health information technologies and systems 5 03/17/2024 Learning Objectives ▸ ▸ ▸ Increasing use of Health information technology (HIT) across all aspects of US health care delivery system since the 1990s resulted in Electronic health records (EHR), telehealth, social media, mobile applications Today, health care providers and organizations depend on reliable Health information technology (HIT) to aid in ▹ managing population health effectively, ▹ while reducing cost and ▹ improving quality patient care. Health information technology (HIT) development was affected by advance in information technology, as well as government and private sector actions. This chapter will provide a chronological overview of the significant government and private sector actions that affected the adoption of Health information technology (HIT). 11 History of Healthcare informatics 6 03/17/2024 Outline 1990’s: The Call for Health information technology (HIT) Institute of Medicine (IOM) Health Insurance Portability and Accountability Act (HIPAA) 2000 – 2010: The Arrival of HIT Health Information Technology for Economic and Clinical Health (HITECH) Act 2010 – Present: Health Care Reform and the Growth of HIT Affordable Care Act (ACA) Medicare Access and CHIP Reauthorization Act (MACRA) Value-based & alternative payment programs 13 Institute of Medicine (IOM) 1990’s: The Call for Health information technology (HIT) 1991: Published a report on the problems with paper-based medical records and called for computer-based patient records (CPR). Computer-based patient records (CPR) defined by Institute of Medicine (IOM) as “an electronic patient record that resides in a system specifically designed to support users by providing accessibility to complete and accurate data, alerts, reminders, clinical decision support systems, links to medical knowledge, and other aids”. 14 7 03/17/2024 1990’s: Computer-based patient records (CPR) offered more than electronic The Call for records, version of paper Health it assisted clinicians in caring for the patient by providing him or her with reminders, alerts, clinical decision, support capabilities and information access to the latest research findings. technology they were adopted by 10% of hospitals and less than 15% of physical practices in 2001. IOM goal was not met. (HIT) Institute of Medicine (IOM) 15 The Health Insurance Portability and Accountability Act (HIPAA) 1996: Signed by President Bill Clinton Designed primarily to make health insurance more affordable and accessible Simplifies administrative processes Protects security and confidentiality of personal health information Brought national attention to the use of health information in electronic form. 16 8 03/17/2024 2000–2010: The Arrival of Health information technology (HIT) Institute of Medicine (IOM) Patient Safety report: 17 Institute of Medicine (IOM) published a report that estimated 44,000-98,000 patients die each year due to medical errors. This report focused on errors that occur in hospitals. A subsequent report by the Institute of Medicine (IOM) in 2004 called for organizations to adopt information technology capable of collecting and sharing essential health information on patients and their care. The report examined the incidence of serious safety issues in facilities other than hospitals. 2003: Medicare Modernization Act 2004: Office of the National Coordinator for Health Information Technology (ONC) 2009: Health Information Technology for Economic and Clinical Health (HITECH) Act 9 03/17/2024 2000–2010: The Arrival of Health information technology (HIT) Transparency and Patient Safety: 2000 2007 2003 The federal government promoted health care transparency and furthering the adoption of health information technology (HIT). The Medicare Modernization Act was passed in 2003, it expanded the program to include prescribing drugs and mandate the use of electronic prescribing. In 2004 President Bush called for the widespread adoption of electronic health records (EHR). In 2006 he issued an executive order to make price information publicly available, 2010 Providers started recognizing the importance of adopting improved health information technology (HIT) to collect and transmit the data needed under the different changes in reimbursement practices 19 2000–2010: The Arrival of Health information technology (HIT) Office of the National Coordinator for Health Information Technology (ONC): 2004 In 2004 president bush established the Office of the National Coordinator for Health Information Technology (ONC) and charged it with providing “leadership for the development and nationwide implementation of an interoperable health information technology 2009 In 2009 the role of the ONC was strengthened when the Health Information Technology for Economic and Clinical Health (HITECH) Act mandated it to provide leadership and oversight of the national efforts to support the adoption of Electronic health records (EHRs) and health information exchange (HIE). 2010 By the end of the decade only 25% of physician practices and 12% of hospitals implemented basic EHR systems. The low adoption of EHR is due to the cost of HIT and the misalignment of incentives (patients, payers and purchasers benefited while physicians bear the cost) 20 10 03/17/2024 2010–Present: Health Care Reform & HIT Growth Health Information Technology for Economic and Clinical Health (HITECH) and Meaningful Use: o Eligible professionals and hospitals that adopt, implement or upgrade to a certified EHR received incentive payment. o “Demonstrating meaningful use” of electronic health records (EHR) granted additional payment. o Three stages of meaningful use criteria were developed over a five-year period Stage 1: focused on data capturing or sharing Stage 2: intended to advance clinical processes Stage3: aim to show improved outcome 21 2010–Present: Health Care Reform & Health information technology (HIT) Growth Health Information Technology for Economic and Clinical Health (HITECH) and Meaningful Use (cont.): 2010 Each eligible professional who adopted and achieved meaningful electronic health record (EHR) use in 2011 or 2012 was able to earn up to $44,000 over a five-year period. The amount decreased over the period, creating incentives to providers to start sooner rather than later. 2013 Eligible providers who apply for the EHR Medicare and Medicaid Incentive Programs are required to use certified EHR technology. The Office of the National Coordinator for Health Information Technology (ONC) has authorized certain organizations to perform the actual testing and certification of EHR systems. 2018 As of December 2015, more than 482,000 health care providers received a total of over $31 billion in payments for participating in the Medicare and Medicaid EHR Incentive Programs. 2022 Eligible hospitals could earn over $2 million through the Medicare EHR Incentive Program, and the Medicaid program made available up to $63,500 for each eligible professional (through 2021) and over $2 million to each eligible hospital. 22 11 03/17/2024 2010–Present: Health Care Reform & HIT Growth Other Health Information Technology for Economic and Clinical Health (HITECH) Programs o Health Information Technology for Economic and Clinical Health (HITECH) funded sixty-two regional extension centers (RECs) throughout the nation to support providers in adopting and becoming meaningful users of electronic health records (EHRs). o The education-based programs included curriculum development, community college consortia, competency examination, and university-based training programs, with the overarching goal of training an additional forty-five thousand HIT professionals. o provided state grant to help build the infrastructure for secure exchange of health information among providers and between providers and consumers. 23 2010–Present: Health Care Reform & Health information technology (HIT) Growth Affordable Care Act: 2010 in 2010 president Obama signed the Patient Protection and Affordable Care Act (PPACA) known as the Affordable Care Act (ACA) in an attempt to achieve the simultaneous triple aims to: Improve patient experience of care, Improve the health of populations, 2015 2015: Medicare Access and CHIP Reauthorization Act (MACRA) Value-based payment methods Alternative payment methods 2022 The final assessment of the success of (Affordable Care Act) ACA is still unknown, however it heavily relies on quality health information technology (HIT). reduce per capita cost of health care 24 12 03/17/2024 Interoperability Definition The ability of a system to exchange electronic health information with and use electronic health information from other systems without special effort on the part of the user HIT Interoperability Efforts ▸ it remains hard to achieve. ▸ Connect: electronic health records (EHRs), health information technology (HIT), home health monitoring systems, telehealth, and large public health databases at state and national levels. ▸ US: the Office of the National Coordinator for Health Information Technology (ONC) published a ten-year plan for achieving health information technology (HIT) interoperability in the US. The goal for 2024 is nationwide interoperability. 25 Interoperability Organizations Health Level Seven International (HL7): focused on technical standards for health information exchange HL7 Fast Healthcare Interoperability Resources (FHIR): standards introduced in 2012 and are under development to improve the exchange of EHR data Sequoia Project: focused on legal and policy barriers associated with nationwide interoperability Common well Health Alliance: a consortium of health information technology (HIT) vendors and organizations who are committed to achieving interoperability. Started in 2013 with six EHR vendors, In 2015, their membership represented 70% of hospitals. 13 03/17/2024 Qatar’s E-Health Program Mission & Goals “Ministry of Public Health.” Ministry of Public Health , www.moph.gov.qa/english/strategies/Supporting-Strategies-andFrameworks/NationalEHealthAndDataManagementStrategy/Pages/default.aspx. 27 Barriers of Interoperability like a jigsaw puzzle with multiple public and private organizations working on different pieces. Concerns about the misalignment of incentives for achieving interoperability remain. Governance and alignment of agendas among disparate organizations NOT technology Health information blocking: occurs when persons or entities knowingly or unreasonably interfere with the exchange or use of electronic health information 14 03/17/2024 Videos Resources AMIA Video: The Promise of Reducing Medical Errors https://www.amia.org/why-informatics/promise-reducingmedical-errors AMIA Video: Why Informatics: https://www.amia.org/why-informatics2 1 3 2 AMIA Video: The Art and Science to Transform Care https://www.amia.org/why-informatics/art-andscience-transform-care 29 Summary 1990’s: The Call for HIT IOM HIPAA 2000 – 2010: The Arrival of HIT HITECH Act Value-based & alternative payment programs 2010 – Present: Health Care Reform and the Growth of HIT Interoperability 30 15 03/17/2024 Conclusion 16