Keynote "Health IT Through your Customers’ Eyes: What Meaningful Use and The HIT Strategic Plan Say About The Changing Health Care Market" Since 2009 the federal EHR incentive program has challenged providers to adopt, use, and interoperate with new information technologies. The criteria for incentive payments sometimes seem burdensome or irrelevant to providers. Most recently, a federal HIT strategic plan has outlined the likely federal programs and requirements over the next six years. This session will dissect the competing interests shaping these programs, and what large public and private health care purchasers - including CMS and large employers - are expecting from IT investments over the next decade. Learning Objectives: Gain understanding of the evolving drivers of meaningful use criteria since 2009 Gain understanding of the current debate about the federal HIT strategic plan Gain understanding of what large health care purchasers are expecting providers to achieve with HIT adoption David Lansky, PhD Chief Executive Officer Pacific Business Group on Health

1. Health IT Through your Customers’ Eyes:
what meaningful use and the federal Health IT
Strategic Plan say about the changing health care
market
iHT2 HIT Summit
March 3, 2015
David Lansky, PhD
President and CEO

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PBGH Members
Apple
Facebook
Google
Hewlett Packard
Microsoft
Oracle
….

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We’re in a race…

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The rationale for EHR incentives

5. HIT Policy Committee
Meaningful Use Workgroup Presentation
Paul Tang
Palo Alto Medical Foundation
Farzad Mostashari,
New York City Health Department
June 16, 2009

6. Health IT and Transformed Health Care
6
• Ultimate vision is to enable significant and measurable
improvements in population health through a
transformed health care delivery system.
• Key goals*:
– Improve quality, safety, & efficiency
– Engage patients & their families
– Improve care coordination
– Improve population and public health; reduce disparities
– Ensure privacy and security protections
*Adapted from National Priorities Partnership. National Priorities and Goals:
Aligning Our Efforts to Transform America’s Healthcare. Washington, DC: National
Quality Forum; 2008.

7. Achievable Vision for 2015
• Prevention, and management, of chronic diseases
– A million heart attacks and strokes prevented
– Heart disease no longer the leading cause of death in the US
• Medical errors
– 50% fewer preventable medication errors
• Health disparities
– The racial/ ethnic gap in diabetes control halved
• Care Coordination
– Preventable hospitalizations and re-admissions cut by 50%
• Patients and families
– All patients have access to their own health information
– Patient preferences for end of life care are followed more often
• Public health
– All health departments have real-time situational awareness of
outbreaks

8. HIT-Enabled Health Reform
Achieving Meaningful Use
2009 2011 2013 2015
HIT-Enabled Health Reform
MeaningfulUseCriteria
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)
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Federal HIT – what it’s not…
• Not about more EHRs
• Not about clinical decision support
• Not about improved documentation
• Not about more HIE
It’s about transforming care to deliver value to the
public – and addressing the national debt.
Payments are conditional upon making progress
towards that goal.

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The shift to “value”

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Where are we now – with MU3?
• Far behind intended pace
of functional
advancement, quality
measurement, and
interoperability
• Significant provider
opposition and slow
uptake
• Perception of “burden”,
cost, and low value
• CMS making modest
accommodations
• Congress proposing
legislative curtailment of
pace and scope

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Reactions to MU3

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Entering a fundamentally new era
• Incentives for system redesign are escalating
• Market pressure will reward those who leverage
HIT and punish those who don’t
• MU incentives and penalties becoming less
important than market forces
• New federal planning to support desired payment
and delivery system environment
• New policy workgroups – like accountable care
• Interoperability roadmap
• Federal Health IT Strategic Plan

14. Vision
Accountable health models:
• Optimal patient/consumer and community health
• Aligned accountability for patient and community health that bridges
employers, health plans, hospitals, providers, communities, and patients
• Aligned financial incentives that encourage market competition to
optimize patient and community health
• Seamless integration of required clinical, financial, administrative, and
operational information across the entire continuum of care to eliminate
information gaps as a root cause of inefficient and ineffective patient care.
• Promotion of innovations and improvements to continuously discover,
test, and evaluate better ways to achieve health and healthcare outcomes
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16. 16
DRAFTSharedNationwideInteroperabilityRoadmap-Version0.5
TheVision
2021 - 2024
Broad-scale
learning health
system
2018 - 2020
Expand interoperable
data, users,
sophistication, scale
2015 - 2017
Nationwide ability to
send, receive, find,
use a common
clinical data set

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Federal HIT Strategic Plan: 2015-2020

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Reactions to Strategic Plan
• Strategic Plan should better integrate its focus on
individuals/consumers as a Health Improvement Plan, rather than
emphasizing data in a “Collect, Share, Use” framework
• The Plan’s focus should be how to build a culture of shared, person-
centered health and care goals, and how federal policies, programs,
and regulations will support individuals, providers, and community
partners to meet these goals
• Federal actions should unambiguously show how they facilitate and
reinforce the Triple Aim
• The end state is not a health IT infrastructure – it is the widespread,
effective use of digitized information to support improved health and
health care. The Plan should use language to emphasize the end, not
the means.

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Joint Recommendations for Refinement
• Articulate a pathway to evolve toward a new paradigm:
More dynamic, interactive learning system
Health equity for consumers and providers
Improved patient/family caregiver experience, as well as improved
empowerment and engagement through consumer participation
Accommodate a pluralistic data and care delivery environment
• Integrate public health and social determinants of health
into the health IT ecosystem and into health improvement
efforts
• Provide clear guidance on privacy framework
• Plan must hold federal partners accountable, with regular,
transparent reporting on progress toward goals

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A critical juncture…
• We are six years into a journey to transform the
health care system.
• We have new commitments to accelerate the
changes in incentives – but they can’t succeed
without modern information flows.
• The health IT sector has to embrace and lead the
change.