Friday, October 07, 2011

#COEHITR - Panel Discussion about #HIT strategic Roadmap in MD

Panel Discussion: Health Reform in Maryland and the 

Health IT Strategic Roadmap

David Horrocks, President, Chesapeake Regional Information System for our Patients (CRISP)
Carolyn Quattrocki, Executive Director, Governor's Office of Health Reform
David Sharp, Ph.D., Director, Center for Health Information Technology
Ben Steffen, Acting Executive Director, Maryland Health Care Commission

Moderator: Ritu Agarwal, Ph.D., Professor and Robert H. Smith Dean's Chair of Information Systems, Director of CHIDS

David Horrocks: CRISP

CRISP is the MD Health Information Exchange. Started looking at how to improve the sharing of health data to support seniors.
CRISP is a not for profit membership corporation.

28 of 46 hospital systems connected.  Pushing to get rest online.
Also run the Regional Extension Center (RECs out of HHS/ONC)

Carolyn Quattrocki, Governor's Office of Health Reform

Health Reform - one of 15 of Governor's goals is to establish a state-wide HIE.

David Sharp - Center for HIT

Health IT is more than just Technology. Empowered to expand use of technology. How to get EMRs adopted. 
Telemedicine and Telehealth.

Ben Steffen - MD Healthcare Commission
Broad authority across MD Health economy. $40B industry in the state.
Work with MD Insurance Administration.

Collaboration is critical as we move forward.
Oversee quality reporting initiatives.
Policy think tank for policymakers. 
Distribution of physicians is sub-optimal.
Working out how to take advantage of Health IT

Q & A

How do we make MD the Number one state in Health Transformation?

David H: HIE in the top quartile. MD may have more hospitals connected than any other state. North East states have made the biggest investments in interoperability.  Medicare waiver: State handles medicare differently. This gives some flexibility.  50 different organizations participate on advisory boards for the HIE.

David S: Trust - very successful in building trust amongst all the players in Health. This puts the State ahead of every other State in the country. Sharing data was agreed as an area that it was not beneficial to compete. Collaboration was more effective. One of first 3 states to have plans approved by ONC.

Carolyn Q: medical leaders combined with political leadership has created a great foundation for transformation. 

Ben S: Don't care where we are. Challenge is to connect all Acute Care Hospitals by end of 2011. 2nd goal is subscription of primary care practices to HIE. More daunting challenge is how we engage small practices. 

What happens when Federal Funding dries up. What Business Models are we establishing to create a sustainable environment?

David S: $26M of Fed funding for training. + $10M of state funding. State model is that everyone pays to participate. Is there value to consumers participating? Still uncertain.

David H:  Feds applying $20B to push adoption of EMRs because existing incentives are misaligned. ie/ we reward pay for volume not quality. We need payment reform that drives quality. incentives are needed to keep patients out of hospitals. 

Carolyn Q: we need to look at direct and indirect incentives.  We need HealthCare Delivery reforms to create a sustainable health economy. Health Benefit Exchange may bring opportunities. Use clearinghouse approach - like UTAH, or use purchasing power of the exchange to drive change. e.g. requires incentives for HIT adoption.

How do we address Health Disparities:

Ben S: Too often we don't focus on the injustice of unequal access to health services. 

What Research Question would you like to see answered?

Rapid Cycle Evaluation - We need help to tune initiatives not posthumous reviews.

How can we engage consumers in all socio-economic categories that will improve health literacy and access and will improve the health system.

What will bring the Consumer to the Table?

Key to health reform is in cost and quality changes. 

We need to make Health easy. People will pay for convenience! Steve Jobs proved this when iTunes/iPod effectively competed against music piracy.

We will know we are making progress in Health when a tagline like "I'm Lovin it" is associated with Health and Wellness not fast food

How about using Amazon shopping-style analytics to help consumers take better care of themselves.  Crowd as a Service to drive behavior change.

Hey folks give up on looking for the silver bullet. We need lots of 10% solutions people can choose from to meet their own needs.

Transparency/Coverage/Cost all come together. Give us the facts so we can make sensible decisions.  Otherwise we are not partners in our own care.

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