Interoperability Framing Joint HITPC and HITSC Meeting October 15, 2014 Erica Galvez...
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Transcript of Interoperability Framing Joint HITPC and HITSC Meeting October 15, 2014 Erica Galvez...
Interoperability FramingJoint HITPC and HITSC MeetingOctober 15, 2014
Erica GalvezInteroperability Portfolio Manager
ONC
Office of the National Coordinator for Health Information Technology
2
Interoperability
• Formally: The ability of a system or product to work with other systems/products without special effort on the part of the customer. Interoperability is made possible by the implementation of standards. (Institute for Electrical and Electronics Engineering )
• In simple terms: All individuals, their families, and their health care providers have appropriate access to health information that facilitates informed decision-making, supports coordinated health management, allows patients to be active partners in their health and care, and improves the overall health of our population.
Office of the National Coordinator for Health Information Technology
3
Health IT Adoption in the Care Delivery System
2001 02 03 04 05 06 07 08 09 10 11 12 20130
20
40
60
80
100
18 17 1721 24
2935
4248 51
57
7278
10.5 11.816.9
21.827.9
33.939.6
48.1
Perc
ent
Any EHR system
Basic system
2001 02 03 04 05 06 07 08 09 10 11 12 20130
20
40
60
80
100
9.4 12.215.6
27.6
44.4
59.4
71.9
85.2
94
Perc
ent
Certified EHR
Basic system
NOTES: EHR is electronic health record. “Any EHR system” is a medical or health record system that is either all or partially electronic (excluding systems solely for billing). Data for 2001–2007 are from in-person National Ambulatory Medical Care Survey (NAMCS) interviews. Data for 2008–2010 are from combined files (in-person NAMCS and mail survey). SOURCE: CDC/NCHS, National Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey, Electronic Health Records Survey.
NOTES: Basic EHR adoption requires the EHR system to have a set of EHR functions defined in Appendix 1. A certified EHR is EHR technology that has been certified as meeting federal requirements for some or all of the hospital objectives of the CMS EHR Incentive Program. Possession means that the hospital has a legal agreement with the EHR vendor, but is not equivalent to adoption.SOURCE: ONC/American Hospital Association (AHA), AHA Annual Survey Information Technology Supplement
Office-Based Physicians Non-Federal Acute Care Hospitals
EHR Adoption
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In 2012, 5 in 10 received discharge summaries routinely; half of those received it electronically
Physician Adoption of HIE
ONC-NCHS analysis of NEHRS 2012-2013
• Lab results: 36%• Imaging reports: 34%• Problem lists: 33%•Medication lists: 34%•Med allergy lists: 34%
In 2013, about one-third of physicians exchange different types of data
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Hospital Adoption of HIE
51% able to query patient health information electronically
41% able to send and receive secure messages containing patient
health information to and from external sources
SOURCE: Office of the National Coordinator for Health Information Technology. 'U.S. Hospitals' Capability to Electronically Query Patient Health Information from Outside Their Organization and System,' Health IT Quick-Stat, nos. 25 & 27. April 2014.
Hospital Exchange With…
2008
Any provider outside the organization
Other hospitals outside the organization
Ambulatory providers outside the organization
Other hospitals inside the organization
2012
58%41%
47%
36%
15%
65%
51%
36%
Source: ONC/AHA, AHA Annual Survey Information Technology Supplement, 2012
7Office of the National Coordinator for Health Information Technology
Office of the National Coordinator for Health Information Technology
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Community and State-based Exchange Infrastructure & Services
State HIE Program: Operational CoreInfrastructure Services
9
90%
At least 1 operational Health Information
Service Provider
73%
At least 1 operational master patient index
69%
At least 1 operational provider directory
67%
At least 1 operational provider authentication
service
Q4 2013
*N = 51 states and DC; territories excluded.*
Q2 2012
59%
At least 1 operational Health Information
Service Provider
33%
At least 1 operational provider directory
At least 1 operational master patient index
29%
43%
At least 1 operational provider authentication
service
Office of the National Coordinator for Health Information Technology
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Public Health
• Most state* health departments accept electronic data aligned with MU measures:– 48 states are electronically receiving data for immunizations– 47 states are electronically receiving data for electronic lab
reporting– 43 states are electronically receiving data for syndrome
surveillance– 36 states are electronically receiving data for cancer
As of October 8, 2014*N=51 (all states + District of Columbia)
Office of the National Coordinator for Health Information Technology
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Transactions
State HIE Program:Quarterly Directed Exchange Transactions
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Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2013 Q3 2013 Q4 20130
50,000,000
100,000,000
150,000,000
200,000,000
250,000,000
72,766,216
70,719,991
147,433,270
168,111,802
155,067,622
157,588,707
236,639,280
Total number of directed exchange transactions per quarter
Reporting period
Dire
cted
tran
sacti
ons
CA, IN, MN and UT reported a decrease > 100 from Q2 ‘12 to Q3 ‘12.
AR, HI, ME, MI, MS, NE, PA, TX and WY reported a decrease > 100 from Q1 ‘13 to Q2 ‘13.
State HIE Program:Quarterly Patient Record Queries
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Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2013 Q3 2013 Q4 20130
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
7,000,000
8,000,000
1,621,749
2,648,397
5,250,223
4,276,042
5,051,047
6,469,248
7,030,659
Total number of patient record queries per quarter
Reporting period
Patie
nt re
cord
que
ries
MI, MN, NE, NJ, NC, OK, UT, and WV reported a decrease > 100 from Q4 ‘12 to Q1 ‘13.
Office of the National Coordinator for Health Information Technology
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Sample EHR Technology DeveloperTransactions
Company one:• Total C-CDA transactions in July 2014: 2.7+ million• C-CDA transactions to other vendors in July 2014: 2.5+ million
Company two:• CCDAs exchanged using MU2 standards: 20 million per month• Web service calls: 75 million per month• Interface messages (HL7 v2, HL7 v3 (XML), NCPDP (XML), CDA
(HL7 v3 XML), ANSI (X12), DICOM): 5-7 billion per month• Messages sent to public health: 15.1 million per month• Immunizations only (also included in public health number above):
5.1 million per month
Office of the National Coordinator for Health Information Technology
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Expanding Ecosystem
Office of the National Coordinator for Health Information Technology
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New Technologies, Data Sources, Data Users
Office of the National Coordinator for Health Information Technology
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Governance
Office of the National Coordinator for Health Information Technology
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Varied Landscape
Office of the National Coordinator for Health Information Technology
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Discussion