Leila Samy, MPH Rural Health IT Coordinator Office of the National Coordinator for Health IT

Leila Samy, MPHRural Health IT CoordinatorOffice of the National Coordinator for Health IT

Hometown Health: Health IT and HIPAA WorkshopSeptember 26, 2014Macon, Georgia

Rural Health and Veteran Health

Office of the National Coordinator for Health IT 2

Leila SamyHHS Office of the

National Coordinator for Health IT

Within an agency charged with promoting nationwide adoption of technology in healthcare to transform healthcare delivery, my efforts are centered on ensuring that rural communities are not left behind.

What We’ll Cover Here

1. Data and trends in Health IT and eHealth• National• Georgia• Rural• CAH

2. White House Rural Council initiatives • rural health • veteran health

3. Links to resources• What ONC has done to support rural health and Veterans• Tools and resources for CAHs/rural hospitals adopting health IT• Federal financing programs• Privacy and Security resources


Hospitals receiving incentive payments for EHR Adoption or Meaningful Use: 2011-2013


Click here for animated version

http://dashboard.healthit.gov/quickstats/images/infographics/Hospitals-Receiving-Payments-for-MU-and-Adoption.gif

Percent of Physicians e-Prescribing through an Electronic Health Record: 2008-2013


Click here for animated version

http://dashboard.healthit.gov/quickstats/images/infographics/Percent-Physicians-eRx-through-EHR.gif

6

Created by HHS Office of the National Coordinator for Health IT, Office of Economic Analysis, Evaluation, and Modeling

2008 20102009 2011 2012 2013

Percent of Physicians e-Prescribing through an Electronic Health RecordLocal Area Trends of EHR Adoption, 2008-2013

2008 20102009 2011 2012 2013



7

2008 20102009 2011 2012 2013



8

2008 20102009 2011 2012 2013



9

2008 20102009 2011 2012 2013



10

2008 20102009 2011 2012 2013



11

Office of the National Coordinator for Health Information Technology 12

Note: Payments for May 2012 and June 2013 include payments to Medicare Advantage providers.

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11Jul-1

1

Aug-11

Sep-11

Oct-11

Nov-11

Dec-11Jan

-12

Feb-12

Mar-12

Apr-12

May-12

Jun-12Jul-1

2

Aug-12

Sep-12

Oct-12

Nov-12

Dec-12Jan

-13

Feb-13

Mar-13

Apr-13

May-13

Jun-13Jul-1

3

Aug-13

Sep-13

Oct-13

Nov-13

Dec-13Jan

-14

Feb-14

Mar-14

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

38.0131.0463.0346.0872.01063.01631.02738.0

3524.04445.0

7274.09152.0

11890.0

18241.0

15386.017332.018055.0

9167.09341.0

11427.012831.0

9480.0

11996.0

13967.0

19938.0

23342.0

25653.0

35575.0

2296.0

6796.0

10738.0

4116.04883.04564.04393.05965.0

7184.08327.0

16116.0

Monthly Total

Cumulative Total

Num

ber o

f Uni

que

Prov

ider

s Pa

id M

onth

ly (t

hous

ands

)

Cum

ulati

ve U

niqu

e Pr

ovid

ers

Paid

Cumulative Providers Paid

371,673

Source: CMS EHR Incentive Program Data as of 03/31/2014

Eligible Professionals and Hospitals Paid under the Medicare or Medicaid EHR Incentive Program

371,673 unique eligible professionals and hospitals (7 out of 10 of all eligible providers) have received a payment under the Medicare or Medicaid EHR Incentive Program

13Office of the National Coordinator for Health Information Technology

Jan-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11Jul-1

1

Aug-11

Sep-11

Oct-11

Nov-11

Dec-11Jan

-12

Feb-12

Mar-12

Apr-12

May-12

Jun-12Jul-1

2

Aug-12

Sep-12

Oct-12

Nov-12

Dec-12Jan

-13

Feb-13

Mar-13

Apr-13

May-13

Jun-13Jul-1

3

Aug-13

Sep-13

Oct-13

Nov-13

Dec-13Jan

-14

Feb-14

Mar-14

$0

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

$1,800

$0

$5,000

$10,000

$15,000

$20,000

$25,000Cumulative Total

$22,904

Monthly Total

Cumulative Total

Amou

nt P

aid

per M

onth

(Mill

ions

)

Cum

ulati

ve A

mou

nt P

aid

(Mill

ions

)

$1,254.5

Source: CMS EHR Incentive Program Data as of 03/31/2014

Payments under the Medicare or Medicaid EHR Incentive ProgramEligible Professionals and Hospitals

The Medicare and Medicaid EHR Incentive Programs have cumulatively paid $22.9 billion in incentive payments as of March 2014

Note: Payments for May 2012 and June 2013 include payments to Medicare Advantage providers.

HOW ARE WE DOING IN GEORGIA?Progress with Health IT Adoption and eHealth in Georgia


How are we doing in Georgia?


HOW ARE WE DOING IN RURAL?Progress with Adoption of Health IT and eHealth


Rural: 38%

Total: 34%Small primary care practices: 35%

Note: From 2009 to 2011, the adoption rate for rural providers *more than doubled* and the percentage of rural physicians that have adopted EHRs slightly higher than for physicians overall

Basic EHR adoption among office-based physiciansin rural areas and small primary care practices

Rural refers to physicians in a county outside of a Metropolitan Statistical Area. Small primary care practices refer to primary care physicians in practices with 10 or fewer physicians. Data source: National Ambulatory Medical Care Survey (NAMCS) Electronic Health Record Supplement mail

surveys, 2008-2011.

How Are We Doing in Rural Areas?

Dec-08Jan

-09

Feb-09

Mar-09

Apr-09

May-09

Jun-09Jul-0

9

Aug-09

Sep-09

Oct-09

Nov-09

Dec-09Jan

-10

Feb-10

Mar-10

Apr-10

May-10

Jun-10Jul-1

0

Aug-10

Sep-10

Oct-10

Nov-10

Dec-10Jan

-11

Feb-11

Mar-11

Apr-11

May-11

Jun-11Jul-1

1

Aug-11

Sep-11

Oct-11

Nov-11

Dec-11Jan

-12

Feb-12

Mar-12

Apr-12

0%

1000%

2000%

3000%

4000%

5000%

6000%

7000%

8000%

9000%

10000% 94%

92%

Percent of Pharmacies in Urban and Rural CountiesEnabled on the Surescripts Network

Percent Enabled (Urban) Percent Enabled (Rural)

Percent Active December 2008: Urban 75%, Rural 61%Percent Active April 2012: Urban 93%, Rural 91%

Note: From 2009 to 2012, rural pharmacies actively prescribing medication electronically *in-creased by 50%*

19Office of the National Coordinator for Health IT

How Are We Doing in Rural Areas?

Rural Overall0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

82%

94%

Hospitals

Payment Rates of Rural and Overall for Hospitals and ProfessionalsNovember 2013

Rural professionals are participating in the

EHR Incentive Programs at roughly the same rate as the

national trend.

However, rural hospitals are lagging

behind the overall trend.

Rural Overall

46% 46%

Professionals

Office of the National Coordinator for Health IT

http://dashboard.healthit.gov/

04/11/2013 Attested Not Attested

from the HHS Office of the National Coordinator for Health IT

87 Percent of CAHs/SRHs Attested to MU Stage 1

Map identifies SRHs and CAHs (n=1.772) from the

American Hospital Association and determines attestation status based on

CMS EHR Incentive Program.

Location of Small Rural Hospitals (SRH) and Critical Access Hospitals (CAH) by Attestation Status

February 2014

Leila Samy, MPH Rural Health IT Coordinator Office of the National Coordinator for Health IT

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