Putting the Meaning into “Meaningful Use”

Joshua Seidman, PhDActing Director, Meaningful UseOffice of Provider Adoption SupportOffice of the National Coordinator for HIT

A Seasonal View of Meaningful Use

A Seasonal View of Meaningful Use

Grass Meaningful Use of Grass

A Personal View on Meaningful Use……Because Getting to MU Can Be a Painful (But Rewarding) Experience

Running ShoesMeaningful Use of Running Shoes

2010 Boston Marathon

Getting to Meaningful Use……To Improve Health & Health Care

TECHNOLOGY ADOPTION

PRACTICE REDESIGN

CONSUMER ENGAGEMENT

HEALTH INFORMATION

EXCHANGE

MEANINGFUL MEANINGFUL USEUSE

OUTCOMES•Better Health•Transformed Care Delivery

•Reduce Health Disparities

Staging of “Meaningful Use”

Focus of:

Stage 1

Stage 3

Stage 2

• HITECH goals– Not about technology– Improving health and transforming health care through

meaningful use of HIT

Framework: HIT Policy Committee’s Recommended Five Priorities

• Improve quality, safety, efficiency and reduce health disparities

• Engage patients & families in their health care• Improve care coordination• Improve population and public health• Ensure adequate privacy & security protections for

personal health information

……Time to GetTime to GetMUVingMUVing

Getting There…Getting There…

Meaningful Use Vanguard Cohort (MUVers)

• MUVers will be role models and practices of excellence

• Early adopters and thought leaders

• Provide input in evaluation of achievement of Stage 1 MU objectives

• MUVers can be a testing ground for other initiatives –e.g., PCMHs

What the MUVCohort Will Do

Gaps Advance MU Train

Spotlight HITRCtool needs

Build MUmomentum

Highlightbest practices

Identify neededMU CoPs

Case studies ofearly adopters

Open-sourceQM tools

Educate on Medicaid/state-specific issues

MU testing system

Identify challenges/trip wires

POSITION FOR PCMH, ACOs, OTHER HEALTH REFORM INNOVATIONS

Thinking Long-Term AboutMeaningful Use

Stage 2 MU Development Process

Stage 2 MU

Real-WorldExperience

With Stage 1

HITPC Stage 2Recommendations

HIT Policy Committee MU Workgroup: Patient/Family Engagement Hearing

• Public hearing held April 20• FACA (Federal Advisory Committee) blog

– 50+ comments – Input accepted at http://healthit.hhs.gov/blog/faca/

• Part of planning trajectory for evolution of MU definition (Stages 2 & 3)

Themes Emerging from Hearing & Blog

• Provide real-time patient access to data • Incorporate patient-generated data into EHR • Encourage innovation

– Connect home/community to care delivery settings– Consider a bold initiative (e.g., 50% of care rendered at home)

• Create sense of community among patients & with health team– Achieve 4 Es: engage, educate, empower, and enable– Meet needs of diverse population

• Focus more on patient outcomes measures– vs. traditional process measures

• Engage with the public about MU– Consider re-orienting MU criteria to what's meaningful to patients

June 4 HITPC/MU WG HearingFocused on Health Disparities

• Using HIT to reduce disparities– Focus on solutions

• Three panels– Health literacy & data collection– Culture (includes language)– Access — to:

• Health care

• Health information

• Technology

Agenda OverviewPanel 1: Health Literacy & Data Collection• Moderator: Neil Calman• Sara Czaja, University of Miami• Cynthia Solomon, MiVia• Gena Wilson, The Institute for Family Health [invited]• Silas Buchanan, The Cave Institute

Panel 2: Culture• Moderator: Joshua Seidman• Russell Davis, National Health IT Collaborative for the Underserved• M. Chris Gibbons, Johns Hopkins Urban Health Institute• Dianne Hasselman, Center for Health Care Strategies• Deena Jang, Asia/Pacific Islander American Health Forum

Panel 3: Access• Moderator: George Hripcsak• Carolyn Clancy, Agency for Healthcare Research & Quality, HHS• Howard Hays, MD, Indian Health Service, HHS• Ian Erlich, Maniilaq Association, Alaska [invited]• R. Scott Hawkins, Boston Healthcare for the Homeless• Cesar Palacios, Proyecto Salud Clinic

Questions to Panelists

• What are greatest risks of HIT implementation in increasing disparities?

• What innovations can prevent these risks?• What research can guide HIT implementers?• What patient/family engagement strategies

can help support future MU of HIT?• How can MU of HIT reduce disparities?• What HIT applications can improve literacy,

access, cultural relevance of health info?

Some Strategies to Pursue

• Ignoring technology not a viable strategy• Ethnographic observation to identify needs

– Meet people where they are

• EHR-generated data to tailor health info• Implications of making chart patient-accessible

Changing what clinicians record• Translation of clinical & administrative data• Multimedia: Not only text-based health info• Interactive approaches

Engaging with ONC in Blogosphere & Twittersphere

Health IT Buzz• http://healthit.hhs.gov/blog/onc/

Federal Advisory Committee Hearings• http://healthit.hhs.gov/blog/faca/

Real-Time Updates on Twitter• https://twitter.com/ONC_HealthIT