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Session Descriptions

Meeting Provider HITECH Needs: The Vendor Perspective
The panel will: Describe the process by which NC vendors are getting organized for EHR deployment, including the support of the vendor selection and group purchasing assistance specified in Section 3012 of the ARRA HITECT stimulus funding FOA; Discuss vendor commitment to supporting NC installations; Describe how providers can best engage the vendors to make sure they are selecting the appropriate system for the business/clinical needs and stimulus goals; and Discuss how vendors can support the regional extension centers.

NC's Plans for An ARRA HITECH Regional Extension Program
The presenter will describe NC’s provider assistance plans specified in Section 3012 of the ARRA HITECH funding FOA.

Bringing ARRA Home to NC: Plans for Applying for & Managing Stimulus Funding
Presenters will discuss NCHICA’s commitment to NC’s success; How the State has organized the efforts; HWTFC’s responsibilities for the Section 3013 application and management of the funds; The role of the HIT Collaborative in providing advice, guidance and support for the application development and coordination with other ARRA efforts (3012 and Broadband); and the application for a Regional Extension Center to support EHR adoption and meaningful use. There will be time for Q&A as well.

Why CPOE?.....and Its Unintended Consequences
As technology becomes more and more prevalent in the healthcare arena, many hospitals are asking the question, "Is this the time to invest in CPOE?" Many articles speak about the benefits of implementing CPOE. The obvious benefits of a CPOE implementation are reducing medication errors and reducing turn-around time, but at what cost? Can CPOE actually have a dollar value besides the actual cost of the project? What other benefits will come from such an expansive project? What about the unintended consequences of implementing CPOE? Are they good or bad or both? CPOE creates many eye-opening impacts. Each consequence must be addressed to determine how to use beneficially or mitigate the impact.

Presenters will address the question of "Why CPOE?" The benefits of implementing CPOE are many and the project can be successful with careful and detailed planning. Once CPOE is live the question becomes what next? Addressing the unintended consequences of implementing CPOE becomes the next generation of challenges that will be addressed in our presentation.

Session Objectives:

  • List the reasons and benefits to moving forward with a CPOE implementation.
  • Describe the potential unintended consequences of implementing CPOE, both good and bad.
  • Discuss how good project planning and paying attention to detail can help mitigate negative consequences and promote positive ones.

The Future of HIE: Meeting Unmet Needs
Health Information Exchange (HIE) is currently at a crossroad. Even the most successful of the current health information organizations (HIOs) are facing numerous daily challenges including sustainability and multiplying regulations. Fresh ideas and money, however, are making their way into the system, giving new possibilities and challenges. This presentation will summarize current and previous efforts at broad HIEs, including functionality, participation and sustainability models, and present ideas on possible future developments with the assumption that HIE will develop to address current and future unmet needs. The presentation will address specific issues such as sustainability, functionality, governance, organizational structure, IT models (e.g., federated and repository models) as well as likely developments in the law that may help or hinder electronic exchanges of health information. The talk will also delve deeply into the failure of current HIEs to consistently and uniformly meet some of the needs of end-users. Looking at those needs, the presenter will make some broad estimations of where HIE may be directed in the next few years and ways to create and sustain HIOs.

Session Objectives:

  • List current regulations affecting the electronic exchange of health information.
  • Discuss the impact of any ultimate stimulus package on the creation of HIOs.
  • Describe the various legal structures from which HIEs may take place.

Understanding Government EHR Incentives - What's In It for Me?
As 2011 draws closer, physicians and administrators are being bombarded with marketing initiatives from vendors and advice from consultants, urging them to move quickly to adopt an EHR, or to buy one EHR in particular. In order to make the right decision, practices need to arm themselves with a complete and accurate understanding of the facts related to the legislation, and must keep up-to-date on the moving targets of "meaningful use" and EHR certification-a daunting proposition given the speed and frequency at which regulations are being proposed and modified. Misinformation and misconceptions abound. This session will clarify the legislation-detail its components, explore its implications, and relate it to your practice.

Session Objectives:

  • Analyze the latest proposals on "meaningful use" and certification
  • Understand how to evaluate the impact on your practice
  • Develop a framework for making the right decision

The Implications of HIE on Healthcare Consumers: The Case of Consumer Empowerment
Emerging technological innovations such as personal health records, electronic health records and the Nationwide Health Information Network provide the ability to increase the sharing of medical records among healthcare stakeholders. Although there are concerns with the electronic sharing of medical records, such as the security of the records, these technologies have the potential to improve the quality of healthcare. Recent studies show that patients want more control over their medical records, which health information exchange (HIE) can allow. Does this notion of consumer control create consumer empowerment? In their discussions on HIE initiatives and technological adoption, many healthcare stakeholders have emphasized the need for consumer empowerment.

The purpose of this examination is to learn more about the implications of HIE on healthcare consumers and how consumer empowerment is discussed by three groups: an AHIC Consumer Empowerment Group, the NCHICA NC Consumer Advisory Council on Health Information, and a group of everyday consumers. This examination revealed that there is no solid definition of consumer empowerment in HIE; therefore it is difficult to understand how and if consumer empowerment will be achieved in HIE. One commonly discussed component of consumer empowerment is literacy, which includes functional literacy, health literacy, and a new concept of HIE literacy. Also, the idea of trust was found to be important in a way that may not be anticipated. The findings from this analysis have implications for consumers, providers, vendors, policy-makers, patient advocates and other healthcare stakeholders.

Session Objectives:

  • Describe the implications of HIE technology on consumers.
  • Explain how consumer empowerment has been discussed in HIE initiatives.
  • State the types of literacy levels needed to for consumers to understand HIE.

Nurse-Driven Clinical IT Solutions: Improving Communication, Efficiency and Outcomes
Nurses empowered to integrate technology with workflow create improved communication, efficiency and clinical outcomes. This session will demonstrate how nursing utilized IT to solve four different clinical initiatives:

  • Ensuring influenza and pneumovac vaccines are given appropriately following CDC guidelines (HQI Indicator)
  • Automation of the IV Titration process
  • Interdisciplinary communication of isolation indicators/active surveillence
  • Making sure provider-nurse communication is not lost with the implementation of CPOE

Nursing involvement in clinical IT assures nursing is implementing care based on best practices, consistent documentation and the safe use of computer applications.

Session Objectives:

  • Describe how technology imbedded vaccination protocols improve compliance, audit and reporting.
  • Describe the Nursing/Pharmacy communication facilitated by an integrated IV Titration pathway.
  • List two improved outcomes from the integrated isolation pathway.
  • Describe the impact of "Airport Monitors" on CPOE Units.

How 21st Century Technology May Affect Informed Consent for HIE
Health IT is quickly transforming the 20th century paper-based, fragmented and siloed healthcare delivery system into an electronic exchange system that provides streamlined, coordinated and comprehensive data to support more timely and effective care delivery. Health IT offers exciting possibilities for improving care, lowering administrative and healthcare delivery costs, preparing for pandemics and disasters, and even new treatment discoveries. However, adoption of health IT and participation in health information exchange (HIE) networks fundamentally changes the scope and dynamics of communications between healthcare providers and consumers and created new challenges to consumer and provider trust in the accuracy, security and privacy of the health information exchanged.

Where applicable law does not require advance consumer consent to exchange personal health information, it is a policy decision as to whether, and for what purposes, consumer consent will be required for that exchange. Consent policies that were developed before an organization's adoption of health IT and participation in an HIE network should be reviewed and updated, as necessary, to verify that the policies are relevant and adequate to ensure both that consumer health information is readily available through HIE for authorized purposes, and that the consumer's health information privacy and security is not compromised.

Updating consumer consent policies to enhance their relevance and applicability to a networked HIE environment is challenging. The Health Information Security and Privacy Collaboration multistate Consent Policy Options Collaborative determined that consent policy decisions require careful consideration of the risks and benefits of a new and promising, yet still unfamiliar, HIE paradigm. The legitimate, yet often competing, interests of all participants in the HIE network must be identified, understood and ultimately balanced in order for the HIE networks to succeed.

Session Objectives:

  • Explain the issues that will affect policy decisions about consumer consent to exchange health information through HIE.
  • Describe the interests that providers, consumers and HIE administrators have regarding consumer consent to exchange health information through HIE.
  • Describe the legal and policy support for differing levels of consumer consent to exchange health information.
What Did We Really Accomplish? Improving Compliance & Documentation of Core Measures for JCAHO
Every healthcare provider is challenged with improving the compliance and documentation of core measures to meet the requirements of the Joint Commission. A case study of how the Carondelet Health Network in Tucson, AZ utilized the electronic medical record to guide compliance and its ultimate achievements will be presented. Carondelet's implementation of the Cerner Millennium Suite of applications required the local team to expend a great amount of time, energy and resources in order to complete the implementation on time and on budget. One of the questions that confronted the team was: How will implementing Cerner help Carondelet improve compliance and documentation to meet the core measurement requirements of the Joint Commission?

This presentation will provide both a retrospective as well as a current compliance review to share Carondelet's progress in meeting these requirements including:

  • Identification of the specific data elements needed;
  • Identification of interdisciplinary processes that support modifications to ongoing documentation in response to requirement changes or workflow needs;
  • Identification of educational needs and training processes; and
  • Determining what worked well and what did not.

Session Objectives:

  • Discuss the need for interdisciplinary review of clinical documentation.
  • Identify needs for and use of required data entry fields and their implications in compliance.
  • Explain "Conditional Logic" use within clinical documentation systems to assist in compliance.
  • Explain the use of reference text within clinical documentation systems to assure compliance.

Consumer Empowerment and Privacy: What Do Healthcare Consumers Really Know and What Do They Really Want?
RTI International conducted a series of 12 focus groups and a short survey of consumers at six sites across the country asking about general knowledge of EHR, PHR and health information exchange (HIE). The questions probed concerns about consent and privacy related to multiple purposes for HIE such as treatment and health research. Nine of the group discussions were conducted in English, and two were in Spanish and one in Chinese Mandarin. The groups were varied based on regional and residence, educational attainment, age, sex, income, chronic illness and English proficiency skills.

Highlights include:

  • Concerns about security of EHRs were more common than concerns about privacy.
  • Privacy concerns focused mostly on access to information by health plans and employers (concerns about discrimination).
  • Groups suggested a system of role-based access to information (minimum necessary to accomplish tasks and with providers having the highest level of access) would protect privacy.
  • Spanish-speaking and Chinese-speaking groups struggled with the term "healthcare provider."
  • Spanish-speaking and Chinese-speaking groups would permit access to all types of health data to doctors, including specially protected data such as HIV, STD, Mental health, drug and alcohol and genetic data.
  • Spanish-speaking groups split on whether paper or electronic records are safer or more accurate.
  • Chinese-speaking group felt paper records are more accurate.

Session Objectives:

  • Describe how the participants in these groups understood the purpose and functions of PHR, EHR and HIE.
  • Describe how the participants viewed access to their health information for various purposes and their beliefs about the need for consent.
  • Describe the differences in beliefs and concerns that exist between the English-speaking and non-English speaking groups.
The Future 'Ain't What It Used To Be' - Applying Yogi Berra's Wisdom to Hospital-Physician Partnerships
Yogi Berra, the great Hall of Fame Catcher, once said: "You got to be careful if you don't know where you're going, because you might not get there." This prophetic statement can easily be applied to the growing importance of developing ambulatory strategies between hospitals and physician practices.

Healthcare organizations recognize the need to link physicians to the hospital to both improve patient care and strengthen ties with referring and employed physicians. With the relaxation of the Stark regulations, hospitals continue to develop ambulatory strategies to support physician practices including:

  • Offering direct financial subsidies
  • Extending the hospital's ambulatory EMR vendor discounts
  • Identifying several third-party vendors of choice which will eventually be integrated to the hospital's HIS
  • Evaluating health information exchange opportunities (e.g., NOVO; RelayHealth) to link practices to the hospital
  • Providing only technical support

This presentation will examine the varying ambulatory strategies -- including success factors, issues and risks -- that exist across the country (e.g., ThedaCare, Piedmont Health and Memorial University Medical Center-Savannah), as well as within North Carolina (e.g., Carolina's HealthCare System, University Health Systems of Eastern Carolina, Novant Health and Moses Cone). This presentation will also provide a case study of New Hanover Regional Medical Center's (NHRMC) ambulatory strategy and deployment. NHRMC will detail its plans and experience supporting multiple practices - including cost, benefit, opportunity and risk, as well as lessons learned.

Session Objectives:

  • Discuss the varying ambulatory strategies that have been successfully deployed across the country and within North Carolina.
  • Examine the cost, benefit, opportunities and risk for the varying strategies.
  • Describe the success measures of NHRMC's proven ambulatory strategy.
Determining ROI for Public Health IT
Very few studies of the costs and benefits of public health IT have been conducted. Quantifying the benefits of minimizing the effects of a disease outbreak, for example, can be challenging. Public health IT, furthermore, is a public good. In other words, it benefits everyone and not just those who have paid for the systems. Evaluating the return on investment for public health IT is imperative, however, in order to define the best practices of cost effective systems and to encourage investment and sustainability in public health IT on a global scale. As data integration needs continue to grow, stakeholders across all spectrums of healthcare from the World Health Organization (WHO) to the local provider play crucial roles in the development of disease surveillance and response systems that aim to reduce morbidity and mortality.

This presentation will provide a review of the value of public health IT systems as documented by several different localized systems, including the Cherokee Indian Health Authority, the NY Institute for Family Health, the NJ Electronic Disease Surveillance System and NC DETECT. US policy regarding investment in public health IT and the requirements of the WHO's International Health Regulations regarding global disease surveillance will also be discussed.

Session Objectives:

  • Describe the primary functions of IT for public health.
  • Describe the value of several different public health IT exemplar systems.
  • Understand US policy as it relates to investment in public health IT.
  • Understand the guidelines from the WHO regarding global disease surveillance and reporting requirements and the implications of these guidelines on local disease surveillance systems.
PCIX: A Real Approach to P4P
Patients with chronic disease frequently have co-morbidities that complicate their treatment. Failure to recognize illness severity can lead to improper treatment that impacts cost and health outcomes. To date there has been no commonly accepted way to measure the complexity of patient illness nor track the treatment outcomes. Current reimbursement models favor capitation or pricing by procedure and are often misaligned with the severity of illness.

To support pay-for-performance (P4P), we need to measure treatment outcomes in terms independent of claims data. Such evaluation and tracking tools would support fair compensation according to illness complexity, facilitate clinical outcomes improvement, and thereby achieve value-based outcomes for patients.

The Patient Complexity Index (PCIX) methodology is based on serum chemistry values used by physicians to diagnose specific medical conditions to evaluate the severity of illness by the deviation of those values from the normal range. By displaying the serum chemistry values on uniquely constructed color-coded radar charts, patients can readily visualize improvement over time and payers can better compensate treatment according to health outcomes. End Stage Renal Disease (ESRD) will be used to demonstrate how PCIX complexity scores do not correlate with current reimbursement methods as revealed in our study.

The discrepancy between reimbursement and PCIX complexity scores may result from the inability of capitation reimbursement models to account for varying levels of complexity that providers face. Our presentation will demonstrate the need to measure quality based on a value-based outcome of treatment results over time in a P4P future.

Session Objectives:

  • Discuss the complexities of measuring the health of a patient over an episode of care and how one approach to P4P put an organization ahead of the curve
  • Explain how a data-based model to measure the health of a group of individuals over time was approached, delivered, measured, and the results that the project was able to achieve in the treatment of ESRD patients.
  • Describe how an approach like this could be utilized to provide valuable metrics as your organization looks at the impact of P4P and the tools needed to quantify clinical outcomes and disease complexities to support realigned reimbursement.

NC Public Health IT Advances in 2009 to Improve Public Health Services
High-quality, cost-effective public health services depend on good information. NC public health leaders have been pursuing multi-year projects to improve the services that critically depend on better information services. The work has been pursued by local, regional and state public health officials supported by grants from private foundations and the state. The initiatives consist of a mix of health IT projects, new public health services that critically depend on health IT, and public health staff training needed to manage public health services more cost-effectively using health IT. Among the projects is an HIE planning process for the southern piedmont (SoPHIE), a statewide broadband provision project for public health (the NCTN) to support HIE, a standards-based environmental health services support system, a statewide training program for business process management (Common Ground), and a statewide EHR implementation.

In 2009, these projects have matured. Many are ending their planning phase and are poised to start implementation. Some projects have first generation implementations working and are considering second generation updates. The work of assessing, planning and piloting with these projects has positioned NC's public health enterprise to make good use of funding opportunities for large implementations -- as anticipated in the "health IT stimulus" legislation. This session will focus on the progress that these initiatives have made in 2009 towards the larger goal of improving the cost-effectiveness of public health services using health IT, lessons learned, and prospects for the next phase of work in this area.

Session Objectives:

  • List at least three projects that contribute to improving public health IT capabilities in NC.
  • List at least one way in which each of these projects improves the cost-effectiveness of public health services.
  • Describe the top three priorities in pursuing the next phase of work in this area.
Applying Business Process Analysis to Define EMR Requirements
It is very hard to get what you want from a software application without determining what your needs are up front. Business process analysis defines the way tasks are conducted, highlights opportunities for improvement, and ultimately helps to develop requirements for the optimal information system solution.

Local public health departments are exploring how to transition their clinics from a system of paper medical charts to an EMR system. This session will give an overview of the steps taken by the Southern Piedmont Partnership for Public Health in analyzing public health business processes to define software requirements, evaluate and select an EMR system.

Step one of the transition to an EMR system entailed approximately 60 subject matter experts from eight health departments working together to collaboratively analyze areas of the health department that would be affected by a new information system - Family Planning, Child Health, Maternal Health, Communicable Disease, Lab, Family Care Coordination, Billing and Registration/Checkout. Workgroup meetings were held to analyze and refine over 50 business processes. The next step consisted of defining features and functionality requirements determined by the analysis. By defining the requirements, well-informed strategic decisions were much easier to make in selecting a software application that best met the need of each health department.

By evaluating public health business processes and working collaboratively, public health agencies can make improvements in service delivery, quality and performance, and the goal of doing more with less can be reached.

Session Objectives:

  • Describe the benefits of business process analysis collaboration.
  • List the steps taken in the development of EMR system requirements.
  • List the steps taken in the evaluation and selection of an EMR system for public health departments.

Using ICD-10 as a Technology Driver
The conversion from ICD-9 to ICD-10 is a massive undertaking that must not be taken lightly by payers and providers of care. There will be payer organizations that will fail to act quickly enough and cease to remain viable, and there will be providers that will face severe revenue cycle difficulties due to a lack of complete preparation. The use of IT as part of a well developed strategy and implementation plan will be key for the survival of payers and providers. With the enhanced detail provided by ICD-10 code sets, ICD-10-compliant systems will enable a level of patient management and outcomes management not previously available. The presenters will explain the approach that payers and providers must take for completely implementing ICD-10. Using specific case study examples, the presenters will describe a Change Leadership/Business Process Reengineering methodology and compliance process that will transform a payer's or provider's compliance effort into an effort for improving outcomes and achieving a short- and long-term competitive advantage.

Session Objectives:

  • Explain how to follow a Change Leadership/Business Process Reengineering methodology in a compliance effort.
  • Explain how a well developed strategy and implementation plan for ICD-10 can lead to a short- and long-term competitive advantage.
  • Describe how the use of ICD-10-compliant systems will lead to improved levels of patient management and outcomes management.

WebCIS & CDW-H at UNC Health Care System
UNC Health Care System's (UNCHCS) web-based clinical information system (WebCIS) consolidates data across 40 different feeding systems, such as radiology, labs and cardiology. Last fall they created a module called "Rounds Report" that pulls current medications from CPOE, recent vitals and fluid Input Outputs from eChart, and recent labs from WebCIS for any list of patients. The system presents them in a user friendly manner that enables providers to scan the current status of all patients across a unit online, document treatment plans in one screen without a single click, and print a concise paper report that they can carry with them during rounds. This presentation will demo and discuss the conceptualization, design, development and rollout of the rounds report across UNCHCS.

In 2007 UNCHCS initiated development of an enterprise-wide data warehouse, the Carolina Data Warehouse for Health (CDW-H). The warehouse incorporates all inpatient and outpatient clinical data, plus administrative data such as billing codes and appointment schedules. CDW-H became operational in the first quarter of 2009 with the extraction of data elements from the two major operational sources of information in UNCHCS: the webCIS EMR and the Siemens Decision Support System which stores transactions from registration, billing, scheduling and inpatient hospital physician order entry systems. The presentation will describe the theory of data warehousing, the process of governance and implementation of the CDW-H, security concerns in the development of a data warehouse, the outcomes of the diabetes and hospital inpatient data marts, and the use of the research web portal of the data warehouse.

Session Objectives:

  • Describe how data from multiple systems, and from multiple provider sources, can be compiled and presented in a concise manner for optimal and efficient patient care.
  • Discuss the importance of governance structure in the implementation process of a data warehouse.
  • Describe the pitfalls in development of security and provisioning for an enterprise data warehouse.

Grant & Project Proposal Readiness: Improving Your Odds of Securing Grants or Project Funding
The American Recovery and Reinvestment Act (ARRA) signed into law on February 17, 2009, allocated a total of $19 billion to implement health information technology (HIT). Funding to develop HIT infrastructure, health information exchange (HIE) demonstration projects, capital projects, EMR adoption and HIT related academic programs are being published faster than some stakeholders can put a project idea together. Depending on the scope of the project, grant or proposal preparation and writing is a project unto itself.

This presentation is designed to educate and foster creative solutions for healthcare stakeholders who wish to leverage their orphaned or current HIT strategy, project plan, PCMH, clinical care coordination concepts, and community relationships to create a robust grant package for EMR adoption or HIE funding.

Session Objectives:

  • Identify potential project funding opportunities
  • Describe the difference between project planning and grant writing
  • List the steps from grant preparation to submission
  • Set the foundation for a coordinated response to funding opportunities

Building on 15 Years of Collaboration: NCHICA's Contributions to NC's Success
Presenters will discuss: The expectations at the founding of NCHICA in 1994; The activities of the NC Consumer Advisory Council on Health Information and consumer expectations of NCHICA’s work; The activities of the NC HIE Council and Committees in support of NCHICA’s efforts; NHIN activities and their importance to NC in the ARRRA HITECH stimulus funding and other initiatives; and the activities undertaken in the HISPC Project and the importance of policy efforts to enable HIE and HIT.

Improving Patient Flow at the Hospital's Front Door - Your Emergency Department
Albert Einstein Medical Center (AEMC), a 509-bed teaching facility located in Philadelphia, is one of the first trauma centers in the nation to have integrated a patient and asset tracking system that is based on a real-time location network. Originally implemented in 2003 to manage the increased communication challenges and workflow complexities associated with a significant increase in the size of the emergency department, AEMC has now used the system to coordinate the care of more than 350,000 patient visits. Today, staff uses the tracking software as a centralized workflow and communication portal in managing over 76,000 visits annually over which time they have reduced average length of stay, ambulance diversions and patient walkouts. In the initial year, increased reimbursements from fewer patient walkouts were valued at over $1 million.

When patients enter the department, they are given an ultrasonic tag, which the staff also wears, which communicates their location and movement to a network of sensors positioned throughout the department. Tags are also placed on movable medical equipment for quick location identification. The tracking software provided receives the location data and uses ED workflow algorithms to interpret interactions between patients, staff and equipment in the context of patient care milestones. As milestones are recognized, the web-based software updates the patient information in map and status view screens sending notifications to staff members who need to know in order to keep patient care progressing with a minimum of delays. The software also interfaces with lab, radiology and ADT systems to integrate the status of orders. As a teaching facility, the emergency department has used the granular tracking of patient movement to extensively analyze patient flow, profile caregivers and support their resident training program.

Session Objectives:

  • Describe the impact of real-time location enabled patient and asset tracking on the operations of an emergency department.
  • Identify the technology components of a real-time location enabled tracking system.
  • Discuss the patient, staff and technology implications of introducing a real-time location system.
  • Identify the role of the emergency department in impacting facility-wide patient flow.

IEEE-USA Medical Technology Policy Committee & Interoperability for the NHIN
This presentation describes the work of the Institute of Electrical and Electronics Engineers - USA (IEEE-USA) Medical Technology Policy Committee in addressing national policy issues relating to health and wellness. Specifically, it addresses our support of the work that has been done by NCHICA and other groups that are working to implement a Nationwide Health Information Network (NHIN). In our white paper on Interoperability for the NHIN, we describe the various types of interoperability - semantic and functional - that are required to provide seamless interchange of medical information among healthcare providers, healthcare consumers, insurers and public health agencies. We discuss the standards that are being developed by various standards development organizations to address interoperability issues. We will also present an overview of our current work on using health IT to improve the quality of healthcare delivery while constraining the rising cost of healthcare in the US.

Session Objectives:

  • Describe the role of the IEEE-USA Medical Technology Policy Committee in formulating medical technology legislation, regulation and policy.
  • Explain the different types of interoperability required for the seamless interchange of medical information in NHIN/HIE/RHIO health information networks.
  • List the major standards (e.g. SNOMED, ICD9/10, HL7) required to support interoperability.
HIT and the Patient-Centered Medical Home
The Patient-Centered Medical Home (PCMH) has been identified as one of the key strategies in the new Administration for tackling the myriad issues with our current healthcare system. PCMH is a model of healthcare that is focused on the patient's needs; it draws from existing chronic care models by emphasizing continuous, comprehensive care. Many of the objectives of the PCMH support the principles put forth in the IOM seminal report on quality of care by promoting safe, timely, effective, efficient, equitable and patient-centered care.

This presentation will review the PCMH model as currently defined through the work of the Patient Centered Primary Care Collaborative (PCPCC) with emphasis on the CMS Medical Home model. This model draws largely from the CMS version of the NCQA's PPC-PCMH quality improvement program which will be implemented in CMS Medical Home Demonstration project.

Session Objectives:

  • Describe the patient-centered medical home - its components and objectives in relationship to medical practice and the national healthcare agenda
  • Develop a plan to transform a medical practice into a medical home
  • Use HIT to enable the medical home
Sutter's Mill 2009: Meeting the RAC Challenge
Millions of healthcare dollars are lost annually due to fraud, waste and abuse (FWA). In 2006, Centers for Medicare and Medicaid Services made the Recovery Audit Contractor (RAC) process permanent through Section 302 of the Tax Relief and Health Care Act. While the initial impact only affects 16 states, there is an aggressive schedule to bring the rest of the county into the program through 2009 and 2010. FWA schemes and errors are complicated, detailed, medical specialty-specific, difficult to identify, and expensive for provider organizations to monitor and manage. Traditional data mining approaches are often not user friendly, only detect a small portion of FWA, and are inadequate to meet the pace and demands of the organizations that they serve.

The time is right for provider organizations to take a proactive approach to monitoring FWA - an approach that identifies ways to avoid penalties associated with FWA and mitigate legal risk, but also identifies ways to optimize claims submittals and identify opportunities for lost revenue for under-submitted claims. This presentation will identify new strategies and methodologies for leveraging logic-based approaches to mitigate FWA risk and financial exposure while simultaneously identifying opportunities to increase revenue lost due to inaccurate under-coding of claims data.

Session Objectives:

  • Explain the need to address FWA in the RAC environment.
  • Describe the criteria and drivers required for a successful FWA program and how that program can drive revenue for your organization.
  • Identify weaknesses inherent in your existing FWA and RAC activities and strategies to address them.

Physician Incentives to Adopt EHR/EMR Systems
This presentation will address the following:

  • the Impact of the 2009 CMS changes as they relate to the physician quality reporting initiative (PQRI) and e-Prescribing and how these items relate to physician incentives for implementing EMR/EHR systems.
  • the proposed impact and disincentives in the government's push to promote e-Prescribing adoption and their current enactment status.
  • the direction of President Barak Obama's Healthcare Strategy as it relates to EMR/EHR systems and the Stark guidelines in Hospital-Physician Alignment in supporting EHR/EMR implementations in physician practices.
  • the calculation for a return-on-investment if implementing a PQRI software package in the physician practices.

Session Objectives:

  • Discuss current CMS initiaties to encourage physicians to adopt EHR/EMR systems.
  • Explain the Stark initiatives.
  • Describe PQRI implementations and ROI calculations.

HITECH Compliance: Strategies for Addressing the New Legal and Technical Challenges for Mobile Information Security
The goal of the Health Information Technology for Economic and Clinical Health (HITECH) Act, embedded within the American Recovery and Reinvestment Act (ARRA) signed earlier this year, was to promote the adoption of health information technologies (HIT) to improve the quality, safety and efficiency of America's health care system. The provisions of HITECH recognized that the current level of security and privacy protections would be a deterrent to adoption and implemented strong standards. As a requirement of HITECH, HHS issued draft Guidance in April 2009 addressing the security of mobile devices and proposed an encryption standard as the only safe-harbor. HITECH contains provisions for HHS to issue the final Guidance regarding mobile devices and other regulations by August 15, 2009. This presentation will address the legal and regulatory framework within HITECH and explore the compliance issues with the HHS Guidance. It will also dive into the governance-risk-compliance challenges of mobile devices and examine how HHS' Guidance impacts healthcare organizations. We also will cover device encryption and how it affects regulatory compliance, and provide a brief technical overview of some of the leading implementations available to all enteriprse and healthcare organizations.

Session Objectives:

  • Discuss the foundations of the HITECH Act as well as the HHS Guidance statements.
  • Describe the legal and regulatory compliance mandates, as well as practical solutions on how to communicate these requirements to the Information Technology staff.
  • Identify and implement an HHS compliant mobile device program to meet the regulatory requirements as documented in HITECH.

Federal to Private Sector: Building Connections in NC to Serve Military & Tribal Members
Presenters will discuss the importance of exchanging information with the private sector to serve Wounded Warriors, dependants and veterans; plans for ARRA HITECH Stimulus funding to drive the meaningful use of electronic health records and health information exchange to improve the quality of care; and provide examples of how connections with the WNC DataLink project has benefited tribal members.