The Decade of Health Information Technology Begins:

1
Beyond the EMR Exchanging Health Information
Outside of Your Organization John W. Loonsk,
MD, FACMI Office of the National Coordinator for
Health Information Technology
2
Some Critical Health Needs

• Avoidance of medical errors
• Up to 98,000 avoidable annual deaths due to
  medical errors
• Improvement of resource utilization
• Up to 300B spent annually on treatments with no
  health yield
• Acceleration of knowledge diffusion
• 17 years for evidence to be integrated into
  practice
• Reduction of variability in healthcare delivery
  and access
• Access to specialty care highly dependent on
  geography
• Empowerment of the consumer
• Capitalize on growing consumer trend of active
  health management
• Strengthening of data privacy and protection
• HIPAA becomes reality
• Promotion of public health and preparedness
• Surveillance is fragmented, and importance to
  homeland security brings heightened awareness

3
Information Exchange Needs During Anthrax Attacks
4
Current State EHR Adoption US Physicians (2005)
3 times more prevalent in metropolitan areas
5
The National Health IT Agenda

• Priorities
• American Health Information Community
• Business needs and priorities
• Use Cases

• Certification
• Certification Commission For Healthcare
  Information Technology
• Criteria development
• Testing

• Networking
• NHIN - network of networks
• Architecture specifications

Agenda

• Business Deployment
• Sustainable business models
• Software
• State / regional partnerships
• Evaluation

• Standards
• Healthcare Information Technology Standards Panel
• Recognized standards

• Policies
• State laws and regulations State Alliance
• Health Information Security and Policy
  Collaboration

6
AHIC Priorities and Use Case Roadmap
7
Standards in the National HIT Agenda
Certification Commission for Healthcare
Information Technology (CCHIT)
Stark and Anti-kickback
American Health Information Community
Priorities (AHIC)
Healthcare Information Technology Standards
Panel (HITSP)
Interoperability
Use
Cases
Specifications
Federal Systems and Healthcare Contracts
(Executive Order 13410)
Nationwide Health Information Network (NHIN)

• Secretary and recognition
• January, 2008 - 52 standards
• January 2009 - 60 standards

8
The Nationwide Health Information Network
State and Local Gov
HealthBank
PCHR Support Organization
Community Health Centers
Common dial tone and chain of trust
Labs
Pharmacies
9
Common Network Dial Tone

• Provider has a patient but not their record
• Updating health data where it is needed
• Patient wants / doesnt want information to be
  electronically released
• Providing the best care and protecting the
  population

• Functions and specifications
• Patient look-up and information retrieval
• Information routing and delivery
• The exchange of consumer preferences
• Support for population data uses

10
Enabling Information Exchange

• Trust Issues
• Tacit ownership
• HIPAA and other legal angst
• Propriety business needs
• Patient confidentiality issues
• Enablers
• Value of exchanging data
• Patient choice x 2
• Support trusted users
• High level access controls
• Minimize identifying information

11
The Nationwide Health Information Network
State and Local Gov
HealthBank
PCHR Support Organization
Community Health Centers
Common dial tone and chain of trust
Labs
Pharmacies
12
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