Meaningful Connections:Patient Centered Medical Home and

Health ITDavid Nace, MD, VP, Chief Medical Officer, McKesson and

Company; Chair, Center for eHealth Information Adoption and Exchange (CeHIA)

Ted Epperly, MD, Program Director & CEO, Family Medicine Residency of Idaho, President, AAFP (Moderator)

Health care Industry – Environmental Factors

– 82% of Americans feel fundamental change is needed.

– Evidence is produced at an astonishing rate, but not effectively put into practice.

– “System” of care is fragmented, uncoordinated and inefficient.

– Primary care continues to be marginalized and threatened.

Current Administration

Tools to Rebuild and Restructure Health Care

Stimulus Plan OverviewHealth care provisions in the stimulus bill

￭ Additional funding for state Medicaid programs ￭ Prevents additional state restrictions on Medicaid coverage

Medicaid$90 B

HealthInsurance$25 B

￭ Extension of COBRA as gap coverage for early retirees

Health IT$21 B

￭ Funding for health connectivity initiatives ￭ Incentives for physicians and hospitals to adopt EHRs

ONCHIT$2 B

￭ New entities to establish standards, HIT policy and certify ￭ New (and more restrictive) privacy provisions

NIH$10 B

￭ Additional funding for scientific research grants

Other HHS$10 B

￭ Comparative effectiveness, wellness and prevention initiatives ￭ Grants, loans and training programs

“HITECH” Act

Meaningful Use: Meaningful Connections• Identifies health IT as a “critical

platform” of the PCMH.• (Re) Conceptualizes health IT as

an e-platform and set of tools.• Health IT functional priorities to

support a PCMH. • Critical capabilities to engage

consumers with health IT. • Explores the current use of health

IT by primary care physicians.

Health IT Capabilities and Functionalities to Support a PCMH

“One Size (Does Not) Fit All”

Measure

•Ability to measure and report on processes of care.

Collaborate

• Ability for team members to communicate among themselves. • Team member access to information during the process of care and care delivery.

Health IT Capabilities and Functionalities to Support “Meaningful Connections”

• What do we mean by “Meaningful Use”– Demonstrable management and

e-exchange of health information that results in improved quality of care.

• Value of the “Connected Medical Home”– Supports participatory medicine,

reduces costs, improves outcomes and closes the “collaboration gap.”

Importance of a Consumer FocusClosing the Collaboration Gap- -Creating Real Time Collaboration

• Patients forget 40-80% of information upon leaving the clinician’s office.

• 75% of patients want on-line services now, but less than 5% have this capability.

• 55% of patients want to connect with clinicians via email.

The Connected Medical Home Importance of a Consumer Focus

“Boots-on-the-Ground” Case ExamplesWhat We Learned

• Current status– Clinician to clinician communication

is more established than clinician to patient communication.

– There is a wide spectrum of health IT adoption.

• Compelling quotes– “HIT is the tool, not the answer.”

– “Using HIT without rethinking patient flow and physician workflow is a waste.”

• HIT adoption is leading to:– Better care coordination (team work)

– Better quality reporting with measureable results

• Implementation is expensive but can result in:

– Fewer patient calls

– Increased satisfaction of patients and physicians

– Increased adoption of best practices and preventive care

– Higher quality and improved outcomes

The PCPCC Center for eHealth Information Adoption and Exchange (CeHIA) - An Open Invitation

Mission: “To evaluate the use and application of health information technology to support and enable its development and broad adoption to

support the patient centered medical home.”

• Release and distribute “Meaningful Connections” report

• Bring clarity and specificity to the term “Meaningful Use”• Launch a participatory engagement strategy• Develop and sustain a PCMH Health IT Resource Center

2009

PCPCC CeHIA Leadership and Call Schedule

• David Nace, MD, VP, Chief Medical Officer, McKesson and Company (Co-Chair)

• Janet Marchibroda, MBA, Chief Healthcare Officer, IBM (Co-Chair)• James Crawford, MD, PhD, SVP, Laboratory Services, North Shore-

Long Island Jewish Health System (Co-Chair)• Chris Nohrden, MPH, Executive Director• Calls Bi-Weekly - Thursday, 1 PM EST - 2nd and 4th Thursday of the

Month • Schedule: 5/14, 5/28, 6/11, 6/25, 7/9, 7/23, (No August Calls), 9/10,

9/24, 10/8, 10/22, 11/12, 12/10• Call in number (712)432-3900, Code 471334#