AcademyHealth
Health Information
Technology
Interest Group Meeting
(HIT IG)
June 26, 2010
Boston, MA
3 pm to 6 pm
Room 201
Hynes Veterans Memorial Convention Center
Welcome and Introductions
 Margo Edmunds, Chair,
HIT Interest Group
– History of the HIT IG:
Policy, Research, Practice, and
Workforce Sessions
– Multidisciplinary HIT IG Advisory
Committee
– Review of Today’s Agenda
– Invitation to IG Business Meeting
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HIT IG Planning Committee
and Friends
 Margo Edmunds, JHU
and IOM
 Susan McBride, Texas
Tech UHC
 Hank Fanberg,
CHRISTUS Health
 Karen Murphy, Moses
Taylor Hospital
 Susan Fenton,
Texas State University
 Ebe Randeree, Florida
State
 Jim Garnham, GRIPA
 Bob Rosati, Visiting
Nurse Services NY
 Shirley Girouard, San
Francisco State Nursing
 Barbara Lund, MAeHC
 Patricia MacTaggart,
GWU
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 Micky Tripathi, MAeHC
 Alex Turchin, Partners
Healthcare
Today’s Agenda
 Policy Update: Micky Tripathi, President
and CEO, Massachusetts e-Health
Collaborative
 Implementation of Meaningful Use
Requirements: Mary Madison, Moderator,
with Kathleen Donaher, Elizabeth Fleck,
and Jim Garnham
 HIT Workforce and Training Issues:
Susan Fenton, Moderator, with Justin
Copie, Barbara Lund and Alex Turchin
 Format: Interactive, audience Q and A
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Health IT Policy Update
 Panelist: Micky Tripathi, President
and CEO, MAeHC
 Moderator: Margo Edmunds,
Institute of Medicine and Johns
Hopkins University
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Questions for Dr. Tripathi
 What role does the Health IT Policy
Committee play under HITECH?
 How did MAeHC get launched and get
commitments for participation?
 What kinds of incentives are needed to
bring people to the table for HIE?
 If MAeHC could do one thing over again,
what would it be?
 What advice do you have for state HIE’s
that are just starting out?
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Summary of Health Policy Issues
  $2 billion under HITECH and $14 - 28 billion in provider
incentives at CMS is a lot of money, and it will be a huge
challenge to coordinate, evaluate, and justify the expense.
  The provider take-up/adoption rate could be 25-100% with the
CMS incentives – no one knows what will actually happen.
  Healthcare is decentralized: Providers ask “what’s in it for
me?” while the policy community is promoting adoption,
efficiency, and patient-centered care.
  More than 200 certified EHRs creates tremendous need for
technology-neutral technical assistance on purchase and
implementation. Vendors are not neutral advisors.
  Team approaches to health information exchange and clinical
care are most effective for patients in the long run.
  To move forward, we need to think about HIT adoption less
as an experiment in technology and more as an experiment in
healthcare reform.
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Panel 1: Implementation of
Meaningful Use Requirements
 Mary Madison, Moderator, AHIMA
Foundation, Chicago, IL
 Kathleen Donaher, Regis College,
Weston, MA
 Elizabeth Fleck, Innovative
Solutions, Rochester, NY
 Jim Garnham, Greater Rochester
IPA (GRIPA), Rochester, NY
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Discussion Questions for
Implementation of MU Reqs
 How do you address workflow issues in
relation to implementing MU requirements?
 What are the long-term prospects for
success of MU when efforts are focused on
hospitals and large group practices, and
are not addressing long-term care,
behavioral health, and home care?
 In preparing the workforce, how do we
ensure access to and training for all of the
electronic functions in an EHR when some
practice settings will not credential
students and trainees as EHR users?
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Summary of Discussion on
Meaningful Use Requirements
  Technology is a tool to take better care of patients and move
their personal health information with them across the
continuum of care.
  Patient-centered care means giving up provider autonomy
and supporting the patient and his/her family and their
preferences, even when you might disagree (e.g., patients
may not want behavioral health records or meds disclosed).
  Privacy and security challenges arise when sharing all or part
of the patient’s data with other providers, e.g., whether the
referring or consulting provider gets patient consent. Some
use opt-in and opt-out permissioning. NY state uses
Affirmative Consent at the Point of Access, v. Point of Source.
No consent = no access (see reference list under NY State).
  Providers will need 24/7 technical support for implementation.
There is never enough face-to-face support and training.
  EHR use is like driving a car. The question isn’t whether you
have a license, it’s whether you know where you want to go.
The most effective EHR training is on the job.
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Panel 2: HIT Workforce and
Training Issues
 Susan Fenton, Moderator, Texas
State University, San Marcos, TX
 Justin Copie, Innovative Solutions,
Rochester, NY
 Barbara Lund, Massachusetts
eHealth Collaborative, Waltham MA
 Alex Turchin, Brigham and
Women’s Hospital/Partners
Healthcare System, Boston, MA
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Community College Consortia
to Educate HIT Professionals in
Health Care Program
 Training to be completed within 6
months or less:
– Practice workflow and information
management redesign specialist
– Clinician/practitioner consultant
– Implementation support specialist
– Implementation manager
– Technical/software support staff
– Trainer
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Community College Consortia
 $36 million total to 5 lead
organizations across the country
 Expected to train 10,500 new
professionals by 2012
 For more info go to ONC
website:
–  http://healthit.hhs.gov/portal/server.pt?
open=512&objID=1804&parentname=CommunityPage
&parentid=2&mode=2&in_hi_userid=10741&cached=tr
ue
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University-based Training for
HIT Professionals
 Certificates and master’s
degrees for:
–  Clinician/public health leader
–  Health information management and
exchange specialist
–  Health information privacy and security
specialist
–  Research and development scientist
–  Programmers and software engineer
–  Health IT sub-specialist
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University-based Training
 $32 million to 9 universities and
university-based consortia
 Expected to train approximately
2,000 new professionals by June
2013.
 For more information go to
http://healthit.hhs.gov/portal/server.pt?
open=512&objID=1808&parentname=Commu
nityPage&parentid=5&mode=2&in_hi_userid=
10741&cached=true
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Discussion Questions for HIT
Workforce and Training
 What types or roles for HIT workers do you foresee
the biggest demand for between now and 2015?
 Even with the emphasis on HIT adoption, the majority
of healthcare workers will not be in HIT roles.
However, the non-HIT healthcare workforce will need
to be able to use HIT effectively. What challenges
and needs do you perceive regarding training the
clinical, research and other healthcare workforce to
use HIT?
 What is the most formidable HIT workforce challenge
the healthcare industry will need to address in the
next 5 years?
 What are the options for formal training in HIT, and
what do they provide to trainees?
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Summary of Workforce Discussion
  With the new ONC funding, new people will be coming into
the field and there will be lots of new job titles, functions, and
types of certification among providers and third parties (e.g.,
data warehouses). It’s a time of rapid change.
  Whether training providers in IT/informatics or training IT
people in healthcare, team approaches work best.
  Where do you set the financial incentives? Some think the
adoption incentives are too low, while others think we’re
spending too much on already highly-paid professionals.
  Training budgets rarely cover changes in products and
upgrades or use of third parties for information exchange.
  Small practices have no training budgets – they need webbased tools (e.g., registries) to report/exchange information.
  What about using all the data we will be collecting? Products
are not interoperable so researchers can’t map data fields
from different EHR data sources.
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Closing Remarks
 Thanks to speakers and participants
 Summary of today’s themes
 Please send resources to
medmunds25@mac.com
 Final discussion deck will be posted on
www.academyhealth.org
 Informal participant feedback on future
meetings and member expansion
 Please join us for business meeting
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Helpful Resources:
Public Sites on HIT Adoption
 AHRQ Health IT Portal
http://healthit.ahrq.gov/portal/server.pt
 Health Resources and Services Administration
(HRSA) Health IT Adoption Toolbox.
http://healthit.ahrq.gov/portal/server.pt
open=512&objID=1077&cached=true&mode=2&userI
D=7330
 ONC HealthIT Portal: http://healthit.hhs.gov
 ONC ListServ: http://healthit.hhs.gov/portal/server.pt,
box on lower right “E-mail updates from ONC”
 White House Blog. Going Beyond Paper and Pencil:
Investments in Health IT. http://www.whitehouse.gov/
blog/2010/02/12/going-beyond-paper-and-pencilinvestments-health-it
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Helpful Resources: Public
Resources on Privacy and Security
of Personal Health Information
 NY State Health Information Security and
Privacy Collaboration. Recommendations for
Standardized Consumer Consent
Policies….Nov 2008.
http://www.nyehealth.org/files/
File_Repository16/pdf/
Consent_White_Paper_20081125.pdf
 Health Information Security and Privacy
Collaboration: Impact Analysis Report.
Prepared by RTI for ONC and AHRQ.
December 2007. www.rti.org/HISPC
 Substance Abuse and Mental Health Services
Administration (SAMHSA), HHS. FAQ’s for
Applying Substance Abuse Confidentiality
Requirements to Health Information Exchange.
June 2010. http://www.samhsa.gov/
HealthPrivacy/docs/EHR-FAQs.pdf
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Helpful Resources: Private
Sector Portals and Papers
 AHIMA Foundation Thought Leaders Lecture
Series
http://ahimafoundation.org/ProDev/
ThoughtLeadersLecture.aspx
 AHIMA Foundation. State HIE Toolkit
http://statehieresources.org/
 AHIMA Foundation Journal: Perspectives in Health
Information Management
http://perspectives.ahima.org/
 American Medical Informatics Association (AMIA).
10 x 10 Training Programs. www.amia.org/10x10
 Bernstein W, Pfister HR, Ingargiola SR. HITECH
Revisited. Manatt Health Solutions, June 2010.
http://www.manatt.com/newsevents.aspx?
id=11688
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Helpful Resources: Private
Sector Portals and Papers
 Edmunds M, Peddicord D, Detmer D, Shortliffe E.
Health IT Policy 101. AMIA 2009, San Francisco, CA.
https://www.amia.org/amia-policy-101 (podcast)
 Goroll AH, Simon SR, Tripathi M, Ascenzo C, Bates
D. Community-wide Implementation of Health
Information Technology: The Massachusetts eHealth
Collaborative Experience. JAMIA, Jan/Feb 2009, Vol
16(1): 132-139.
 Hersh W, Margolis A, Quiros F, Otero P. Building a
Health Informatics Workforce in Developing
Countries. Health Affairs, Feb 2010, 29(2):274-277.
 ihealthbeat.com, California Healthcare Foundation
(free daily Health IT news summary).
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Resource List continued
 Penfield S, Martin Anderson K, Edmunds M, Belanger
M. Toward Health Information Liquidity: Realization
of Better, More Efficient Care From the Free Flow of
Information. Booz Allen Hamilton, January 2009.
http://www.boozallen.com/media/file/
Toward_Health_Information_Liquidity.pdf
 Van Ornum, Michael. Electronic Prescribing: A
Safety and Implementation Guide. Jones and Bartlett,
2009.
http://www.jblearning.com/catalog/9780763758493/
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