REAL WORLD
Learning from Beacon Community
on EHR Adoption
Presented By William F Pilkington
CEO, Cabarrus Health Alliance
at the Public Health Data Standards Consortium
November 4, 2010
Beacon Project
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Office of the National Coordinator
(ONC) awarded $15.9 million to
SPCCP in May 2010
One of 15 original awards
nationwide
Program for communities to build
and strengthen their health IT
infrastructure and exchange
capabilities, to demonstrate the
vision of a future where hospitals,
clinicians, and patients are
meaningful users of health IT, and
together the community achieves
measurable improvements in
health care quality, safety,
efficiency, and population health
Beacon Measures
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Readmissions and ED Visits
Diabetes
Congestive Heart Failure
Population Health
Meaningful Use
SPCCP Overview
SPCCP is the collaboration of healthcare
providers and community agencies to
increase the access and quality for the
Medicaid recipients and the dually eligible
Medicaid/Medicare recipients in Cabarrus,
Rowan and Stanly counties.
In addition to assisting the Medicaid clients
of its counties, SPCCP also has a program
for the uninsured in Cabarrus County. The
Community Care Plan (CCP) is designed to
provide access to routine healthcare, early
intervention and remediation of disease
conditions, access to dental care, and mental
health services for the uninsured indigent.
Beacon Community Partners
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Two large hospital systems – Carolinas Healthcare System, Novant Health
Three county health departments – Cabarrus Health Alliance, Rowan
County Health Department and Stanly County Health Department
Three large practices groups – Cabarrus Family Medicine, NorthEast
Partners, Stanly Medical System
Beacon Community Partners (cont)
• Community Care of NC Informatics Center
• Duke University School of Medicine
• North Carolina Comprehensive Assessment
for Tracking Community Health (NCCATCH), UNC- Charlotte
• NC Institute of Public Health, UNC Gillings
School of Global Public Health
• Cecil G. Sheps Center for Health Services
Research, UNC – Chapel Hill
Public Health IT
• $2 billion for clinical
system meaningful use
Public Health Issues
• Lack of visibility for public health in HIT
reform
• Goals for public health reductions in
diabetes, obesity, etc. do not equate the
clinical goals
• 50-year food and dietary surplus will not
change in the 30-month Beacon period
Public Health and Meaningful Use
• http://onc-chpl.force.com/ehrcert
• The vast majority of ONC certified systems
are not addressing core public health
– Only one system addresses demographics
– A large majority ignore surveillance
• Suggestion: advocate now that Stage 2
criterion do not make public health data
needs optional
Possible Public Health Phase II
Priorities
• Establish a standard, core set of public health outcome
measures and data requirements
• Develop HIE standards/services to enable the sharing and
reporting of communicable and chronic disease information
• Develop standardized assessment protocols (using the core
set of public health outcomes measures) to evaluate the
impact of healthcare interventions on community health
• Clarify public health’s healthcare, disease management, and
prevention role and how these do/should compliment role of
other healthcare
Enhanced Privacy and Security
• Control Physical and System
Access
• Monitor Workstation Use and
Security
• Audit access and need-toknow
• Enhance Device and Media
Controls
• Employ Transmission Security
EHR Considerations
Advantages
Disadvantages
• Improve quality of care
• Cost reductions
• Promote evidence-based
medicine
• Record-keeping and mobility
• Cost
• Time
Stanly County, N.C. Department of Health
• One EHR does not fit all – each health department
functions differently and the ability to select an EHR
accordingly is important
• Reporting functions should be easier and quicker for
custom reports (since not required to go through the
State HIE system)
• Assess fees carefully:
– Since we are not currently a batch county, there will be a fee to
convert to a batch process and a yearly fee to support the
interface between our EHR and HIE
– Beyond the required support fees for an EHR, there are other
support fees for other hardware requirements (storage, servers,
etc.)
Cabarrus Health Alliance
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Business process re-engineering is essential.
You need a provider champion.
Know your business constraints.
Know your partners and how their decisions will affect
your implementation.
• Health Information Exchange: Know which data you
want to exchange with whom
Contact
William F Pilkington
CEO
Cabarrus Health Alliance
The Public Health Authority for Cabarrus County
ppilkington@cabarrushealth.org
(704) 920-1203