Arizona
Rural & Critical Access Hospitals
HIT/Quality Workshop
December 6, 2013
Connie K. Ihde
Regional Extension Center Director ~ Programs Director
Arizona Health-e Connection
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Health IT Activities in Arizona:
An Update
1
Agenda
• Overview of Health IT: The Arizona Landscape
– EHR Incentive Program
– Arizona E-Prescribing Initiative
– Arizona Regional Extension Center
– Arizona HIE Marketplace
2
National EHR
Progress & Challenges
•
As of July 2013:
– 61% of CAHs had attested to Stage 1 MU (Figure 1).
– 68% of other (non-CAH) eligible hospitals had attested to Stage 1 MU at this
same point in time.
•
89% of CAHs plan to attest to Stage 1 MU by the end of 2013
•
Another 10% of CAHs plan to attest to MU by the end of 2014 or beyond
•
Less than two percent do not have plans to attest to MU.
•
Overall, 89% of CAHs reported that they currently use an EHR system
•
49% of CAHs planned to upgrade/install a new EHR within one year
•
SOURCE: ONC analysis of HIMSS Analytics 2013 CAH Survey Supplement and Medicare and Medicaid EHR Incentive Program data Note:
Attestation is based upon ONC analysis of Medicare and Medicaid EHR Incentive Program data
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Arizona EHR Progress
$
Arizona Eligible Hospital Medicare And Medicaid Payments
January 2011 to September 2013
AIU and MU
Program Type
Medicaid
(AHCCCS)
Medicare/Medicaid
AIU
Count
AIU Amount
MU
Count
MU Amount
Total
Count
Total Amount
2
$ 4,580,961
1
$ 1,409,960
3
$
5,990,921
64
$71,283,457
23
$18,412,316
87
$89,695,772
48
$69,189,823
$164,876,517
Medicare
Total
Total Payments to Hospitals:
$164,876,517
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Program Activities
Arizona Health-e Connection
Arizona E-Prescribing Initiatives
Arizona Regional Extension Center
Arizona HIE Marketplace
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Arizona E-Prescribing Initiative
6
AZ eRx Initiative:
Areas of Focus
Pharmacy
Incentive
Program
Provider &
Pharmacy
Technical
Assistance
Education and
Resources
E-Prescribing
of Controlled
Substances
SafeRx Project
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AzHeC eRx Goals
By end of 2013, aim to achieve the following:
• 70% of all Arizona prescription electronically routed to
pharmacies
• 60% of Arizona prescribers routing prescriptions
electronically
• 100% of Arizona pharmacies with e-prescribing
capabilities
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EPCS is LEGAL in Arizona
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Surescripts National
SafeRx Ranking
Surescripts ranks Arizona as 29th in its annual SafeRx rankings
Arizona – 29th
2010
2011
2012
Total Prescriptions Routed Electronically
5.9M
10.8M
16.4M
% of Total Prescriptions Represented by Renewal Response
26%
27%
21%
Prescription benefit requests
9.6M
8.5M
22.4M
115%
64%
62%
2.7M
2.8M
5.2M
Rate of Response to Benefit Requests
(Year-End)
Total Responses to Medication History Requests (est)
*
*
Rankings are calculated to reflect new prescriptions plus responses to prescription renewal requests to mail order and retail pharmacies as a
percentage of all prescriptions within a state that are able to be submitted electronically.
Total number of physicians per state sourced from SK&A. In addition to physicians, nurse practitioners and physician assistants may also eprescribe in the state.
Despite the number 29 ranking, Arizona experienced explosive growth in ePrescribing by
nearly tripling the number of ePrescriptions from 2010 thru 2012
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SafeRx Project
Initial Findings
Surescripts ranks Arizona as 29th in its annual SafeRx rankings
• 21% of total transactions are Refill Responses
– Above average, but number should be higher
• 50% of eligible prescriptions transmitted electronically
– Top 5 average = 66%
• 70% of visits with Rx benefit eligibility requests
– Top 5 average = 97%
• 26% of visits with medication history responses
– Top 5 average = 49%
• 56% of patients with available Rx benefit & Med history data
– Top 5 average = 73%
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Strategy to Improve
SafeRx Ranking
• Payer Outreach
– Low percentage of visits for which eligibility, benefit and
medication history data is available
• Targeted Prescribers
– Low percentage of requests medication history (EHR)
– Low percentage of eligible prescriptions routed electronically
(prescriber)
• Community Awareness
– Low percentage of eligible prescriptions routed electronically
(patient)
The three components are complementary of one another, and the success of one
will positively effect the others. The net result of the approach will increase the
volume of SafeRx-measured transactions
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Technical Assistance
Program
Need assistance with e-prescribing workflow or
technical issues? AzHeC is available to provide
FREE assistance to solve your problems!
Contact AzHeC at 602-688-7200, ehr@azhec.org or visit
http://www.azhec.org/?page=Provider_Assistance to get
assistance today!
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Arizona Regional Extension Center
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What is the REC?
Arizona’s trusted,
unbiased health IT and
Meaningful Use
resource…
assisting 18 CAHs/RHs
and over 2,500 Arizona
providers to achieve
Meaningful Use and
other health IT goals!
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REC CAH/RH
Progress to Date
M1 = Sign-up
CAHs & Rural Hospitals
M2 = Go-Live on
certified EHR
18
18
18
12
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M3 = Stage 1
Meaningful Use
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0
M1
M2
M3
Goal: 18 CAH to
Stage 1 Meaningful Use
by April 5, 2014
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REC Provider
Progress to Date
REC Grant Memberships
M1 = Sign-up
2,500+
3000
M2 = Go-Live on
certified EHR
Specialists
2,200+
2500
1,958
2000
1,958
Non Grant Credit
PPCPs
M3 = Stage 1
Meaningful Use
1500
1,020
1000
Grant Credit PPCPs
500
0
M1
100% of Goal
M2
100% of Goal
M3
52% of Goal
Goal:
1,958 PPCPs to Stage 1
Meaningful Use by April 5,
2014
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Arizona Health Information
Exchange (HIE) Marketplace
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Arizona HIE Marketplace
Purpose
Provide viable
options for health
information
exchange (HIE) to
Arizona health
care providers.
HIE
Marketplace
Phase 1
Direct
Exchange
Phase 2
Basic
Robust
Robust Health
Information
Exchange
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Who Uses Direct Exchange?
Providers
Direct Exchange
can be used by
Long term
care
Hospitals
Direct
Exchange
Users
multiple individuals
and entities for
health care
coordination
purposes.
Laboratories
Patients
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Health Information Network
of Arizona
(HINAz)
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Current Participation
• Current participation includes 35 entities:
•
12 hospitals, including 4 CAHs
•
7 health plans
•
3 community health centers
•
1 reference lab
•
7 community providers
•
3 long term care facilities
•
2 county corrections departments
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Sample of Current
Participants
• Banner Health
• Maricopa Integrated Health
System
• Tucson Medical Center
• Carondelet Health Network
• Northern Arizona Healthcare
• Pima County Corrections
• El Rio Health Center
• Marana Health Center
• Villa Maria Care Center
• Cardiovascular Consultants
• Genesis Ob/Gyn
• Yuma Regional Medical Center
• Casa Grande Regional
Medical Center
• Little Colorado Medical Center
• Copper Queen Community
Hospital
• Sonora Quest Laboratories
• UnitedHealthcare
• Blue Cross Blue Shield of
Arizona
• Care1st Arizona
• AND MORE!
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Participant Status
• Data suppliers status:
• Banner Health – fully live
• Carondelet Health Network – fully live
• Sonora Quest Laboratories – fully live
• Benson Hospital – fully live
• Maricopa Integrated Health Systems – mostly live
• Multi-Specialty Interdisciplinary Clinics (Children’s
Rehabilitation Services) – partially live
• Cardiovascular Consultants – partially live
• Data users status:
• Pima County Detention Center
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Getting the Support
You Need
• E-Prescribing Initiative
– www.azhec.org/?page=eRx_Initiative
•
Arizona Regional Extension Center
– www.arizonarec.org
• HIE Marketplace
– www.azhec.org/?page=HIE_Marketplace
•
Health Information Network of Arizona
– www.hinaz.org
Arizona Health-e Connection
602-688-7200
ehr@azhec.org
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