Intro to Health Informatics 第二周笔记

Federal policies and initiatives to encourage healthcare providers to adopt Electronic Health records (EHR).

chronic disease patient sees a lot of doctors per year

Average multi-chronic disease patient see 14 healthcare providers per year.

US has less PCPs comparing to other countries

More physician leads to more incomplete or missing records

Poor coordination btw/ physicians leads to mis use of medications, duplicate medications and no medication review for a lot of patients -- solution: medication reconciliation form.

E-prescribing as a solution for errors

2 reasons: people are living longer and having more behavior issues

P4P: pay for performance.

PGP:Physician group practice project

Marshfield EHR

ACO: Accountable care organization. Pioneer ACOs mush:

Pioneer ACOs

Paste_Image.png

quality reporting

Outcome measure： mean A1C

Meaningful Use stages

Stage 1 Mu measures

Stage 1 MU clinical measures

Stage 2 MU

Stage 2 encourages User usage: VDT

Stage 3: proposed standard 1

Stage3: proposed patient engagement requirement

Stage3: proposed provider requirement

Stage 3: proposed Interoperability requirements 1

Stage 3: proposed Interoperability requirements 2

Types of incentives

Medicare Incentiev payment

Status Update

Status Update

Who adopted EMR

Most of the adopter are happy

about 18% say they would like to return to paper given the chance.

todo: summarize the interview.

Supplementary Materials

《Contemporary Health Informatics》Chapter 2 Summary

Key Concepts/Vocabulary

● “Pay-for-performance” ● Office of the National Coordinator for Health IT (ONC) ● EHR certification ● Meaningful Use and Its Three Stages ● Incentive payments for Medicare/Medicaid Providers ● Process and Outcome Quality Measures ● Secondary Use of Clinical Data

Readings

• The growing burden of chronic disease in America.
• ARHQ - Reducing and Preventing Adverse Drug Events To Decrease Hospital Costs
• The National Progress Report and Safe-Rx Rankings Year 2012 (PDF)
• Medscape - Why Are So Many Patients Noncompliant?
• CDC - Multiple Chronic Conditions Among Adults Aged 45 and Over: Trends Over the Past 10 Years (PDF)
• Better to BEST (PDF)
• CMS - PGP Fact Sheet (PDF)
• ACO Results: What We Know So Far
• HealthIT - Eligible Professionals & Eligible Hospitals
• HealthIT - Certification Programs & Policy
• HealthIT - Testing and Test Methods
• AHRQ - Selecting Structure Measures for Clinical Quality Measurement
• Medical records, patient care, and medical education
• CMS - 2014 Definition Stage 1 of Meaningful Use
• HealthIT - CMS Electronic Health Record Incentive Programs
• CMS - Eligible Professional Meaningful Use Table of Contents (PDF)
• CMS - Stage 2 - Centers for Medicare and Medicaid Services
• HealthIT - Patient Ability Electronically View Health Information
• CMS - EHR Incentive Programs
• HealthIT - Electronic Health Record Adoption
• CDC - Physician Adoption of Electronic Health Record Systems: United States, 2011 (PDF)
• RAND Research Report - Factors Affecting Physician Professional Satisfaction and Their Implications for Patient Care, Health Systems, and Health Policy
• NEJM - Implementation of the Federal Health Information Technology Initiative

Graphics

• Lesson 2 Exercise 2
• Lesson 2 Exercise 5

Websites

• http://innovation.cms.gov/initiatives/Pioneer-ACO-Model/
• http://www.healthit.gov/

2015-08-30 初稿
2015-09-07 补充Supplementary Materials