Expanding Access to Financing & Telehealth for Rural Health Care Providers: Washington State September 13, 2016 in Olympia, Washington September 15, 2016 in Cheney, Washington Leila Samy, MPH Rural Health and Veteran Health Office of the National Coordinator US Department of Health and Human Services
Within an agency charged with promoting nationwide adoption of technology in healthcare to transform care delivery, I am charged with working to ensure that rural communities are not left behind . Leila Samy Rural Health Coordinator HHS Office of the National Coordinator for Health IT @LeilaSamy Office of the National Coordinator for 2 Health IT
What I’ll Cover Here 1. Data and trends in Health IT and eHealth Overall, Rural, Critical Access Hospitals (CAH) – 2. Collaborative rural health and Veteran health initiatives 3. Links to resources Office of the National Coordinator for 3 Health IT
Hospitals receiving incentive payments for EHR Adoption or Meaningful Use: 2011-2013 Click here for animated version Office of the National Coordinator for 4 Health IT
Percent of Physicians e-Prescribing through an Electronic Health Record : 2008-2013 Click here for animated version Office of the National Coordinator for 5 Health IT
Percent of Physicians e-Prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, 2008-2013 2008 2009 2010 2011 2012 2013 Created by HHS Office of the National Coordinator for Health IT, Office of Economic Analysis, Evaluation, and Modeling 6
Percent of Physicians e-Prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, 2008-2013 2008 2009 2010 2011 2012 2013 Created by HHS Office of the National Coordinator for Health IT, Office of Economic Analysis, Evaluation, and Modeling 7
Percent of Physicians e-Prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, 2008-2013 2008 2009 2010 2011 2012 2013 Created by HHS Office of the National Coordinator for Health IT, Office of Economic Analysis, Evaluation, and Modeling 8
Percent of Physicians e-Prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, 2008-2013 2008 2009 2010 2011 2012 2013 Created by HHS Office of the National Coordinator for Health IT, Office of Economic Analysis, Evaluation, and Modeling 9
Percent of Physicians e-Prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, 2008-2013 2008 2009 2010 2011 2012 2013 Created by HHS Office of the National Coordinator for Health IT, Office of Economic Analysis, Evaluation, and Modeling 10
Percent of Physicians e-Prescribing through an Electronic Health Record Local Area Trends of EHR Adoption, 2008-2013 2008 2009 2010 2011 2012 2013 Created by HHS Office of the National Coordinator for Health IT, Office of Economic Analysis, Evaluation, and Modeling 11
Payments under the Medicare or Medicaid EHR Incentive Program Eligible Professionals and Hospitals The Medicare and Medicaid EHR Incentive Programs have cumulatively paid $22.9 billion in incentive payments as of March 2014 Cumulative Total $1,800 $25,000 $22,904 $1,600 $1,254.5 $20,000 Cumulative Amount Paid (Millions) Amount Paid per Month (Millions) $1,400 Monthly Total $1,200 Cumulative Total $15,000 Note: Payments for May $1,000 2012 and June 2013 include payments to Medicare Advantage $800 providers. $10,000 $600 $400 $5,000 $200 $0 $0 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Source: CMS EHR Incentive Program Office of the National Coordinator for Health Information Technology 12 Data as of 03/31/2014
Progress with Adoption of Health IT and eHealth Office of the National Coordinator for 13 Health IT
How Are We Doing in Rural Areas? Basic EHR adoption among office-based physicians in rural areas and small primary care practices Rural: 38% Small primary care practices: 35% Total: 34% Note: From 2009 to 2011, the adoption rate for rural providers *more than doubled* and the percentage of rural physicians that have adopted EHRs slightly higher than for physicians overall Rural refers to physicians in a county outside of a Metropolitan Statistical Area. Small primary care practices refer to primary care physicians in practices with 10 or fewer physicians. Data source: National Ambulatory Medical Care Survey (NAMCS) Electronic Health Record Supplement mail surveys, 2008-2011.
How Are We Doing in Rural Areas? Percent of Pharmacies in Urban and Rural Counties Enabled on the Surescripts Network 100% 94% 90% 92% 80% Percent Active December 2008: Urban 75%, Rural 61% Percent Active April 2012: Urban 93%, Rural 91% 70% 60% 50% Note: From 2009 to 2012, rural 40% pharmacies actively prescribing 30% medication electronically *increased by 50%* 20% 10% 0% Dec-08 Jan-09 Feb-09 Mar-09 Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 Percent Enabled (Urban) Percent Enabled (Rural) Office of the National Coordinator for 15 Health IT
95 Percent of All Eligible Hospitals Demonstrated Meaningful Use of Certified Health IT by 2015 Office of the National Coordinator for 16 Health IT
93 Percent of Critical Access and Small Rural Hospitals Demonstrated Meaningful Use of Certified Health IT by 2015 Office of the National Coordinator for 17 Health IT
Office of the National Coordinator for 18 Health IT
Location of Critical Access and Small Rural Hospitals that Demonstrated Meaningful Use of Health IT Under Medicare as of April 2015 Percent of All Eligible Hospitals that Demonstrated Meaningful Use Under Medicare, April 2015 Office of the National Coordinator for 19 Health IT
2013 CAH Survey Data – What we’ve learned See: http://goo.gl/hoo5YR Office of the National Coordinator for 20 Health IT
CAH Progress with Advanced Health IT Capabilities As of 2013, 89 percent of CAHs had an EHR in place; • – 62% with an EHR had a fully electronic system, – 27% with an EHR had a system that was part electronic and part paper. Most CAHs adopted (as of 2013) or planned to adopt (by the end of • 2014) telehealth, teleradiology, and capabilities associated with care coordination and health information exchange with other providers and patients. As of 2013, CAHs reported the highest rates of adoption for • teleradiology (70%) and telehealth (59%) capabilities. 15% of CAHs reported patient engagement capabilities. Office of the National Coordinator for 21 Health IT
Critical Access Hospital Challenges and Factors Associated with Advanced Health IT Capabilities • Financing and workforce related challenges were most commonly reported. • CAHs that pooled resources with other hospitals were more likely to have EHR and capabilities related to health information exchange and care coordination. • CAHs with faster internet upload speeds were more likely to have the capability to provide patients with the option to view, download, and transmit their health information. Office of the National Coordinator for 22 Health IT
Links to Data on CAH Progress and Challenges • ONC Blog Posting: http://goo.gl/hoo5YR • ONC Data Brief: http://goo.gl/gkMx9y • Health Affairs paper on CAH progress and challenges: http://goo.gl/sAF6At Office of the National Coordinator for 23 Health IT
More Data Health IT use varies dramatically among rural providers • HHS funded technical assistance had a huge impact among rural • providers Missing a year of incentive payments was more common among • rural providers Rural providers and hospitals had higher rates of electronic • exchange with other providers, but lower rates of exchange with patients Office of the National Coordinator for 24 Health IT
WHAT ARE WE DOING TO HELP? Office of the National Coordinator for 25 Health IT
Collaborate with and Leverage Federal and private sector partners • Streamline programs serving rural America 1. Technical assistance 2. Funding , Broadband & Workforce 3. Veterans’ Care Coordination and Quality Office of the National Coordinator for 26 Health IT
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