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EHR & Healthcare

  By Nainil Chheda
 nainil@eliteral.com
http://www.nainil.com
This Presentation Contains
•   EHR Industry Trends
•   HIPAA
•   CCR
•   CCHIT
Percentage Of Office-Based Physicians
 Using Electronic Medical Records, By
               Specialty
Probability Of Using Electronic Medical
 Records (EMRs) By Practice Size And
               Ownership
Degree Of Electronic Health Record
(EHR) Implementation, By Practice
            Size, 2005
Perceived Benefits Of Electronic
 Health Records (EHRs) To The
         Practice, 2005
HIPAA
• What is HIPAA?
  – Health Insurance Portability and Accountability Act of
    1996 (HIPAA), also known as the
    Kennedy/Kassebaum Act
  – Primary purpose was to improve health insurance
    accessibility for people changing employers or leaving
    the workforce
  – HIPAA also included “Administrative Simplification”
    provisions to encourage and protect the electronic
    transmission of health-related data
What are the HIPAA Administrative
   Simplification Provisions?
• 1. National standards for electronic data
  transmission
• 2. Unique health identifiers for providers,
  employers, plans, and individuals
• 3. Security standards to protect electronically
  maintained health information
• 4. Privacy and confidentiality provisions for
  individually identifiable health care data
Who must comply with HIPAA?
1.Health care providers or any other
  person or organization that furnishes, bills,
  or is paid for health care in its normal
  course of business
2.Health plans that provide or pay the cost
  of medical care, including Medicare and
  Medicaid
3.Health care clearinghouses that process
  data elements or transactions
Continuity of Care Records (CCR)
• The CCR, or Continuity of Care Record, is
  a standard specification being developed
  jointly by:
  – ASTM International,
  – the Massachusetts Medical Society (MMS),
  – the Health Information Management and
    Systems Society (HIMSS),
  – and the American Academy of Family
    Physicians (AAFP).
Goal of CCR
• To create a CCR that will enable the next
  provider to easily access the information
  outlined above at the beginning of a first
  encounter and easily update the
  information when the patient goes on to
  another provider, in order to support the
  safety, quality, and continuity of patient
  care.
Uses of CCR
• The CCR may be used as a vehicle to
  exchange clinical information among
  providers, institutions, or other entities.
• It may also be used by the patient as a
  brief summary of recent care.
Conceptual Model of CCR
                              Conceptual Model of the CCR

1    Document Identifying Information
     “From/To” info re Provider/Clinician
     “                                      Optional
     Reason for Referral/Transfer           Extension

2            Patient Identifying            Optional
                Information                 Extension
3                                           Extension   Eligibility, Co-payment, etc.
      Insurance and Financial Info
4      Health Status of Patient             Extension   Med. Specialty-specific Info
       Diagnosis/Problems/Conditions
       Adverse Reaction/Alerts
       Current Medications                  Extension   Disease Management-specific Info
       Immunizations                                    Personal Health Record Info
       Vital Signs                          Extension
                                                        Documented by the Patient
       Lab Results
       Procedures/Assessments

                                            Extension   Med. Specialty-specific Info
5      Care Documentation
                                            Extension   Disease Management-specific Info
                                            Extension   Institution-specific information

                                            Extension   Care Documentation for Payers
                                                        (Attachments)
                                            Extension   Personal Health Record Info
                                                        Documented by the Patient
6     Care Plan Recommendation

                                                                     Version 6– 10/31/03
    Mandated Core Elements of the CCR
CCR Benefits
•   The next healthcare provider will not have to search for or guess about a
    patient’s allergies, medications, or current and recent past diagnoses and
    other pertinent information.
•   The next healthcare provider will be informed about the patient’s most
    recent healthcare assessment and services.
•   The next healthcare provider will be informed about recommendations of
    the caregiver who last treated the patient.
•   As patient demographics will be provided, time and effort will be saved by
    not having to repeatedly ask a patient for demographic information in detail.
    Rather, this information can be more quickly and easily verified.
•   A patient’s insurance status will be more easily established. Over time, this
    can be expanded within the system.
•   Costs associated with the patient’s care will be reduced, for example
    through avoiding repetitive tests and basic information gathering.
•   The effort required to update the patient’s most essential and relevant
    information will be minimized
What is CCHIT?
• CCHIT – Certificate Commission for
  Health Information Technology

• CCHIT's mission:
  To accelerate the adoption of health
  information technology by creating an
  efficient, credible and sustainable product
  certification program
CCHIT’s Goal
• Reduce the risk of HIT investment by
  physicians and other providers
• Ensure interoperability (compatibility) of
  HIT products
• Assure the participants that the ROI will be
  improved quality
• Protect the privacy of patients' personal
  health information
Who would benefit from CCHIT
• Physicians & Hospitals
• Health Systems
• Vendors
• Healthcare consumers (accurate & secure
  record of health)
• Standards development experts (CCR)
• Quality Improvement Organizations
  (CCHIT)
Thank You
• Nainil Chheda
• www.nainil.com
Copyright Information
No part of this publication may be reproduced or transmitted in any
  form or for any purpose without the express permission of Nainil
  Chheda (nainil@eliteral.com). The information contained herein may
  be changed without prior notice.

Data contained in this document serves informational purposes only.

The information in this document is proprietary to Nainil Chheda. This
  document is a preliminary version and not subject to other
  agreement with Nainil Chheda. Nainil assumes no responsibility for
  errors or omissions in this document. Nainil does not warrant the
  accuracy or completeness of the information, text, graphics, links, or
  other items contained within this material. Nainil shall have no
  liability for damages of any kind including without limitation direct,
  special, indirect, or consequential damages that may result from the
  use of these materials.

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EHR Healthcare Trends HIPAA CCR CCHIT

  • 1. EHR & Healthcare By Nainil Chheda nainil@eliteral.com http://www.nainil.com
  • 2. This Presentation Contains • EHR Industry Trends • HIPAA • CCR • CCHIT
  • 3. Percentage Of Office-Based Physicians Using Electronic Medical Records, By Specialty
  • 4. Probability Of Using Electronic Medical Records (EMRs) By Practice Size And Ownership
  • 5. Degree Of Electronic Health Record (EHR) Implementation, By Practice Size, 2005
  • 6. Perceived Benefits Of Electronic Health Records (EHRs) To The Practice, 2005
  • 7. HIPAA • What is HIPAA? – Health Insurance Portability and Accountability Act of 1996 (HIPAA), also known as the Kennedy/Kassebaum Act – Primary purpose was to improve health insurance accessibility for people changing employers or leaving the workforce – HIPAA also included “Administrative Simplification” provisions to encourage and protect the electronic transmission of health-related data
  • 8. What are the HIPAA Administrative Simplification Provisions? • 1. National standards for electronic data transmission • 2. Unique health identifiers for providers, employers, plans, and individuals • 3. Security standards to protect electronically maintained health information • 4. Privacy and confidentiality provisions for individually identifiable health care data
  • 9. Who must comply with HIPAA? 1.Health care providers or any other person or organization that furnishes, bills, or is paid for health care in its normal course of business 2.Health plans that provide or pay the cost of medical care, including Medicare and Medicaid 3.Health care clearinghouses that process data elements or transactions
  • 10. Continuity of Care Records (CCR) • The CCR, or Continuity of Care Record, is a standard specification being developed jointly by: – ASTM International, – the Massachusetts Medical Society (MMS), – the Health Information Management and Systems Society (HIMSS), – and the American Academy of Family Physicians (AAFP).
  • 11. Goal of CCR • To create a CCR that will enable the next provider to easily access the information outlined above at the beginning of a first encounter and easily update the information when the patient goes on to another provider, in order to support the safety, quality, and continuity of patient care.
  • 12. Uses of CCR • The CCR may be used as a vehicle to exchange clinical information among providers, institutions, or other entities. • It may also be used by the patient as a brief summary of recent care.
  • 13. Conceptual Model of CCR Conceptual Model of the CCR 1 Document Identifying Information “From/To” info re Provider/Clinician “ Optional Reason for Referral/Transfer Extension 2 Patient Identifying Optional Information Extension 3 Extension Eligibility, Co-payment, etc. Insurance and Financial Info 4 Health Status of Patient Extension Med. Specialty-specific Info Diagnosis/Problems/Conditions Adverse Reaction/Alerts Current Medications Extension Disease Management-specific Info Immunizations Personal Health Record Info Vital Signs Extension Documented by the Patient Lab Results Procedures/Assessments Extension Med. Specialty-specific Info 5 Care Documentation Extension Disease Management-specific Info Extension Institution-specific information Extension Care Documentation for Payers (Attachments) Extension Personal Health Record Info Documented by the Patient 6 Care Plan Recommendation Version 6– 10/31/03 Mandated Core Elements of the CCR
  • 14. CCR Benefits • The next healthcare provider will not have to search for or guess about a patient’s allergies, medications, or current and recent past diagnoses and other pertinent information. • The next healthcare provider will be informed about the patient’s most recent healthcare assessment and services. • The next healthcare provider will be informed about recommendations of the caregiver who last treated the patient. • As patient demographics will be provided, time and effort will be saved by not having to repeatedly ask a patient for demographic information in detail. Rather, this information can be more quickly and easily verified. • A patient’s insurance status will be more easily established. Over time, this can be expanded within the system. • Costs associated with the patient’s care will be reduced, for example through avoiding repetitive tests and basic information gathering. • The effort required to update the patient’s most essential and relevant information will be minimized
  • 15. What is CCHIT? • CCHIT – Certificate Commission for Health Information Technology • CCHIT's mission: To accelerate the adoption of health information technology by creating an efficient, credible and sustainable product certification program
  • 16. CCHIT’s Goal • Reduce the risk of HIT investment by physicians and other providers • Ensure interoperability (compatibility) of HIT products • Assure the participants that the ROI will be improved quality • Protect the privacy of patients' personal health information
  • 17. Who would benefit from CCHIT • Physicians & Hospitals • Health Systems • Vendors • Healthcare consumers (accurate & secure record of health) • Standards development experts (CCR) • Quality Improvement Organizations (CCHIT)
  • 18. Thank You • Nainil Chheda • www.nainil.com
  • 19. Copyright Information No part of this publication may be reproduced or transmitted in any form or for any purpose without the express permission of Nainil Chheda (nainil@eliteral.com). The information contained herein may be changed without prior notice. Data contained in this document serves informational purposes only. The information in this document is proprietary to Nainil Chheda. This document is a preliminary version and not subject to other agreement with Nainil Chheda. Nainil assumes no responsibility for errors or omissions in this document. Nainil does not warrant the accuracy or completeness of the information, text, graphics, links, or other items contained within this material. Nainil shall have no liability for damages of any kind including without limitation direct, special, indirect, or consequential damages that may result from the use of these materials.