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Maine, Kentucky and Ohio are among states that have most accelerated the adoption of meaningful use of electronic health records and whose healthcare providers have received incentive payments at a high rate.
Farzad Mostashari, MD, the national health IT coordinator, saluted those states and others that have accelerated EHR adoption and celebrated three years of work by those who have received grants, such as state health information exchanges, workforce training and community college programs, model beacon communities and regional health IT extension centers.
Health IT representatives from the states described how they relied on various programs funded by the Office of the National Coordinator for Health IT to achieve high rates of meaningful use, such as beacon communities and extension centers.
Across the Medicare and Medicaid meaningful use programs, 81 percent, or 4,114 hospitals, are now registered, while the majority of hospitals have received payments under the health IT incentive program, Mostashari said at the 2012 ONC annual meeting on Dec. 12. For eligible physicians and professionals, 320,000, or 62 percent of the total 520,000 who may qualify, have registered and half of them have been paid.
“It’s finally happening that when my patient shows up in another hospital’s emergency room, it might make financial sense to want that other hospital to know that the patient was just discharged from my hospital. Technology is on the move. Payment systems are shifting,” he said.
Mostashari spotlighted Maine, "the small but mighty," for its proportion of the state participating in the meaningful use program. Cathy Bruno, executive sponsor of Bangor Beacon Community and vice president and chief information officer of Eastern Maine Healthcare. Systems, said that Maine Medicaid’s meaningful use program has distributed $62 million to 2,000 professionals and all of Maine’s hospitals. The state’s regional extension center is helping providers reach meaningful use and connecting them with the statewide health information exchange.
“Coupled with comprehensive care management efforts, the Bangor Beacon Community is changing the way healthcare services are delivered, patient information is shared and the way we work together to care for our community,” she said.
Over the past year, ONC has challenged states to vie for the highest percentage of eligible physicians and hospitals paid incentives. Mostashari said the states with the highest percentages are:
• Maine, 42 percent
• Delaware, 34 percent
• Massachusetts, 33 percent
• New Hampshire, 32 percent
• Mississippi, 31 percent
Mostashari also recognized those states that have moved up the most in the rankings, including California, Georgia, Rhode Island, Washington, Kentucky, Wisconsin, Connecticut, New York, New Jersey, and Iowa.
He said, however, that it’s not enough to have adoption of systems, certified products, meaningful use attestations, directed exchanges, or query transactions, and improvements in process measures.
“We need to help doctors, hospitals, and patients who are using this technology make it meaningful,” he said.
He cited examples from the North Carolina AHEC (Area Health Education Center), which decreased the proportion of their patients with A1C measurements greater than 9 from 40 percent down to 10 percent. The New Orleans AIDS taskforce has used registry functions to perform risk stratification to identify who is at highest need. And the Lone Star Circle of Care Health Center in Texas uses analytics from clinical quality measures on all patients, and not just a required sample, to find out who needs help to improve.
“We have challenges in changing cultures, expectations and clinical leadership, and fusing together the technology with payment models and incorporating the patients as partners, and figuring out the workflows and ensuring the privacy and security of patients,” Mostashari said.
To that end, ONC launched an education effort at the meeting to offer online tools, videos, and fact sheets to help providers and organizations protect patients’ health information when using smart phones, tablets and other mobile devices.