Health IT Policy Committee Meeting May 6, 2014 Data Analytics Update 1.

Health IT Policy Committee MeetingMay 6, 2014

Data Analytics Update

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Hospital EHR and Stage 2 functionality adoption: 2013 survey data

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HOSPITAL EHR AND STAGE 2 FUNCTIONALITY ADOPTION

Draft timeline of upcoming data on meaningful useimplementation and impacts

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Q214

Q314

Q414

Q115

Continue monitoring provider adoption of functionalities necessary for Stage 2 and potential Stage 3 objectives

-- Hospital survey data collected in late 2013(AHA Health IT Supplement)

-- Hospital survey data collected in late 2014(AHA Health IT Supplement)

-- Physician survey data collected in mid 2014(National Ambulatory Medical Care Survey EHR Supplement)

Monitor number of providers attesting to Stage 2 and their performance on Stage 2 objectives

-- EHR Incentive Program attestation data (most 2014 attestations expected to occur in quarters 3 and 4; data from early attesters may be available after quarter 2)

Evaluate proposed Stage 3 objectives to identify potential policy adjustments and best practices for implementation

-- 12 quantitative and qualitative research projects funded by the Agency for Healthcare Research and Quality

Continue assessing whether physicians report clinical benefits from meaningful use functionalities and objectives

-- Physician survey data on benefits from meaningful use EHRs and proposed Stage 3 objectives collected mid 2013 (Physician Workflow Survey)

Estimated date of data availability(calendar year quarters)

Today’s focus

Hospital EHR adoption has increasedmore than five-fold since 2008

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NOTES: Basic EHR adoption requires the EHR system to have a set of 10 EHR functions including clinician notes. A certified EHR is EHR technology that has been certified as meeting federal requirements for some or all of the hospital objectives of the CMS EHR Incentive Program. Possession means that the hospital has a legal agreement with the EHR vendor, but is not equivalent to adoption.*Significantly different from previous year (p < 0.05).SOURCE: ONC/American Hospital Association (AHA), AHA Annual Survey Information Technology Supplement

EHR adoption among non-federal acute care hospitals: 2008-2013

Most stage 2 functionalities had high adoption rates

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Hospital adoption of computerized capabilities to meet meaningful use stage 2 objectives, 2012-2013

*Data not available for 2012. NOTES: Estimates reflect the survey responses of 2,655 non-federal acute care hospitals. Estimates calculated from answers to the survey question “Does your hospital currently have a computerized system which allows for…?” [multiple functionalities listed]SOURCE: ONC/American Hospital Association (AHA), AHA Annual Survey Information Technology Supplement

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Adoption rates for selected patient engagement functionalities were variable

Hospital adoption of patient engagement functionalities, 2012-2013

*Data not available for 2012. NOTES: MU is meaningful use. Estimates reflect the survey responses of 2,655 non-federal acute care hospitals. Estimates calculated from answers to the survey questions “Does your hospital currently have an electronic system that allows you to do the following?” [multiple functionalities listed] and “Are patients able to do any of the following regarding their health/medical records?” [multiple functionalities listed] SOURCE: ONC/American Hospital Association (AHA), AHA Annual Survey Information Technology Supplement

Many hospitals had adopted most stage 2 core functionalities; few had adopted all

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>=1 >=2 >=3 >=4 >=5 >=6 >=7 >=8 >=9 >=10 >=11 >=12 >=13 >=14 >=15 160%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100% 99% 98% 98% 97% 97% 96% 96% 94% 92%88%

81%

71%

58%

45%

27%

6%

Number of stage 2 core functionalities adopted

Perc

ent o

f hos

pita

ls

Hospital adoption of computerized capabilities to meet meaningful use stage 2 objectives, 2013

NOTES: Estimates reflect the survey responses of 2,655 non-federal acute care hospitals. Estimates calculated from answers to the survey question “Does your hospital currently have a computerized system which allows for…?” [multiple functionalities listed]. The survey queried on adoption of capabilities related to 16 Stage 2 core objectives; estimates reflect the number of objectives the hospital reported having adopted.SOURCE: ONC/American Hospital Association (AHA), AHA Annual Survey Information Technology Supplement

Some differences in number of stage 2 core functionalities adopted by hospital characteristics

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>=8 >=12 >=13 >=14 >=15 160%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Critical Access Small rural Small urbanMedium Large

Number of stage 2 core functionalities adopted

Perc

ent o

f hos

pita

ls

NOTES: Estimates reflect the survey responses of 2,655 non-federal acute care hospitals. Estimates calculated from answers to the survey question “Does your hospital currently have a computerized system which allows for…?” [multiple functionalities listed]. The survey queried on adoption of capabilities related to 16 Stage 2 core objectives; estimates reflect the number of objectives the hospital reported having adopted. Large = 400+ staffed beds; Medium = 100-399 staffed beds; Small = <100 staffed beds. Rural = non-metropolitan; Urban = metropolitan. SOURCE: ONC/American Hospital Association (AHA), AHA Annual Survey Information Technology Supplement

Hospital adoption of computerized capabilities to meet meaningful use stage 2 objectives by hospital size/type/location, 2013

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2014 Edition EHR Certification Update2014 EDITION EHR CERTIFICATION UPDATE

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Most attested hospitals have products with 2014 Edition versions certified as of April 2014

5%

19%

76%

Current vendor(s) do not have 2014 Base EHR certifiedLikely can meet 2014 Base EHR with new product(s) from current vendor(s)Likely can upgrade current product(s) to 2014 Edition to meet 2014 Base EHR

N = 4.1k

Eligible hospitals by 2014 Edition certification status of products used to attest in 2011-2013, April 2014

NOTES: Estimates based on product(s) eligible hospitals used to attest to Meaningful Use in the Medicare EHR Incentive Program merged to the Certified Health IT Products List to obtain information on whether 2014 Edition versions of the product(s) had been certified as of April 18, 2014. Estimates reflect certification status only and do not reflect vendor/product rollout or implementation timelines.

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Few differences in 2014 Edition certification status by hospital characteristics

All Hospitals Critical Access Small Rural Small Urban Medium Large

-0.0478852698104035 -0.0600985221674877-0.0922509225092251-0.0726872246696035-0.0227412415488629-0.0260663507109005

0.194701020904229 0.1891625615763550.1457564575645760.2246696035242290.1954517516902270.23696682464455

0.757413709285367 0.7507389162561580.76199261992620.702643171806167

0.781807006760910.73696682464455


N = 4,114 N = 1,015N = 542 N = 454

N = 1,627 N = 311

NOTES: Estimates based on product(s) eligible hospitals used to attest to Meaningful Use in the Medicare EHR Incentive Program merged to the Certified Health IT Products List to obtain information on whether 2014 Edition versions of the product(s) had been certified as of April 18, 2014. Estimates reflect certification status only and do not reflect vendor/product rollout or implementation timelines. Large = 400+ staffed beds; Medium = 100-399 staffed beds; Small = <100 staffed beds. Rural = non-metropolitan; Urban = metropolitan.

Eligible hospitals by 2014 Edition certification status of products used to attest in 2011-2013, April 2014

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Most attested professionals used products with 2014 Edition versions certified as of April 2014

17%

5%

78%


N = 267k

Eligible professionals by 2014 Edition certification status of products used to attest in 2011-2013, April 2014

NOTES: Estimates based on product(s) eligible professionals used to attest to Meaningful Use in the Medicare EHR Incentive Program merged to the Certified Health IT Products List to obtain information on whether 2014 Edition versions of the product(s) had been certified as of April 18, 2014. Estimates reflect certification status only and do not reflect vendor/product rollout or implementation timelines.

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Some differences in 2014 Edition certification statusby professional type/specialty

-0.167437073079442 -0.0812727143162545-0.108840664457583-0.153794313468041-0.235757003462386-0.117021276595745

-0.233887349953832-0.441135993994745

-0.872382719321495

0.05464208851876110.07118933941423790.0397959846663635

0.0577948711990054

0.154128632882174

0.09574468085106380.012280701754386

0.0598023270361567

0.777920838401797 0.8475379462695080.8513633508760530.7884108153329540.61011436365544

0.7872340425531920.753831948291782

0.499061678969098

0.125099390405513


N = 267k N = 28k N = 92k N = 86k

Physicians Non-Physicians

N = 9k N = 94 N = 10k N = 8k N = 7k

Eligible professionals by 2014 Edition certification status of products used to attest in 2011-2013, April 2014

NOTES: Estimates based on product(s) eligible professionals used to attest to Meaningful Use in the Medicare EHR Incentive Program merged to the Certified Health IT Products List to obtain information on whether 2014 Edition versions of the product(s) had been certified as of April 18, 2014. Estimates reflect certification status only and do not reflect vendor/product rollout or implementation timelines.

147 Inpatient EHR Vendors

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142 36 25 68 54Inpatient

CEHRT Vendors(N = 325)

2011 only(N = 178)

2014 only(N = 54)

To which editions has vendor certified any product(s)?

Were vendor’s product(s) used to attest in 2011-2013?

2011 and 2014(N = 93)

Not used to attest in 2011-2013


Used to attest in2011-2013

147 Inpatient EHR vendors had 2014 Edition certified products as of April 2014

Never used to attest in 2011-2013, not yet certified to 2014 Edition

Used to attest in 2011-2013, not yet certified to 2014 Edition

Used to attest in 2011-2013, certified to 2014 Edition

Never used to attest in 2011-2013, certified to 2014 Edition

New vendor (no 2011 Edition product), certified to 2014 Edition

Inpatient EHR vendors by editions of products certified and whether products have been used to attest, April 2014

245 Ambulatory EHR Vendors

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327 384 108 55 82Ambulatory

CEHRT Vendors(N = 956)

2011 only(N = 178)

2014 only(N = 82)

To which editions has vendor certified any product(s)?

Were vendor’s product(s) used to attest in 2011-2013?

2011 and 2014(N = 163)



Used to attest in2011-2013

245 Ambulatory EHR vendors had 2014 Edition certified products as of April 2014

Never used to attest in 2011-2013, not yet certified to 2014 Edition

Used to attest in 2011-2013, not yet certified to 2014 Edition

Used to attest in 2011-2013, certified to 2014 Edition

Never used to attest in 2011-2013, certified to 2014 Edition

New vendor (no 2011 Edition product), certified to 2014 Edition

Ambulatory EHR vendors by editions of products certified and whether products have been used to attest, April 2014

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Plans for next update in June:

Comprehensive analysis of three years of EHR Incentive Programs, 2011-2013

Year-over-year progress and performance by key characteristics and geography

PLANS FOR NEXT UPDATE IN JUNE

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Questions?QUESTIONS?

Health IT Policy Committee Meeting May 6, 2014 Data Analytics Update 1.

Documents

Transcript of Health IT Policy Committee Meeting May 6, 2014 Data Analytics Update 1.