# Presentation: 740112

## MASSACHUSETTS eHEALTH COLLABORATIVEAHIC Quality Working Group

**April 2007**

## AGENDA

**AGENDA**

**MAeHC Background**
**MAeHC Quality Measurement Initiatives**

## MAeHC ROOTS ARE IN MOVEMENT TO IMPROVE QUALITY, SAFETY, EFFICIENCY OF CARE

**Universal adoption of electronic health records**
**MA-SAFE**

**$50M commitment to heath information infrastructure**
**Recognition of “systems” problem**

## 33 ORGANIZATIONS ON MAeHC BOARD

**33 ORGANIZATIONS ON MAeHC BOARD**

**Health plans and payer organizations**
**Blue Cross Blue Shield of Massachusetts**
**Fallon Community Health Plan**
**Harvard Pilgrim Health Care**
**Massachusetts Association of Health Plans**
**Tufts Associated Health Maintenance Organization**
**Healthcare purchaser organizations**
**Associated Industries of Massachusetts**
**Massachusetts Business Roundtable**
**Massachusetts Group Insurance Commission**
**Non-voting members**
**Center for Medicare & Medicaid Services**

**Hospitals and hospital associations**
**Baystate Health System**
**Beth Israel Deaconess Medical Center**
**Boston Medical Center**
**Caritas Christi**
**Fallon Clinic, Inc.**
**Lahey Clinic Medical Center**
**Massachusetts Hospital Association**
**Massachusetts Council of Community Hospitals**
**Partners Healthcare**
**Tufts-New England Medical Center**
**University of Massachusetts Memorial Medical Center**
**Governmental agencies**
**Executive Office of Health and Human Services**

**Healthcare professional associations**
**American College of Physicians **
**Massachusetts League of Community Health Centers**
**Massachusetts Medical Society**
**Massachusetts Nurses Association**
**Consumer, public interest, and at-large**
**Health Care for All**
**Massachusetts Coalition for the Prevention of Medical Errors**
**Massachusetts Health Data Consortium**
**Massachusetts Taxpayers Foundation**
**Massachusetts Technology Collaborative**
**MassPRO, Inc.**
**New England Healthcare Institute**
**Massachusetts Health Quality Partners**
**Tufts University Medical School**
**UMass Medical School**

## THREE COMMUNITIES SELECTED FROM 35 APPLICANTS

***Newburyport***

***Brockton***

***North Adams***

## SCOPE OF PILOT PROJECTS

**Offices**

**111**

**41**

**25**

**177**

**Small**

**Med**

**Large**

**295**

**85**

**65**

**445**

**PCPs**

**Specialists**

**Physicians**

**Almost 450 physicians...**

**...****who care for ~500K patients...**

**...****in almost 200 offices.**

**Brockton**

**Newburyport**

**N. Adams**

**All**

**Brockton**

**Newburyport**

**N. Adams**

**All**

**Brockton**

**Newburyport**

**N. Adams**

**All**

## PILOT PROJECTS HAVE FOUR MAIN PIECES

**PILOT PROJECTS HAVE FOUR MAIN PIECES**

** ****Quality**
** ****Cost**
** ****Productivity**
** ****Etc.**

**Connectivity**

**Clinical IT implementation/ support**

**Evaluation**

**Quality measurement**
**Pilot evaluation**

**Clinical access to data**
**Data gathering and aggregation**
**Communication**

**Hardware/software**
**Implementation/tech support**
**Systems integration**
**Workflow redesign**
**Decision support**

**Intra-community connectivity**

**Management & coordination**

**Joint oversight and decision-making bodies**
**Multi-stakeholder governance**

## MAeHC PILOT PROJECTS SLATED TO END IN JULY 2008Pilot Extension To Continue To July 2010 

**MAeHC PILOT PROJECTS SLATED TO END IN JULY 2008****Pilot Extension To Continue To July 2010**** **

**Activities**

**2004**

**2005**

**2006**

**2007**

**2008**

**ACP-MA summit**
**MAeHC launch**
**Community RFA launch**
**Pilot communities announced**
**EHR vendor RFP**
**EHR vendor finalization**
**Physician recruitment**
**EHR implementation**
**HIE implementation**
**Evaluation**
**Formal pilot completion**

## PILOT COMMUNITIES WILL BE THE FIRST IN THE COUNTRY TO BE COMPLETELY “WIRED” FOR HEALTHCARE

- Ethel Roy, 81, visited earlier this month with Dr. Stephen St. Clair, her urologist, at his office in North Adams. (Stephen Rose for the Boston Globe)** **

## HEALTH INFORMATION EXCHANGENorthern Berkshire Example

***Patient recruitment***

***Health data exchange***

***Referrals mgmt***

***Patient portal***

## DISTINGUISHING THE OFFICE RECORD FROM THE COMMUNITY RECORD

**DISTINGUISHING THE OFFICE RECORD FROM ****THE COMMUNITY RECORD**

## Slide 12

## AGENDA

**AGENDA**

**MAeHC Background**
**MAeHC Quality Measurement Initiatives**

## MAeHC QUALITY DATA WAREHOUSE DATA FLOWS

## MAeHC QUALITY DATA WAREHOUSE PRIVACY APPROACH

**MAeHC QUALITY DATA WAREHOUSE PRIVACY APPROACH**

**Brockton**

**Newburyport**

**North Adams**

**Outcomes analysis**

**Benchmarking**

## MAeHC QUALITY DATA WAREHOUSE BENCHMARKING METRICS

**1.  Breast Cancer Screening**
**2.  Colorectal Cancer Screening**
**3.  Cervical Cancer Screening**
**4.  Tobacco Use #**
**5.  Advising Smokers to Quit**
**6.  Influenza Vaccination**
**7.  Pneumonia Vaccination**
**8.  Drug Therapy for Lowering LDL Cholesterol#**
**9.  Beta-Blocker Treatment after Heart Attack**
**10.  Beta-Blocker Therapy – Post MI**
**11.  ACE Inhibitor /ARB Therapy#**
**12.  LVF Assessment#**
**13.  HbA1C Management**
**14.  HbA1C Management Control**
**15.  Blood Pressure Management#**
**16.  Lipid Measurement**
**17.  LDL Cholesterol Level (<130mg/dL)**
**18.  Eye Exam**
**19.  Use of Appropriate Medications for People w/ Asthma**
**20.  Asthma: Pharmacologic Therapy#**
**21.  Antidepressant Medication Management 1**
**22.  Antidepressant Medication Management 2**
**23.  Screening for Human Immunodeficiency Virus#**
**24.  Anti-D Immune Globulin#**
**25.  Appropriate Treatment for Children with Upper RI**
**26.  Appropriate Testing for Children with Pharyngitis**

***CLINICAL MEASURES FOR PHYSICIAN PERFORMANCE***
***AQA Recommended Starter Set***

**Patient demographics**
**Medications**
**Problems**
**Procedures**
**Allergies**
**Lab Results**
**Radiology Results**
**Immunizations**
**Vitals**

***Clinical data “superset”***

## QUALITY DATA WAREHOUSE CHALLENGES

**QUALITY DATA WAREHOUSE CHALLENGES**

**Brockton**

**Newburyport**

**North Adams**

**Outcomes analysis**

**Benchmarking**

## www.maehc.orgMicky Tripathi, PhD MPPPresident & CEOmtripathi@maehc.org781-434-7905