# Presentation: 020979

## MASSACHUSETTS eHEALTH COLLABORATIVE

**June 2005**

## MAeHC VISION

**To improve the quality, safety, and cost-effectiveness of health care in Massachusetts by the widespread use of electronic health records, clinical decision support, and clinical data exchange in all clinical settings, that is supported in a way that is financially sustainable.**

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

## 34 ORGANIZATIONS REPRESENTED ON MAeHC BOARD...

**Massachusetts Medical Society**
**Massachusetts League of Community Health Centers**
**Massachusetts Nurses Association**
**Massachusetts Council of Community Hospitals**
**Massachusetts Association of Health Plans**
**Massachusetts Health Data Consortium**
**Massachusetts Group Insurance Commission**
**Massachusetts Hospital Association**
**Massachusetts Technology Collaborative**
**Massachusetts Taxpayers Foundation**
**MassPRO, Inc.**
**New England Healthcare Institute**
**Partners Healthcare**
**Tufts Associated Health Maintenance Organization, Inc **
**Tufts-New England Medical Center**
**University of Massachusetts Memorial Medical Center**

**Alliance for Health Care Improvement**
**American College of Physicians **
**Associated Industries of Massachusetts**
**Baystate Health System**
**Beth Israel Deaconess Medical Center**
**Blue Cross Blue Shield of Massachusetts**
**Boston Medical Center**
**Caritas Christi**
**Executive Office of Health and Human Services**
**Fallon Clinic, Inc.**
**Fallon Community Health Plan**
**Harvard Pilgrim Health Care**
**Health Care for All**
**Lahey Clinic Medical Center**
**Massachusetts Business Roundtable**
**Massachusetts Coalition for the Prevention of Medical Errors**
**Massachusetts Health Quality Partners**

## EXECUTIVE COMMITTEE AND OFFICERS

**Allan Goroll, MD (Chairman)****	****American College of Physicians**
**Mitch Adams (Vice-Chairman)****	****Massachusetts Technology Collaborative****	**
**Richard Lord (Treasurer)****	****Associated Industries of Massachusetts**
**Larry Gottlieb, MD (Secretary)****	****Alliance for Health Care Improvement**
**Carl Ascenzo****	****Blue Cross Blue Shield of Mass**
**Ellen Hafer****	****Mass League of Community Health Centers**
**Ron Hollander****	****Mass Hospital Association**
**John McDonough****	****Health Care for All**
**Dolores Mitchell****	****Mass Group Insurance Commission**
**Julie Pinkham, RN****	****Mass Nurses Association**
**Ron Preston****	****Exec Office of Health & Human Services**
**Craig Samitt, MD****	****Fallon Clinic**
**Steven Simon, MD****	****American College of Physicians**
**Vacant****	****Mass Health Data Consortium**
**Al Harvey, MD****	****Mass Medical Society**
**Micky Tripathi (ex-officio)****	****MAeHC**

## MAeHC ORGANIZATION STRUCTURE

**MAeHC ORGANIZATION STRUCTURE**

**Board of Directors**

**CEO**

**Office of Operations**

**Finance**

**External Communications**

**Legal**

**Working Groups**

***Shared services***

- Multiple reports

**Consumer Advisory Committee**

**Physician Advisory Committee**

**COO**
**(Team Leader)**

**Senior Ops Exec  Region 1**

**Senior Ops Exec  Region 2**

**Senior Ops Exec  Region 3**

**Planning & Project Mgmt**

**Vendor mgmt**

**Business practices**

**Evaluation**

**Budgets**

**Clinical requirements**

**Data standards& exchange**

**Legal/ regulatory  & contracting**

**Privacy & security**

**Quality measurement**

**Reimbursement**

**Vendor **
**selection**

**Pilot selection & evaluation**

## WORKING GROUPS UNDERPIN COLLABORATIVE PROCESS AND ALLOW US TO DRAW ON BROAD EXPERTISE

_***Working Group***_

_***Leaders***_

**Larry Garber MD**
**Eric Handler MD**
**John Halamka MD**
**John Fallon MD**
**Tisa Hughes**
**David Bates MD**
**Steven Simon MD**
**Leon Goldman MD**
**Dale Magee MD**
**Barbra Rabson**
**Cindy Bero**

_***Affiliation***_

**Quality measurement**

**Financing & reimbursement**

**Pilot selection & evaluation**

**Data standards and exchange**

**Clin/fxnl**
**requirements**

**Vendor selection**

**Privacy/security**

**Legal**

**Fallon Clinic**
**Center for Medicare and Medicaid Services**
**CareGroup, Harvard Medical School **
**Blue Cross Blue Shield**
**Blue Cross Blue Shield**
**Partners Healthcare, Harvard Medical School**
**Harvard Pilgrim, Harvard Medical School**
**CareGroup**
**Central Massachusetts IPA, MA Medical Society**
**MA Health Quality Partners**
**Partners Healthcare**

## MAeHC STRATEGY

**Improve quality, safety, and affordability of health care through:**
**Universal adoption of modern information technology in clinical settings**
**Access to comprehensive clinical information in real-time at the point-of-care**

**Tools for better, more accessible health care...**

## MAeHC APPROACH

**Pilot projects**

**Lots of barriers – need to learn about them**
**Replicability and sustainability – clearly show net benefit**
**Systems approach through concentration of resources **

## 35 COMMUNITIES READY TO GO

## THE GRID AND THE LAST MILE

**THE GRID AND THE LAST MILE**

## THREE PILOT COMMUNITIES STRONG INDIVIDUALLY AND COLLECTIVELY

**Pilot Characteristics**

**High capture of medical encounters**
**Breadth and depth of community cohesion**
**Wide array of ancillary providers**
**Broad & deep physician commitment**
**Strong, dedicated leadership**
**Demonstrated commitment to using IT to transform health care delivery**
**Represent a diversity of patients, practices, locations, and size**
**Platforms for conducting all dimensions of evaluation**
**Models to enable state-wide expansion**

## DIVERSE ARRAY OF SETTINGS

**Offices**

**125**

**42**

**22**

**189**

**Small**

**Medium**

**Large**

**Almost 600 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**

## FOUR MAIN AREAS OF ACTIVITY IN PILOT PROJECTS

**FOUR MAIN AREAS OF ACTIVITY IN PILOT PROJECTS**

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

**Connectivity**

**Clinical IT implementation/ support**

**Evaluation/ transformation**

**Quality measurement**
**Pilot evaluation**
**Transformation models**

**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**
**Structure, composition, process**

## BREAKDOWN OF PILOT PROJECT ACTIVITIES

**Connectivity**

**Clinical IT implementation/ support**

**Evaluation/ transformation**

**Management & coordination**

## EVALUATION PROGRAM WILL SUPPORT THREE KEY PILOT PROGRAM OBJECTIVES

**EVALUATION PROGRAM WILL SUPPORT THREE KEY PILOT PROGRAM OBJECTIVES**

**What are the most significant adoption barriers?**
**What are the best ways to overcome them?**

**What are the costs (direct and indirect) of adoption of IT?**
**What are the benefits?**
**How are the costs and benefits distributed across payers, providers, government, patients, ancillaries, etc?**
**How much money will be required to implement statewide?**

**What is general framework of incentives to implement and sustain the model?**
**What are the most effective management strategies for implementing and sustaining in communities?**
**What are the most effective organization models and tactics for implementing and sustaining statewide?**

**Value**

**Replication**

**Efficacy vs Effectiveness**

## PILOT PROJECT COORDINATION

**PILOT PROJECT COORDINATION**

**Inter-Community**
**Coordination Committee**

**Technical **
**Work Group**

**Community **
**Physician**
**Council**

**Privacy &**
**Security**
**Work Group**

**Community **
**Consumer**
**Council**

**Chair:  **MAeHC CEO
**Members:  **Community advocates; MAeHC COO, SPEs, Selected Working Group Chairs

**Co-Chairs:  **Senior Pilot Exec & Community Advocate
**Members:  **Physicians, Hospital, Consumers

**Pilot Steering**
**Committee**

## PILOT TIMELINE OVERVIEW

**PILOT TIMELINE OVERVIEW**

**Activities**

**2004**

**2005**

**2006**

**2007**

**2008**

**ACP-MA summit**
**MAeHC launch**
**Community RFA launch**
**Pilot communities announced**
**EHR vendor RFP**
**EHR vendor finalization**
**Community EHR implementation**
**Intra-community connectivity**
**Evaluation**
**Pilot completion**

## WE HAVE TO DEMONSTRATE THE VALUE OF WHAT WE’RE DOING...

***Net ***
***benefit***

**Cost**

**Savings**

**Status**
**quo**

**Quality/**
**safety**
**gain**

## ...AND QUICKLY REACH BEYOND THE PILOT COMMUNITIES

**Funding**

**Access to infrastructure**

**Community building**

**Community forums**
**Web community**
**Conferences**
**Newsletter or regular conference calls**
**Templates, boilerplate, implementation guides**

**Privacy/security standardization**
**Preferred vendor arrangements**
**Standardization and certification**
**Professional assistance**

**Capital funding initiative**
**Sustainable business planning**
**Grant identification and sharing**

**Community participation**

**Lead time**

**3 DOWN, (AT LEAST) 32 TO GO**