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2016 NH Health Information Technology & Health Information

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2016 NH Health Information Technology & Health Information The State of Health Information Technology and Health Information Exchange in New Hampshire SURVEY RESULTS May 27, 2016 Table 10 edited September 10, 2016 Prepared for: New Hampshire Department of Health and Human Services, Office of Medicaid Business and Policy By: Institute for Health Policy and Practice at the University of New Hampshire Lead Authors: Sarah M. Eck, PhD Patrick B. Miller, MPH Research Assistance: Tracy Keirns Elizabeth Trivett Table of Contents 1.0 Executive Summary ................................................................................................................................................................................................. 4 1.1 Purpose ............................................................................................................................................................................................................... 4 1.2 Study Population ................................................................................................................................................................................................. 4 1.3 Findings Summary ............................................................................................................................................................................................... 5 2.0 Methodology ......................................................................................................................................................................................................... 10 2.1 Provider Database Development ...................................................................................................................................................................... 10 2.2 Survey Instrument Development ...................................................................................................................................................................... 11 2.3 Fielding the Survey ............................................................................................................................................................................................ 11 2.4 Analysis ............................................................................................................................................................................................................. 11 4.0 Results: Electronic Health Records (EHR) and EHR Incentive Programs ................................................................................................................ 18 4.1 EHR Systems Overview ..................................................................................................................................................................................... 18 4.2 Medicare and Medicaid EHR Incentive Programs ............................................................................................................................................. 22 4.3 CEHRT Technology, Vendor Brands, and EHR Consolidation Plans ................................................................................................................... 38 4.4 EHR Capabilities and Meeting Specific Meaningful Use Objectives .................................................................................................................. 47 4.5 Health Information Exchange Capabilities ........................................................................................................................................................ 60 5.0 Results: Broadband, Payment Arrangements, Security, and Future State ............................................................................................................ 67 5.1 Broadband ......................................................................................................................................................................................................... 67 5.2 Security ............................................................................................................................................................................................................. 69 5.3 Payment Arrangements .................................................................................................................................................................................... 70 5.4 Health Information Technology (HIT) and Health Information Exchange (HIE) Future State ........................................................................... 75 5.4.1. Desired and Future States of HIT (Q64) ................................................................................................................................................... 75 5.4.2 Current and Future States of HIE (Q65) ..................................................................................................................................................... 78 6.0 Appendices ............................................................................................................................................................................................................ 81 6.1 Appendix A: Index of Tables and Figures .......................................................................................................................................................... 81 6.2 Appendix B: Survey Instrument ........................................................................................................................................................................ 83 [Remainder of Page Left Intentionally Blank] The State of Health Information Technology and Exchange in New Hampshire Survey Results May 27, 2016 1.0 Executive Summary 1.1 Purpose This web-based survey was conducted on behalf of the New Hampshire Department of Health and Human Services (NH DHHS) Office of Medicaid Business and Policy (OMBP) to understand the current New Hampshire landscape of health provider implementation and use of health information technology (HIT) and health information exchange (HIE). A similar survey was conducted in 2012. This current survey is intended to support planning needs [e.g., internal NH DHHS, 1115 Delivery System Reform Incentive Payment Program (DSRIP) Waiver, State Innovation Models Initiative (SIM), and regulatory reporting requirements from the Centers for Medicare and Medicaid Services (CMS)]. 1.2 Study Population The study population consisted of 15 provider types: Community Mental Health Center Dentist, General Dentist, Pediatric Federally Qualified Health Center Freestanding Urgent Care Center Home Health and Hospice Agency Hospital, Critical Access Hospital, New Hampshire Hospital Hospital, Non-Critical Access Hospital, Rehabilitation Nursing Home and Skilled Nursing Facility Nursing Home, County Nursing Home, Glencliff Home Practice, Other (denotes primary, and specialty, care practices not owned by a hospital) Rural Health Clinic 4 The State of Health Information Technology and Exchange in New Hampshire Survey Results May 27, 2016 1.3 Findings Summary Survey Response Rates. The response rates by provider type varied considerably. Of the 720 surveys administered, 266 (37%) of organizations responded. The Community Mental Health Centers (CMHCs) and New Hampshire Hospital (NHH) had the highest response rates of 100% each. In descending order, the next highest response rates were the Federally Qualified Health Centers (FQHCs) with a 91% response rate (n=10); county nursing homes with a 70% response rate (n=7); rehabilitation hospitals with a 67% response rate (n=2); home health and hospice agencies with a 54% response rate (n=21); and critical access hospitals (CAHs) also with a 54% response rate (n=7). While neither of the two, non-hospital owned Rural Health Clinics (RHCs) responded, additional RHCs were included in the responses of multiple hospitals. There is one, Vermont-based FQHC with a New Hampshire site which was also included in the survey. Survey Respondents. In descending order, the most frequently used titles by survey respondents to identify themselves included: “Practice Manager or Office Manager” (30%; n=80); “Chief Executive Officer or Executive Director” (18%; n=48); “Administrator” (17%; n=46); “Other” (13%; n=33); “Chief Information Officer or Director of Information Technology” (11%; n=29); and “Owner” (9%; n=24). Number of Electronic Health Record (EHR) Systems. The majority of respondents reported using one EHR system (70%; n=186) while 10% (n=25) of respondents use two EHR systems. Of the 266 respondents, 21% (n=55) do not have an EHR system in place. Of those without any EHR system (n=55), dentists comprised the largest percentage (78%; n=43) followed by other practices (primary and specialty care practices not owned by a hospital) (15%; n=8). Organizations Attesting for Medicare EHR Incentive Program Prior to 2015. Seventy-four percent (74%) (n=137) of organizations did not attest for the Medicare EHR Incentive Program prior to the 2015 program year while 26% (n=47) indicated that their organizations had attested for the Medicare EHR Incentive Program. All (100%; n=7) of CAHs; 100% (n=8) of non-CAHs; 75% (n=21) of independent practices; 40% (n=4) of FQHCs; and 30% (n=3) of CMHCs reported attesting for the Medicare EHR Incentive Program prior to 2015. Lower rates were shown for county nursing homes (14%; n=1); home health and hospice agencies (6%; n=1); and general dentists (3%; n=2). There were multiple reasons that organizations did not attest
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