Sharing Advance Care Planning Documents in Massachusetts Public Meeting
The Massachusetts eHealth Initiative (MeHI) hosted a public meeting on December 7, 2017, focusing on advancing care planning documents. The agenda included discussions on advance directives, MeHI's request for information, specific considerations by healthcare experts, audience participation, and next steps. MeHI, as the designated state agency, strives to coordinate healthcare innovation and promote the adoption of health information technologies to enhance the quality and efficiency of healthcare in Massachusetts.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
Sharing Advance Care Planning Documents in Massachusetts Public Meeting December 7, 2017
Agenda PROGRAM AGENDA 1:00 1:20 PM Welcome and Kick-off Anna Gosline (BCBS) Introduction and Overview of Process Laurance Stuntz (MeHI) 1:20 1:35 PM Remarks Secretary Alice Bonner (EOEA) 1:35 1:50 PM Advance Directives Landscape Andrew Ikhyun Kim (EOEA) 1:50 2:10 PM MeHI RFI and Responses Laurance Stuntz (MeHI) 2:10 2:30 PM Discussion / Specific Considerations Lauge Sokol-Hessner, MD (BIDMC) Erik Fromme, MD (Ariadne Labs) 2:30 3:50 PM Audience Comments & Questions 3:50 4:00 PM Closing Comments and Next Steps 2
MeHI Overview MeHI is the designated state agency for: Coordinating health care innovation, technology and competitiveness Accelerating the adoption of health information technologies Promoting health IT to improve the safety, quality and efficiency of health care in Massachusetts MeHI is a division of the Massachusetts Technology Collaborative, a state economic development agency Advancing the dissemination of electronic health records systems in all health care provider settings 3
MeHI Vision, Mission and Goals VISION MISSION Massachusetts is the global eHealth leader. Our connected communities enjoy better health at lower cost and serve as models of innovation and economic development. To leverage the Commonwealth s extraordinary digital health infrastructure and expertise to drive innovation in healthcare GOALS Support Health Reform Mass Digital Health Initiative Consumer eHealth Engagement Adoption 4
Coalition Mission Ensure that health care for everyone in Massachusetts is In accordance with their goals, values and preferences At all stages of life and in all steps of their care Six priorities to achieve its mission: 1) Everyone in Massachusetts, 18 or older, has designated a health care decision- maker (health care proxy). 2) Everyone in Massachusetts, 18 or older, has had a conversation (and continues to have conversations) with their proxy to communicate their goals, values and preferences for care at the end of life. 3) All Massachusetts clinicians have appropriate training to facilitate high-quality communication with patients on advance care planning and serious illness. 4) Everyone in Massachusetts facing a serious illness has had a high-quality, informed goals and values conversation with their care team. 5) All Massachusetts health care providers have systems in place to elicit and document goals, values and preferences for patients with serious illness. 6) All Massachusetts health care providers have systems in place to share patient goals, values and preferences across care settings, to ensure they are accessible regardless of place of care. 5
e-ACP Sharing Initiative To Date Stakeholder Meeting: May 24, 2017 Strawman Proposal RFI content of information requested Interviews/Landscape Review and Analysis: Summer/Fall 2017 Current state of ACP processes, both in MA and nationwide Request for Information. - issued July 31, 2017, responses September 15th 9 Responses + Interview with Maryland Public Meeting December 7, 2017 6
Goals for Todays Discussion 1) Develop common understanding about the state of the art for e-sharing ACP documents 2) Gather public input about the right approach for Massachusetts a. Necessary components b. Stakeholders to involve c. Key metrics to track 7
Landscape Review Andrew Kim
Request For Information (RFI) Goals: Better understand tech solutions to e-capture/share ACP documents and their potential for implementation in MA Solicit specific information about architectural approaches, existing technologies, evidence of efficacy and cost Hear about possible solutions to current challenges to digitizing and sharing these documents and in ensuring that the content of ACP conversations are clearly documented and accessible across health care settings Key Areas of interest: Best practices/policy for increasing storage, sharing, and use at point of care Systems architectural choices for storage/sharing Specific technical solutions for storage/sharing Include: What has worked in other states What the state of the technologies is What might be new on the horizon 11
Summarized Recommendations Technology can facilitate adoption and usage but, by itself, is insufficient; we must also Ensure robust public outreach and education program Create an environment of trust Enable patients and providers to have and document conversations Ensure reliability of documentation Need a single source of truth, accessible to all stakeholders Ease of access regardless of place of care Consumers able to share with clinicians AND designated family/caregivers Any solution must address: Disparities (no internet, unfamiliarity with technology, etc.) Privacy and security concerns Version control 12
Technology Recommendations Be readily accessible by the entire health and care ecosystem Maintain accurate patient and provider identities and relationships Have standard forms and processes; patient index; databases Co-exist with other systems across the healthcare landscape Standards-based (agree on common code sets / terminology) Allow integration with acute and ambulatory EHRs, HIEs Have both provider-facing and consumer facing components Consumers: Educate patients about need for ACP & help make informed decisions Providers: Collect and update ACP information/documents and find in EHR Be flexible and adaptable to future changes Able to be used on any device (phone, tablet, PC) Accessible from social media Integrated with mobile health devices 13
Some Suggested Options Central eRegistry (repository) Single point of storage and access for ACP documents o Operated by the state OR o Privately-managed and operated technology platform Public-private partnership Private: stores, manages and maintains ACP documents on behalf of state State: supports core registry functions Internet-based centralized statewide registry for MOLST/POLST Internet, not EHR-system, dependent Future: build out complete AD registry Online tool for ACP planning Co-developed, state-run cloud portal to host documents Web-based application with: patient-facing interface databases, and interface for information exchange 14
Panel Remarks and Audience Discussion
Next Steps Synthesize today s comments and recommendations (by end of year) Develop draft recommendations (Q1 2018) Stakeholder Responsibilities Timing and Scope Funding Required Metrics Review and revise recommendations with Stakeholders (mid 2018) Likely public meeting Develop the path forward to implementation 17
