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EHR Accessibility Module Challenge
       Overview Webinar


                  Webinar Presentation

                  Friday, April 6th




                                         1
On today’s call:




                JL Neptune    David Baquis     Matt Quinn        Rosaly      Alok Doshi
Adam Wong
                                                               Correa-de-
                Senior Vice   Accessibility     Computer         Araujo        CCIIO
  Program
                 President     Specialist        Scientist
  Analyst
                                                                Deputy        Office of
                Health 2.0    U.S. Access        National       Director       Health
Office of the
                                Board           Institute of                 Insurance
 National
                                              Standards and    Office on     Exchange,
Coordinator
                                               Technology      Disability,      CMS
                                                                  HHS


                                                                                          2
Agenda for Today’s Meeting


 ONC    and the Investing in Innovation (i2) Program

 An   Introduction to Accessibility and Usability

 An   Overview of the EHR Challenge

 Q&A About    the Challenge




                                                        3
ONC and i2




             4
EHR Accessibility


    David Baquis
  U.S. Access Board

    Matt Quinn
      NIST
                      5
What is the Access Board?




                            6
U.S. Access Board
• Independent Federal agency

• Promulgates guidelines and standards for
  accessible design

• Provides technical assistance and training



                                               7
What is Accessibility?



                         8
Accessible Design

• Accessibility is design criteria which
  removes barriers that make it difficult or
  impossible for some people with
  disabilities to use HIT
• It’s rooted in civil rights with the intention
  to provide an assurance of technological
  non-discrimination

                                                   9
Standards and Guidelines




                           10
Web Content Accessibility Guidelines (2008)
(WCAG 2.0: http://www.w3.org/TR/WCAG/)



 Section 508 Standards (2000)
     www.section508.gov



                                              11
Stakeholders



               12
Who Benefits?
Disabilities:         User groups:
• Hearing             • Patient/clients
• Vision              • Guests/customers
• Speech              • Clinicians
• Mobility            • Caregivers/families
• Dexterity           • Students/instructors
• Cognitive           • Admin personnel
                      • Payers/insurance reps
                      • Analysts, researchers

                                                13
Accessibility Examples




                         14
Internet Sites
• Are text equivalents provided for
  non-text elements?

• Are multimedia videos captioned?

• Are row and column headers
  identified in data tables?
PHR Development Software
• Non mouse use: Can I create and
  update a PHR using only a
  keyboard?
• Do electronic forms allow
  assistive technology to access
  the information and functionality
  necessary for completion and
  submission of the forms?
• Alternative means of identifying
  elements, for people who are
  color blind?
Handheld Devices




                   17
How to Reach the U.S. Access Board

• Telephone (voice):
   – 202-272-0013 (direct to David Baquis)
   – 800-872-2253 (toll-free in U.S.)

• E-mail: 508@access-board.gov

• Internet: http://www.access-board.gov

                                             18
Accessibility and Usability in a
Prototype Ambulatory Electronic
  Healthy Record Pilot Project
     Rosaly Correa-de-Araujo, MD, MSc, PhD
       Deputy Director, Office on Disability
 U.S. Department of Health and Human Services
        Office of the National Coordinator’s Challenge Grant Webinar
                                 April 6, 2012




                                                                       19
Background
• People with Disabilities
   –   54 million
   –   19.3% non-institutionalized population ≥ 5 years
   –   4 times as likely to report fair or poor health
   –   $400 billion in health care expenditure
• Health Information Technology (HIT)
   – Significant federal investment, adoption of EHRs & PHRs
   – Patient portals available to support health care management
   – Development and implementation of systems/services is far advanced,
     but no HIT accessibility specifications/policies
   – Infrastructure limitations, inaccessible designs/content precludes use
     by people with disabilities
   – Accessibility & usability are high priority for the disability community



                                                                           20
Background (cont’d)
• We are unaware of any published prototype
  accessible EHR/PHR systems. One grant award
  has been made by the Department of
  Education recently on this topic.




                                            21
Background (cont’d)
• Benefits of EHRs
  – Accessible EHRS will allow people with disabilities
    to benefit from personalized online interactions
    with health care information
  – Create more efficient clinical practices:
     • reduced duplication of tests
     • enhanced quality/safety of care
     • Improve care coordination
  – Reduce paperwork
  – Regulatory compliance

                                                      22
Background (cont’d)
• Costs
  – EHRs/PHRs expected to contribute to reduction in
    health care costs, but operating alone, these
    systems are not designed to address the current
    challenges around cost and quality of care.




                                                   23
Challenge Grant Brief Description
• Design, test, implement a module prototype
  application that is not only compatible and
  consistent with certified EHR system, but
  ensures accessibility and easy interaction by
  people with disabilities.


                             Focus on
                            CONSUMER
                                                  24
Standards for Compliance
• Web Content Accessibility Guidelines (WCAG
  2.0), W3C Web Accessibility Initiative for
  website accessibility
• Section 508 Standards by the Access Board
• Section 508, Rehabilitation Act
• Communications Act, standards for
  telecommunication services and equipment


                                               25
Grant Submission Requirements

             General

Acceptable                No ONC
 Platforms                 Logo


                        Functionality
Data Used
                          Accuracy
             Security
                                    26
Evaluation Criteria
• Design and usability
• Creative and innovative use of technologies
• Compliance with disability and accessibility
  standards
• Integration of EHR Module with HIT and EHR
  Systems
• Potential Impact and ability to drive adoption and
  engagement
• Use of NwHIN standards

                                                   27
Timeline
•   Submission Period Begins: 1:00 pm, EDT, January 30, 2011
•   Submission Period Ends: 11:59 pm, EDT, July 23, 2012
•   Evaluation Process Begins: 12:01am, EDT, July 27, 2012
•   Evaluation Process Ends: 11:59pm, EDT, August 10, 2012
•   Winners Notified: August 13, 2012
•   Winner Demo at Relevant Industry Conference: TBD




                                                               28
Challenge Grant
Awards                     Evaluation & Awards
• Prize Categories         • Evaluation by an Expert
   – 1st Place: $60K         Panel, America COMPETES
   – 2nd Place: 20K          Act
   – 3rd Place: $5K
                           • Award Announcement:
                             August 13, 2012 (12:00 PM
                             EDT)

                           • Demos at relevant industry
                             conference

                                                          29
For More Information and
      Registration:
 www.health2challenge.org

   Jean-Luc: jl@health2challenge.org
     Adam: Adam.wong@hhs.gov
   David: baquis@access-board.gov
    Rosaly: Rosaly.correa@hhs.gov

                                       30

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EHR Challenge Webinar Slides 4.6.12

  • 1. EHR Accessibility Module Challenge Overview Webinar Webinar Presentation Friday, April 6th 1
  • 2. On today’s call: JL Neptune David Baquis Matt Quinn Rosaly Alok Doshi Adam Wong Correa-de- Senior Vice Accessibility Computer Araujo CCIIO Program President Specialist Scientist Analyst Deputy Office of Health 2.0 U.S. Access National Director Health Office of the Board Institute of Insurance National Standards and Office on Exchange, Coordinator Technology Disability, CMS HHS 2
  • 3. Agenda for Today’s Meeting  ONC and the Investing in Innovation (i2) Program  An Introduction to Accessibility and Usability  An Overview of the EHR Challenge  Q&A About the Challenge 3
  • 5. EHR Accessibility David Baquis U.S. Access Board Matt Quinn NIST 5
  • 6. What is the Access Board? 6
  • 7. U.S. Access Board • Independent Federal agency • Promulgates guidelines and standards for accessible design • Provides technical assistance and training 7
  • 9. Accessible Design • Accessibility is design criteria which removes barriers that make it difficult or impossible for some people with disabilities to use HIT • It’s rooted in civil rights with the intention to provide an assurance of technological non-discrimination 9
  • 11. Web Content Accessibility Guidelines (2008) (WCAG 2.0: http://www.w3.org/TR/WCAG/) Section 508 Standards (2000) www.section508.gov 11
  • 13. Who Benefits? Disabilities: User groups: • Hearing • Patient/clients • Vision • Guests/customers • Speech • Clinicians • Mobility • Caregivers/families • Dexterity • Students/instructors • Cognitive • Admin personnel • Payers/insurance reps • Analysts, researchers 13
  • 15. Internet Sites • Are text equivalents provided for non-text elements? • Are multimedia videos captioned? • Are row and column headers identified in data tables?
  • 16. PHR Development Software • Non mouse use: Can I create and update a PHR using only a keyboard? • Do electronic forms allow assistive technology to access the information and functionality necessary for completion and submission of the forms? • Alternative means of identifying elements, for people who are color blind?
  • 18. How to Reach the U.S. Access Board • Telephone (voice): – 202-272-0013 (direct to David Baquis) – 800-872-2253 (toll-free in U.S.) • E-mail: 508@access-board.gov • Internet: http://www.access-board.gov 18
  • 19. Accessibility and Usability in a Prototype Ambulatory Electronic Healthy Record Pilot Project Rosaly Correa-de-Araujo, MD, MSc, PhD Deputy Director, Office on Disability U.S. Department of Health and Human Services Office of the National Coordinator’s Challenge Grant Webinar April 6, 2012 19
  • 20. Background • People with Disabilities – 54 million – 19.3% non-institutionalized population ≥ 5 years – 4 times as likely to report fair or poor health – $400 billion in health care expenditure • Health Information Technology (HIT) – Significant federal investment, adoption of EHRs & PHRs – Patient portals available to support health care management – Development and implementation of systems/services is far advanced, but no HIT accessibility specifications/policies – Infrastructure limitations, inaccessible designs/content precludes use by people with disabilities – Accessibility & usability are high priority for the disability community 20
  • 21. Background (cont’d) • We are unaware of any published prototype accessible EHR/PHR systems. One grant award has been made by the Department of Education recently on this topic. 21
  • 22. Background (cont’d) • Benefits of EHRs – Accessible EHRS will allow people with disabilities to benefit from personalized online interactions with health care information – Create more efficient clinical practices: • reduced duplication of tests • enhanced quality/safety of care • Improve care coordination – Reduce paperwork – Regulatory compliance 22
  • 23. Background (cont’d) • Costs – EHRs/PHRs expected to contribute to reduction in health care costs, but operating alone, these systems are not designed to address the current challenges around cost and quality of care. 23
  • 24. Challenge Grant Brief Description • Design, test, implement a module prototype application that is not only compatible and consistent with certified EHR system, but ensures accessibility and easy interaction by people with disabilities. Focus on CONSUMER 24
  • 25. Standards for Compliance • Web Content Accessibility Guidelines (WCAG 2.0), W3C Web Accessibility Initiative for website accessibility • Section 508 Standards by the Access Board • Section 508, Rehabilitation Act • Communications Act, standards for telecommunication services and equipment 25
  • 26. Grant Submission Requirements General Acceptable No ONC Platforms Logo Functionality Data Used Accuracy Security 26
  • 27. Evaluation Criteria • Design and usability • Creative and innovative use of technologies • Compliance with disability and accessibility standards • Integration of EHR Module with HIT and EHR Systems • Potential Impact and ability to drive adoption and engagement • Use of NwHIN standards 27
  • 28. Timeline • Submission Period Begins: 1:00 pm, EDT, January 30, 2011 • Submission Period Ends: 11:59 pm, EDT, July 23, 2012 • Evaluation Process Begins: 12:01am, EDT, July 27, 2012 • Evaluation Process Ends: 11:59pm, EDT, August 10, 2012 • Winners Notified: August 13, 2012 • Winner Demo at Relevant Industry Conference: TBD 28
  • 29. Challenge Grant Awards Evaluation & Awards • Prize Categories • Evaluation by an Expert – 1st Place: $60K Panel, America COMPETES – 2nd Place: 20K Act – 3rd Place: $5K • Award Announcement: August 13, 2012 (12:00 PM EDT) • Demos at relevant industry conference 29
  • 30. For More Information and Registration: www.health2challenge.org Jean-Luc: jl@health2challenge.org Adam: Adam.wong@hhs.gov David: baquis@access-board.gov Rosaly: Rosaly.correa@hhs.gov 30