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Panel Interstate and Other State HIE HIT


Health & Medicine

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1. Electronic Health Information Exchange in Illinois John Lekich, Project Manager Illinois Office of Health Information Technology 2. Illinois at a Glance ã 13 million…
  • 1. Electronic Health Information Exchange in Illinois John Lekich, Project Manager Illinois Office of Health Information Technology
  • 2. Illinois at a Glance • 13 million patients • > 50,000 physicians • > 200 hospitals • Urban and rural • Statewide Exchange • 5 Regional Exchanges
  • 3. Goals of the Illinois Health Information Exchange • Improve health care quality and outcomes • Control the cost of health care and enhance value for patients and payers • Maximize federal health information technology funding to Illinois and its health care providers • Enhance public health and disease surveillance; reduce disparities
  • 4. Key Drivers of ILHIE Implementation • State health care transformation agenda – Medicaid Care Coordination • State law creating a statewide HIE network • Federal HITECH Act – EHR incentives for physicians and hospitals – HIE infrastructure funding – Broadband funding • Affordable Care Act Implementation
  • 5. ILHIE Authority Established, April 2011 ILHIE Direct Statewide Go-live, Dec 2011 ILHIE Executive Director Hired, Sept 2012 ILHIE Phase II Go-live, July 2013 ILHIE Operating as Public- Private Entity, Feb 2014 ILHIE Timeline
  • 6. Infrastructure for Health Care Reform Better Care, Health, & Cost Care Coordination Information Sharing ILHIE Network
  • 7. Implementation Phase I: ILHIE DIRECT • 1,700+ health care professionals statewide • Approximately 75% are Medicaid providers • State agencies for programs that require secure exchange with entities outside State government • Participating providers include: – Individual physicians and nurses – Hospitals – Long term care facilities – Community mental health providers – Dentists
  • 8. ILHIE Direct Participation
  • 9. Implementation Phase II • Public Health Node Access for electronic reporting to the Illinois Department of Public Health • Enterprise Direct – integration of ILHIE Direct into an EHR system • Care Summary Exchange – bi-directional, query- based records exchange • Approximately 50 health care entities will be on- boarded for Phase II services by the end of 2013
  • 10. Ongoing Challenges • EHR adoption rates increasing but still low among some providers • Competing priorities for technical staff and resources • Evolving standards and market options • Patient consent management
  • 11. California eHealth Stakeholder Webinar June 5, 2013 11
  • 12. California’s eHealth Vision: Improve the health and well-being of all Californians 1212
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  • 16. Integrated components for Appropriate HIE HIE Governance Legal Technology OCM Trust 16
  • 17. Connecting Michigan for Health 2013 17
  • 18. Summary stats for Massachusetts • 6.5 million citizens • 4,500 care delivery organizations • 39,000 providers – 27,000 physicians – + nurse practitioners, physician assistants, nurse mid-wives, dentists • Health IT snapshot – 70% EHR adoption – 97% e-prescribing – 68% labs sending structured lab results – $150M+ Medicaid EHR incentive dollars paid  Healthcare Reform  Health IT enabler: HIX & accountable care  Legislative action (c. 305, c. 224)  ‘Opt in’ state  Physician Licensing Requirement Starts - January 2015  All Providers on EHRs and HIE Connection - January 2017 18
  • 19. Adoption 19 The Statewide Health Information Exchange…the Mass HIway State Designated Entity for Health IT Region Extension Center MEDICAID Incentive Payment Program Health Information Exchange Operation Phase 1 Phase 2 2012-2013 • State assumes HISP role • ‘Directed’ exchange • Provider ‘push’ 2013-2014 • Query-based exchange enabled • Development of registries • Patient-directed exchange Executive Office of Health & Human Services ………….. …………..  Design, Development, Implementation - Federal Medicaid/MMIS funds & Federal ARRA HITECH; state match contribution from the State eHealth Institute Fund  Operation, Maintenance - Medicaid/MMIS funds, G&A funds & private/commercial subscription fees
  • 20. Catalyzing connections & advancing toward impact 20 HIway Implementation Grants grantees & their trading partners by location Discharge summaries from acute care to SNF and Home Health Pre-hospital transport care coordination for homeless Care management for Heart Failure patients Referrals from specialty care to home health Decision support through 2-way exchange of data Coordination of care for elderly psychiatric patients • Grantees (32) • Trading partners (50)
  • 21. 21 Lessons Learned  Stick with standards – invent when needed, then keep it simple  Plan for sustainability early – funding takes time  Engage with carrots rather than sticks  Make it real – identify a use case  Test network is important  Clinical champions make things happen  The impact on clinical workflow cannot be underestimated  Security and consent matters take time
  • 22. Massachusetts eHealth Institute 617-371-3999 MeHI Community - www.thehitcommunity.org/mehi/ www.mehi.masstech.org kennedy@masstech.org Twitter - @seankennedy6 Mass HIway Last Mile Program 1.855.MA-HIWAY (1.855.624.4929) Option 1 MassHIway@maehi.org mehi.masstech.org/what-we-do/mass-hiway Connect with MeHI & the HIway 22
  • 23. HIE Across Colorado
  • 24. CORHIO’s Progress 43 Number of Office-Based Physicians/Providers Number of Hospitals (over 90% of beds) Unique Patients With Clinical Info in the HIE Go to www.CORHIO.org for the most up-to-date info 1,700+ 2,164,000+ 115 Number of Long-Term Facilities 12 Number of Behavioral Health Orgs 3 National/Regional Reference Labs
  • 25. Data Being Exchanged • Laboratory & pathology test results • Hospital ADT information • Consult reports • Transcription notes • Radiology reports • Newborn screening results (public health) • CCDs (non-discrete data) • Reportable conditions (i.e. electronic lab reporting – public health) • Immunization information (CIIS – Public Health) • Patient referrals w/ attachments (point to point/DIRECT) • HIE to HIE with Quality Health Network 25
  • 26. In Development • CCD uploads & CCDs w/ discrete data • High-quality medical image sharing (using Colorado Telehealth Network VNA) • IHE XCA interstate exchange • Orders • Syndromic surveillance (biosurveillance) • Cancer registry • Smoking cessation program (w/ Denver Public Health & National Jewish) • Data analytics - support & partnering • Healtheway/Direct Trust membership • Patient data sharing 26
  • 27. Florida Health Information Exchange
  • 28. Walt Culbertson  President, Health Transactions, Inc.  Host and Producer of Jacksonville Florida’s Medical Update Show Appearing on Comcast Cable  Technical and Operations Lead, Florida Health Information Exchange  Founding Chair of the Southern Healthcare Administrative Regional Process (SHARP), a regional collaborative workgroup alliance of private and public health care organizations and HHS, HRSA and CMS  Founding Co-Chair of a CMS Sponsored Southern Insurance Commissioner Task Force  Founding Security and Privacy Co-Chair for the Workgroup for Electronic Data Interchange (WEDi) Strategic National Implementation Process (SNIP)  Executive Board of the HIPAA Conformance Certification Organization (HCCO)  Data Interchange Standards Association (DISA), and DISA XML-EDI  Healthcare Information Management Systems Society (HIMSS) Past Roles  Former Adjunct Professor or eBusiness, Florida State University  Interim Program Director, Center for the Advancement of Health IT, a Florida Regional Extension Center  President, ePrescribe America, Inc.  Founding Executive Director of ePrescribe Florida, a collaboration of Florida’s leading healthplans, provider and pharmacy organizations, and electronic prescribing vendors  Founding Chief Technology, Security and Privacy Officer, Webify Solutions (Subsidiary of IBM)  Founding Chief Technology, Security and Privacy Officer of Availity, LLC  Vice President of Healthcare for Computer Management Consultants  Vice President of HIPAA Solutions for the TriZetto Group  Director in the Healthcare Consulting Practice of PriceWaterhouseCoopers, LLC. 28
  • 29. 1. Direct Secure Messaging (DSM) is a NHIN Direct complaint secure e-mail system that allows participants to push encrypted health information to other participants and to respond to requests for information 2. Patient Look-Up (PLU) is a NHIN CONNECT compliant service that allows clinicians to query for and retrieve patient records from other participating nodes on the Florida statewide network Both services maintain the same policies and workflows around patient consent and authorization that exist in paper-based data exchanges today. Two Florida HIE Services 29
  • 30. DSM Connections to Other States as of May 31, 2013 HISP connection complete Testing in progress Ongoing discussions DSM is connecting over 4,000 Florida users
  • 31. Disaster Preparedness Use Care • Dislocated patient presents in neighboring state emergency department • Rendering provider or facility sends direct message to patient’s health plan or Florida care provider • Clinical information is returned via direct message in structured or unstructured format Page 32
  • 32. Contact • Website: www.florida-hie.net • Email: Walt.Culbertson@ahca.myflorida.com • Phone: Walt Culbertson @ 904-651-1805 Page 33
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