health information technology the texas landscape presentation to tasscc 2010 nora belcher texas...
TRANSCRIPT
Health Information TechnologyThe Texas Landscape
Presentation to TASSCC 2010
Nora BelcherTexas e-Health Alliance
August 3, 2010
Health Information TechnologyOverview
• Background• Vision for HIE
• Texas Landscape• Future Activities
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BackgroundTerminology
• Most discussion of health IT falls into two categories:
– Electronic health records – Promoting the adoption and use of electronic health records (EHRs) by doctors and hospitals.
– Health information exchange – Establishing and promoting the use of electronic health information exchange (HIE) networks across which health care providers can share health information electronically
• The federal government officially makes a distinction between electronic health records and electronic medical records but most people (including the federal government themselves), uses them largely interchangeably.
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BackgroundPlanning and Policy Development – Federal
• Initiated through April 2004 State of the Union address• Furthered through the creation of the Office of the National
Coordinator for Health Information Technology
• Ongoing federal health IT initiatives Open, deliberative policy development process (Health IT Policy
Committee) Certification and standardization (Health IT Standards Committee) Health information exchange pilots (Nationwide Health Information
Network) Privacy & security (Health Information Security and Privacy Collaboration) New health IT initiatives through the ARRA
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• Several new health IT initiatives created and funded through the American Recovery and Reinvestment Act of 2009 (ARRA)
Electronic health record incentives (estimated $36-$46 billion)
Health information infrastructure ($2 billion)• State grants for HIE planning and implementation• Health IT regional extension centers• Health IT workforce program
BackgroundPlanning and Policy Development – Federal
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• Electronic health record incentives (estimated $36-$46 billion)
Incentives for the adoption and use of electronic health records by hospitals and physicians through Medicaid and Medicare (estimated $36-$46 million)
HHSC submitted Advanced Planning Document to CMS to support the development of a State Medicaid Health IT Plan (SMHP), which was approved.
BackgroundPlanning and Policy Development – Federal
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• Health information technology allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of health IT will:
• Improve health care quality; • Prevent medical errors; • Reduce health care costs; • Increase administrative efficiencies; • Decrease paperwork; and • Expand access to affordable care.*
*U.S. Department of Health and Human Services
Vision for HIE: Federal
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• A healthcare system supported by a technological infrastructure made up of:
- Ubiquitous, interoperable, electronic medical records composed of structured data elements; and
- A secure network to support the exchange of health information among providers.
Vision for HIE: State
• Common elements and bottom line:– Nationwide, interoperable, electronic health information
networks– Secure and private– Right information, right provider, right time– Full geographic and population coverage of HIE capacity
• Cost/benefits studies– Estimated $77.8 billion annual, national savings from an
electronic health information infrastructure.– Estimated $14.2 billion annual, Texas savings from an
electronic health information infrastructure.
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Coordinated Vision for HIE
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•State HIE Cooperative Agreement Program$28.8 million – HHSC/ Office of e-Health Coordination (OeHC)
•Medicaid Health IT Plan/EHR Incentive Payment Program$4.5 million planning – HHSC/Medicaid
•Health IT Regional Extension Centers (REC)$35.7 million – 4 awards
•Strategic Health IT Advanced Research Projects (SHARP)$15 million – UT Health Science Center, Houston
•Beacon Community Program8 Texas applicants, 0 awards
•Health IT Workforce Grants$5.4 million – Texas State University, San Marcos
Texas Landscape: State Funding and Projects
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• Already-deployed HIE assets– 16 identified local HIE initiatives at many
different stages of planning, implementation, and operation• Sometimes called Regional Health Information
Organizations (RHIOs)– State (or higher) –level data sources/services,
public and private• Public (e.g., state immunization registry)• Private (e.g., lab ordering portals, eRx networks,
payer-based eligibility and benefits portals)
Texas Landscape: Additional Components
What Does It Mean For You?
• Major open questions– Funding/sustainability– Achieving population and geographic coverage – network
topology– Patient involvement in HIE – consent? How much?– Provider liability
• Impact on state agencies– Direct impact– Indirect impact
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Texas Legislative Activity
• Increasing interest in health IT in the Texas Legislature– Before 2005 – 0 health IT bills filed– 2005 – 1 health IT bill filed– 2007 – 6 health IT bills filed– 2009 – 30 health IT bills filed
• 81st Regular Legislative Session (2009 )– Health passport expansion– Electronic prescribing (also LBB report)– Medicaid-based HIE
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Future Activities• The Texas path forward
State HIE planning and implementation grant
THSA and workgroups
Clear role for local HIEs
State Medicaid Health IT Plan development and implementation
• Other, Ongoing Texas state-level projects Office of e-Health Coordination Medicaid HIE Initiative
• Private-sector developments Regional initiatives Stakeholders (employers, payers, etc.)
Conclusion
• Background• Vision
• Texas Landscape• Future Activities• Open questions
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