10/31/2014. Electronic Health Information Exchange in Pennsylvania: Where We Are, Where We re Going, and Why This Matters. Where We Are in the World

Transcription

1 PA ehealth Partnership Authority Electronic Health Information Exchange in Pennsylvania: Where We Are, Where We re Going, and Why This Matters. PHCA/CALM Annual Convention Valley Forge, PA November 13, 2014 Where We Are in the World The World Health Organization reports that, in 2012, the United States per capita health spending was nearly $9,000, ranked third in the world, behind only Norway and Switzerland, and U.S. healthcare spending as a percentage of GDP is the highest in the world. WHO also found, in a 2000 report, that the performance of the U.S. healthcare system ranks 37 th in the world. A more recent study of deaths from all causes, released by the National Research Council and the Institute of Medicine, ranked the U.S. 17 th out of 17 nations. 2 National Transformation Effort Health Information Technology and Economic Health Act (HITECH) is a major driver of transformation through incentive programs to promote technology usage to achieve improved safety and quality of healthcare: 56 States and territories incentivized to adopt health information exchange (~$540M) Meaningful Use incentives for eligible providers (~$24+B) 3 1

2 ONC Vision: Health IT Ecosystem 4 Pennsylvania Cost Impacts: Between 1999 and 2009 healthcare expenditures nearly doubled Medicaid costs account for 27% of the state budget (~$29B) and by 2025 will account for nearly 50% 5% of the patients account for half of the healthcare cost PA s interstate collaboration focus is currently in the Mid-Atlantic region. 5 ehie*: Why? Aligned with Triple Aim (IHI): Improve health of populations Enhance patient experience of care (quality, access, and reliability) Reduce per capita cost of care Slide adapted from Trudi Matthews, HealthBridge/Greater Cincinnati Beacon Collaboration Presentation at ONC Meeting 4/3/13 *ehie: electronic Health Information Exchange 6 2

3 ehie: Why? ehie implementation can: Increase the speed and accuracy of diagnosis for individuals and populations Alert providers/care teams to an admission of patient Reduce readmissions and redundant tests through ehie with other providers who have treated the same patients Increase patient satisfaction by reducing their tim e spent in the healthcare system and eliminating frustrating duplication 7 ehie: Success Stories How do we know it will work in PA? The Medical University of South Carolina study of ER care ehie saved approximately $2,000 per patient over the course of one year Participating providers saved, on average, one hour and forty-five minutes per patient 89% reported that the quality of care improved Washington State ER data-sharing initiative ER visits by Medicaid patients reduced by 10 percent in the program s first year Contributed to $33 million reduction in Medicaid ER costs 8 ehie: Activities in PA PA regional success stories: At ClinicalConnect, an organ transplant patient in rural western Pennsylvania contacted local ER physician with health concern. The physician viewed patient s medical history electronically, contacted transplant coordinator. Prevented unnecessary/costly readmission, avoided patient travel to Pittsburgh KeyHIE demonstrated the reduction of unnecessary readmissions within 30 days for patients with heart failure and COPD Johnstown-area urologist used Authority s DIRECT messaging system through the AlliedHIE. Reported positive impact on office workflow and improved access to lab information and patient data at the point of care. Also added additional speed to essential clinical information 9 3

4 PA s Journey to ehie Collaboration among industry participants to: Enable better patient care through connected providers Enhance the quality, reliability and continuity of healthcare delivery Reduce potential for adverse events, medication errors and eliminating duplicate testing State leadership crosses organizational boundaries and overcomes inherent competitive nature and data silos in healthcare 10 Pennsylvania s Act 121 of 2012 Governance of independent state agency by Board of Directors Develop/establish/maintain statewide electronic health information exchange Develop/maintain directory of healthcare provider contact info Develop/adopt interoperability standards Develop/maintain statewide consent registry (opt-out model supports opt-back-in for PA s network P3N) Develop certification requirements for connected entities Establish/collect fees to sustain Authority services Establish advisory groups and election of 2 ex-officio board members Develop/conduct public information programs Annual Report to Governor/Legislature 11 Strategic Plan Vision: Electronic health information exchange enables initiatives striving to improve patient experience, population health and healthcare cost. Mission: To establish a statewide interoperable system for participating organizations to electronically move health information in a manner that ensures the secure and authorized exchange of health information to provide and improve care to patients. Guiding Principles: Privacy Security Governance Transparent Inclusive Collaboration Align and Adapt Interoperability Efficiency Technology Platform Incremental Incentives Operations 12 4

5 Strategic Plan Summary 13 PA s Statewide Framework Advisory groups and related committee work Trust communities for HISPs and HIOs Separate certification programs for Health Information Service Providers (HISPs ~ directed exchange) and Health Information Organizations (HIOs ~ query based exchange). Available on paehealth.org website Certification includes technical, legal and policy aspects such as, but not limited to, security, HIPAA, auditing, breaches and data sharing policies Promotes trust and understanding Supports processes for evolving Entities must prove compliance with adopted standards Benefit of creating a harmonized legal framework for certified HIO s and member organizations 14 PA s Advisory Committees 15 5

6 P3N: PA Patient and Provider Network 16 Patient Brochure 17 Patient Brochure 18 6

7 Opt-Out or Opt-Back-In Form 19 Online Resource: 20 HIO Options for Providers Annual HIO Survey since 2011 shows growing market and options for providers to support exchange strategies 2014 survey in progress 21 7

8 Opportunities for Collaboration Advancing solutions to common problems such as: Super protected data barriers related to HIV/AIDS, Mental Health, Drug and Alcohol Common understanding and engagement through shared educational themes and outreach tools Ongoing assessment of current landscape realities to inform collaboration and strategic initiatives State innovation model efforts for care delivery and payment reform including more effective data reporting National dialogue and input on regulations Influencing state efforts through participation in committees and Annual Plenary/Conference 22 Take Away Considerations Do you have a data sharing strategy? Areas that could benefit: Quality reporting Payment models Internal care coordination and work flow efficiencies Sharing across care settings and care teams More data to support clinical decision support and reliability across multiple sources Patient engagement Participation in innovative initiatives Compliance with state and federal law 23 PA ehealth Partnership Authority Questions? For online resources and to register as a stakeholder: Alix Goss Executive Director algoss@pa.gov (717)

9 Alexandra (Alix) Goss Executive Director Pennsylvania ehealth Partnership Authority Alexandra (Alix) Goss was named the Executive Director of the Pennsylvania ehealth Partnership Authority in January 2014 after serving as the PA Health Information Technology Coordinator for one year and the program director of the Authority since In her roles, she has guided Pennsylvania s efforts to improve quality and safety of healthcare by working with stakeholders to create and build a statewide network for electronic health information exchange (ehie). ehie is shown to improve efficiency in healthcare, reduce costs and make care more convenient for patients. This shared infrastructure will enable unaffiliated organizations to securely exchange health information, allowing providers and patients to make the best possible health decisions. Alix has worked on the state s ehie exchange strategy since 2008, with a focus on technical architecture and privacy and security framework. For more than 20 years, she has held leadership roles in developing national healthcare standards, implementing federal regulations, systems integration and operations management in the private and public sectors of healthcare. She is currently serving a four-year term as a member of the Department of Health and Human Services National Committee on Vital and Health Statistics (NCVHS). 25 9