Care Coordination and Health Information Exchange in Illinois!

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1 Care Coordination and Health Information Exchange in Illinois National Academy for State Health Policy 26 th Annual State Health Policy Conference Seattle, WA October 10, 2013

2 Illinois Health Information Technology Agenda Use health information technology infrastructure to support health care system transformation generally, State Medicaid reform and care coordination mandates specifically Implement statewide HIE network to promote secure, interoperable exchange of health data Leverage statewide technology infrastructure through enterprise approach; across State government programs and departments to promote efficiency and innovation 2

3 Illinois Health IT Environment Key Factors Average EHR adoption rates (35-40% for ambulatory providers) Wide variation in EHR adoption by provider type Wide variation in data standards, despite national push for interoperability Unprecedented shift in Medicaid program; care coordination mandates Participation in CMMI Statewide Innovation Model Design Project 3

4 Infrastructure for Health Care Transformation Better Care, Health & Cost Care Coordination Information Sharing ILHIE Network 4

5 What is the Illinois Health Information Exchange (ILHIE)? The statewide health information exchange network created by State statute in 2010 Core services and standards operated and governed by the Illinois HIE Authority A hub for secure communications and message routing to ensure connectivity among state, regional and enterprise HIEs Means of electronic exchange with State health information technology systems 5

6 ILHIE services for Care Coordination ILHIE Direct, Web-Based Secure Messaging Integrated Direct Secure messaging embedded into an EHR system Single user sign-on and user interface stays the same Aggregate Patient Record Exchange (CCD) Acquires all patient records available for a specific patient via ILHIE network EHR Lite web-based viewer can be used 6

7 Implementation Phase I: ILHIE Direct Secure Messaging Secure, HIPAA-compliant Facilitates care coordination among providers; attachment of large files, high resolution documents Provides an on-ramp to more complex exchange Very low cost, few technical requirements Meets federal Stage 1 meaningful use requirements for record exchange 2,500 users statewide 7

8 Implementation Phase II: Integrated Direct Direct secure messaging embedded into existing EHR system Single sign-on, no separate portal User interface stays the same Requires technical integration

9 Implementation Phase II: EHR Exchange Patient Record Exchange What most people think of as HIE Records from multiple data sources on the network are queried and returned in a standard format Can be viewed in and absorbed into an EHR system Requires an ONC-certified EHR system, OR can be viewed with an EHR Lite web-based interface Requires technical integration Annual service costs range from $195 to $150K, dependent upon number of users Go-live scheduled for end of 2013

10 Additional Service Development: RxClaims Feed Pilot ILHIE will facilitate daily feed of Rx fill data for patients served by 12 Emergency Department and 100 medical home sites in a care coordination network Care coordination entity will map the claims data and configure it for push to its portal Targeted outcomes are improved medication adherence and reconciliation, reduced adverse events and duplicative prescriptions Goal is to scale to other care coordination entities

11 Implementation Timeline HITECH Act Passed 2009 ILHIE Direct Service Established 2011 ILHIE Phase II services, further Medicaid reform measures 2013 ILHIE Statute Passed 2010 Medicaid Reform Implementation Begins 2012 ILHIE service & connectivity expansion, Medicaid care coordination expansion 2014

12 Key Success Factors State executive level support Long-term governance structure with an open and transparent policy process Commitment to standardization Close alignment between HIE and Medicaid Flexible implementation plan

13 Key Challenges Scope of change in health care delivery system Severely constrained State resources Funding Time Slow vendor development and response Slow evolution of national standards Highly complex policy requirements

14 Thank You Laura Zaremba Director Illinois Office of Health Information Technology Office of Governor Pat Quinn