How To Run The Hawai I Health Information Exchange
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- Rosalind Powell
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1 Hawai i HIE Update to Board of Directors To facilitate the meaningful exchange of health information among your network of health care providers that enable high quality and affordable health care statewide Christine Sakuda, Executive Director May 21 st,
2 Legislative Update 1. Resolution re-designating HHIE as the sole statewide HIE 1. HCR40, Rep. Della Au Belatti, Chair 2. ADOPTED on 4/24/ DoH HTH 907: YR2 biennium request for $1M $750K 1. Develops interfaces between Department of Health and medical providers 2. PASSED in Budget Conference 4/21/ MQD ID 902 IA-03: $200K(10/% match) to HHIE 1. Develops the clinical health information exchange network among medical providers 2. Required for federal SMHP $2M (90%) = $1.8M. 3. PASSED in Budget Conference 4/21/ FY2014 DoH contract to be executed before June 30,
3 Legislative Update Cont. SB2470: The Hawaii Health Connector Purpose of bill: transparency, funding, oversight, engagement: Est. legislative oversight committee Regular reporting to legislature Submit annual sustainability plan Annual state audit Appropriate general funds to provide for sustainability. 3
4 Legislative Update Cont. HB2581: State Innovation Waiver Taskforce Unfunded taskforce to develop a health care reform plan that meets requirements for obtaining a state innovation waiver to preserve the Prepaid Health Care Act. 1. Healthcare Transformation Coordinator, Chair; 2. Director of Health; 3. Director of Labor And Industrial Relations; 4. DHS Medquest Division Administrator; 5. Insurance Commissioner; 6. Attorney General; 7. State CIO of OIMT; 8. Administrator of the EUTF; 9. Executive Director of the Hawaii Health Connector; 10. Executive Director of the Hawaii Health Information Exchange; 11. Representative of the Chamber Of Commerce; 12. Representative of the HAH; 13. Representative of the HPCA; 14. Two Persons With Expertise In Health Care Delivery; 15. A Person With Expertise In Health Insurance 16. A Person Representing Small Businesses 4
5 PROGRAM UPDATES 5
6 Milestones Summary (April 2014) 6
7 SUCCESS! 133 Medicaid and 209 Medicare PCPs achieved MU to date Just 403 to go 7
8 SUCCESS! Security Awareness Training in high demand Location Number Amount The Queen s Medical Center (11/2013) 159 $ 6, Hilo Medical Center (11/2013) 122 $ 4, West Hawaii IPA (12/2013) 24 $ Kona Community Hospital (12/2013) 27 $ 1, Castle Medical Center (2/2014) 96 $ 3, Kuakini Hospital (2/2014) 97 $ 3, J. Walter Cameron Center Maui (4/3/2014) 48 $ 2, Kauai Veterans Center Kauai (5/1/2014) 27 $ The Queen s Medical Center (5/15/2014) 131 $5, Subtotal 731 $ 28, Average Attendee fee = $30-50/person 8
9 SUCCESS! HPREC No Cost Extension APPROVED Approved Extension Period: 12 months April 2014 April 2015 $780,000 = Estimated ONC grant funds as of April 2014 available for expenditure during NCE period 9
10 SUCCESS! April 7 th : 382 providers / 805 users on the Direct Secure Messaging Network *26 Specialties and types of organizations e.g., Care Home, Labs, Neurology represented in All Others All Others* Internal Med Pharmacy Family Practice DOH GI OB-GYN Ophthalmology Orthopedics Pediatrics 12
11 Direct Secure Messages Processed *Exclude: e-referrals tracking on HISP Include: ToC from Hospitals received via HHIE Direct Accts Hawai i HIE Staff DoH PH Reporting, Hospitals, Labs reporting M.D., R.N., C.M.A., R.P.H. 13
12 DSA Execution Update April 2014 Member Execution Year Contract Status Project Status DoH 2014 Finalizing Implementing Castle MC 2013 Executed Completed HPH 2013 Executed Implementing QMC 2013 Executed Implementing HHSC/Hilo MC 2013 Executed Implementing DLS 2013 Executed Implementing CLH 2013 Executed Completed KAISER 2013 Lab Executed HMSA 2014 Negotiating United Health 2014 Pending AlohaCare 2014 Pending eclinical Works 2014 Executed Defining Specs Kuakini 2014 Negotiating Wahiawa 2014 Negotiating 14
13 The HHIE Data Set as captured and exported by EHRs Summary of HIE Interfaces and Data Feeds EXISTING Data Source Mbr ADT ELR Lab Results Immunizations Radiology CCD/CCDA Transition of Care Medication (Direct + XDR) (RDE or RXA) HHSC -Hilo Medical Center CLH LAB FEED DLS LAB FEED Castle Medical Center Queen's Medical Center Hawaii Pacific Health Pharm: PBMs/Retail Pharmacy/PT Radiology Imaging Centers CY 2014 PLANNED HMSA AlohaCare Kaiser Permanente Hawaii HHSC- Kona Community Hospital 2015 PLANNED (Alphabetized) HHSC - Kauai Veterans Mem Hosp HHSC - Maui Memorial Med Ctr HHSC - Sam Mahelona Mem Hosp HHSC -Lanai Community Hospital Kahuku Hospital Kuakini Medical Center * Molokai General Hospital North Hawaii Community Hosp Wahiawa General Hospital 15 *Kuakini sending lab results using Direct
14 Radiology Imaging and Results Delivery Service System available as of April 1, 2014 Image Viewing Tool: via Claron, OneMedNet secure transport from community and hospital imaging providers notification with hyperlink to Referring and Consulting physicians/end-users Images available upon upload by Imaging Providers No PHI downloading on user equipment Image reports: via the Health enet ProAccess HHIE- Locally Hosted Service Image Cache, 3 to 6 months retention Historical imaging studies available upon request to Imaging Providers Benefits Delivers information near real time Saves time Eliminates CD-burning and handling Meets Stage 2 Meaningful Use Requirements for EPs Challenges Executing DSA and Statement Of Work with Imaging Providers Starting to approach Hospital-based Imaging Providers Provider concerns around cost 18
15 Medication Management Tool Enables high quality medication reconciliation Assists with patient management, monitoring and decision making Pharmacists access and share up-to-date medication and laboratory information LIVE for Pharm2Pharm as of May 1, 2014 Expanding Pharm2Pharm users to Oahu in June, 2014 Pali Momi (June), Castle MC (mid-june), Queens West (fall) Benefits medication history acquired from 14+ robust data sources, within 45 seconds of registration Pharmacies: CVS, Walgreens, Safeway Insurance: HMSA, Wellpoint, Aetna, Humana, Humana Surescripts Up to 12 months of retail medication data Analyzes medication history: interactions, duplicate therapy, compliance, Formulary interchange Challenges investigating incomplete data feeds from local sources Provider concerns around cost 19
16 Examples of the Med Rec Tool 20
17 HCS Medication Reconciliation and Decision Support Tool Medication decision support Drug-Allergy Interactions Drug-Drug Interactions Critical Results Duplicates in Therapy 21
18 Security Risk Assessment Purpose is to identify: relevant threats and vulnerabilities (both internal and external) to the Hawai i HIE or threats directed through organizations against other organizations; impact (i.e., harm) to the Hawai i HIE that may occur given the potential for vulnerabilities, and; likelihood that harm will occur. Determine risk (typically, degree of harm and likelihood of harm occurring) Information Security Committee reviewing preliminary report on Thursday May 22,
19 Health Care Transformation Program Update by Beth Giesting May 12, 2014
20 Health Innovation Plan BH Focus Update Primary Care Practice Policy Care Coordination & SU Behavioral Health Payment Workforce HIT
21 Health Information Technology Priority Tasks Develop, maintain, oversee State HIT plan Support HHIE as designated information exchange Develop All-Payer Claims Database Ensure State participation in data governance, security, interoperability, etc. Resources Staff: Beth (.5 FTE), Alfred,? Resources: 2-year federal APCD grant Additional needs: $110,000-$150,000 for State HIT coordinator
22 Summary Must Do: 1. Transformation per Act Further develop SHIP with BH focus 3. Plan structure and support for office 4. Work with EUTF (trustee) 5. Support HHIE as designated information exchange 6. Develop All-Payer Claims Database 7. Develop/oversee ACA Innovation Waiver Taskforce 8. Oversee ACA/Connector for Governor s Office 9. Connector board member Additional Priorities: 1. Develop CMMI and other federal proposals 2. Support telehealth infrastructure 3. Develop DPS pilot 4. Develop, maintain, oversee State HIT plan 5. Ensure State participation in data governance, security, interoperability, etc. Resources Staff: Beth, Joy, Erik, Alfred,? Arlene (temporarily borrowed from DCCA) Resources: HAH, HAHP, and federal APCD grant Additional needs: $100,000 for transformation $110, ,000 for HIT $150,000 for ACA Innovation Waiver Task Force >$400,000 total need
23 Mahalo! Christine Sakuda 27
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