Health Information Technology The Texas Landscape Presentation to TASSCC 2010 Nora Belcher Texas e-health Alliance August 3, 2010
Health Information Technology Overview Background Vision for HIE Texas Landscape Future Activities Page 2
Background Terminology 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. Page 3
Background Planning 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 Page 4
Background Planning and Policy Development Federal 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 Page 5
Background Planning and Policy Development Federal 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. Page 6
Vision for HIE: Federal 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 Page 7
Vision for HIE: State 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. Page 8
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 Coordinated Vision for HIE 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. Page 9
Texas Landscape: State Funding and Projects 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 Program 8 Texas applicants, 0 awards Health IT Workforce Grants $5.4 million Texas State University, San Marcos Page 10
Texas Landscape: Additional Components 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) Page 11
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 Page 12
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 81 st Regular Legislative Session (2009 ) Health passport expansion Electronic prescribing (also LBB report) Medicaid-based HIE Page 13
The Texas path forward Future Activities 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.) Page 14
Conclusion Background Vision Texas Landscape Future Activities Open questions Page 15
Questions? Nora Belcher Executive Director Texas e-health Alliance nora@txeha.org (512) 536-1340 Page 16