Georgia Health Information Exchange Update

1
Georgia Health Information Exchange Update

• Glenn E. Pearson, FACHE
• Executive Vice President, Georgia Hospital
  Association
• TAG Health Care Society
• October 11, 2007

2
Outline

• GHIE
• HITT Board
• Lessons Learned from Other Efforts

3
Georgia Health Information Exchange History

• Roots trace back to late 1990s payer/provider
  initiatives
• Evolved into Georgia Strategic Local
  Implementation Process (GSLIP)
• After HIPAA, evolved into e-health issues
• Sponsored Georgia e-Health Summit (June 15, 2005)
• Sponsored Georgia RHIO Development Summit
  (October 7, 2005)
• Inaugural event (March 1, 2006)

4
Approach

• Establish collaborative, stakeholder-driven
  strategies and priorities to create a win/win
  approach to electronic communications
• Inventory present Georgia-based efforts to
  identify opportunities while building on existing
  foundation
• Build on recognized or emerging best practices

5
Approach (continued)

• Increase stakeholder value incrementally
• Support maturing national standards and
  guidelines
• Develop operation using sound, ROI-driven
  business formation principles

6
Milestone Meetings

• Georgia eHealth Summit June 2005
• Georgia RHIO Development Summit October 2005
• Inaugural Meeting March 2006
• Diabetes Summit November 2006

7
Organizational Milestones

• February 24, 2006 Incorporated as Georgia
  Health Information Exchange
• March 31 Ratified bylaws
• May 26 Position Paper completed
• May 23 First donation (from Georgia Medical
  Care Foundation) received
• June 9 Formal statements of support distributed
  and new committees announced
• September 26 Donation from Blue Cross/Blue
  Shield
• October 22 Notification of 501 (c) (3) status

8
Organizational Milestones (continued)

• March 2007 Hired Assistant Director
• June 19 First official board meeting
• October Nominating committee meets to consider
  candidates for Executive Director

9
Draft Mission Statement

• The mission of the GHIE is to facilitate a
  health information exchange to improve public
  health, quality of care, and the efficiency of
  health services through the more effective use of
  automated personal health information. Projects
  undertaken by the GHIE will be geared to
  fostering enhanced and mutually beneficial
  relationships between healthcare stakeholders.

10
Objectives

• Establish a forum for the secure and efficient
  exchange of healthcare information within Georgia
• Represent the cumulative interests of the States
  healthcare market participants
• Act as a conduit between Georgia and the national
  efforts

11
Organizational Approach

• Umbrella organization with various initiatives
  around the state
• Operating Committee and Advisory Board

12
Focus Areas

• Education
• ePrescribing
• EHR Dynamics
• Statewide Inventory of IT Capabilities
• Pilot Project Discussions
• Advance Directives
• Medication Reconciliation
• Cancer
• Coordination of Statewide Standards and Practices
• Patient Identification
• Privacy
• Security

13
GHIE Board

• Hospital Alan Kent, Meadows Regional Medical
  Center
• Physician Jim Morrow, MD, North Fulton Family
  Medicine
• Nursing Home Fred Watson, GHCA
• Mental Health Tod Citron, Cobb CSB
• Pharmaceutical Industry Jim Bracewell, Georgia
  Pharmacy Association
• Quality Improvement Dennis White, gmcf
• Payer Dieter Freer , CIGNA HC of Georgia
• Consumer (Vacant)
• Chamber of Commerce George Israel, GCOC
• Employer (Vacant)

14
GHIE Board (continued)

• Chair, Operations Committee Glenn Pearson, GHA
• Chair, Regional Coordination Committee (Vacant)
• Chair, IT Committee (Vacant)
• DCH (Vacant)
• DPH (Vacant)
• CMS (Vacant)
• Chair, Communications and Events Committee
  (Vacant)

15
Signed Letters of Support

• Bacon County Hospital Barrow Regional
  Medical Center Bluegate Corporation
  Cartersville Medical Center Central Georgia
  Medical Center Cobb County Community Service
  Board Coffee Regional Medical Center Columbus
  Regional Healthcare System Compuware
  Corporation Coventry Healthcare of Georgia
  Crisp Regional Hospital Donalsonville Hospital
  ECT Global Emanuel Medical Center eSimplify,
  Inc. Georgia Chamber of Commerce Georgia
  Health Care Association Georgia Healthcare
  Leadership Council Georgia Hospital Association
  Georgia Medical Care Foundation Georgia
  Pharmacy Association Hamilton Medical Center
  Hughston Orthopedic Hospital Inner Harbor for
  Children and Families Intel Americas
  Jefferson Hospital Kaiser Permanente of Georgia
  McDuffie Regional Medical Center Meadows
  Regional Medical Center Medical Systems
  Development Corporation Mitchell McCormick
  Inc. Noble Associates Consulting, Inc.
  Oconee Regional Medical Center Patient
  Placement Systems Piedmont Healthcare
  Pineland Community Service Board Smart Document
  Solutions Three Bridges Consulting Tift
  Regional Medical Center UHS-Pruitt Corporation
  VHA of Georgia Walton Rehabilitation Health
  System WellStar Health System Wills Memorial
  Hospital

16
Financing Model

• Umbrella Organization
• Corporate support
• Grant funding
• Member assessment
• Each Stand-alone Project
• Defensible business model that recognizes
  different circumstances of
• Large hospitals
• Small hospitals
• Large physician groups
• Smaller groups/solo practitioners
• Other providers

17
Potential Sources of Funding for Stand-Alone
Projects

• Grants/business partnerships for start-up capital
• Precedent 2004 11.5M WellPoint funding for 36
  rural hospital telemedicine clinics
• Redeployment of capital and operating funds spent
  on non-interoperable systems
• Credible demonstration of cost-effectiveness from
  process improvement (ROI) ongoing operations
• Economies of scale

18
Health Information Technology and Transparency
Board
19
History and Purposes

• Created by Executive Order of Governor Sonny
  Purdue, signed October, 2006
• Consistent with President Bushs Executive Order
  four cornerstones
• Health IT
• Quality Information
• Pricing Information
• Quality and Efficiency

20
Structure

• Organized into two functional areas
• Transparency for pricing and quality
• Health Information Exchange
• 12-person Advisory Council
• Subcommittees for each functional area
• Also board of expert advisors
• Monthly meetings

21
Transparency Activities

• Focus is creating online access to pricing and
  quality data
• Comprehensive in scope
• Hospitals
• Physicians
• Pharmacies
• Other providers
• Vendor RFPs issued in early summer
• Received 3.9M CMS for transparency efforts

22
Health Information Exchange

• Awarding up to three grants totaling 900k
• August 1 Grant notices posted
• August 31 19 Letters of Intent submitted
• September 28 Grant applications due
• October 5-16 Grant evaluation period
• October 17 Evaluation consensus meeting
• October 23-30 Letters sent to awardees
• November 1 Official announcements

23
HIE Lessons Learned from Other Efforts

• Progress is slower than anticipated
• Greatest challenge is organizational/ relational,
  not technical
• Coordination is required to avoid nearby RHIO
  efforts from becoming silos
• Clinical value alone is not enough to sustain HIE
  projects

24
Lessons Learned (continued)

• Grant funding alone is not a sustainable
  financing model
• Being first out of the chute is not necessarily
  advantageous conflicting technology models