Health Information Exchange State and National Update

1
(No Transcript)
2
Health Information ExchangeState and National
Update

• Summarize recent national HIE activities
• Overview of Kansas statewide HIT / HIE
  Initiative
• Identify next steps to advance HIT / HIE in Kansas

3
Recent HIE Developments at the National Level
4
Presidents August 2006 Executive Order

• Directs Federal agencies that administer or
  sponsor federal health insurance programs to
• Increase transparency in pricing
• Increase transparency In quality
• Encourage adoption of health information
  technology (IT) standards
• Provide options that promote quality and
  efficiency in health care

5
Secretary Leavitts Four Cornerstones

• Connect the system (standards)
• Measure and publish quality
• Measure and publish price
• Create positive incentives

6
Lack of Comprehensive Privacy Policy

• Early focus on interoperability standards
• Lack of focus on privacy
• Jan 2007 GAO report emphasizes need for
  comprehensive approach
• American Health Information Community (AHIC)
  Privacy Workgroup
• State-level Health Information Privacy and
  Security Collaboration (HISPC)

7
State Alliance for e-Health

• HHS Contract w / National Governors Association
• Governance models
• Sustainable business models for HIE
• Role of private payers
• Integration of state public health and health
  care programs

8
Congressional Bills

• SB 3454 (Brownback) and HR 5559 (Moore
  co-sponsor)
• Establish independent health record trusts,
  modeled after banking industry
• Create lifetime EHRs with health plan and debit
  card functionality
• Connect EHRs and build a national health
  information network
• Provide health information data (within
  authorized boundaries) to emergency departments
  and researchers
• Offers tax credits to employers to encourage
  employee participation
• Creates source of tax-free income to support
  operations of the trust

9
HIT / HIE Resources

• Agency for Healthcare Research and Quality
  National Resource Center for HIT www.ahrq.gov
• Connecting for Health / Markle Foundation
  www.connectingforhealth.org/commonframework/
• U.S. Dept. Health and Human Services (ONC, AHIC,
  NHIN, etc.) www.hhs.gov/healthit/
• Certification Commission for HIT (CCHIT)
  www.cchit.org
• eHealth Initiative www.ehealthinitiative.org
• Healthcare IT News www.healthcareitnews.com

10
Health Information ExchangeState and National
Update

• Summarize recent national HIE activities
• Overview of Kansas statewide HIT / HIE Initiative
• Identify next steps to advance HIT / HIE in
  Kansas

?
11
HIE at the State Level
12
Kansas HIE Initiatives Overview

13
Privacy and Security Collaboration(a/k/a HISPC)

• Federal HHS Grant funded through Research
  Triangle International (RTI)
• In partnership with the National Governors
  Association
• Purpose Assess and develop plans to address
  variations in business policies and state laws
  that affect privacy and security practices

14
Privacy and Security Collaboration(a/k/a HISPC)

• Kansas
• Sponsored by Governors Health Care Cost
  Containment Commission (H4C)
• One of 34 states awarded subcontract
• Timeline May 2006 through December 2008
• Public-private project team
• State (KHPA, H4C)
• Kansas Health Institute project manager
• KU Center for Healthcare Informatics
• Mid-America Coalition on Healthcare
• Lathrop Gage

15
Results HISPC I

• HIPAA identified as dominate perceived barrier
• Interpreted in a variety of ways
• Need for education and standardization
• Kansas laws are antiquated and in need of
  modernization
• Consumer participation has been difficult
• Largely unaware of issues around HIT / HIE,
  privacy, and security

16
Key Recommendations from HIE Workgroups

• Establish leadership group
• Create public / private entity
• Provide education
• Leverage existing resources
• Demonstrate impact of HIE
• Resolve privacy and security barriers
• Seek funding from multiple sources

17
Leadership GroupGovernors HIE Commission

• Created February 2007 by Executive Order
• Public / private approach to
• advance the recommendations of the HIE workgroups
  created through the HIT / HIE Policy Initiative
• ensure privacy and security of personal health
  information by utilizing solutions from Privacy
  Security Collaborative
• First meeting March 28, 2007

18
Leadership GroupHIE Commission Membership

• Tom Bell, Kansas Hospital Association
• Karen Braman, Preferred Health Systems, Co-Chair
• Jennifer Brull, MD, Prairie Star Family Practice
• Helen Connors, KU Center for Healthcare
  Informatics
• Joe Davison, MD, West Wichita Family Physicians
• Jeff Ellis, Lathrop and Gage, Co-Chair
• Diana Hilburn, Via Christi Health Systems
• Jackie John, Great Plains Health Alliance
• Maren Turner, AARP Kansas

19
Leadership GroupHIE Commission Membership

• Ken Mishler, Kansas Foundation for Medical Care
• Marci Nielsen, Kansas Health Policy Authority
• Sandy Praeger, Kansas Insurance Commissioner
• Howard Rodenberg, MD, Kansas Department of Health
  Environment
• Kristi Schmitt, Finney County Health Department
• Bob St. Peter, MD, Kansas Health Institute
• Bill Thornton, MGP Ingredients
• Bill Wallace, Blue Cross Blue Shield Kansas

20
HIE Commission Scope

• The Commission shall
• promote the public good by ensuring an equitable
  and ethical approach to HIE for the improvement
  of health care
• encourage collaboration and facilitate a
  standardized approach to interoperable HIE in
  Kansas and across state lines
• recommend policy that will advance HIE in Kansas
  while protecting the privacy and security of
  citizens private health information
• leverage existing HIE initiatives in Kansas and
  proactively seek opportunities to utilize HIE for
  the betterment of Kansas health care system

21
HISPC IIEducation / Leverage Resources

• Provide Education
• Develop curricula for providers and consumers
• Support development through Kan Ed
• FCC Grant 3.8 Million
• Connects 44 facilities
• Private Broadband Network

22
HISPC IILegal Work Group

• Yvonne Anderson, Kansas Department of Health
  Environment
• Doug Anning, Polsinelli Shalton Flanigan
  Suelthaus PC
• Allison Burghart, Kansas Department of
  Administration
• Michelle Carter-Gouge, Preferred Health Systems
• Joann Corpstein, Kansas Department of Aging
• Jeff Ellis, Lathrop Gage L.C.
• Lisa Foos, Preferred Health Systems
• Gail Edson Halterman, Lathrop Gage L.C.

23
HISPC IIResolve Privacy and Security Barriers
Legal Work Group

• Dick Hay, Foulston Siefkin LLP
• Julie Roth, Lathrop Gage L.C.
• Martie Ross, Lathrop Gage L.C.
• Janet Kerr, Kansas Department of Social
  Rehabilitative Services
• Gary Knight, Via Christi Health System
• Marta Fisher Linenberger, Foulston Siefkin LLP
• Sunee Mickle, Blue Cross Blue Shield Kansas
• Steve Schwarm, Polsinelli Shalton Flanigan
  Suelthaus PC

24
HISPC IIResolve Privacy and Security
BarriersLegal Work Group

• Jerry Slaughter, Kansas Medical Society
• Deborah Stern, Kansas Hospital Association
• Mark Stafford, State Board of Healing Arts
• Christina Stephan, Kansas Health Institute
• Craig Van Aalst, Kansas Insurance Department
• Catherine Walberg, KaMMCO

25
Legal Work GroupTasks

• Identify and analyze relevant laws
• Catalog laws
• Proposed legislation

26
HISPC IILegal Work Group

• Chapter __
• SENATE CONCURRENT RESOLUTION No. __
• A CONCURRENT RESOLUTION approving . . .
• WHEREAS, Individuals of this State have the
  primary interest in the confidentiality,
  security, integrity, and availability of their
  health information
• WHEREAS, The availability, quality and
  efficiency in the delivery of health care depend
  upon the efficient and secure collection, use,
  maintenance, and exchange of health information
• WHEREAS, The use of current and emerging
  technology facilitates the efficient and secure
  collection use, maintenance and exchange of
  health information and

27
HISPC IIResolve Privacy and Security Barriers
Legal Work Group

• WHEREAS, The States antiquated and
  decentralized statutory and regulatory scheme,
  and its interaction with federal mandates,
  creates confusion and is a significant barrier to
  the efficient and secure collection, use,
  maintenance, and exchange of health information.
  
• Be it resolved by the Senate of the State of
  Kansas, the House of Representatives concurring
  therein That the laws of this State should be
  reviewed, modified as necessary, and construed to
  protect the interests of individuals in the
  confidentiality, security, integrity and
  availability of their health information to
  promote the use of modern technology in the
  collection, use, maintenance, and exchange of
  health information to promote uniformity in
  policy and to codify all standards in a cohesive
  and comprehensive statutory structure.

28
Health Information ExchangeState and National
Update

• Summarize recent national HIE activities
• Overview of Kansas statewide HIT / HIE Initiative
• Identify next steps to advance HIT / HIE in Kansas

?
29
Kansas Health Policy AuthorityPrioritiesSystem
Reform and Better Health

• Transparency project health care cost and
  quality
• Health literacy
• Medical home definition
• Medicaid provider reimbursement
• Community health Record (HIE)
• Form standardization

• Increase tobacco user fee
• Statewide smoking ban
• Partner with community organizations
• Education Commissioner
• Collect fitness data in schools
• Increase physical fitness
• Wellness for small businesses
• Healthier food for state employees
• Dental care for pregnant women
• Tobacco cessation in Medicaid
• Expand cancer screening

• Aggressive outreach and enrollment of eligible
  children (target population 20,000)
• Premium assistance for low income adults without
  children (target population 38,000)
• Small business initiatives (target population
  15,000 young adults and 12,000 employees of small
  businesses)

30
List of Kansas HIT / HIE Activity

• Central Plains Regional Health Care Foundation
  Clinics Patient Index Segwick County
• Community Health Center (Health Choice) Project
• Jayhawk Point of Care (POC) Pratt
• Kansas City Health Exchange (KCHE) Community
  health Record
• Northwest Kansas Health Alliance Critical
  Access Hospitals
• Kansas Public Health eXchange (PHIX) Public
  health department providers

• KAN-ED hospitals and other member institutions
  within the state
• University of Kansas Medical Center, Center for
  Telemedicine and Telehealth
• University of Kansas Center for Healthcare
  Informatics (CHI)
• Kansas Hospital Association Electronic Health
  Record Work Group
• Kansas Department of Health and Environment
  (KDHE) Information Links grant

HISPC State Implementation Project Summary and
Impact Analysis, Nov 2007
31
List of Kansas HIT / HIE Activity

• KC Carelink Kansas City healthcare safety-net
  providers
• The Outcomes / Information Sharing / Information
  Systems Commnittee of the Mid-America Regional
  Council Regional Health Care Initiative
• The Kansas City Quality Improvement Consortium
  United Auto Workers / Ford Community Health Care
  Initiative
• Sedgwick County Community Health Record

• HISPC Kansas Health Information Security and
  Privacy Collaboration
• CareEntrust Kansas City employer-based
  community health record pilot project (state
  employees)
• Governors Health Information Exchange Commission
  Extension of Governors Health Care Cost
  Containment Commission

HISPC State Implementation Project Summary and
Impact Analysis, Nov 2007
32
Next Steps

• HISPC III (Calendar Year 2008)
• Further develop educational package
• Expand review and recommend legislative package
• Establish governance group and resource center
• Coordinate with Kansas Health Policy Authority
  (KHPA)
• Collaboration initiative

33
Questions?
34
(No Transcript)