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Florida RHIOs: Where Are We Headed? How Do We Get There?

Florida RHIOs: Where Are We Headed? How Do We Get There?. Florida Association of Medical Directors of Information Systems March 17, 2007. Christopher B. Sullivan, Ph.D. Florida Center for Health Information and Policy Analysis Agency for Health Care Administration.

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Florida RHIOs: Where Are We Headed? How Do We Get There?

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  1. Florida RHIOs:Where Are We Headed?How Do We Get There? Florida Association of Medical Directors of Information Systems March 17, 2007 Christopher B. Sullivan, Ph.D. Florida Center for Health Information and Policy Analysis Agency for Health Care Administration

  2. Where Is Health Care Headed? • The Shape Of Things To Come? 5.4 Million years 50 years The Economist , December 13, 2003

  3. A Solution at the Federal Level: The Nationwide Health Information Network • Transform health care through adoption of health information technology to realize higher quality health care at a lower cost. • April 2004, President Bush signed an Executive Order establishing the position of the National Coordinator for Health Information Technology • July 2004, David J. Brailer M.D., proposes a Framework for Strategic Action, for national adoption of health information technology. HEALTH INFORMATION TECHNOLOGY LEADERSHIP PANEL FINAL REPORT The Lewin Group, Inc., March 2005

  4. Framework for Strategic Action Health information technology (Health IT) allows comprehensive management of medical information and its secure exchange between health care consumers and providers. It will: • Improve health care quality • Reduce health care costs • Decrease paperwork • Expand access to affordable care http://www.hhs.gov/healthit/

  5. HHS - Framework for Strategic Action Interoperable health IT will improve individual patient care, but it will also bring many public health benefits including: • Early detection of infectious disease outbreaks Improved chronic disease management; and • Evaluation of health care based on quality information that can be compared. http://www.hhs.gov/healthit

  6. Predicted Cost Savings from HIT • Studies in ambulatory care settings estimate that EHRs would save $112 billion per year (7.5% of health care spending) • $34 billion annually for in-office reduction • $78 billion annually from interoperability of those EHRs. • ONC estimates annual savings attributable to widespread EHR adoption lie between 7.5% and 30% of annual health care spending. HEALTH INFORMATION TECHNOLOGY LEADERSHIP PANEL FINAL REPORT The Lewin Group, Inc., March 2005

  7. Nationwide Health Information Network The NHIN will “link all health records through an interoperable system that protects privacy as it connects patients, providers and payers, resulting in fewer medical mistakes, less hassle, lower costs and better health.“ HHS Secretary Mike Leavitt http://www.hhs.gov/healthit/

  8. Nationwide Health Information Network

  9. The Florida Health Information Network Florida’s Health Information Networks 1. Big Bend RHIO 2. Central Florida RHIO 3. Community Health Information Organization 4. Escambia HIN 5. Jacksonville Health Information Network 6. Palm Beach County Community Health Alliance 7. Pinellas RHIO 8. Space Coast Health Information Network 9. South Florida HII 10. Tampa Bay RHIO See: http://ahca.myflorida.com/dhit

  10. The Florida Health Information Network in Health Care Policy • Health policy decisions in the Florida Legislature and Governor’s Office endorsed developing Florida’s health information technology infrastructure • Governor Jeb Bush signed an Executive Order in May 2004 creating the Governor’s Health Information Infrastructure Advisory Board to lead Florida’s development of health information exchange

  11. The Governor’s Health Information Infrastructure Advisory Board • The Board’s 2005 Interim Report of the GHIIAB called for the creation of the Florida Health Information Network • The Florida Health Information Network is the statewide network that will integrate the Regional Health Information Networks to enable statewide health information exchange

  12. The Florida Health Information Network Strategy: • Build out health information networks using a grants program to leverage the development of local RHIOs • Integrate the RHIOs with a state-level server that will manage data exchange among RHIOs and other state and federal databases • Create a not-for-profit organization to maintain the FHIN and set standards of interoperability for the RHIOs

  13. Functions of the Florida Health Information Network • The Florida Health Information Network will facilitate communications and data exchange among the RHIOs by coordinating requests for medical records inside and outside of Florida • The Florida Health Information Network will specify and maintain technical standards for interoperability among the RHIOs

  14. 1. Big Bend RHIO2. Tampa Bay RHIO3. Palm Beach County Community Health Alliance4. South Florida HII5. Escambia HIN6. Jacksonville HIN7. Community Health Information Organization 8. Central Florida RHIO9. Pinellas RHIO10. Space Coast HIN Medicaid Florida Center DOH SHOTsVital Statistics Florida Health Information Network Certification of Physicians with DOH Licensing Database

  15. Technical Standards for the FHIN

  16. The Florida Health Information Network Begins at the Local Level • The Florida Health Information Network is being built from the local community up • An essential element of the strategic plan is to empower local stakeholder collaborations focused on health information exchange • The driver of this plan is the FHIN Grants Program and Regional Health Information Organizations in the local community

  17. Grants Program to Develop Regional Health Information Organizations • Planning Grants: Support engaging local health care stakeholders to develop a strategic plan for health information exchange • Implementation Grants: Support projects that demonstrate health information exchange among two or more competing providers • Training Grants: Support practitioner training designed to increase physician and dentist use of electronic health record systems

  18. Grants Program, 2006-2007 • In 2005 the Legislature appropriated $1.5 million for grants awarded to nine projects • Five Planning Grants • Three Implementation Grants • One Training Grant • In 2006 the Agency awarded six grants with another $2 million appropriated by the Legislature

  19. What is a Regional Health Information Organization?

  20. An Example of a Florida RHIO:Palm Beach County Community Health AllianceAll-Care Health Record SystemGlades and West Palm Beach, Florida

  21. Partners Public Funders Free Clinics Private Funders Health Dept. Social Services Hospitals PBC Community Health Alliance (An Alliance of Funders and Providers Serving Health Care Consumers) Collaborative Projects Care Expansion Language Access Project Access Shared EHR Common Eligibility Palm Beach County Community Health Alliance

  22. Western Palm Beach County Health Information Infrastructure Operations and Evaluation Project The Glades Community • 28% uninsured rate • Glades General Hospital is only Acute Care facility • 17,753 ER visits; 1,900 Medicaid discharges in 2002 • Prevent duplication between hospital and clinics

  23. All-Care Shared Health Record • Real-time electronic interface to existing data systems used by hospitals, clinics, mental health centers, and other safety net providers • Free clinics, Federally Qualified Health Centers, Palm Beach County Medical Society Project Access and key competitor safety net hospitals are participating • Viewable via the Web - after patients have signed authorizations

  24. All-Care Clinical Data List • Date of Visit and Encounter Type • Clinic and Provider Names • Diagnosis and CPT codes • (Hospital) Discharge code • Prescribed and Filled drugs • Lab results • Radiology Results

  25. An Example of a Florida Regional Health Information Organization:Big Bend RHIOTallahassee, Florida

  26. Region Served by the Big Bend RHIO Tallahassee

  27. Big Bend RHIO is Anchored in the Community • Board members represent local providers • Most clinical Board members have sophisticated Electronic Medical Record systems in use • FSU College of Medicine, Tallahassee Community College included on Board • Capital Health Plan covers 37% of patients • Optical Fiber medical area network (pMAN), currently providing connectivity

  28. NFWC Urology pMAN Network TMH Radiology CRMC TDI BBRHIO RHIN VSA CHP CHP. VPN CHP. Remote & VPN Users TNC

  29. Big Bend RHIO RHIN Architecture VPN Small organizations can connect either directly to the RHIN or through a VPN gateway Organizations can connect bi-directly to feed their data and receive data directly into their EMR In the early Phases CHP, CRMC & TMH will provide a one way feed of their data. They have the largest repositories and the priority is to make their data available ASAP

  30. Health Information Exchange Services • Big Bend RHIO will establish a community repository for the storage and retrieval of: • Demographic/encounter data • Medication claims data and e-prescribing • Document viewer including lab/radiology • Secure messaging • Disaster recovery • Remote data backup outside service area

  31. Next Steps for the Florida Health Information Network • Establish a statutory entity, the Florida Health Information Network Corporation to implement the state level network • As a not-for-profit organization, the Florida Health Information Network Corporation would be accountable to the public and responsive to health care providers

  32. Health Information Networks Included as an “Innovative Idea” in 2007 • Idea 85 of Speaker Marco Rubio’s 100 Innovative Ideas addresses health information exchange • “Improve patient care through technology by expanding electronic health records and regional health information networks.”

  33. FHIN Bills in the 2007 Legislative Session • H1121 and S 2348 – Florida Health Information Network Act • H 1123 – Florida Health Information Network Corporation, public records exemption • Patient medical or health records confidential • Cannot be disclosed without patient consent, unless in a life-threatening emergency.

  34. Proposed FHIN Budget 2007-2010

  35. The Future of the Florida Health Information Network • The Florida Health Information Network vision will integrate clinical health information exchange in Florida through a network architecture that will empower physicians to access timely and accurate medical records in order to deliver high quality medical care for their patients.

  36. Christopher B. Sullivan, Ph.D. Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Office of Health Information Technology 2727 Mahan Drive Tallahassee, FL 32309 sullivac@ahca.myflorida.com

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