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wyoming health information organization wyhio
Wyoming Health Information OrganizationWyHIO

The mission of the WYHIO is to enhance access, quality, safety, and the efficiency of healthcare in Wyoming through the implementation of electronic health care information exchange and interoperability that is secure and confidential and utilizes technology that will assure interconnectivity within Wyoming and the rest of the nation.

  • Formed August 2005, Incorporated as not for profit, 501 (c) 3 corporation January, 2006
  • Seeking private grants for operations and projects
  • Working with provider & consumer organizations to educate on HCIT
  • Will take next organizational steps to appoint a permanent board
health information technology
Health Information Technology
  • Studied by the WHCC summer and fall of 2003
  • Recommendation made by WHCC October, 2003 to fund a feasibility study and plan for statewide interoperable HCIT system
  • Study and plan funded by legislature in 2004
  • 2003 WHCC recommendation
  • 2004 HCIT Bill , Enrolled Act 31 Enacted (in binder)
  • IT-2 Subcommittee/JSI Report
  • WHC 2005 recommendation
  • WyHIO
  • 2005 Bill Draft (in binder)
whcc health care information technology recommendation fall 2003
WHCC Health Care Information Technology Recommendation, Fall 2003

Rationale for the system:

  • improve effectiveness of service delivery and ultimately improve the overall quality of healthcare in Wyoming
  • increase patient safety & reduce medical errors,
  • reduce duplication of health services, thereby reducing costs
  • Improve administrative efficiency
The Institute of Medicine in 1999 reported that 44,000-98,000 people died EVERY YEAR in America from medical error

Secretary HHS called for study of health reform measures to address patient safety and error reduction.

One of the major recommendations was to develop an information technology infrastructure. IOM defined the framework for an EHR
  • HHS estimated a potential savings of 10% of total annual spending on healthcare
The National Center for Quality Assurance reported in 2003 that 50,000 people die EVERY YEAR in America because known conditions such as high blood pressure or elevated cholesterol are not adequately monitored and controlled.
  • The healthcare industry spends only 2% of its revenue for information technology compared to an average 6% share spent by American businesses.
By 2003, Wyoming businesses had seen five years of double digit increases in insurance premiums
  • Little Federal activity on Health IT use and delivery system change
labor health and social services committee meeting october 2003
Labor Health and Social Services Committee Meeting - October 2003
  • The Health Technology Center reported in testimony that computerized physician order entry (CPOE) reduced adverse drug events by fifty-five percent (55%)
  • Nine percent (9%) of redundant lab tests at a hospital could be eliminated using a computerized system.
enrolled act no 31
Enrolled Act No. 31
  • Enacted during the 2004 WY legislative session
  • $400,000 appropriation
technical subcommittee
Dr. Geoffrey Smith, Chair

Dr. Robert Fagnant

Laurie Hansen, RN

Steve Hopkins

Dr. Joy Lewis

Dr. James Lugg

Jeffrey McSchooler

Matthew Rodosky

Dr. Brent Sherard

David Squires

Dr. Scott Tenney

Technical Subcommittee
tech subcommittee timeline
Tech Subcommittee Timeline
  • Issued RFP July 1, 2004
  • Selected John Snow, Inc. in November 2004 to conduct study & develop plan
  • Final report made to WHCC September 1, 2005
whcc recommendation
WHCC Recommendation
  • Reviewed report with IT-2 & JSI
  • Data analysis of hospitals, practitioners & Cost Model
  • Sensitivity analysis – dial on a radio

What if …..

hub share information
HubShare Information
  • Centralized Network Services electronically connects providers enablingsharing of patient information
  • Architecture and infrastructure allows providers to use different software yet share information


  • Little ROI for providers to install EMR
  • Negative business case to share information
  • Benefits flow to payers and patients
spokes enabling technology
SpokesEnabling Technology
  • 10 Hospitals
  • 250-300 Physicians
  • Assessed for Ready/Willing/Able to connect to the hub and commence sharing
power behind the wheel promote it
Power Behind the Wheel Promote IT

Four Focused Initiatives

  • E-prescribing
  • Administrative Transaction Processing
  • Continuity of Care Record
  • Hospital Portal
spokes power enable promote
Spokes & PowerEnable & Promote


  • Incentives needed to drive adoption
  • Loans, matching grants, revised reimbursement, other mechanisms
technical support organization manage
Technical Support OrganizationManage
  • Technical staff to work with providers
  • Ensure security of network
  • Build, maintain and upgrade network
technical support organization
Technical Support Organization


  • Practitioners want/need technical assistance
  • Hub needs ongoing monitoring and maintenance 24/7/365
wyhio manage

Wyoming Health Information Organization

  • Vehicle steering the wheel
  • Negotiate legal, organizational and electronic issues
  • Requires administrative staff
  • Formed August 2005 from stakeholders
why should wyoming help build the wheel
Why Should Wyoming Help Build the Wheel?
  • Providers in varying degrees of adoption
  • Without infusion of state funds, businesses lack financial incentives to install & use IT
  • Proprietary and legal issues require an organization to negotiate them among the stakeholders
  • Benefits accrue to WY as payer of benefits and to its citizens
whcc recommendation summary
WHCC Recommendation Summary
  • $41 Million over 5 years
  • Builds foundation for functional and interoperable electronic health records network
  • Builds an organization to bring stakeholders together to ESPM
bill 06lso 0261
Bill # 06LSO – 0261
  • The Hub and focused initiatives - $20,094,440 (appropriation allocated until spent)
  • WyHIO (Manage) - $946,471 (two years, partial allocation only – other funds necessary
  • Providers - $37 million (two years, partial allocation only – local match required)
  • Independent Security Audits - $40,000 (full, two-year appropriation)
  • Wyoming Department of Health - $240,000 (full, two-year appropriation)
2005 hhs actions
2005 HHS Actions

Awarded contracts to address IT adoption barriers in 4 areas:

  • Compliance Certification Process -- Certification Commission for Health Information Technology (CCHIT) -- $2.7 million
  • National Health Information Network – 4 consortiums to develop a prototype -- $18.6 million
  • Privacy and Security – NGA and RTI, Inc. -- $ 11.5 million, 40 state/territory contracts
  • Standards Harmonization – ANSI -- $3.3 million
compliance certification
Compliance Certification
  • Ambulatory EHRs certification criteria by 3/2006
  • Inpatient EHR certification criteria by 3/2007
  • Network certification criteria by 3/2008
national health information network
National Health Information Network
  • Spring 2006 – Detailed technical design & architecture, recommend data & technical standards & security policies
  • Fall 2006 - Evaluate 4 functional prototypes, live demonstrations
privacy and security
Privacy and Security
  • October 2006 – interim assessment of state variations
  • March 2007 – final assessment of variation, solutions and implementation of plan
standards timeline
Standards Timeline
  • 2006 implement processes to resolve gaps in standards
  • Develop business model for Health Information Technology Standards Panel
  • Ongoing panel necessary because of need for new standards due to new procedures and processes in the industry
medicare part d
Medicare Part D
  • 4 pilots to test e-prescribing standards
  • $6 million
  • MMA requires adoption of standards by 2008
bipartisan support at federal level senators frist and clinton op ed article in washington post
Bipartisan Support at Federal LevelSenators Frist and Clinton op-ed article in Washington Post

“Businesses in other sectors have embraced the information revolution to cut costs and improve productivity”

“It’s time we realize the full potential of the information revolution to improve the quality of the health care system as well.”

wyhio interim board
WyHIO Interim Board
  • Geoff Smith, MD Interventional Radiologist, Chairman
  • Andrew Fisher, Great West Life
  • Bob Fagnant, MD OB-Gyn, WMS
  • Larry Madsen, Black Hills Bentonite – Purchaser
  • Steve Chasson, WY Primary Care Association
  • Dana Barnett – UMC, WHA
  • Leland Clabots – WDH
  • Carol Jenkins – WHCC Ex-Officio
  • Completed organizational documents and filings
  • Seeking funding -- “seed money” grants to fund operating expenses in 2006
  • Inform membership and educate the public about interoperable EHRs
thank you
Thank You
  • Wyoming Medical Center Foundation
  • Blue Envelope Health Fund
  • Great West Life
  • United Medical Center
  • Wyoming Medical Center
  • Sweetwater County Memorial Hospital
  • Wyoming Health Initiative
  • Anne Larsen
  • Wyoming Department of Health
  • Wyoming Department of Administration & Information

Risk Assessment


Probability of Success


Hub & Initiatives