Georgia Health Information Exchange

1. Georgia Health Information Exchange Georgia Rural Health IT Forum January 26, 2012

2. Georgia HIE Mission & Vision Revisited Mission Facilitate a statewide health information exchange for Georgia that is trusted and valued by all stakeholders in order to improve health care coordination, reduce costs, and establish a solid foundation for long-term financial sustainability. Vision Foster a healthier Georgia through the use and exchange of electronic health information by improving patient-centered health care, increasing efficiency and promoting the health status of the entire state population. 2

3. Vision: Coordinated Care in Georgia 3

4. Georgia’s Objectives to Achieve HIE 4

5. Georgia HIE Governance 5

6. Georgia HIE Governance Structure Georgia Public/Private Collaborative Actual & Potential Participants Georgia State Government Data Contributors (Providers, Payers, Others) Georgia Medicaid eHealth State Agency Council Provides input HIT Coordinator Local/Regional HIEs Provides input Committees & Workgroups GHIE Inc. GA-HITREC GHIE Board Recommends Statewide HIE Policies & Requirements DCH Approves & Enforces Policies 6

7. GHIE Committees and Workgroups Act and Get Involved • Clinical • E-prescribing • Lab results exchange • Patient care summary exchange • Finance To get involved inquire at hitt@dch.ga.gov • GHIE, • Legal & Privacy • Secondary Use (On Hold) • Service Area Health Information Exchanges (SAHIEs) • Technology 7

8. Stay Engaged & Spread the Word • Quarterly DCH Town Halls • Monthly eNewsletter: DCH-I Coming Soon • Follow us on Facebook and Twitter • Regular webcasts and roundtable events 8

9. Georgia’s Story: Progress 9

10. 10

11. 11

12. 12

13. Recent Progress • Technical & Policy Readiness Assessment • Environmental Scan • Legal & Privacy Services • Financial Modeling Services • Advertising & Marketing Services 13

14. Georgia HIE Development Status • Phase 1 • Direct (Secure Messaging) • Active RFP; responses due Jan 31st • Q2 deployment • Phase 2 and 3 • Core and Value-Added Services • RFP expected to post in Q1 • Deployment • Phase 2: Q3 • Phase 3: Q4 14

15. Potential Phasing of Georgia HIE Services 15

16. By September 30, 2012 Georgia providers will share at least 1 million electronic health information messages using Direct 16

17. Connecting more than 17

18. Connecting more than 50 counties 18

19. Connecting more than 50 counties 40 healthcare organizations 19

20. Connecting more than 50 counties 40 healthcare organizations Tens of thousands of clinicians and patients 20

21. In 2012, Georgia will… • Enter Top 10 of states using Direct • Enter Top 20 of ePrescribing states • Have one of the most robust statewide health information exchanges in the country ONC stated that with Phase 1, Georgia will “leap frog most other states” in its progress to establish a statewide health information exchange. 21

22. Upcoming Events March 12, 2012 • Georgia eHealth Summit June 2012: Georgia Health IT Town Hall • Provider registration for the Georgia HIE • Measurement framework • Phase 2 implementation progress 22

23. Questions 23

24. Appendix 24

25. Health Information Exchange • What is HIE? • Enables secure exchange of patient health information between providers and healthcare organizations • Why is HIE important? • HIE saves lives and improves health care outcomes by enhancing communication between providers, allowing for improved decision support and enabling patients to access information and better manage their personal healthcare 25

26. Health Information Exchange • What are the benefits of HIE? • When clinical records are available at the point of care, patients receive more accurate and timely service. • Reduced likelihood of dangerous drug interactions • Avoidance of duplicate testing and unnecessary procedures • Improved provider-patient communication and coordination of care • Enhanced security for personal health information 26

27. Georgia & Interoperability Personal Health Records EMS Providers Primary Care Physicians Georgia Hospitals & Health Centers Nursing Homes State Agencies Community Service Boards Telemedicine Health Systems Payor Organizations Laboratories FCHCs 27 Specialty Facilities Pharmacies Federal Agencies Radiology SAHIEs

28. HIE Phase 1: Direct Secure Messaging Georgia’s Health Information Exchange Model (Phase 1) 28

29. What is Direct? • Simple.Connects healthcare stakeholders through universal addressing using simple push of information. • Secure.Users can easily verify messages are complete and not tampered with en route. • Scalable.Enables Internet scale with no need for central network authority that must provide sophisticated services such as EMPI, distributed query/retrieve, or data storage. • Standards-based.Built on well-established Internet standards, commonly used for secure e-mail communication; i.e.,. SMTP (or XDR) for transport, S/MIME for encryption, X.509 certificates for identity assurance Direct Project specifies a simple, secure, scalable, standards-based way for participants to send encrypted health information directly to known, trusted recipients over the Internet. h.elthie@direct.ahospital.org b.wells@direct.aclinic.org

30. What you need for Direct • HIE Participant • Individual or organization that has a demonstrated need to exchange health information • Certificate Authority (CA) • Issues digital certificates to HIE Participants • Registration Authority (RA) • Verifies identities of HIE Participants • HISP (Health Information Service Provider) • Provides and manages Direct addresses, publishes certificates, routes (possibly storing) Direct messages • HISPs can offer other HIE services 30

31. Direct Addresses • Direct Addresses are used to route information • Look like email addresses • Used only for health information exchange b.wells@direct.aclinic.org • An individual may have multiple Direct addresses Endpoint Domain Direct Address

32. Georgia Statewide HIE: Use Case #1Referral to Specialist (Example of “Push”) 2. Referring provider sends referral and reference clinical documents to the specialist system 1. Provider uses EHR to initiate referral message and locate specialists Provider’s EHR system looks up specialist practices in GA’S HIE provider directory 3. GA HIE Network documents access to Network in audit log Patient visits primary care provider; provider needs to refer patient to a specialist Security Services & Authorization Framework Provider Directory Secure Message Exchange via Direct Project Transaction Audit Log & Reporting Georgia Statewide Health Information Exchange Phase 1 4. Specialist receives referral request and sends response to referring physician through the GA HIE Network 5. Specialist sees patient