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State of Tennessee The Governor’s eHealth Council ahdi Association for Healthcare Documentation Integrity. Executive Order # 35 Governor Phil Bredesen Signed Executive Order # 35 on April 6, 2006 to establish the Governor’s eHealth Council.

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Presentation Transcript
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State of Tennessee

The Governor’s eHealth Council

ahdi

Association for Healthcare Documentation Integrity

slide2
Executive Order # 35

Governor Phil Bredesen Signed Executive Order # 35 on April 6, 2006 to establish the Governor’s eHealth Council.

slide3
The Council shall advise and support the State of Tennessee as it develops and implements an overall strategy for the adoption and use of the electronic medical records and create a plan to promote its use by all healthcare stakeholders.
  • The Council shall identify obstacles to the implementation of an effective health information infrastructure and provide recommendations to remove or minimize those obstacles.
  • The Council shall advise appropriate parties within State government on issues related to the development and implementation of the health information infrastructure.
  • The Council shall use best practices in minimizing and eliminating redundant efforts and duplicative initiatives.
ehealth council members
eHealthCouncil Members
  • CIGNA HealthCare
  • Caremark Rx, Inc.
  • Eastman Chemical Company
  • FedEx Corporation
  • SharedHealth
  • CenterStone
  • Dell
  • Nissan North America
  • HCA Healthcare
  • BlueCross BlueShield of Tennessee
  • Vanderbilt University Medical Center
  • State of Tennessee, Bureau of TennCare
  • The State RHIO organizations
our focus
Our Focus
  • To convene, facilitate and incubate regional stakeholders to use health information technology to improve the quality of care delivered by providing necessary information at the point of care.
  • Patient data will be used for treatment and other uses as permitted by HIPAA
  • Focus on Tennessee’s 95 counties - Urban and Rural
    • Secondary focus on contiguous states, especially contiguous counties
state of tennessee population
State of Tennessee: Population

Population: Aprox. 6.1 Million

slide7

eHealth Council Framework

  • Coordinating organization facilitates rules of engagement:
    • Data-sharing Agreement
    • Legal Framework
    • Standards
    • Interoperability
    • Transparency
    • Value
    • Quality/Cost

Common Portal

H.I.E.

EMR / EHR/PHR Implementation

Structured Notes & Paper Records

Administrative Transactions (claims…)

Secure Clinical Messaging (labs, imaging, TeleHealth…)

ePrescribing Roll Out

Broadband % of Access, Stakeholders, Automation

Framework for Trust and Collaboration

County-by-County Implementation that Progresses in Stages

goal broadband connectivity in 95 counties
Goal: Broadband Connectivity in 95 Counties

Source: Federal Communications Commission, http://www.universalservice.org/rhc/tools/rhcdb/Rural/2005/result.asp

goal broadband connectivity in 95 counties1
Goal: Broadband Connectivity in 95 Counties
  • URBAN:
  • Practices: 1,335
  • Licensed M.D.s: 7,302
  • Primary Care/Pediatrics: 3,019
  • Hospitals: 160
  • Physician Practices: 3,779
  • Licensed M.D.s: 15,387
  • Primary Care/Pediatrics: 6,992
  • SEMI-RURAL
  • Practices: 1,362
  • Licensed M.D.s: 6,695
  • Primary Care/Pediatrics: 3,085
  • RURAL
  • Practices: 887
  • Licensed M.D.s: 1,390
  • Primary Care/Pediatrics: 888

Sources: Federal Communications Commission, http://www.universalservice.org/rhc/tools/rhcdb/Rural/2005/result.asp; 2007 Tennessee Healthcare Technology Readiness Assessment, TNHIMSS, www.TennesseeAnytime.org/eHealth; Tennessee Dept. of Health 2007.

fcc designations
FCC Designations

Source: Federal Communications Commission, http://www.universalservice.org/rhc/tools/rhcdb/Rural/2005/result.asp

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eHealth Council Framework

  • Coordinating organization facilitates rules of engagement:
    • Data-sharing Agreement
    • Legal Framework
    • Standards
    • Interoperability
    • Transparency
    • Value
    • Quality/Cost

Common Portal

H.I.E.

EMR / EHR/PHR Implementation

Structured Notes & Paper Records

Administrative Transactions (claims…)

Secure Clinical Messaging (labs, imaging, TeleHealth…)

ePrescribing Roll Out

Broadband % of Access, Stakeholders, Automation

Framework for Trust and Collaboration

County-by-County Implementation that Progresses in Stages

we have a good start
We have a good start
  • 29% physician practices already have T-1 connectivity
  • 67% hospitals already have T-1 connectivity

Source: 2007 Tennessee Healthcare Technology Readiness Assessment, TNHIMSS, www.TennesseeAnytime.org/eHealth

connectivity disparities from urban to rural
Connectivity: Disparities from Urban to Rural

URBAN

SEMI-RURAL

RURAL

Source: 2007 Tennessee Healthcare Technology Readiness Assessment, TNHIMSS, www.TennesseeAnytime.org/eHealth

current emr usage
Current EMR Usage

Source: 2007 Tennessee Healthcare Technology Readiness Assessment, TNHIMSS, www.TennesseeAnytime.org/eHealth

emr disparities from urban to rural
EMR: Disparities from Urban to Rural

URBAN

SEMI-RURAL

RURAL

Source: 2007 Tennessee Healthcare Technology Readiness Assessment, TNHIMSS, www.TennesseeAnytime.org/eHealth

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eHealth Council Framework

  • Coordinating organization facilitates rules of engagement:
    • Data-sharing Agreement
    • Legal Framework
    • Standards
    • Interoperability
    • Transparency
    • Value
    • Quality/Cost

Common Portal

H.I.E.

EMR / EHR/PHR Implementation

Structured Notes & Paper Records

Administrative Transactions (claims…)

Secure Clinical Messaging (labs, imaging, TeleHealth…)

ePrescribing Roll Out

Broadband % of Access, Stakeholders, Automation

Framework for Trust and Collaboration

County-by-County Implementation that Progresses in Stages

scripts per capita
Scripts Per Capita

Tennesseans rank 3rd in the nation in prescriptions per person in 2006

Source: The Kaiser Family Foundation, 2007.

high prescription drug use has consequences
High Prescription Drug Use Has Consequences
  • Consequences of high prescription drug use include medication errors, adverse effects, accidental poisoning, antibiotic resistance, and prescription abuse
    • Tennessee’s accidental poisoning rate is 26% above the national average and cost about $593 million in 2003
    • Tennessee has some of the highest rates of antibiotic resistance in the nation
    • Tennessee is among the top 5 states for use of prescription
    • Hydrocodone is the number one prescribed drug in Tennessee, making up almost 3% of all prescriptions

Source: The Tennessee Prescription Safety Program of the Tennessee Medical Association 2007.

tn drug snapshot bcbst commercial
TN Drug Snapshot: BCBST Commercial

* Courtesy of Dr. Bruce Taffel, Shared Health

current eprescribing
Current ePrescribing

Source: 2007 Tennessee Healthcare Technology Readiness Assessment, TNHIMSS, www.TennesseeAnytime.org/eHealth

why is ehealth important
Why Is eHealth Important?
  • 1.5 million Americans suffer from medication mistakes each year.
  • Each year 800,000 preventable ADEs occur in long-term care facilities.
  • 530,000 preventable ADEs occur among the general population.
slide22

eHealth Council Framework

  • Coordinating organization facilitates rules of engagement:
    • Data-sharing Agreement
    • Legal Framework
    • Standards
    • Interoperability
    • Transparency
    • Value
    • Quality/Cost

Common Portal

H.I.E.

EMR / EHR/PHR Implementation

Structured Notes & Paper Records

Administrative Transactions (claims…)

Secure Clinical Messaging (labs, imaging, TeleHealth…)

ePrescribing Roll Out

Broadband % of Access, Stakeholders, Automation

Framework for Trust and Collaboration

County-by-County Implementation that Progresses in Stages

steps
Steps
  • Standards
  • Formats
  • Segments

Discharge Summary

Dictation

Transmission

Transcription

Data Access

Quality Assurance

health reform needed
Health Reform Needed
  • 1999 Institute of Medicine Report “To Err is Human” reported that 44,000-98,000 people die each year from medical errors
  • Medical errors are the 8th leading cause of death. Higher than:
    • Motor vehicle accidents (43,000)
    • Breast cancer (42,297)
    • AIDS (16,516)

Source: Institute of Medicine (1999). To Err is Human: Building a Safer Health System. Retrieved May 20, 2006 from http://www.iom.edu/CMS/8089/5575.aspx.

but tennessee is no healthier
But TennesseeIs No Healthier!

Tennessee Ranks 47th in Overall Health Status

Source: United Health Foundation and Public Health Association

existing hies
Existing HIEs
  • Shared Health
    • Statewide
    • Claims based data
    • Exchanging information since June 2006
    • Already includes more than 2.2 million people (1/3 of Tennessee’s population)
  • MidSouth eHealth Alliance
    • Shelby, Tipton and Fayette counties (Memphis area)
    • Clinical data
    • Exchanging information since June 2006
    • Already includes almost 1 million records
  • CareSpark
    • 7 counties in Upper East Tennessee and 7 counties in Virginia
    • Expected to go live by the end of 2007
    • Administrative and clinical data
emerging initiatives
Emerging Initiatives
  • TeleHealth
    • $1.6 million grant to Community Health Network to organize, equip and maintain a TeleHealth network
      • Up to 45 community health centers including federally qualified health centers
      • Making specialty care available to rural and underserved areas
      • Serving ~100,000 patients
  • Middle Tennessee Rural Health Information Network
    • $1.6 million HRSA grant to connect 3 critical access hospitals and the regional tertiary hospital and implement EMR with information exchange
  • Public health services
    • Goal: Expose medical care and medication dispensed in public health facilities where there are no payers billed
      • Department of Health
        • 89 County Health Departments + 6 subcontracted counties
        • ~1,000,000 patient encounters per year
      • Department of Mental Health
        • 5 Regional Mental Health Hospitals
next steps on the road map
Next StepsOn The Road Map
  • Connectivity
    • Utilize existing TNII network to extend broadband connectivity to physicians across the state
      • Already private, secure network
      • Infrastructure already exists in every county
      • Makes broadband available to physicians at state negotiated rates
  • ePrescribing
    • Currently designing pilot projects for each grand division
how can i learn more
How Can I Learn More?

www.TennesseeAnytime.org/eHealth