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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
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


Where Is Health Care Headed?

  • The Shape Of Things To Come?

5.4 Million years

50 years

The Economist , December 13, 2003


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


Framework for Strategic Action Information Network

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/


HHS - Framework for Strategic Action Information Network

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


Predicted Cost Savings from HIT Information Network

  • 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


Nationwide Health Information Network 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/



The florida health information network
The Florida Health Information Network 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


The florida health information network in health care policy
The Florida Health Information Network in Health Care Policy Information Network

  • 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


The governor s health information infrastructure advisory board
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


The florida health information network strategy
The Florida Health Information Network Strategy: Board

  • 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


Functions of the florida health information network
Functions of the Florida Health Information Network Board

  • 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


1. Big Bend RHIO Board2. 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



The florida health information network begins at the local level
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


Grants program to develop regional health information organizations
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


Grants program 2006 2007
Grants Program, 2006-2007 Organizations

  • 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



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


Partners Organizations

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


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


All care shared health record
All-Care Shared Health Record Operations and Evaluation Project

  • 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


All care clinical data list
All-Care Clinical Data List Operations and Evaluation Project

  • 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


An example of a florida regional health information organization big bend rhio tallahassee florida
An Example of a Florida Regional Health Information Organization:Big Bend RHIOTallahassee, Florida


Region served by the big bend rhio
Region Served by the Big Bend RHIO Organization:

Tallahassee


Big bend rhio is anchored in the community
Big Bend RHIO is Anchored in the Community Organization:

  • 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


Pman network

NFWC Organization:

Urology

pMAN Network

TMH

Radiology

CRMC

TDI

BBRHIO RHIN

VSA

CHP

CHP.

VPN

CHP.

Remote

&

VPN Users

TNC


Big Bend RHIO RHIN Architecture Organization:

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


Health information exchange services
Health Information Exchange Services Organization:

  • 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


Next steps for the florida health information network
Next Steps for the Florida Health Information Network Organization:

  • 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


Health information networks included as an innovative idea in 2007
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.”


Fhin bills in the 2007 legislative session
FHIN Bills in the 2007 Legislative Session Idea” in 2007

  • 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.



The future of the florida health information network
The Future of the Florida Health Information Network Idea” in 2007

  • 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.


Christopher B. Sullivan, Ph.D. Idea” in 2007

Agency for Health Care Administration

Florida Center for Health Information and Policy Analysis

Office of Health Information Technology

2727 Mahan Drive

Tallahassee, FL 32309

[email protected]


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