Transcript Document

Arizona’s Health IT Roadmap 2.0:
December 6, 2013
Background for Roadmap 2.0
• Where have we been? What are key influencers?
– Health-e Connection Roadmap 1.0 (2006)
– HIE Cooperative Agreement findings
– Stakeholder comments
– Changing federal landscape
– Questions about role of the State
• How can we drive the pathway forward for health IT success in
Arizona? How can we make the biggest impact?
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Purpose of Roadmap 2.0
• Develop a 2014 – 2016 strategic plan and roadmap for HIT/HIE in
Arizona
• The Roadmap will show how Arizona will enable sustainable HIT/HIE
across multiple providers to: improve patient safety, improve health
care quality, and decrease health care costs.
• Content areas of focus will include summaries for:
 Public Health
 AHCCCS
 HINAz
• How the Roadmap will be used
– What are the steps that we should take to ensure that the widest
numbers of providers have access to HIT & HIE?
– How can the capability of statewide health information exchange
support the changing health care landscape?
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Fundamental Shifts Are Occurring
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4 --
Arizona Health IT Roadmap 2.0
Vision
Arizonans will experience
an improved quality of health
enabled by robust
health information technology
and exchange.
Project Mission
Determine the Roadmap
for Arizona to establish
effective, efficient
health information technology
and exchange.
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5 --
Project Team
Arizona Strategic Enterprise Technology Office (ASET)
• Funder of Roadmap 2.0 project
• Coordinator of state agency participation
• Lorie Mayer - State IT Coordinator
Arizona Health-e Connection (AzHeC)
• Convener for Health IT in Arizona
• Lead for Stakeholder Engagement and Communication
• Melissa Rutala - CEO
Mosaica Partners
• Consultants and subject matter experts in HIE and health IT
• Lead for Project Design and Implementation
• Laura Kolkman - President
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Roadmap 2.0 Key Stakeholders
Health Care Providers
 Hospital Systems
 Physicians
 Other Providers
 Behavioral Health
 Long Term / Post Acute Care
Health Care Ancillary Providers
 Laboratories
 Imaging
 Pharmacy
Health Care Payers
 AHCCCS
 Commercial Payers
Government Agencies
 Public Health – ADHS
 County Health Agencies
 Federal Partners – IHS VA
Other Organizations
 AzHeC
 HINAz
 Legal Counsel
 Consumers
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Project Scope
 Three year outlook 2014 - 2016
 Health Information Exchange (HIE)
− HINAz
− Bi-directional electronic exchange with
State agencies
− ACOs
− “Direct” exchange
− Robust exchange
− Exchange with IHS and VA
− Exchange outside of Arizona
 Telemedicine/ Telehealth
− Mobile Health and apps (mHealth)
 Meaningful Use Requirements
 Data Access and Use
− Access to State-held information
− Use of information for exchange
 Legislation, Regulation & Policy
 Health Information Technology (HIT)
− EHR adoption and use
− Personal Health Records (PHR)
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Project Process
Open and transparent with broad stakeholder participation
• Hold pre-project workshops with AHCCCS and Public Health focused on
Meaningful Use Stage 2 readiness
• Hold project Kick-Off to introduce and explain the project
• Conduct 7 envisioning workshops – with key healthcare stakeholders – to
describe Arizona’s HIT/HIE desired future state COMPLETE
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
Hospitals
Providers
Payers
AHCCCS
Public Health - ADHS
• Validate workshop findings through a survey of the broader stakeholder
community. COMPLETE
• Convene public meeting to review progress and solicit feedback
OCTOBER 1, 1-3pm
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Roadmap 2.0 – Development
Objectives
Capabilities
Enablers
Capabilities
Enablers
What we want to
achieve
Provide consumers with their own health information
to encourage greater participation in their own care
decisions
Enable patients to be willing and able to participate in
their care
Involve patients and families in health care decisions
Promote patient accountability
Provide timely, relevant patient education
Provide patient with their information
Inform patient fully about their care
Provide patients timely alerts and actions
Coordinate care (easily) across care settings
Provide consumers
with their own health
information to Enable patients to be
encourage greater willing and able to Involve patients and
Provide timely,
participation in their participate in their families in health Promote patient relevant patient Provide patient with
own care decisions
care
care decisions accountability
education their information
x
Enablers
x
x
What we must be able
to do to achieve
objectives
Initiatives
Capabilities
Provide consumers with their own health information
to encourage greater participation in their own care
decisions
Enable patients to be wil ing and able to participate in
their care
Involve patients and families in health care decisions
Promote patient accountability
Provide timely, relevant patient education
Provide patient with their information
Inform patient ful y about their care
Provide patients timely alerts and actions
Coordinate care (easily) across care settings
Provide consumers
with their own health
information to Enable patients to be
encourage greater wil ing and able to Involve patients and
Provide timely,
participation in their participate in their families in health Promote patient relevant patient Provide patient with
own care decisions care
care decisions accountability education their information
x
Capabilities
Enablers
x
x
What needs to
be in place
Provide consumers with their own health information
to encourage greater participation in their own care
decisions
Enable patients to be willing and able to participate in
their care
Involve patients and families in health care decisions
Promote patient accountability
Provide timely, relevant patient education
Provide patient with their information
Inform patient fully about their care
Provide patients timely alerts and actions
Coordinate care (easily) across care settings
Provide consumers
with their own health
information to Enable patients to be
encourage greater willing and able to Involve patients and
Provide timely,
participation in their participate in their families in health Promote patient relevant patient Provide patient with
own care decisions
care
care decisions accountability
education
their information
Roadmap
2.0
x
x
x
Projects or programs
to put the enablers in
place
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10 -
Summary of Barriers Identified During Workshops
Access
Lack of access to appropriate technology
Payment
Lack of aligned incentives for wellness among
payers, providers, and consumers
Change
Fear or unwillingness to adapt to something new
Priorities
Too many competing priorities
Competition
Competition among providers motivates them to
keep information within their own organizations
Privacy
Lack of clarity in understanding how all the HIT
activity fits together. (Who's in charge?)
Process
Confusion
Cost of EMR
Cost of HIE
Culture
Data
Education
Lack of a known repeatable process for sharing
health information
Cost of EMR adoption too high
Regulation
Regulations that inhibit the full exchange and use
of health information
Cost of HIE connection and interfaces
Resources
Lack of provider resources to support adopting HIT
/ HIE
Cultural barriers
Standards
Lack of consistent, adopted technology standards
for interoperability
Lack of general agreement on the most important
data to be shared
Lack of education on the sharing of patient
information
Sustainability
Technology
Lack of clear statewide governance and direction
for HIT / HIE
Trust
Infrastructure
Lack of viable statewide HIT/ HIE infrastructure
Value
Patient
Identification
Lack of efficient and sure means to identify
patients and providers
Governance
Uncertainty regarding privacy and security
regulations and the associated risks.
Unknown if statewide HIE is sustainable
Lack of suitable technology acceptable to
providers
Lack of trust
Difficult to calculate and communicate the
economic value of Health IT and exchange
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Survey
Barriers Identified as Most Important to Address
174 Respondents
Barriers
% of Respondents That Chose This Barrier
Cost of HIE:
Cost of HIE connection and interfaces
41.38%
Confusion:
Lack of clarity in understanding how all the HIT / HIE activity fits together. (“Who's in charge?”)
40.80%
Infrastructure:
Lack of viable statewide HIT/ HIE infrastructure
37.93%
Standards:
Lack of consistent, adopted technology standards for interoperability
36.78%
Cost of EMR:
Cost of EMR adoption too high
33.33%
Payment:
Lack of aligned incentives for wellness among payers, providers, and consumers
30.46%
Priorities:
Too many competing priorities
29.31%
Access:
Lack of access to appropriate technology
27.01%
Trust:
Lack of trust
25.86%
Change:
Fear or unwillingness to adapt to something new
25.29%
Governance:
Lack of clear statewide governance and direction for HIT / HIE
25.29%
Resources:
Lack of provider resources to support adopting HIT / HIE
24.14%
Value:
Difficult to calculate and communicate the economic value of Health IT and exchange
23.56%
Sustainability: Unknown if statewide HIE is sustainable
22.41%
Privacy:
Uncertainty regarding privacy and security regulations and the associated risks
20.69%
Regulation:
Regulations that inhibit the full exchange and use of health information
20.69%
Competition:
Competition among providers motivates them to keep information within their own organizations
17.24%
Data:
Lack of general agreement on the most important data to be shared
17.24%
Education:
Lack of education on the sharing of patient information
16.67%
Patient ID
Lack of efficient and sure means to identify patients and providers
14.37%
Process:
Lack of a known repeatable process for sharing health information
13.79%
Technology:
Lack of suitable technology acceptable to providers
10.92%
Culture:
Cultural barriers
7.47%
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Barriers Identified as Most Important to Address
174 Respondents
Barriers
% of Respondents That Chose This Barrier
Cost of HIE:
Cost of HIE connection and interfaces
41.38%
Confusion:
Lack of clarity in understanding how all the
HIT / HIE activity fits together. (“Who's in charge?”)
40.80%
Infrastructure: Lack of viable statewide HIT / HIE infrastructure
37.93%
Standards:
Lack of consistent, adopted
technology standards for interoperability
36.78%
Cost of EMR:
Cost of EMR adoption too high
33.33%
Payment:
Lack of aligned incentives for wellness
among payers, providers, and consumers
30.46%
Priorities:
Too many competing priorities
29.31%
Access:
Lack of access to appropriate technology
27.01%
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Barriers Identified as Most Important to Address
174 Respondents
Barriers
% of Respondents That Chose This Barrier
Trust:
Lack of trust
25.86%
Change:
Fear or unwillingness to adapt to something new
25.29%
Governance:
Lack of clear statewide governance and
direction for HIT / HIE
25.29%
Resources:
Lack of provider resources to
support adopting HIT / HIE
24.14%
Value:
Difficult to calculate and communicate the
economic value of Health IT and exchange
23.56%
Sustainability: Unknown if statewide HIE is sustainable
22.41%
Privacy:
Uncertainty regarding privacy and security
regulations and the associated risks
20.69%
Regulation:
Regulations that inhibit the full exchange and
use of health information
20.69%
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Barriers Identified as Most Important to Address
174 Respondents
Barriers
% of Respondents That Chose This Barrier
Competition:
Competition among providers motivates them to
keep information within their own organizations
17.24%
Data:
Lack of general agreement on the
most important data to be shared
17.24%
Education:
Lack of education on the sharing
of patient information
16.67%
Patient ID
Lack of efficient and sure means to
identify patients and providers
14.37%
Process:
Lack of a known repeatable process for
sharing health information
13.79%
Technology:
Lack of suitable technology acceptable to providers
10.92%
Culture:
Cultural barriers
7.47%
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Next Steps
• Use the feedback received so far to draft initiatives
• Vet initiatives with stakeholders via workshops and
October 1st public meeting
• Incorporate feedback on initiatives and draft
Roadmap 2.0
• Publish Roadmap 2.0 in December 2013
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June
Public Health &
Medicaid
Pre-Workshops
June 11-12
Executive Council
Meetings
Project Kick-Off
Meeting June 24
Envisioning
Workshops
July 22 – Aug 2
Healthcare
Stakeholders
Survey
Enablers
Workshop
Sept 6
AzHeC Summit
Sept 10 - 11
Initiatives
Workshop
Sept 30
General
Stakeholder
Meeting
Oct 1
Release Final
Roadmap
January 2014
July
August
Sept
Oct
Nov
Dec
Jan
2014
Consumer Campaign
• State HIE Cooperative Agreement Grant
- Awarded to HINAz in collaboration with AzHeC
- Timeframe: June-December 2013
• Consumer Health IT Education & Awareness
Campaign
- Phase IA: HIE acceleration
- Phase IB: HIE/HIINAz awareness
- Phase II: General health IT community awareness
Consumer Connections
Task Force
• Health Plans
Blue Cross Blue Shield of Arizona, Aetna/Mercy Care, United Health Care, Care 1st, Cigna,
Health Choice, Phoenix Health Plan, University of Arizona Health Plan
• Health Care Organizations
Banner Health, Carondelet Health Network, Tucson Medical Center, Northern Arizona
Healthcare, El Rio Community Center, Jewish Family and Children Services, Sonora Quest
Laboratories, Marana Health Center
• Government Agencies
AHCCS/ASET, AZDHS, AZDES/DDD, Pima County, Governor’s Advisory Council on Aging &
Office on Aging, Arizona Chamber of Commerce
• Non-Profit Community Organizations (partial list)
Arizona Heart Association, Arizona Cancer Society Action Network, Arizona Diabetes
Association, Arizona Partnership for Immunization (TAPI), Arizona Leukemia & Lymphoma
Society, Arizona Council of Human Services Providers, Arizona Pharmacy Association,
children’s Action Alliance, Tucson Osteopathic Medical Foundation, Pima Council on Aging,
and many others.
Consumer Campaign
Strategy
• Message Strategy
- Create a consumer health IT organization and brand.
- Describe EHRs, E-Prescribing & HIE as one movement.
- Link eHealth Technology to other consumer technology,
i.e. banking, retail.
• Distribution Strategy
- Engage a broad-base of community organizations in
message development for consumer campaign.
- Develop a consumer health IT website sponsored by
HINAz/AzHeC as focal point with broad base of support.
- Utilize the distribution channels of consumer task force
plus a PR/advertising campaign to maximize total
impressions.
Consumer Consent
Toolkit
• Overview of legal requirements
- Three step Consent Process: Notice/Signature/Change of Consent
- Patient rights under Arizona law
- Critical points to understand
• Key documents for consent process
- Notice of Health Information Practices
- Change of Consent Form
• Patient education materials
- Consumer Fact Sheet
- Sample script
- Nurse video
• Consent and ROI (request for information) Policies
Elements of General
Consumer Campaign
• Create Consumer Campaign Brand
• Develop Messages & Materials
• Execute Public Relations & Advertising Campaign
• Launch Consumer Campaign Website
Campaign Logo
Web site:
eHealth4az.org
eHealthforAZ.org
Print Ad
Advertising Buy
PRINT
• Arizona Parenting
• The Arizona Republic
• Section A, Wednesday, Sunday
ONLINE
• AZ Central.com
• AZStar.net
• Latino Perspectives
• The Arizona Republic
• Living Well monthly section
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Arizona Daily Star
Lovin' Life After 50
Daily News - Sun Publishing
Independent Newspapers-Sun City
Sun Lakes Splash
RADIO
Phoenix Public Radio
• KJZZ
• KBACH
Tucson
• KUAZ
• KUAT FM
Provider Poster
Arizona eHealth Provider
_________________________
has been recognized for achievements in advancing eHealth
technology to improve health care quality and delivery
eHealth4AZ represents more than 50 Arizona stakeholders, including hospitals and health
care systems, health plans, state and county governments and non-profit organizations.
We recognize providers who are effectively using eHealth tools such as electronic health
records, electronic prescribing, patient portals, and health information exchange. We
educate consumers on how to become more active and engaged in their own health and
wellness through eHealth technology.
Find out more about eHealth in Arizona at www.eHealth4AZ.org.