Transcript Document

Texas Approach to Supporting
Statewide Health Information
Exchange
2013 Crossroads Conference
Healthcare Informatics in West Texas
June 6, 2013
Presentation Overview
• Background
• Who, What, Why?
• Texas Vision and Approach to Statewide HIE
• Legislative Update
• Resource Information
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Who are we?
• The Texas Health Services
Authority (THSA) was created
in 2007 by the Texas Legislature
through House Bill 1066
• Public-private partnership,
legally structured as a
nonprofit corporation, to
promote and coordinate the
development of HIE in Texas
• Governed by a 13-member
Board of Directors appointed
by the Governor with advice
and consent of the Texas Senate
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What are we doing and why?
• Funding authority provided through
the American Recovery and
Reinvestment Act for planning and
implementation grants to states to
facilitate and expand HIE.
• In March 2010, the Office of the
National Coordinator (ONC) for HIT,
US Department of Health and Human
Services, awarded Texas $28.8 million
over four years to plan and implement
HIE in Texas.
• Implementation of the Texas HIE Plan is
being coordinated between the Texas
Health and Human Services
Commission and THSA.
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What are we doing any why?
Short-Term: Federal Funds
• Develop and implement State HIE Plan in
accordance with ONC grant award.
• Support core HIE services to ensure hospitals and
physicians can exchange clinical health data across
secure networks to qualify for Medicare and
Medicaid Electronic Health Record (EHR) incentive
payments.
• Ensure Texas providers and hospitals are eligible to
receive billions in “meaningful use” incentive
payments over the next decade.
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What are we doing and why?
• Meaningful Use Stage 2 focuses on actual use
cases of electronic information exchange
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•
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Measure #1 requires that a provider send a summary of care record
for more than 50% of transitions of care and referrals
Measure #2 requires that a provider electronically transmit a
summary of care for more than 10% of transitions of care and
referrals
Measure #3 requires at least one summary of care document sent
electronically to recipient with different EHR vendor or to CMS test
EHR
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What are we doing any why?
Long-Term: Quality, Safety, and Efficiency
• Ensure providers have the right information at the
right time.
o Better care
o Reduce duplicate tests
o Avoid adverse drug interactions
• Improve quality by increasing provider access to upto-date clinical research and new clinical guidelines to
use when making medical decisions
• Increase patient access to health information and
empower patients to better manage their personal
care.
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What is our Approach to Statewide HIE?
GOAL
Enable improvements in the quality and efficiency of the Texas health
care sector by enabling HIE infrastructure for the state.
OBJECTIVE
Deliver private, secure, and reliable HIE services to all Texas patients
and providers through local HIE networks where the capacity exists
and through Health Information Service Providers (HISPs) where it
does not.
STRATEGIES
1. General State-Level Operations
2. Local HIE Grant Program
3. White Space Initiative
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What are we doing to support local and
regional HIE initiatives?
• $19.5 million Local HIE Grant
Program to support new or expanding
HIE initiatives by partially funding
planning, development, and
operations of local HIE networks
• Administered by HHSC with support
from THSA
• Funded 16 HIEs through this
program; 12 moved into operations in
2012
• HIEs committed to connect 80-90% of
all hospitals and physicians in Texas
• Significant local accountability
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Local HIE Servicer Area Interactive map
available at: http://hietexas.org/localhies/hie-service-areas-and-info
Local HIE Profile Sheets
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Contact Information
Governance
Technical Model
HIE Services
Privacy and Security
Sustainability Approach
http://www.hietexas.org/localhies/hie-service-areas-and-info
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What should I do if I am interested in
joining an HIE?
1.
Determine which HIE or HIEs are covering your county.
o http://hietexas.org/local-hies/hie-service-areas-andinfo
2.
Review the HIE profile sheet(s) to ensure you
understand what services the HIE is offering, the
technology model they are supporting, their approach to
privacy and security, fees, etc.
2.
Contact the HIE to learn how to sign up to participate.
2.
Get involved with the HIE through its governance to
help to ensure the HIE is meeting your needs and the
needs of other providers in your community.
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What are we doing to support providers not
served by a Local HIE?
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The THSA has qualified HISPs to
support hospitals and physicians
located in areas without a local HIE, or
the Texas “White Space.”
HISPs provide secure email-based
messaging solutions for the transport
of clinical information between
providers, including clinical summary
exchange and electronic lab results.
HISP connectivity services enable
subscribing providers to meet federal
Meaningful Use requirements.
All HISPs are eligible to receive a
subsidized payment on behalf of
eligible Texas hospitals and physicians
to reduce initial provider service costs.
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Why is a THSA-qualified HISP a good HIE
option?
• Using a THSA-qualified HISP is a simple, efficient, secure, and low
cost way to exchange patient information with other clinicians in
compliance with HIPAA and federal Meaningful Use requirements.
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SIMPLE – Enables exchange of patient information with other
clinicians using secure e-mail. No new hardware – a computer
with access to the Internet is all that is needed.
EFFICIENT - Pull the plug on your fax machine and send out
referrals and consults via secure e-mail right from your
computer.
SECURE - E-mail messages are secure and fully HIPAAcompliant, with all messages and attachments encrypted.
LOW COST - The THSA is offering a subsidy in the form of a
voucher to offset your initial costs ($400 per physician/$5,000
per hospitals). No long-term contract required.
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How would a provider use a HISP?
The diagram above depicts a primary care physician (PCP) making a referral to a specialist. The PCP could
export a patient’s care summary from their EHR, attach it to a Direct message along with a referral order, and
send it over to the specialist via the email-like HISP. The specialist can then login to a Direct email account,
open the message, download the care summary and referral, and import it into their EHR. If the PCP or
specialist does not have a compatible EHR, a PDF version of the summary and referral could also be attached
and sent securely through a HISP.
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What should I do if I am interested in using
a THSA-qualified HISP?
1. Request a Voucher Number from THSA.
o http://hietexas.org/white-space/voucherrequests
2. Select a THSA-qualified HISP.
3. Use the HISP you have selected to securely
send clinical information to other providers.
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Where can I find more information?
• HISP Pricing and
Profile Sheets
• White Space Fact
Sheet and Q&A
• Voucher Request
Process
• Marketing Materials
• All available at:
www.hietexas.org/whit
e-space/overview
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What is general state-level operations?
• Planning and Governance
o Convene stakeholders and
build consensus
• State-Level Technical Services
o Inter-HIE/HISP Connectivity
o Gateway Services to eHealth
Exchange and State-Level
Data Sources
o Consent Management
• Sustainability
• HIT Policy Development
o Privacy and Security
o Interoperability
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THSA State-Level Shared Services (HIETexas)
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HIETexas Services
• Current
o Local Participants
o Local HIEs – Grant program awardees
o Other Authorized HIEs with the State
o eHealth Exchange Participants (e.g., other state HIEs, VA, DoD,
and SSA)
o Medication History – Data source for HIEs in Texas
• Future
o State Data Sources (e.g., Medicaid, Immunization Registry,
Cancer Registry, and Prescription Access in Texas)
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HIETexas Services
• Security
o Federated Trust
o Authentication, Access
o Security, Confidentiality, Accuracy
• Patient Consent Management
o Service to query HIETexas for all available consent documents
for a patient from all other participants
• Clinical Document Exchange (Treatment)
o Service to query HIETexas for all available clinical documents
for a patient from all other participants
• eHealth Exchange Connectivity
• Medication History
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HIETexas – Key Principles
• THSA follows an open, transparent, and inclusive process
• Patient privacy, security, and preferences are foundational
• No protected health information data will be made available, stored,
or accessible to HIETexas or InterSystems
• We will align with applicable national (open) standards
• Our systems will be designed to scale and be responsive
• We are risk adverse
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Legislative Update – Health Information Exchange
• SB 1643 (Williams, 83R) relates to the monitoring of prescriptions for
certain controlled substances; and also provides a penalty.
• An amendment was added to SB 1643 that includes HIE-related
issues:
o Defines “Health Information Exchange”
o Allows health care providers to access information in the
Prescription Drug Monitoring Program through an HIE
• SB 1367 (Duncan, 83R) relates to abolishing the Texas Health
Insurance Pool
o Redirects $5 Million of prompt-pay penalties to the THSA
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Legislative Update - Privacy
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Two bills passed this session relating to medical privacy
o SB 1609 (Schwertner, 83R)
o SB 1610 (Schwertner, 83R)
SB 1609 amends the Texas covered entity training provision implemented
by HB 300 (Nelson, 82R) last session.
o Clarifies context of training; extends time for completion of training to
90 days, and again within one year of material change in law; and
limits time to retain of proof of training to 6 years
SB 1610 amends the “breach notification” provision implemented by HB
300 (Nelson, 82R) last session.
o Clarifies which law must be followed when the individual affected by
breach resides in another state; and allows written notice to be given
at the last known address of the individual
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Where can I read more?
• www.hietexas.org - THSA/Statewide HIE Website
o State HIE Plan
o Local HIE Grant Program RFA, HIE Profiles, and Approved
Business and Operational Plans
o White Space Program Background, Marketing Materials, FAQ,
and RFQ
o THSA Annual Report to Governor and Texas Legislature
o Privacy and Security White Papers
o Links to other reports and other helpful sites
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Tony Gilman
Chief Executive Officer
Texas Health Services Authority
(512) 814-0321
[email protected]
www.HIETexas.org
Follow THSA on Twitter @HIETexas
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