August 2009
In this issue:
HIE News
HIE Spotlight
Technology Corner
HIE Matters
Advocacy and Public Policy
Calendar of Events
Tools and Resources
HIE Spotlight
Maine's Statewide HIE Goes Live, Part 1
As policymakers in Washington debate how to reform the nation’s healthcare system, Maine has taken a major step toward transforming how care will be delivered to the state’s 1.3 million residents. Physicians, hospital leaders, consumer advocates and public health officials gathered in Portland last week to announce that Maine’s nonprofit, HealthInfoNet, network will “go live” this summer, making Maine one of the largest statewide electronic HIEs using clinical data. Delaware and Vermont have similar statewide exchanges in operation.
Dr. Blumenthal visited Maine Medical Center's emergency department to see first-hand how the new system will be used by medical care teams.
photo credit: Healthcare IT News
The announcement coincided with a visit to Maine by the Obama Administration’s top health information technology official, Dr. David Blumenthal, who was the keynote speaker at the statewide Hanley Leadership Forum on July 31st in Portland and then visited Maine Medical Center’s emergency department to see first-hand how the new system will be used by medical care teams.
Under development for the past five years, HealthInfoNet will allow caregivers access to clinical information they need to provide care for their patients. As HealthInfoNet expands services across the state, the HIE estimates $50 million per year in healthcare costs will be saved as caregivers order fewer unnecessary and duplicative tests, procedures, prescriptions and hospital admissions.
Despite a substantial budget shortfall, the state of Maine has included $1.7 million in its 2010-2011 budget to allow HealthInfoNet to “go live” this summer and to position Maine for federal matching funds that are expected to be available later this year under the American Recovery and Reinvestment Act. Some $8 million has been raised so far to build HealthInfoNet. Another $12 million is needed to build out the statewide infrastructure. It is estimated that it will cost approximately $6 million to operate HealthInfoNet on an annual basis.
Beginning this summer, more than 2,000 healthcare providers---including nearly half of the rural and urban hospitals across Maine and one-third of practicing physicians in Maine---will have access for the first time to HealthInfoNet’s secure clinical data repository. Use of the system will be phased in over the next several months.
Hospitals and physician practices taking part in HealthInfoNet’s current demonstration phase (which began in early 2008) account for more than half of the state’s annual inpatient hospital admissions, 50 percent of the annual emergency department visits, and nearly 40 percent of Maine’s outpatient visits each year. Following the successful completion of the demonstration phase in mid-2010, plans call for HealthInfoNet to be expanded over time to include other providers who care for Maine’s entire population.
Technology Corner
CAeHC Demonstrates NHIN-enabled Gateways among Five California HIEs
Using recently released NHIN-enabled CONNECT and other NHIN-enabled Gateway software, five members of the California eHealth Collaborative demonstrated their production-ready ability to share patient clinical information for treatment purposes among regional health care provider networks in California. California eHealth Collaborative (CAeHC), announced a successful demonstration of five community-based HIE projects in California using Nationwide Health Information Network (NHIN)-enabled gateways to securely exchange clinical health information to improve patient care. As part of the "Connecting California to Improve Patient Care" conference, held on July 10th at the Krug Event Center in Healdsburg, California, CAeHC hosted the live demonstration.
The 160 attendees at the conference included industry leaders with direct experience in successful deployment and operation of health information technology. Another 126 people logged into a webinar service to view the live demonstration. The public test demonstrated different scenarios showing how clinicians can provide improved care by obtaining critical clinical information from a patient's medical record even if the health data is located in another community. The exchanges were recorded in an online webinar, which is available on the Collaborative’s website at www.caehc.org. The patient care scenario narrative behind each data exchange in the demonstration is also available on the Collaborative website.
Share and Network on HIMSS Clinical Decision Support Wiki
Many organizations struggle to successfully deploy clinical decision support (CDS), a goal that takes on new importance since effective clinical decision support is a critical component of ‘meaningful EMR use,’ as required for stimulus funding under the American Reinvestment and Recovery Act. Now, to help realize the promise of clinical decision support to enable meaningful EMR use and widely improve care delivery and outcomes, the HIMSS Clinical Decision Support Task Force is opening its CDS Wiki to the public. Anyone interested in becoming part of the HIMSS CDS wiki community can visit this link to join. HIMSS e-Prescribing Task Force also launched the HIMSS E-Prescribing Wiki in January. The E-Prescribing Wiki is available at this link. Read more
HIE NEWS
THICC and Allscripts Form HIE in Connecticut
Allscripts and Transforming Healthcare in Connecticut Communities (THICC) - a coalition of Connecticut-based hospitals, physician practices, employer groups and insurers – have formed a statewide HIE. The first step in their effort is to develop the "physician office of the future" sharing patient information electronically across multiple healthcare organizations and stakeholders. The THICC HIE will link information from existing electronic health record (EHR) systems and those now being implemented by hospitals and physicians in response to EHR incentive funds included in the American Recovery and Reinvestment Act (ARRA) of 2009. As more Connecticut providers join the HIE and implement an EHR, improved access to timely clinical information will enable more coordinated patient care, better health outcomes and lower costs.
In addition to supporting the HIE and EHR rollout, THICC will develop training and deployment tools for physician practices that will allow them to quickly adopt the new health information technologies. "THICC will be a significant aid to Connecticut physicians and the communities they serve,” explained Bruce Campbell, MD, Chief Information Officer of ProHealth Physicians, the largest primary care medical group in Connecticut. “Our ability to provide the best care to our patients depends on the ease of access to important information held by other organizations involved in a patient's care. Today, this information is difficult to access and sometimes completely unavailable when it is needed most - and THICC is the answer."
Ohio Partnership Collaborates on Interoperable HIE
MEDNETWorld.com, The Rubicon Group, eHealth Ohio, Bostech Corporation and TechColumbus Platform Lab have formed the Ohio Health Point-of-Care (HPOC) Service enabling interoperable electronic exchange of clinical data for healthcare providers. The HIE partnership provides clinicians and physicians with unprecedented electronic access to detailed medical health records for each patient. The Ohio HPOC Service offers healthcare providers in the state of Ohio complete access to patient health records, including vision and dental records. Ohio healthcare providers utilizing The Ohio HPOC Service will have the option to participate in revenue enhancing quality monitoring initiatives, gain improved operational performance, and find easier access to participate in clinical trials.
HITSP Approves New Interoperability Specifications in Line with American Recovery and Reinvestment Act of 2009
The Healthcare Information Technology Standards Panel (HITSP) approved four specifications at its July 8th meeting. They include: HITSP/IS107 – Electronic Health Record (EHR)-Centric Interoperability Specification; HITSP/TN904 – Exchange Architecture & Harmonization Framework Technical Note; HITSP/TN903 – Data Architecture Technical Note; and HITSP/SC108- SC116 – Service Collaborations. “HITSP has transformed its existing work to be completely aligned with the American Recovery and Reinvestment Act of 2009 (ARRA),” explained Dr. John Halamka, HITSP chair. “These approved specifications represent the culmination of some 90 days and 13,000 hours of volunteer effort to meet the requirements of this landmark piece of legislation.” For more information or to download the approved specifications, visit www.hitsp.org.
State Alliance for e-Health Report Offers Guidance for States on Health IT
A new report from the State Alliance for e-Health, Preparing to Implement HITECH: A State Guide for Electronic Health Information Exchange, aims to help states lead the way in using health IT and HIE and guide them as they begin instituting the federal Health Information Technology for Economic and Clinical Health (HITECH) Act. The report recommends actions states should begin undertaking now to successfully implement the HITECH Act, including:
- Preparing or updating the state plan for HIE adoption;
- Engaging stakeholders;
- Establishing a state leadership office to manage the different phases of HIE implementation;
- Preparing state agencies to participate; implementing privacy strategies and reforms;
- Determining the HIE business model;
- Creating a communications strategy; and
- Establishing opportunities for health IT training and education.
The report and state initiatives to implement health IT and electronic HIE will provide a central focus for the State Alliance for e-Health’s semi-annual conference, to be held August 7 in Burlington, Vermont. The State Alliance – supported by funding from the U.S. Department of Health and Human Services – provides a nationwide forum through which governors, state policymakers and other stakeholders can work together to identify effective HIT policies and best practices and explore solutions to challenges related to the exchange of health information.
ADVOCACY AND PUBLIC POLICY
HHS Delegates Authority for the HIPAA Security Rule to Office for Civil Rights
U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that authority for the administration and enforcement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule has been delegated to the Office for Civil Rights (OCR). The Security Rule had previously been delegated to the Centers for Medicare & Medicaid Services (CMS).
“I can certainly see how such a change will create operational efficiencies for HHS as it conducts rulemaking, provides guidance and increases enforcement activities relating to both HIPAA and ARRA,” said HIMSS Senior Director of Privacy and Security, Lisa Gallagher. She explained that the Kathleen Sebelius, Secretary of the Department of Health and Human Services (HHS), indicated that she would improve inefficiencies in the department. This transition is one such step since the OCR managed privacy, but not security, complaints, related to HIPAA. Thus, two federal departments – CMS and OCR – oversaw the complaints. Now, with all responsibility and enforcement going through OCR, the entire process, said Gallagher, should be easier and more efficient. For more information, visit OCR Web site: http://www.hhs.gov/ocr/privacy/index.html.
8th Annual Policy Summit, A Cornerstone Event for National Health IT Week
The nationwide emphasis on the role of information technology in healthcare reform and the American Recovery and Reinvestment Act of 2009 makes this a critical time to become involved in advocating for health IT policy. Health IT advocates from across the nation will descend on the nation’s capital for National Health IT Week, Sept. 21 -25. Events during National Health IT Week, now in its fourth year, promote widespread adoption of health IT to improve patient safety and healthcare quality. The cornerstone event during National Health IT Week is the highly-anticipated HIMSS 8th Annual Policy Summit, Sept. 22-23 at the Renaissance Hotel in Washington, DC. The Policy Summit features keynotes and roundtable discussions by key federal legislative decision-makers. Read more
Healthcare Reform Update … A Special Report from HIMSS Congressional Affairs
Congressional leaders expressed their intention to hold votes on healthcare reform legislation upon returning from their August Recess in September.* The Energy and Commerce Committee, one of three Committees of jurisdiction over healthcare reform, plans to conclude their mark-up of H.R. 3200, the Affordable Health Choices Act. This decision comes on the heels of a compromise that was made with Blue Dog Democrats on the Committee concerning the reduction of over $100 billion in spending in the legislation, an increase in small business that would be exempt from a mandate to provide health insurance, and agreement to not have a floor vote until September.
Also, the Senate Finance Committee received early estimates from the Congressional Budget Office (CBO) that their draft healthcare reform legislation (yet to be released) totals approximately $900 billion. This figure is significantly less than the approximate cost estimate of H.R. 3200 at over $1 trillion. Members of the Committee report high hopes of holding a vote within the Committee by Friday, August 7. Read more
White House and Feds Gear Up for Health Reform…A Special Report from HIMSS Federal Affairs
President Obama continues to press for health reform during trips across the country. He spoke to an AARP tele-town hall meeting in Washington, DC, then traveled to Bristol, TN for a town hall meeting last week. Health IT continues to be one of the tools the President mentions that will enable health reform. We anticipate continued activity from the President and the White House Health Reform Office during the August Recess. Executive Branch-watchers are still calling for a Rose Garden signing ceremony of a health reform bill by late October.
From an American Recovery and Reinvestment Act of 2009 (ARRA) perspective, HIMSS was attended a listening session last week to learn more about the Social Security Administration’s Medical Evidence Gathering and Analysis through Health IT (MEGAHIT) program—unofficially known as the NHIN Phase III. The ARRA appropriated $24 million to expand the MEGAHIT program from two current RHIO/HIE partners to 10-20 RHIO/HIE partners. SSA will host a webinar to overview this program on Tuesday, August 11, at 2:00 p.m. EDT. To attend the webinar, visit the SSA Web site (There is no advance registration). HIMSS anticipates an RFP will be released for the MEGAHIT expansion on or around August 7. We look forward to providing updated information on this opportunity for RHIOs and HIEs as it becomes available. Read more
Volunteers Work Together to Help Healthcare Providers Secure Stimulus Funding
Today’s digital environment leaves little room for paper notes and files. Over 225 volunteers with the Certification Commission for Health Information Technology (CCHIT) came together for a kickoff meeting in Chicago last week to advance this initiative in the healthcare industry. The Commission offered more detailed guidance to volunteers on how they intend to update and broaden certification programs for EHR technologies.
Mark Leavitt, MD, PhD, Commission chair, explained how those plans lined up with the recommendations of the HIT Policy Committee, a Federal advisory committee established by ARRA that was meeting in Washington DC at the same time as the kickoff. “For providers and hospitals to have any chance of meeting ARRA incentive requirements in 2011, certified EHR technologies must be promptly available. To do that, we will launch preliminary HHS/ARRA EHR technology certification programs in less than 90 days, drawing upon our inspection and certification experience and marketplace knowledge. Our current, very comprehensive certification programs -- though no longer the sole route to government certification -- will become even more robust to serve EHR purchasers who want maximal assurance of EHR completeness and integration.”
Sen. Moore Receives NEHIMSS Leadership Award
The New England Chapter of HIMSS (NEHIMSS) has awarded Massachusetts State Senator Richard Moore with its “2008 Healthcare Leadership of the Year” award. This nomination was bestowed on Sen. Moore for his leadership, dedication, research, and initiatives reflecting healthcare IT as well as his contributions to the New England Chapter of HIMSS. The award was presented on July 15th by Jon Mello-NEHIMSS Advocacy Chair and Paula J. Magnanti, 8th Annual Awards Chair and past president NEHIMSS. Sen. Moore is the Chairman of the Legislature's Committee on Healthcare Financing, and President-Elect of the National Conference of State Legislatures. He was also a principal architect of the landmark 2006 Massachusetts healthcare reform law that has expanded access to healthcare to 97.2% of the states’ residents.
Calendar of Events
Register Now for 7th Annual CDC PHIN Conference
The best of the healthcare informatics community will come together at the 7th Annual CDC Public Health Information Network (PHIN) Conference at the Hyatt Regency Hotel in Atlanta, GA on August 30 through September 3, 2009. Co-Sponsored by the National Association of County and City Health Officials (NACCHO), the event will feature a series of keynote, plenary, workgroup, and networking sessions that drive home the theme "Informatics: Investment for the Future." The HIMSS Health Information Exchange (HIE) Steering Committee will be featured on a panel discussing health information exchange and public health real world lessons learned, while HIMSS staff will present on the Nicholas E. Davies Public Health Award program.
With healthcare reform on the horizon, don't miss this chance to learn more about the roll Public Health Informatics will play. To register or learn more about the PHIN Conference, go to www.cdc.gov/phin .
HIMSS Summit of the Southeast
Join the TN, AL, AR, KY and GA HIMSS Chapters for this event!
September 9, 2009
8:00 - 5:00 PM
Hutton Hotel, Nashville, TN
Members $75; Non-Members, $100. To register click here
Sponsorships and Exhibits are also available. Click here for more information or to download the Sponsorship forms. Exhibit space is filling fast, so don't delay. For more information on the agenda or general questions, please visit www.TNHIMSS.org or e-mail Silas Deane at Silas@logicmediagroup.com.
HIMSS 8th Annual Policy Summit
Cornerstone Event of National Health IT Week
September 22-23, 2009
The Renaissance Hotel Washington, DC
Social Security Administration Webinar
Social Security and Health IT: Get the Benefits You Deserve
Medical Evidence Gathering and Analysis through Health IT (MEGAHIT) Program
Tuesday, August 11, 2009
2:00 p.m. EDT
The Social Security Administration will host a national webinar to announce the availability of funding and explain how to apply for contracts for electronic medical evidence gathering services. SSA will also discuss why they use medical records, how they use health IT to gather medical information, and how to submit a proposal to join us in meaningfully exchanging information. Join the webinar at http://www.socialsecurity.gov/hit.
HIE Matters
New State Law to Aid Patient Info Exchange
by State Rep. Cindy Rosenwald (D-NH)
Amid so much talk about expanding health insurance, we must not overlook the fact that real health reform also requires cost control and quality improvement. One good avenue to control cost and improve quality is through improved information sharing among providers. Patients whose providers have access to their accurate health information on a timely basis will benefit because doctors will be able to make better clinical decisions.
These same patients can also expect less expensive care since there will be less duplication of costly diagnostic imaging, laboratory testing and medical procedures. The benefit to individuals when their doctors have quick access to accurate medical records is perhaps obvious. After all, many people can't remember the specific dose of a particular medication or the results of a CT scan. An electronic medical record can also prevent serious errors from that old standby: a doctor's terrible handwriting.
New electronic health information technology also has population health benefits in addition. This is because the vast amount of real time clinical health information is a treasure trove for public health researchers. As a nation, we can expect significant, large-scale analysis to yield improved treatment ideas.
This Spring the Legislature took a major step forward in advancing the adoption of health information exchange among providers. House Bill 542 sets out the strategic framework, starting with principles developed by the Citizen's Health Initiative, to bring about the successful exchange of health information among an individual's doctors, no matter where they are located.
The American Recovery and Reinvestment Act includes $20 billion to promote health information technology and exchange. When Gov. John Lynch signs HB 542 into law, New Hampshire will be poised to benefit from our share of the incentive.
New Hampshire has a long tradition of respecting individual privacy, and HB 542 contains important privacy protections for patients. It makes clear that the health information may only be used by providers and solely for the purpose of treatment, not for marketing or any other commercial purpose.
In addition, the Health Insurance Privacy and Accountability Act (HIPAA) and all other state and federal privacy laws must apply, and national certification standards must be adhered to. Finally, individuals are able to choose not to have their health information included in an exchange program.
Rep. Rosenwald is Chair of the Health, Human Services and Elderly Affairs Committee in the New Hampshire House of Representatives.
TOOLS AND RESOURCES
HIMSS HIE Topic Series
HIE Fact Sheet
Sub-Network Organizations and HIE
Chronic Disease Management and HIEs
HIMSS White Papers & Reports
Exploring the Use of Open Source Software for Health Information Exchange is a follow up white paper to 2008’s Evaluating Open Source Software for Health Information Exchange that was prepared by the HIE Open Source Task Force as a primer on open source deployment in health information exchange environments. This current white paper focuses on assessing how open source software is used or planned to be used by HIE organizations.
HIMSS Healthcare Information Exchange National / International Technology Guide White Paper The HIMSS HIE International Technology Task Force developed The HIE National/International Technology Guide that explored technology solutions proven successful within Health Information Exchanges (HIE) across international borders along with a snap shot of U.S. based HIEs. The purpose of this whitepaper was to explore the lessons learned and technical solutions deployed in other countries that may benefit others involved in data exchange deployment.
Health Information Exchanges: Similarities and Differences white paper indicates there may be many similarities as well as differences across HIEs. This whitepaper is the result of a self reported survey conducted in 2008 for the purpose of gaining insight into HIE practices. This survey effort was spearheaded by the 2007 – 2008 HIMSS HIE Best Practices Task Force.
Evaluating Open Source Software for Health Information Exchange was prepared by the HIE Open Source Task Force as a primer on open source deployment in health information exchange environments.
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Member Only Benefit: GRANTS OFFICE
HIMSS Grants Advantage subscription service provides information on identifying funding initiatives, the steps needed to apply and succeed in the entire grants life cycle, including identification, submission, award receipt, reporting and closure. Grants Advantage can help you find the funding resources in categories that include, but are not limited to:
- Health IT
- Facility planning and construction
- Health services planning
- Specialized health research
- Education
- Veteran's health
Learn more about the benefits of subscribing to HIMSS Grants Advantage
HISPC Reports, Tools Available
The Washington-based Office of the National Coordinator (ONC) is making available Health Information Security and Privacy Collaboration (HISPC) Phase 3 tools, templates, and reports, including an Action and Implementation Manual (AIM). The AIM serves as a how-to guide for state-level stakeholders and presents each of the seven multistate collaboratives’ work in a condensed educational format, according to ONC. To download the manual or to access the tools and resources developed by the multi-state collaboratives during HISPC Phase 3, visit http://healthit.hhs.gov/HISPC.