eHI’s Mission and Focus

1. States Getting Connected: Gulf States Activities & eHI Annual Survey ResultsTogether for Quality Stakeholder CouncilFebruary 7, 2007Andrew Weniger Program Director, State and Regional InitiativeseHealth Initiative

2. eHI’s Mission and Focus • Our mission is to improve the quality, safety, and efficiency of healthcare through information and information technology • We engage multiple and diverse stakeholders at both the national level, and within states and communities: • Finding common ground among the multiple constituencies in healthcare on policies and practices for transforming healthcare with information and information technology—at the national level • Building a bridge between rapidly emerging national policies and best practices and efforts at the state, regional and community levels • Placing a special focus on mobilization of information--to support improvements in quality • Directly supporting state, regional and community stakeholders utilizing our multi-stakeholder-developed common principles, policies and practices

3. Collaboration is the Key to Our Success: eHI’s Multi-Stakeholder Membership • Consumer and patient groups • Employers, healthcare purchasers, and payers • Health care information technology suppliers • Hospitals and other providers • Pharmaceutical and medical device manufacturers • Pharmacies, laboratories and other ancillary providers • Practicing clinicians and clinician groups • Public health agencies • Quality improvement organizations • Research and academic institutions • State, regional and community-based health information organizations

4. eHI’s Connecting Communities Membership • Active coalition of leaders of more than 280 state, regional and community-based health information exchange initiatives and organizations

5. eHI & Gulf States Status

6. Gulf States ProjectLouisianaTexasMississippi FloridaAssessment Findings & Roadmap Progress

7. State-Specific Approach • Completed assessment process for four Gulf Coast states (LA, MS, TX, and FL) • Expanded upon existing state surveys • Increase awareness within the state of other state and national initiatives • Identify the readiness of communities to increase their use of health information technology • This information is used as a basis for a state specific Roadmap

8. Roadmap: Louisiana • Based on state-wide assessments • Integrated into an overall plan through a two-day meeting at the Vanderbilt Center for Better Health • Involved Louisiana healthcare leaders and identified many of the major issues and differences facing the state • Incorporated • Phase I – completion of LaHIE prototype (Oct. 2006) • Phase II – post-prototype organizational and metrics

9. Roadmap: Texas • Produced by People, Process and Technology subcommittees of HITAC • Placed an emphasis upon • Widespread use of EHRs by providers • Developing Organizational, Technical and Social Capabilities for HIE • Received public comments on Roadmap from 11 organizations

10. Assessment: Mississippi • Purpose: Gather information concerning HIT and HIE activities and perceptions in Mississippi • Inventory of current HIT/HIE projects and initiatives • Value of statewide infrastructure • Barriers / challenges to adoption of HIE • Statewide versus regional approach • Leadership / roles & responsibilities / forums to promote adoption • Competing priorities in the state

11. Roadmap: Florida • Roadmap to leverage existing statewide and regional initiatives

12. Assessment & Roadmap: Alabama • Assessment Purpose: Gather information concerning HIT and HIE activities and perceptions in Alabama • Roadmap Process: Two day session March 8 – 9 designed to outline the Together for Quality strategic plan and tactical approach

13. What is Happening in the States?

14. What is Happening in the States? • About half of the states in the United States have either an executive order or a legislative mandate in place that is designed to stimulate the use of HIT to improve health and healthcare • Emphasis on quality, patient safety and curbing rising healthcare costs rank high as the primary drivers for state leadership around health information technology. • Up to date information on Legislation and Executive Orders at: http://ccbh.ehealthinitiative.org/communities/community.aspx?Section=288

15. What is Happening in the States? How are States getting started? • Primary Drivers: • Quality • Patient safety • Curbing rising healthcare costs • States from the get-go are recognizing the importance of local efforts, and are taking steps to closely integrate state initiatives with efforts at the regional and local levels

16. What is Happening in the States? How are States Executing? • Most states are convening or participating in multi-stakeholder groups to develop plans for improving health and healthcare through HIT/HIE • Increasingly states are providing grant funds to support not only regional and local HIE efforts, but also the development of plans • In most cases, the Governor's Office, Medicaid or the state's Department of Health is taking leadership in state-wide efforts related to HIT/HIE

17. Where are States? Stage 1 AWARENESS 15% Stage 2 REGIONAL ACTIVITY 17% Stage 3 STATE LEADERSHIP 25% Stage 4 STATEWIDE PLANNING 29% Stage 5 STATEWIDE PLAN 8% Stage 6 STATEWIDE IMPLEMENTATION 6% • Recognition of the need for HIE among multiple stakeholders in your state, region, or community • No coordinated, statewide activity • Regional or community-specific HIE activity • Silos of HIE activity with possibly some cross-over • No coordinated, statewide activity • Either legislation has been passed or an executive order issued • Statewide planning initiative being formulated • Well underway with coordinated, statewide planning • Structures in place have statewide representation • Clear on how to deliver statewide plan • Plan / Roadmap complete and accepted • Plan / Roadmap communicated to the public • Implementation of state plan or Roadmap is well underway, with key milestones completed Source: 2006 Third Annual Survey of Health Information Exchange at the State, Regional and Community Levels available online at www.ehealthinitiative.org

18. Intersection Between Quality and HIT/HIE Initiatives • Rapidly emerging transparency and P4P initiatives are driving demand for information • Difficult to get there with paper • HIT and HIE enables performance measurement and quality improvement • Increasingly HIE initiatives are looking at performance reporting and quality improvement reporting as services that provide value • Increasingly, employers and payers are building incentives for use of electronic information, directly and indirectly • Don’t Build Each Effort as a Silo: Integrate…Each Helps the Other!

19. Key Take-aways • Health information technology is here and interoperability or health information exchange is the key area of focus • Rapid changes in policy at the national, state and local levels • Every stakeholder group is getting engaged… • National standards and state best practices are emerging to support interoperability and quality

20. Key Take-aways • There is a near term opportunity….in the convergence of movements on both HIT andquality • Mobilizing health information is going to dramatically improve the quality and safety of healthcare in Alabama and across the U.S.

21. Andrew Weniger Program Director eHealth Initiative and Foundation www.ehealthinitiative.org 818 Connecticut Avenue, N.W., Suite 500 Washington, D.C. 20006 202.536.4829 andrew.weniger@ehealthinitiative.org