Health Information Technology The Texas Landscape Presentation to Texas Association of Rural Health Clinics

1. Health Information TechnologyThe Texas LandscapePresentation to Texas Association of Rural Health Clinics Nora Belcher Texas e-Health Alliance August 12, 2010

2. Health Information TechnologyOverview • Background • Vision for HIE • Texas Landscape • Future Activities

3. Background Planning and Policy Development – Federal • Initiated through April 2004 State of the Union address • Furthered through the creation of the Office of the National Coordinator for Health Information Technology • Ongoing federal health IT initiatives • Open, deliberative policy development process (Health IT Policy Committee) • Certification and standardization (Health IT Standards Committee) • Health information exchange pilots (Nationwide Health Information Network) • Privacy & security (Health Information Security and Privacy Collaboration) • New health IT initiatives through the ARRA

4. Background Planning and Policy Development – Federal • Several new health IT initiatives created and funded through the American Recovery and Reinvestment Act of 2009 (ARRA) • Electronic health record incentives (estimated $36-$46 billion) • Health information infrastructure ($2 billion) • State grants for HIE planning and implementation • Health IT regional extension centers • Health IT workforce program

5. Background Planning and Policy Development – Federal • Electronic health record incentives (estimated $36-$46 billion) • Incentives for the adoption and use of electronic health records by hospitals and physicians through Medicaid and Medicare (estimated $36-$46 million) • Eligible professional: you must be a physician, dentist, certified nurse midwife, or physician assistant (PA) practicing in a federally qualified health center led by a PA. In addition, Medicaid services must comprise a certain volume of your practice: 30% for non-hospital-based professionals (20% for non-hospital-based pediatricians); 30% for professionals who practice predominately in federally qualified health centers or rural health clinics; and 10% for children’s hospitals and acute-care hospitals.

6. Vision for HIE: Federal • Health information technology allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of health IT will: • Improve health care quality; • Prevent medical errors; • Reduce health care costs; • Increase administrative efficiencies; • Decrease paperwork; and • Expand access to affordable care.* *U.S. Department of Health and Human Services

7. Vision for HIE: State • A healthcare system supported by a technological infrastructure made up of: - Ubiquitous, interoperable, electronic medical records composed of structured data elements; and - A secure network to support the exchange of health information among providers.

8. Texas Landscape: State Funding and Projects • State HIE Cooperative Agreement Program $28.8 million – HHSC/ Office of e-Health Coordination (OeHC) • Medicaid Health IT Plan/EHR Incentive Payment Program $4.5 million planning – HHSC/Medicaid • Health IT Regional Extension Centers (REC) $35.7 million – 4 awards • Strategic Health IT Advanced Research Projects (SHARP) $15 million – UT Health Science Center, Houston • Beacon Community Program 8 Texas applicants, 0 awards • Health IT Workforce Grants $5.4 million – Texas State University, San Marcos

9. Texas Health and Human Services Commission Medicaid eHealth/THSA Texas REC Coalition Steering Committee Texas HIE Coalition Steering Committee

10. Already-deployed HIE assets 16 identified local HIE initiatives at many different stages of planning, implementation, and operation Sometimes called Regional Health Information Organizations (RHIOs) State (or higher) –level data sources/services, public and private Public (e.g., state immunization registry) Private (e.g., lab ordering portals, eRx networks, payer-based eligibility and benefits portals) Texas Landscape: Additional Components

11. What Does It Mean For You? • Major open questions • Funding/sustainability • Achieving population and geographic coverage – network topology • Patient involvement in HIE – consent? How much? • Provider liability • Impact on state agencies • Direct impact • Indirect impact

12. Texas Legislative Activity Increasing interest in health IT in the Texas Legislature Before 2005 – 0 health IT bills filed 2005 – 1 health IT bill filed 2007 – 6 health IT bills filed 2009 – 30 health IT bills filed 81st Regular Legislative Session (2009 ) Health passport expansion Electronic prescribing (also LBB report) Medicaid-based HIE

13. Future Activities • The Texas path forward • State HIE planning and implementation grant • THSA and workgroups • Clear role for local HIEs • State Medicaid Health IT Plan development and implementation • Other, Ongoing Texas state-level projects • Office of e-Health Coordination • Medicaid HIE Initiative • Private-sector developments • Regional initiatives • Stakeholders (employers, payers, etc.)

14. HHSC Survey The 2010 Health Information Technology Survey will help the Health and Human Services Commission (HHSC) develop important programs for Texas providers and patients.  In five to ten minutes you can help shape the health-care policy that affects you, your business, and the people you serve!  http://www.surveymonkey.com/s/593369B

15. Helpful Links http://www.txrecs.org/ http://www.cms.gov/EHRIncentivePrograms/ http://www.thsa.org/ http://www.tmhp.com/Pages/HealthIT/HIT_Home.aspx

16. Questions? Nora Belcher Executive Director Texas e-Health Alliance nora@txeha.org (512) 536-1340