New York State Health Information Technology Operational Plan

1. New York State Health Information Technology Operational Plan Rachel Block Deputy Commissioner Office of Health Information Technology Transformation Department of Health David Whitlinger Executive Director New York eHealth Collaborative OCTOBER 12, 2010

2. The Vision for New York The vision is collaborative and coordinated care to support individual and population health in order to improve quality and reduce cost Interoperable health IT can improve individual patient care in numerous ways, including:1 Complete, accurate, and searchable health information, available at the point of diagnosis and care, allowing for more informed decision making to enhance the quality and reliability of health care delivery. More efficient and convenient delivery of care, without having to wait for the exchange of records or paperwork and without requiring unnecessary or repetitive tests or procedures. Earlier diagnosis and characterization of disease, with the potential to thereby improve outcomes and reduce costs. Reductions in adverse events through an improved understanding of each patient’s particular medical history, potential for drug-drug interactions, or (eventually) enhanced understanding of a patient's metabolism or even genetic profile and likelihood of a positive or potentially harmful response to a course of treatment. Increased efficiencies related to administrative tasks, allowing for more interaction with and transfer of information to patients, caregivers, and clinical care coordinators, and monitoring of patient care. Labs, X-Rays, etc. Consultant Physicians Health Plans, PBMs Pharmacies Hospitals Physical Therapy, Nutrition Services, Etc. Public Health and Other Agencies Long Term Care PATIENT / INDIVIDUAL 2 1 http://healthit.hhs.gov/, U.S. Department of Health & Human Services, accessed 1/27/2010

3. Grant Funding

4. Major Elements of NY HIT Strategic & Operations Plan • Promote broad adoption of HIT & HIE usage to drive statewide efficiencies in the delivery of care. • Develop statewide HIE services, and where appropriate consolidate infrastructure to lower overall costs and reduce technical variability of commodity components (“public utility” model) • Formalize Health Information Exchanges within the state by designating “Qualified HIT Entities” that provide HIE services and manage state HIT policy implementation. • Build upon the state’s investment in “collaborative care” organizations through further development of technical services to support new care models • Incorporate the expansion of public health and population health data services into the HIE infrastructure.

5. Route data in support of care transitions EXAMPLE • Provider refers patient to a specialist, hospital or other provider for consultation or service HIE service checks participant directory for routing instructions and sends referral request with pertinent patient information / history, diagnosis and service requested to consulting provider; business rules can be stored in HIE service for elements of real-time decision support Participant Directory / Consents / Disclosure Log HIE service submits referral authorization request to payer for approval and referral # HIE service routes visit summary to PCP, specialist or other interested and trusted party (e.g., health insurance case manager). HIE log can store summary or link to allow for tracking and later lookup. HIE Service Standard format visit summary with consultation notes transmitted to HIE network. Patient visits consulting provider, receives services, and details are noted in patient chart , electronic medical record or other result is created (e.g., at lab) Patient visits PCP or specialist and establishes trusted relationship and consents for release of data; consents and provider routing preferences are sent to HIE service Health Plan, etc.

6. Service Prioritization and Delivery

7. Preliminary Services Development Release

8. Statewide Services Example

9. Major Elements of NY HIT Strategic & Operations Plan • Promote broad adoption of HIT & HIE usage to drive statewide efficiencies in the delivery of care. • Develop statewide HIE services, and where appropriate consolidate infrastructure to lower overall costs and reduce technical variability of commodity components (“public utility” model) • Formalize Health Information Exchanges within the state by designating “Qualified HIT Entities” that provide HIE services and manage state HIT policy implementation. • Build upon the state’s investment in “collaborative care” organizations through further development of technical services to support new care models • Incorporate the expansion of public health and population health data services into the HIE infrastructure.

10. Qualified HIT Entity & Collaborative Care Communities

11. High Level Model Provide care coordination support DOH Supplier of HIE Service Supplier of HIE Service Collab Care Comm Provider Provides HIE tech services Pays for HIE tech services Provide statewide HIE service Provide statewide HIE service Pays for provision of statewide HIE services Provide on ramp to HIE services Administer core services and enforce SPG Qualified HIT Entity NYeC Fees for HIT/HIE services Fees for statewide services

12. Major Elements of NY HIT Strategic & Operations Plan • Promote broad adoption of HIT & HIE usage to drive statewide efficiencies in the delivery of care. • Develop statewide HIE services, and where appropriate consolidate infrastructure to lower overall costs and reduce technical variability of commodity components (“public utility” model) • Formalize Health Information Exchanges within the state by designating “Qualified HIT Entities” that provide HIE services and manage state HIT policy implementation. • Build upon the state’s investment in “collaborative care” organizations through further development of technical services to support new care models • Incorporate the expansion of public health and population health data services into the HIE infrastructure.

13. The Statewide Collaboration Process GET INVOLVED! DoH & NYeC Board Policy & Operations Council HIT Strategy Group Work Groups Newsletter: http://www.nyehealth.org/index.php/news-and-events/newsletter

14. http://www.nyehealth.org/ Submit comments by October 18