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advocacy@himss.org. 2. Agenda. Background on HIMSSHealth IT on the National-levelState Health IT ActivitiesState Employee Health Benefits ProgramsMedicaidPublic HealthWhere are We Going?: Healthcare Reform and Health IT. advocacy@himss.org. 3. HIMSS. The Healthcare Information and Manageme
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1. Prescription for Reform: The Leadership Role of States in Healthcare IT K. Meredith Taylor, MPHDirector, HIMSS Congressional Affairs
2. advocacy@himss.org 2 Agenda Background on HIMSS
Health IT on the National-level
State Health IT Activities
State Employee Health Benefits Programs
Medicaid
Public Health
Where are We Going?: Healthcare Reform and Health IT
3. advocacy@himss.org 3 HIMSS The Healthcare Information and Management
Systems Society (HIMSS) is the healthcare
industry's membership organization exclusively
focused on providing global leadership for the
optimal use of healthcare information
technology (IT) and management systems for
the betterment of healthcare.
4. advocacy@himss.org 4 Society Today 20,000 Individual Members of which 73% work in the field (non-vendors, non-consultants)
330 Corporate Members
90+ committees, task forces, & work groups
47 Chapters
3 corporations, over 175 staff
Top 5 largest healthcare conference in US
Top 50 largest conference of any kind in US
5. advocacy@himss.org 5
6. advocacy@himss.org 6 Healthcare Landscape • 1999 IOM “to Err is Human” noted that there were 1.3 million injuries a year and nearly 100,000 deaths from medical error alone
Healthcare now represents 16% of GDP
2 trillion individuals in the U.S. lack health insurance
70% of healthcare transactions are in paper today
Paper administrative costs can be 20 cents on the dollar
Healthcare only invests 2-3% of revenue on IT vs 10- 15% in other industries (retail, grocery)
7. advocacy@himss.org 7 What’s Driving Action? Quality
Patient Safety
Medication Errors
Efficiency
Administrative Costs
Accountability – facilitating improved reporting of outcomes
Bio-preparedness
Disaster Management
8. advocacy@himss.org 8 What is Health IT? Healthcare Information Technology: “Healthcare Information Technology”, “Health Information Technology”, “Health IT”, and “HIT”
The use of electronic technology (computers and computer programs) to store, protect, retrieve, and transfer clinical, administrative, and financial information electronically within health care settings
Used in various care settings:
– In-patient (hospital, medical/surgical, long-term care, etc.)
– Out-patient (ambulatory, specialty (e.g., pediatric, cardiac, mental health)
Examples:
– Electronic Health/Medical Records
– Personal Health Records (PHRs)
– Computerized Physician Order Entry Systems (CPOE)
– Computerized Decision Support Systems (CDSS)
– Computerized Electronic Alert Systems (e.g., drug interactions)
– Medical Devices, Handheld Computers, Imaging, etc
– Financial/Billing/Administrative Systems
– Electronic Communications with Patients
– On-line data sources for Patients
9. advocacy@himss.org 9 The Value of Interoperability and Electronic Health Records
• January 2005 CITL Study1: Standardized, encoded, electronic healthcare information exchange would:
Save the US healthcare system $337B over a 10-year implementation period, and $78B in each year thereafter
September 2005 RAND Study2: Widespread adoption and effective use of electronic medical record systems (EMRs) and other health information technology (HIT) improvements would:
Save the US healthcare system $162B annually
Potential health and safety benefits could double savings
Improve quality and efficiency of the healthcare system
1. J Walker et. al. Health Affairs, January 2005.
2 R Hill t d t Al H lthAffiS t b /O t b 2005
10. advocacy@himss.org 10 Federal Government Action President George W. Bush
Executive Order 13355
HIT mentioned in State of the Union – 5 Years Running!
ONC funding has decreased, but finally stabilized
Federal Landscape:
Dr. Kolodner permanent 2nd National Coordinator
Secretary of Health and Human Services – Still Big HIT Proponent
Agencies Meeting Executive Order Requirements
HITSP established
CCHIT established
AHIC transitioning to AHIC 2.0
Race to implement initiatives before end of Bush Administration
11. advocacy@himss.org 11 Prominent Nationwide HIT Initiatives Health Information Security and Privacy Collaboration (HISPC)
National Governors Associations’ State Alliance for e-Health
National Conference of State Legislatures’ Project Health Information Technology Champions
American Health Information Management Association’s (AHIMA) State-level HIE Consensus Project
12. advocacy@himss.org 12 Action on Capitol Hill No significant action during 110th Congress
E-prescribing only success story
Currently tracking over 100 separate pieces of HIT related legislation
What to expect during final days of 2nd Session (2008)?
S. 1693 (Wired for Health Care Quality Act)
H.R. 6898, The Health-e Information Technology Act of 2008
H.R. 6357, PRO(TECH)T Act of 2008
H.R. 1467 (10,000 Trained by 2010)
Passed House
Track all HIT legislation at the HIMSS Legislative Tracker at: www.himss.org/advocacy/actioncenter.asp
13. advocacy@himss.org 13 Fiscal State of the States For states, overall revenue growth slowed in 2007 and tighter fiscal conditions are expected in 2008
States’ single largest expenditure in 2007 was healthcare
Medicaid comprises 22% of state spending
Challenges in expanding SCHIP
Strains of the aging population
Reduction in federal funding
*The Fiscal Survey of States, National Governors Association. December 2007.
14. advocacy@himss.org 14 The Climate for HIT States recognize role in driving HIT to transform healthcare
Role of states as conveners, purchasers, payers, and regulators of healthcare. States are leveraging publicly funded health programs to drive HIT.
15. advocacy@himss.org 15 The Climate for HIT Newly Elected Governors in 2008
Governor Bobby Jindal, Louisiana
Governor Steve Beshear, Kentucky
State of the State Addresses
Over 1,000 pieces of HIT related state legislation
Federal assistance
16. advocacy@himss.org 16 General HIT Landscape “eHealth Progress Across the States in 2007”
Report developed by the NGA, HMA, and made possible by the Commonwealth Fund
1st of its kind survey of state officials and their eHealth activities
25 states reported operations of electronic health information exchanges that involved a publicly funded health program
Disease Registries most commonly reported eHealth Activities underway within Public Health
Quality and Transparency issues drive the need and reasoning for state Health Initiatives
Collaboration among competitive entities and the coordination of multiple efforts into a statewide strategy as some of the leading challenges surround state involvement in eHealth activities
17. advocacy@himss.org 17 Role of States Convener, payer, purchaser, and regulator of healthcare
Leveraging publicly funded health programs
Medicaid
Public Health
State Employee Health Benefits Programs
Streamlining multiple efforts through the use of certified health information technologies
18. advocacy@himss.org 18 State EmployeesMinnesota
As of January 2008, all providers that contract with the Minnesota Advantage Health Plan, the state employee health benefits program, are required to conduct pharmacy transactions through a single Pharmacy Benefits Manager, Navitus Health Solutions.
The Minnesota Department of Employee Relations (DOER) expects the initiative to improve the quality of healthcare, while lowering health plan costs paid by employees and taxpayers.
*Electronic Health Records for Minnesota by 2015?”. HIMSS Fact Sheet. 2007.
19. advocacy@himss.org 19 MedicaidTennessee TennCare, Tennessee’s Medicaid Program, utilizes Shared Health’s Clinical Health Record for all Medicaid beneficiaries in the state.
TennCare and Shared Health are sponsoring an ePrescribing Pilot Program among rural healthcare providers in the state.
*Shared Health. Press Releases. Accessible at: www.sharedhealth.com
20. advocacy@himss.org 20 Public Health Connecticut
S1484, Requires Commissioner of Public Health to engage with eHealth Connecticut in the development of a state-wide HIT plan (Signed into law)
Indiana
S551, Established the Indiana Health Informatics Corporation to develop and operate a state-wide system for the electronic HIE. Requires the inclusion of public health informatics (Signed into law)
21. advocacy@himss.org 21 Certified Health Information Technologies
Vermont
Vermont Information Technology Leaders, Inc. (VITL) release of the Pre-Screened Electronic Health Record Product List
Virginia
Governor’s Health Information Technology Council encouraging HIT vendors in the state to build-on standards developed by CCHIT
HB2198, HIT that is purchased by a state agency must be certified by a recognized certification body or to adhere to standards for interoperability and data exchange (Signed into law)
*”State Policy and Certified Health Information Technologies”. HIMSS Fact Sheet. 2008
22. advocacy@himss.org 22 Where are We Going?Healthcare Reform and Health IT Healthcare Reform will be a priority issue for the 111th Congress and the new Administration
To date, healthcare reform legislation includes provisions for health IT
Presidential Candidates and Party Platforms include health IT as a tool to transform healthcare
23. advocacy@himss.org 23 Where are We Going?Healthcare Reform and Health IT McCain vs. Obama Provide citizens with choices of different health insurance plans
Encourage Personal Responsibility
Tax credit to individuals and families to increase incentive to purchase health insurance
No mandate for health insurance coverage
No HIT component yet
Universal coverage utilizing a mix of private and public modalities
Quality, affordable and portable coverage for All
Children required to have insurance, no mandate for adults
Lower costs by modernizing the U.S. healthcare system
Up to $10B per year for HIT
24. advocacy@himss.org 24 Where are We Going?Healthcare Reform and Health IT Massachusetts
SB 2863 (Enacted, August 2008)
Requires residents to obtain healthcare coverage and establishes subsidies for low income residents to obtain coverage
Establishes Massachusetts e-Health Institute to plan and oversee state health IT activities
Authorizes $25 million for the Institute
25. 25 Questions? Contact Your HIMSS Government Relations Team
David W. Roberts, FHIMSS, Vice President, Government Relations, 703-562-8811
K. Meredith Taylor, Director, Congressional Affairs, 703-562-8847
Blair Hedgepeth, Senior Manager, Congressional Affairs, 703-562-8810
Kathie Westpheling, Manager, Public Policy, 703-562-8831
Wayne Humphries, Manager, Public Policy Initiatives, 703-562-8870
Mary Walker, Executive in Residence, 703-562-8835 Tom Leary, FHIMSS, Senior Director, Federal Affairs, 703-562-8814 Jonathan French, Manager, Federal Affairs, 793-562-8823
Stephanie Tsoucalas, Coordinator, Federal Affairs, 703-562-8800 Tom Keefe, Senior Director, State Government Relations, 703-562-8813
TBD, Manager, State Government Relations, 703-562-8847
Arnol Simmons, Coordinator, State Government Relations, 703-562-8826
Sharolyn Rosier Hyson, Senior Manager, Public Policy Communications, 703-562-8819
HIMSS Arlington Office
4300 Wilson Boulevard, Suite 250
Arlington, VA 22203
advocacy@himss.org