NYS Health IT Strategy Overview

1. NYS Health IT Strategy Overview Rachel Block Deputy Commissioner Health Information Technology Transformation NYS Department of Health January 9, 2012

2. NYS Health IT Strategy: Broad Goals • Launched in 2006 as a component of HEAL NY • Build health information infrastructure to support state health reform goals • Support clinicians and consumers with information at point of care • Advance care coordination • Strengthen public health surveillance and response • Enhance quality and outcome measures OVERALL STRATEGY IS ABOUT SYSTEMS CHANGE, NOT JUST HEALTH IT

3. Building Blocks for Interoperable Health IT • Governance • State, New York eHealth Collaborative (NYeC) • Regional Health Information Organizations (RHIOs) • Policies and standards • Privacy, technical, business/contracting • Clinical use • Structured use cases, decision support • Technical requirements • Web-based data exchange protocols • Adoption support • “Soup to nuts” implementation support provided in a community context ALL COMPONENTS ARE IMPORTANT TO ACHIEVE LONG TERM GOALS BUT INCREMENTAL EFFORTS WILL BE NEEDED TO OBTAIN SHORT-TERM VALUE AND CLINICAL ADOPTION

4. HEAL Phase 5Advancing Interoperability and Community-wide EHR Adoption • $104M competitive procurement to 19 projects • Focus: • Statewide Health Information Network for New York • Clinical Information Services • Electronic Health Record Adoption CHITAs RHIOs Patient history queries Electronic eligibility requests ePrescribing Med history delivery Lab results delivery Rad order / delivery Transcribed report delivery Public health reporting Quality reporting PHR delivery Clinical decision support • 7,450 clinicians from 265 different clinical practices sending data to RHIO via EHR. • 1,276 clinicians retrieving data from RHIO directly into EHR • 4,253 clinicians RHIO query via portal • 2,393 clinicians in 376 practices retrieving lab results directly into EHR

6. HEAL 10 and 17 • Continue to advance New York’s health information infrastructure based on clinical and programmatic priorities and specific goals for improving quality, affordability and outcomes • Aligning health information infrastructure as an underpinning to improved coordination of patient care leveraging new care delivery and reimbursement models -- the Patient Centered Medical Home (PCMH) • Build on health information infrastructure and advance key health reforms included in the PCMH model to improve care • Advance health IT as a key component to payment and broad health care reform

7. HEAL 10/17 Care Coordination Framework

8. RHIO HIE Services RHIO PROVIDER CAPABILITIES All RHIOs provide their members with: Health Information Exchange Software Patient Record Lookup Patient Record Locator Service In order to support patient and provider trust as embodied in NY State HIT Policy Guidance (SPG); each RHIO has the software application capability and operational capability to support; Patient identity Provider identity and authentication Patient/Provider record consent Auditing and Logging These basic infrastructure capabilities are necessities for any applications that may want to access and use patient records. Secure message routing and alerting is seen as an emerging base infrastructure capability that would be governed by the same SPG as patient data. Patient Database Identity Mgmt & Authentication Provider Database Patient Consent Management Message Routing EHR data interfaces (custom development) Z A C B Y X PRACTICE Y HOSPITAL X HOSPITAL Z FQHC B HOSPITAL A PRACTICE C

9. HITEC Evaluation Activities HEAL 5 HEAL 10 Further statewide hospital, physician and nursing home surveys to measure EHR adoption over time. Evaluation of nine PCMH communities to understand practice transformation process and physician satisfaction. Qualitative examination of lessons learned from development of SHIN-NY. Examination of effects of interoperable EHRs on quality and utilization of care in two NYS communities with advanced health IT initiatives. • 20 Community Specific evaluations with the 16 grantees. • Examination of impact of HEAL funded Health IT and HIE on quality, efficiency, provider and consumer experiences, workflow and health policy. • Statewide survey of physicians and hospitals to determine rates of adoption of EHRs. HEAL 17 • Examination of effect of interoperable EHRs on the value of care as measured by quality and utilization. • Comparison of HEAL funded communities and non-HEAL funded communities on outcomes of quality and efficiency to better understand the impact of the HEAL NY program.

10. Telemedicine – Key Component of Future Health IT and Care Coordination Models • Governance, policy and technical infrastructure to support health information exchange including telemedicine applications and tools • Issues to be resolved: • Technical implementation and adoption support services will be needed* • Integrating data into EHRs* • Payment policy and care coordination models