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Colleen Woods Health IT Coordinator State of New Jersey March 7, 2012

Connecting Patients to a Greater State of Health. New Jersey Health Information Technology. Colleen Woods Health IT Coordinator State of New Jersey March 7, 2012. The Condition of Healthcare. The Population is Aging (Baby Boomers)

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Colleen Woods Health IT Coordinator State of New Jersey March 7, 2012

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  1. Connecting Patients to a Greater State of Health New Jersey Health Information Technology Colleen Woods Health IT Coordinator State of New Jersey March 7, 2012

  2. The Condition of Healthcare • The Population is Aging (Baby Boomers) • Nursing, Physician and Other Clinical Shortages • More than 51% of the US Population’s healthcare is financed in some way by tax dollars (Medicare, Medicaid, Charity Care, Government Employees, Armed Services, Firefighters, Police, Teachers, Etc…) • Healthcare IT adoption is 12 years behind other industries • Today’s healthcare information network for sharing clinical information is connect via phones and fax • In New Jersey 60 – 70% of providers are still using paper-based medical records (NJHA Estimate)

  3. “Where Wisdom Lives” David Brooks New York Times Columnist “The average 56-year-old couple pays about $140,000 into the Medicare system over a lifetime and receives about $430,000 in benefits back. The program is also completely unaffordable. Medicare has unfinanced liabilities of more than $30 trillion. The Medicare trustees say the program is about a decade from insolvency. “ – New York Times, Monday June 6, 2011

  4. Healthcare Transformation Payment Transformation Delivery of Care Transformation Health Information Technology Transformation Electronic Health Records (EHRs) Health Information Organizations (HIOs) Health Information Network (HIN)

  5. Seeing Results Primary Care Practices of Better Health Greater Cleveland Practices that use electronic health records saw significantly higher achievement and improvement in meeting standards of care and outcomes in diabetes than practices using paper records. --NEJM, September 1, 2011 • Nearly 51% of patients in EHR practices received care that met all of the endorsed standards. • Only 7% of patients at paper-based practices received this same level of care– a difference of 44%. • After accounting for differences in patient characteristics between EHR and paper-based practices, EHR patients still received 35% more of the care standards.

  6. Primary Care Practices with Advanced Electronic Health Information Capacity by Country Adoption of health information technology (IT) among primary care practices is highly variable across countries, with the United States lagging well behind other nations Percent reporting at least 9 of 14 clinical IT functions* * Count of 14 functions includes: electronic medical record; electronic prescribing and ordering of tests; electronic access test results, Rx alerts, clinical notes; computerized system for tracking lab tests, guidelines, alerts to provide patients with test results, preventive/follow-up care reminders; and computerized list of patients by diagnosis, medications, due for tests or preventive care. Source: 1. 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

  7. Percentage of Office-Based Physicians planning to apply for Meaningful Use Incentives* New Jersey (31%) has a lower percentage of physicians potentially able to meet meaningful use core criteria when compared with national average New Jersey (16%) has the lowest percent of physicians in the country using any EMR/EHR system *Also includes office-based physicians who have EHR system capabilities to support eight Stage 1 Core Set meaningful use objectives • Source: • CDC/NCHS, National Ambulatory Medical Care Survey • Electronic Medical Record/Electronic Health Record Systems of Office-based Physicians: United States, 2010, and Preliminary 2011 State Estimates

  8. New Jersey HIT Overview

  9. NwHIN, Health Plans • Conceptual Technical Architecture • Full Operation • NJHIN • Onboarding • Security Compliance State Gov’t HIO • State Data Sources: • Immunizations • Medicaid • Blood Screening • Bio surveillance • DMV Demographics • Other registries GATEWAY • Health Entity Directory • Web Services Registry • Provider Directory • (supporting DIRECT) • Provider Credentialing • State Gateway Services • Relay Service (External Queries) • Patient Discovery & Document Exchange • Statewide Data Aggregation NJHIN Core Services Certificate Authority Health-e-cITi Camden Trenton Health Team MOHIE Jersey Health Connect Surescripts & Labs Physician Office IDN Hospital Long Term Care EMS EMS Home Health • NJHIO Nodes • Pt Discovery & Document Exchange Gateways • HIO-level MPI • HIO-level Record Locator • Consent Mgmt (interim) • DIRECT Services • Security Compliance Hospital Assisted Living Behavioral Health Physician Office

  10. HIOs and IDNs • Health-e-cITi-NJ • Newark Beth Israel Medical Center • St. Michael’s Medical Center • East Orange General Hospital • Meadowlands Hospital • Christ Hospital • University Hospital • St. Joseph’s Healthcare System • Jersey City Regional Medical Center • FQHC - Newark Community Health Center • Jersey Health Connect • Atlantic Health • Morristown Memorial, Overlook, Newton • CentraState • Children's Specialized Hospital • CJHIEP (Physician Organization) • Hackensack University Medical • Holy Name Medical Center • Hunterdon Healthcare • JFK Health System • Parker Memorial Home (LTC) • Robert Wood Johnson University Hospital • Robert Wood Johnson – Hamilton • Robert Wood Johnson- Rahway • Saint Barnabas Medical Center • Saint Clare’s Health Services • Saint Peter’s Healthcare System • Somerset Medical Center • Trinitas Regional Medical Center Bergen Sussex Passaic Essex Hudson Morris Warren Union Somerset Hunterdon Middlesex • MOHIE • Bayshore Community Hospital • Community Medical Center • Jersey Shore University Medical Center • Kimball Medical Center • K. Hovnanian Children’s Hospital • Monmouth Medical Center • Ocean Medical Center • Riverview Medical Center • Southern Ocean Medical Center • FQHC - Monmouth Family Health Center Monmouth Mercer Ocean Burlington Camden • Trenton Health Team • Capital Health System • St. Francis Medical Center • City of Trenton • FQHC - Henry J. Austin Health Center Gloucester Atlantic Salem • IDNs • AtlantiCare Regional Medical Center • Barnabas Healthcare System • South Jersey Health System • Virtua Health • Camden • Cooper • Lourdes • Virtua • Underwood • Kennedy • FQHC – Camcare / Project Hope Cumberland Cape May

  11. Use Cases

  12. Where Are We Today?

  13. Health IT Goals for New Jersey 2014: EHRs for All New Jerseyans • We envision a New Jersey Health IT environment by 2014 where all NJ consumers have a secure electronic health record that includes all health related information and services (including behavioral health & addiction services)! www.nj.gov/njhit

  14. EHR Adoption

  15. $81+ mil. in EHR Incentives Paid in NJ www.nj.gov/njhit As of 2/18/2012

  16. New Jersey HIOs--Stages Stages of Health Information Organization Development Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Stage 7 Starting Organizing Planning Piloting Operating Sustaining Innovating Health-e-cITi Camden Jersey Health Connect Trenton MOHIE Stage 4: Well under way with implementation - technical, financial and legal. (Pilot project or implementation with multiyear budget identified and tagged for a specific need) Stage 5: Fully operational health information organization; transmitting data that is being used by healthcare stakeholders. www.nj.gov/njhit

  17. HIOs Momentum: Connecting Hospitals and Physicians to HIOs, IDNs • Almost 2,000 Physicians Sharing/Exchanging Data within a NJ HIO or IDN • 48 Hospitals Members • 16 Hospitals Exchanging Data within a NJ HIO or IDN www.nj.gov/njhit

  18. Aligning Behavioral Health With Health IT

  19. NJ Behavioral Health IT Initiatives NJ Health IT Vision Statement - “We envision a New Jersey HIT environment by 2014 where: All NJ consumers have a secure electronic health record that includes all health related information and services (includes behavioral health & addiction services)” • Camden Coalition • Catholic Charities of Trenton • Behavioral Health Information Collaborative • Bergen Regional Medical Center/CAMCare • The Nicholson Foundation • NJAMAA Subcommittee Participation

  20. Aligning for the Future • Medicaid Waiver Programs are providing a combination of both traditional medical services as well as non-medical services to those who meet both the established clinical and financial criteria • EMR system being purchased for State Institutions • Administrative Service Organization for the Management Behavioral Health Care Organization (ASO/MBHO Model)

  21. HIT Privacy and Security • HIPAA • Consent for Sensitive Data • For Example: All patients are auto-connected to the hospital via a Personal Health Record • Initial consent is either “all in” or “all out” • Once in the PHR, the patient can: • Manage granularity of sensitive data • Assign relationships to physicians • See who has looked at their record

  22. Health IT Goals for New Jersey 2012: Moving from Local to Statewide • HIOs Continue Implementing • Connect HIO to HIO • Integration of BH and CH • New Jersey SHARE • State Health Access and Records Exchange www.nj.gov/njhit

  23. NJ HIT Program Focus for 2012+ = Completed 2013 • Phase 7: • Personal and National • Disease Management • Syndromic Surveillance • Full EHR Adoption • Connect NHIN • Interstate Exchange • Meaningful Use Phase 3 • Phase 1: Strategy • Planning • Funding Request • Strategic Planning • Organizational Structure 2012 Q2-Q4 • Phase 6: • Focus on Exchange • Data Exchange and Analytics • State HIO • State Health Registries • Long term Care Integration • Behavioral Health Integration • Meaningful Use Stage 2 • Phase 2: Planning • Funding • Governance • HIO Initial Build • Policies • Initial Stakeholder Outreach • Operational Plan • State Medicaid HIT Plan Consumer & Stakeholder Outreach EHR Adoption Enabling New Jersey Health Information Exchange • Phase 5: Implementation • Implement Financial Sustainability • HIO Trust Agreements • Establish NJHIN • HIO Connection • Research pilots • PHR Focus • SHARE (State HIO) • Phase 3: Foundation • Standing Up Regional HIOs • Architecture & Standards • Quality Measures • Legal Framework • Use Cases for Care Coordination • Phase 4: Framework • Design Financial Sustainability • Medicaid Incentive Program and Meaningful Use Stage 1 • NJHIN Planning • Use Case Development #1-5 • Legislation and Regulation 2011 Q4 – 2012 Q4 2011 Q1 Q2 2011 Q2 –Q4

  24. NJ Health IT Champion Program Thank you, NJ Health IT Champions!

  25. Questions? Reference: www.nj.gov/njhit

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