Health Information Technology The Texas Landscape Presentation to TASSCC 2010

1. Health Information TechnologyThe Texas LandscapePresentation to TASSCC 2010 Nora Belcher Texas e-Health Alliance August 3, 2010

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

3. BackgroundTerminology • Most discussion of health IT falls into two categories: • Electronic health records – Promoting the adoption and use of electronic health records (EHRs) by doctors and hospitals. • Health information exchange – Establishing and promoting the use of electronic health information exchange (HIE) networks across which health care providers can share health information electronically • The federal government officially makes a distinction between electronic health records and electronic medical records but most people (including the federal government themselves), uses them largely interchangeably.

4. 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

5. 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

6. 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) • HHSC submitted Advanced Planning Document to CMS to support the development of a State Medicaid Health IT Plan (SMHP), which was approved.

7. 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

8. 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.

9. Coordinated Vision for HIE • Common elements and bottom line: • Nationwide, interoperable, electronic health information networks • Secure and private • Right information, right provider, right time • Full geographic and population coverage of HIE capacity • Cost/benefits studies • Estimated $77.8 billion annual, national savings from an electronic health information infrastructure. • Estimated $14.2 billion annual, Texas savings from an electronic health information infrastructure.

10. 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

11. 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

12. 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

13. 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

14. 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.)

15. Conclusion • Background • Vision • Texas Landscape • Future Activities • Open questions

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