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Health Information Technology and Puerto Rico. Juan Eugenio Rodríguez de Hostos Chief Information Officer, Government of Puerto Rico Dr. José Piovanetti Chief Medical Information Officer / CIO, Health Umbrella. Boeing 767 ± 200 Passengers.
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Health Information Technologyand Puerto Rico Juan Eugenio Rodríguez de Hostos Chief Information Officer, Government of Puerto Rico Dr. José Piovanetti Chief Medical Information Officer / CIO, Health Umbrella
Boeing 767 ± 200 Passengers Quality of Health Care in America Committee of the Institute of Medicine (IOM) - September 1999 - Facts • “44,000 to 98,000 people die in hospitals each year dueto preventable medical errors…” • Equivalent to 120 to 260 persons / day • One jet airliner crash, daily, for one year…
Health IT and the Government • The Government of Puerto Rico has awakened to the fact that our healthcare system is broken and that IT can play a pivotal role in enhancing the health of our citizens. • The CIO’s strategic plan is based on connectivity, service, integration, interoperability and data security across the entire Government and Island. • Healthcare is a main focus. Why? The benefits to citizens are IMMENSE
Action Plan • Reevaluate how PR-DoH does business • Look for ways to serve our customers better: • Integrate ASES and PAM from technological point of view • MMIS • Improve Reforma’s offerings through operational and technological integration with other welfare agencies • TGP and data-exchanges • Digitize and integrate medicine in Puerto Rico • HIE and EMR • Provide better connectivity for the Health Ecosystem • PREPA.net and Broadband
How can Broadband facilitate better health? • Connected patients • Telemedicine requires bandwidth to transmit images in real time • Personal Health Records (PHR): Patients control information and participate in their health • Connected health care providers, laboratories, pharmacies • Supports a system that provides the right information to define the right care at the right time for any patient. • Allows access to information from anywhere on the island. • Connect PR to the National Health Information Network
Funding Sources • ARRA Broadband • Mapping and Planning*: $1.4 million approved • Infrastructure, Public Computer Centers, Adoption • $12.6 million to INTECO for Infrastructure • Second round will be closing in a couple of weeks • ARRA HITECH • HIE Planning and Implementation*: $7.8 million approved • Regional Extension Centers • EMR and Health Informatics educational curricula • EMR incentives • Other Health IT non-ARRA • MMIS* – planning grant approved • HIT* – working on grant approval * States Only
Health Information Exchange Hospitals / IDNs State and Federal Healthcare-related Agencies Labs. CDC FDA SSA DoH Medicare / Medicaid Pharmacies Hosted or On-Site EHRs PHR’s State, Nationwide and International HIE Networks Payers / Health Plans
Hospital Record Records Returned Laboratory Results Specialist Record Temporary Aggregationof Patient History Index of Where Patients Have Records Clinical Encounter Community Requests for Records Patient Authorized Inquiry PR-HIO Patient Data Delivered to Physician
Hospital Record Laboratory Results Specialist Record Temporary Aggregation of Patient History Index of Where Patients Have Records Nationwide Records Returned Requests for Records Authorized Inquiry from HIO Another HIO PR-HIO Patient Data Delivered to Other HIO
Approach • “Health Umbrella” CIO, José Piovanetti, MD • Health Information Exchange • Environmental assessment, strategic and operational plans to be completed by September 2010 • Steering body to be created with local stakeholders • Clinical/Public Health, Technical, Operational, Legislation, Financial, and Governance working groups • HIE Implementation, 2-3 years • Accelerate Government’s HIT/EMR project(s) • Government ensures money used correctly, Meaningful Use criteria are met and plan followed
Our involvement with you! • We will be… • Providing periodic updates and info about ARRA programs and deadlines • Asking stakeholders to participate in various concurrent initiatives, committees and workgroups • Holding Town Hall meetings to communicate progress with HIE planning and hear ideas and concerns • Educating citizens on Electronic Medical Records and their benefits and address concerns regarding privacy • Interested in meeting consultants, product and service providers as we finalize HIE planning • Recruiting your help communicating with Association members and enlisting their responses • Asking you to call Washington so PR gets its fair share of funds
HIT/HIE Timeline NHII / NHIN State Health Information Exchange Cooperative Agreement Program MMIS / MITA NPRM Dec 30, 2009 “Meaningful Use” MU Stage 1 MU Stage 2 MU Stage 3 Medicare Incentives Penalties Medicaid Incentives HIPAA v5010 Transactions ICD-10 CM/PCS Adoption Oct 1, 2013