Advancing Electronic Health Information Exchange in the ...


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Advancing Electronic Health Information Exchange in the ...

  1. 1. Advancing Electronic Health Information Exchange in the Behavioral Health Industry SAMHSA Behavioral Health and Information Technology April 15, 2010 Jennie Harvell Office of the Assistant Secretary for Planning and Evaluation Department of Health and Human Service and Sue Mitchell Consultant
  2. 2. Current HIT Landscape <ul><li>HITECH made available $20 billion to advance the use of technology for the electronic exchange and use of health information to: </li></ul><ul><ul><li>Improve quality and coordination of care, </li></ul></ul><ul><ul><li>Reduce errors, and </li></ul></ul><ul><ul><li>Reduce health care costs </li></ul></ul><ul><li>Two key HITECH provisions: </li></ul><ul><ul><li>Medicare and Medicaid payment incentives for the “meaningful use” of certified EHR technology by “eligible professionals” and “eligible hospitals” </li></ul></ul><ul><ul><li>Grants to States to support and expand the electronic exchange and use of health information </li></ul></ul>
  3. 3. Target of Meaningful Use EHR Payment Incentives <ul><li>Acute Care Hospitals </li></ul><ul><li>Children’s Hospitals </li></ul><ul><li>Acute Care Hospitals </li></ul><ul><li>(sub § (d) hospitals) </li></ul><ul><li>CAHs </li></ul>Eligible Hospitals: N/A Hospital-based EPs * There are Medicaid volume requirements Excluded EPs: <ul><li>Physicians: </li></ul><ul><li>NPs </li></ul><ul><li>CNMs </li></ul><ul><li>Dentists </li></ul><ul><li>PAs who lead FQHCs/RHCs </li></ul><ul><li>Doctor of: </li></ul><ul><li>Medicine or Osteopathy </li></ul><ul><li>Dental Surgery or Dental Medicine </li></ul><ul><li>Podiatric Medicine </li></ul><ul><li>Optometry </li></ul><ul><li>Chiropractor </li></ul>Eligible Professionals (EPs): Medicaid* Medicare Eligibility
  4. 4. State HIE Exchange Grant Program <ul><li>In March 2010, ONC awarded $548 million in grants to 56 States, territories, and qualified State Designated Entities (SDE) to facilitate and expand secure, electronic movement and use of health information among organizations using nationally recognized standards. </li></ul><ul><li>Each grantee described its State HIE Program in terms of the following domains: </li></ul><ul><ul><li>Governance </li></ul></ul><ul><ul><li>Finance </li></ul></ul><ul><ul><li>Technical Infrastructure </li></ul></ul><ul><ul><li>Business and Technical Operations </li></ul></ul><ul><ul><li>Legal/Policy </li></ul></ul><ul><li>Each State HIE Program has a State Health IT Coordinator charged with supporting the: </li></ul><ul><ul><li>State HIE Grant Program </li></ul></ul><ul><ul><li>Medicare and Medicaid Meaningful Use Program </li></ul></ul>
  5. 5. State Health Information Exchange Toolkit <ul><li>ONC is supporting development of a State HIE Toolkit to provide State HIT Coordinators with practical “how to” guidance on “developing and implementing plans for achieving statewide Interoperability…”. </li></ul><ul><li>The Toolkit is dynamic and will provide guidance around each of the previously listed domains and other emerging areas. </li></ul><ul><li>http:// / </li></ul>
  6. 6. Emerging Toolkit Module: Vulnerable Populations & HIE <ul><li>To achieve promised quality and continuity of care improvements, efficiency gains, and cost reductions from health IT implementation, the emerging HIE infrastructure must support the HIE needs of vulnerable populations including those in need of Post-acute Care (PAC), Long Term Care (LTC), and Behavioral Health (BH) services. </li></ul><ul><li>During single episodes of care and across multiple episodes of care over time, these individuals may: </li></ul><ul><ul><li>receive services from geographically dispersed members of interdisciplinary care teams; </li></ul></ul><ul><ul><li>have multiple prescribed medications; </li></ul></ul><ul><ul><li>have numerous care transitions requiring real time information; and </li></ul></ul><ul><ul><li>have multiple health care payers. </li></ul></ul><ul><li>Service delivery to persons receiving PAC, LTC and/or BH services may involve multiple Federal, State, and local health agencies. </li></ul><ul><li>The clinical complexity of these individuals suggests the value of technology for: </li></ul><ul><ul><li>e-prescribing; and </li></ul></ul><ul><ul><li>electronic exchange of health information to improve quality of health care, such as promoting care coordination. </li></ul></ul>
  7. 7. Draft Toolkit Module: Vulnerable Populations & HIE <ul><li>The Draft Toolkit module: </li></ul><ul><li>Starts where the State Health IT Coordinators are by focusing on the: </li></ul><ul><ul><li>Domains of the State HIE Grant Program; and </li></ul></ul><ul><ul><li>Medicare and Medicaid Meaningful Use (MU) Program </li></ul></ul><ul><li>Provides a “primer” about this vulnerable population and their providers. This information could be used by: </li></ul><ul><ul><li>State HIT Coordinators who want to extend HIE activities to include these individuals, their providers, and/or state and local oversight agencies; and </li></ul></ul><ul><ul><li>PAC, LTC and BH providers who want to engage in State HIE activities. </li></ul></ul><ul><li>Highlights how ONC adopted standards and EHR certification criteria align with draft CCHIT EHR certification criteria for PAC, LTC, and BH providers </li></ul>
  8. 8. Draft Toolkit Module: Vulnerable Populations & HIE <ul><li>Highlights alignment of one of the ONC adopted standards (CCD) for exchange of patient summary documents with proposed CCHIT EHR certification criteria for PAC, LTC, and BH providers </li></ul><ul><li>Highlights “intersections” between the MU criteria and PAC, LTC, and BH providers: </li></ul><ul><ul><li>EP& EH Meaningful Use Objective – Exchange Key Clinical Information </li></ul></ul><ul><ul><li>EP & EH Meaningful Use Objective – Perform Medication Reconciliation at Transition of Care </li></ul></ul><ul><ul><li>EP & EH Meaningful Use Objective – Provide Summary Care Record at Transition of Care </li></ul></ul><ul><ul><li>EP and EH MU Objective - Electronic insurance eligibility checking </li></ul></ul><ul><ul><li>EP and EH MU Objective - Electronic claims submission </li></ul></ul><ul><ul><li>EP and EH MU Objective - Exchange key clinical information (e.g., problem list, medication list, allergies, diagnostic test results), among providers and authorized entities </li></ul></ul><ul><ul><li>EP Quality Measure – A1c for Diabetics & Others Requiring Lab Results </li></ul></ul>
  9. 9. Resources <ul><li>ONC HIE solicitation, Listing of States receiving ONC HIE grants, and award amounts: http:// =512&objID=1488&mode=2 </li></ul><ul><li>Link to ONC rules on: </li></ul><ul><ul><li>Initial Set of Standards and Certification Criteria (IFR) </li></ul></ul><ul><ul><li>Certification Program (NPRM) http:// =512&objID=1153&parentname= CommunityPage&parentid =67&mode=2&in_hi_userid=11113&cached=true </li></ul></ul><ul><li>CMS NPRM on Medicare and Medicaid EHR Incentive Program (and related information) </li></ul><ul><li>State HIE Toolkit: http:// / </li></ul><ul><li>Questions? [email_address] or [email_address] </li></ul>