MO-HITECH Presentation


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This slide presentation was given at a rural hospitals conference in Jefferson City, MO in May 2010.

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MO-HITECH Presentation

  1. 1. Missouri Statewide Health Information Organization<br />MO-HITECH<br /><br />
  2. 2. Missouri’s Health Information Exchange:<br />Missouri has an unprecedented opportunity to access federal funds to plan, design, implement and support the statewide exchange of electronic health information.<br />2<br />
  3. 3. Current state vs. future vision<br />Pharmacies<br />Pharmacies<br />Labs<br />Hospitals<br />Labs<br />Hospitals<br />Health Info<br />Exchange<br />Physicians<br />Clinics<br />Physicians<br />Clinics<br />Consumers<br />Government<br />Payers<br />Government<br />Payers<br />Consumers<br />Current Confusion<br />Evolving and Competing <br />Landscape<br />Future Vision<br />Improved Access and Use of <br />Health Information<br />3<br />
  4. 4. 4<br /> ARRA and HITECH Act:Opportunity for Missouri’s Health Care Providers and Consumers<br />
  5. 5. ARRA & HITECH Funding<br />ARRA<br />American Recovery & Reinvestment Act<br />$787 Billion federal stimulus package passed by Congress and signed by President Obama in February 2009.<br />HITECH Act<br />Health Information Technology for Economic & Clinical Health Act<br />$50 billion section of the stimulus package focused on funding and supporting widespread adoption of health information technology.<br />MO-HITECH<br />Missouri Office of Health Information Technology<br />$1 billion funding opportunity for Missouri over the next five years.<br />5<br />
  6. 6. Above $1 Billion<br />$500 Million - $1 Billion<br />$100-500 Million<br />Below $100 Million<br />Estimated Meaningful Use Funding by State<br />Missouri:<br />Projected funds from State HIE Program: $13.8 M<br />Projected funds from Medicare Meaningful Use: $442 M<br />Projected funds from Medicaid Meaningful Use: $404 M<br />6<br />
  7. 7. Missouri Opportunities Under HITECH:$1 Billion Potential Investment<br />7<br />
  8. 8. 8<br />Support for Missouri’s Health Care providers<br />
  9. 9. 9<br />Development of Missouri’s Health Information Exchange:Goals, Planning and Timelines<br />
  10. 10. 10<br />State Goals<br />Improve the quality of medical decision-making and the coordination of care;<br />Provide accountability in safeguarding the privacy and security of medical information; <br />Reduce preventable medical errors and avoid duplication of treatment;<br />Improve the public health;<br />Enhance the affordability and value of health care; and<br />Empower Missourians to take a more active role in their own health care.<br />
  11. 11. Collaborative Stakeholder Process<br />The state has overseen and guided an open, transparent and collaborative process to develop a statewide health information exchange strategic and operational plan.<br /><ul><li> HIE regional listening sessions
  12. 12. Advisory Board and Workgroups formed
  13. 13. Public invited to review, comment and offer feedback
  14. 14. More than 200 stakeholders engaged across the state</li></ul>11<br />
  15. 15. MO-HITECH<br />MO-HITECH Framework<br />Advisory Board<br />Manatt & State Employees to Staff & Facilitate Workgroups<br />Governance Workgroup<br />Technical Infrastructure Workgroup<br />Finance Workgroup<br />Business & Technical Operations Workgroup<br />Consumer Engagement Workgroup<br />Legal/ Policy Workgroup<br />Draft Strategic and <br />Operational Plans<br />Draft Sections of Strategic and Operational Plans<br />Strategic and Operational Plans<br />12<br />
  16. 16. MO-HITECH Advisory Board<br />Barrett A. Toan<br />Private Sector Co-Chair <br />Ronald J. Levy, <br />Director, DSS and MO-HITECH Coordinator<br />Donald Babb<br />CEO, Citizens Memorial Hospital, Bolivar <br />Steve Calloway<br />Pharmacy <br />Representative Shalonn Curls <br />Margaret T. Donnelly<br />Director DHSS<br />Karen Edison, MD<br />Missouri Center for Health Policy <br />Tracy Godfrey, MD<br />Family Physician, Joplin <br />Tom Hale, MD, PhD<br />Sisters of Mercy Health System <br />Sandra Johnson, JD, LL.M<br />Emerita Professor of Law and Health Care Ethics, St. Louis University School of Law<br />Herb B. Kuhn<br />President & CEO, Missouri Hospital Association <br />Ian McCaslin, MD<br />Director, MO HealthNet Division <br />Joe Pierle, CEO<br />Missouri Primary Care Association <br />Verneda Robinson<br />CEO, Swope Health Systems <br />Andrea Routh<br />Health Advocacy Alliance <br />Senator Eric Schmitt <br />MahreeSkala<br />Missouri Association of Local Public Health Agencies <br />Steven C. Walli<br />President & CEO, United Healthcare MO <br />David Weiss, CIO<br />BJC Healthcare <br />Karl Wilson<br />President & CEO, Crider Health Center<br />13<br />
  17. 17. Workgroup Co-Chairs <br /><ul><li>Technical Infrastructure
  18. 18. Mitzi Cardenas, CIO, Truman Medical Center
  19. 19. Doug Young, CIO, Information Technology Services Division
  20. 20. Legal/Policy
  21. 21. Sandra Johnson, Professor Emerita of Law and Health Care Ethics, St. Louis University School of Law
  22. 22. Doug Nelson, Deputy Chief of Staff, Governor Jay Nixon
  23. 23. Finance
  24. 24. John M. Huff, Director, Department of Insurance
  25. 25. Donna Checkett, Senior Vice President, Aetna Medicaid
  26. 26. Governance
  27. 27. Steve Roling, Healthcare Foundation of Greater Kansas City
  28. 28. Ronald J. Levy, Director, Department of Social Services
  29. 29. Consumer Engagement
  30. 30. Scott Lakin, Lakin Consulting
  31. 31. Margaret T. Donnelly, Director, Department of Health and Senior Services
  32. 32. Business and Technical Operations
  33. 33. Karl Kochendorfer, MD, University of Missouri - Columbia
  34. 34. Ian McCaslin, MD, Director, MO HealthNet Division </li></ul>14<br />
  35. 35. 15<br />Missouri’s Action Plan<br />6 Coordinated Planning Tracks<br /><ul><li>Establish governance and decision-making process
  36. 36. Develop privacy and security plan
  37. 37. Develop technology plan
  38. 38. Develop financing plan
  39. 39. Develop EHR adoption plan
  40. 40. Develop consumer engagement plan</li></ul>3 Key Work Products<br /><ul><li>State HIE Plan
  41. 41. Strategic
  42. 42. Operational
  43. 43. State Medicaid Plan
  44. 44. Regional Extension Center
  45. 45. EHR adoption plan</li></ul>Health IT is the enabler, not the result<br />
  46. 46. Operational Plan<br />Strategic Plan<br />State HIE Grant Application<br />Letter of Intent Submitted<br />Submit Application to HHS<br />Submit Strategic Plan to HHS<br />Project Initiation<br />Submit Operational Plan to HHS<br />Executive Order 09-27<br />Publish Draft Strategic Plan for Review/Comment<br />Begin Landscape Assessment & Interviews<br />Publish Draft Operational Plan for Review/ Comment<br />Statewide Kickoff Meeting <br /><ul><li>Support State application process
  47. 47. Conduct stakeholder interviews
  48. 48. Establish MO-HITECH
  49. 49. Establish Advisory Board
  50. 50. Convene Workgroups
  51. 51. Draft Strategic Plan
  52. 52. Publish Draft Strategic Plan for Review
  53. 53. Develop detailed project timeline and work plan
  54. 54. Engage and educate stakeholders
  55. 55. Convene Advisory Board & Workgroups
  56. 56. Draft Operational Plan
  57. 57. Publish Draft Operational Plan for Review
  58. 58. Update project timeline and work plan
  59. 59. Engage and educate stakeholders </li></ul>Funding Announcement<br />16<br />
  60. 60. 17<br />Missouri’s Health Information Exchange:A Strategic and Operational Roadmap<br />
  61. 61. MO-HITECH Approach to Statewide HIE<br />Approach<br />Statewide Network Comprised of Diverse Qualified Organizations <br />Market Determines Structure – Statewide HIO Backfills<br />Statewide HIO is the Market<br />Qualified HIOs given Exclusive Territories – Statewide HIO Provides Governance, Outreach<br /><ul><li>Range of “qualified organizations” pursuing regional or localized exchange are core structure
  62. 62. Statewide HIO provides statewide policy guidance, core services to enable interoperability
  63. 63. Statewide HIO leads collaborative governance with Qualified Organizations
  64. 64. Abandon core services focus, leaving the private market to address interoperability
  65. 65. Provide backfills where market fails to assure ‘No provider left behind’
  66. 66. Focus on education, convening, and statewide policy guidance
  67. 67. Divide Missouri into markets/territories assigned to existing HIOs, new HIOs or the Statewide HIO
  68. 68. Statewide HIO provides governance, manages monopolies for public good
  69. 69. Statewide HIO may provide core services to Qualified Organizations
  70. 70. Statewide HIO is primary vehicle for HIE
  71. 71. Statewide HIO builds infrastructure, consolidates HIOs for economies of scale
  72. 72. MO HIOs focus on local governance, adoption</li></ul>Given the relatively nascent HIE market in Missouri and the desire to pursue an effective public-private governance model, Missouri intends to develop a <br />“Statewide Network Comprised of Diverse Qualified Organizations.”<br />18<br />
  73. 73. Governance: Board of Directors<br />Statewide HIE in Missouri will be governed by a collaborative multi-stakeholder organization – the Missouri Statewide Health Information Organization (MSHIO).<br />Not-for-profit – 501c3 – public/private partnership<br />15-member MSHIO Board appointed by MO-HITECH Advisory Board June 30<br />13 private sector representatives<br />2 state representatives<br />Consumer advocates and providers must be represented on the Board at all times<br />Draft articles of incorporation and bylaws completed<br />19<br />
  74. 74. 20<br />Governance: Qualified Organizations<br />Missouri Statewide Health Information Organization (MSHIO) will be comprised of “qualified organizations” as participating members.<br /><ul><li>A qualified organization is a health care organization or aggregator of health care providers that is capable of fulfilling certain obligations and requirements:
  75. 75. Technical, legal, policy and procedural obligations as defined by MSHIO
  76. 76. Willing to enter into a binding contract with MSHIO</li></li></ul><li>21<br />Governance: Qualified Organizations<br />Qualified organizations may be, but are not limited to:<br /><ul><li>Provider networks:
  77. 77. Hospitals, health systems, provider groups, FQHCs/RHCs, regional HIOs, etc.
  78. 78. Private, non-provider networks:
  79. 79. Clearinghouses, payors, vendors
  80. 80. Medicaid and Missouri State Employee Health Plans</li></li></ul><li>Statewide Network Comprised of Diverse Qualified Organizations<br />NHIN Gateway<br />Interstate Connectivity<br />Clinic<br />Clinic<br />Labs<br />Hospitals<br />Physician<br />Groups<br />Clinics<br />Public Health<br />Hospital System<br />Lab <br />Enterprise<br />Private<br />Network<br />Payers<br />Long Term<br />Care<br />EHR Light<br />Missouri Statewide Health Information Exchange Network<br />FQHC<br />Provider<br />Consortium<br />Hospital<br />Rural Health<br />Center<br />Labs<br />RHIO<br />Medicaid<br />RHIO<br />Clinical<br />Lab<br />Lab<br />MMIS<br />Eligibility<br />Paid <br />Claims<br />Hospital<br />RHC<br />FQHC<br />Hospital<br />RHC<br />Cyber <br />Access<br />22<br />22<br />22<br />
  81. 81. Consumer Engagement<br />MSHIO is committed to utilizing health information exchange to empower Missourians to take a more active role in their own health care. <br /><ul><li>Consumer advocates will be represented on the MSHIO Board
  82. 82. Consumer Advisory Council will be established
  83. 83. Consumer engagement and information strategy will be developed</li></ul>23<br />
  84. 84. Technical Infrastructure: Principles<br />MSHIO will support the development of regional HIE (qualified organizations) efforts while linking those networks together to enable statewide exchange of health information.<br />Principles<br />No provider left behind<br />Alignment with meaningful use<br />Interoperability and accessibility <br />Leverage resources – public and private <br />Consistency with national standards<br />24<br />
  85. 85. Technical Infrastructure: Services<br />MSHIO will provide core infrastructure services to support health care transactions, information exchange and help meet meaningful use requirements for providers.<br /><ul><li>Core infrastructure and services:
  86. 86. Provider registries and Master Patient Index (MPI)
  87. 87. Secure messaging and clinical information exchange
  88. 88. Consent management
  89. 89. Electronic access to Medicaid data
  90. 90. Reporting services
  91. 91. Potential value-added services:
  92. 92. Electronic lab ordering and results delivery
  93. 93. Electronic prescribing (e-prescribing)
  94. 94. “EHRLite” web viewers for providers without EHRs</li></ul>25<br />
  95. 95. Legal/Policy: Patient Consent Model<br />Evaluation and final decision related to an opt-in versus opt-out model is complex and must consider the following:<br />Consumer and provider trust<br />State and federal requirements<br />Clinical value of the information<br />Technical feasibility and cost<br />Administrative burden and implementation cost<br />Preliminary recommendation is that MSHIO utilize an opt-in patient consent framework.<br />26<br />
  96. 96. Finance: Funding and Sustainability<br />To date, Missouri has received notice of federal funding for $22.3 million:<br /><ul><li>$13.8 million planning and implementation grant
  97. 97. $1.7 million Medicaid IT planning grant
  98. 98. $6.8 million for Regional Extension Center
  99. 99. These funds represent “seed money” for the planning and implementation of statewide HIE and provides for meaningful use and adoption of EHRs.
  100. 100. A model and plan is being developed to ensure there is long-term financial sustainability for operating the MSHIO.</li></ul>27<br />
  101. 101. 28<br />Finance<br />A six year all-in cost model for statewide HIE<br />
  102. 102. Finalize and submit MSHIO Operational Plan to ONC (June 30)<br />Appoint MSHIO Board of Directors (June 30)<br />Incorporate MSHIO (July)<br />Recruit executive staff (July-October)<br />Develop and release Request for Proposal (RFP) for technical infrastructure and core services (July-October)<br />Coordinate with Missouri HIT Assistance Center, Medicaid and Missouri’s border states (ongoing)<br /><ul><li>Visit for more information</li></ul>Next Steps <br />
  103. 103. 30<br />