Louisianas Vision for Health Information TechnologyJoshua Hardy State Health IT Coordinator

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS*Still miles to go

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS

Source: Blumenthal, D.B. (2010) Launching HITECH, New England Journal of Medicine.

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS*The Challenge.

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS

Incentivize adoption of EHRsSecurely exchange health information among disparate IDNs/providersUtilize HIT platforms to collect quality improvement measures and perform analytics

Innovations in care delivery as specified in ACA also provide incentives for using information most easily obtained through EHR-based organizationsCertified EHRs have QM built-in.CMS plans to test the ability of EHRs to submit clinical quality data for inpatient hospital quality measures, and to test its technical ability to accept data from EHRs on the following measurement topics:Emergency Department Throughput StrokeVenous Thromboembolism (VTE)

*The Original Health Information Exchange still going strong.

*Source: 2012 National eHealth Collaborative Stakeholder Survey

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS*

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS

Source: 2012 National eHealth Collaborative Stakeholder Survey

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS*

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS

Source: 2012 National eHealth Collaborative Stakeholder Survey

The Office of Standards & InteroperabilityTo help build nationwide EHRinteroperability,the Office of Standards & Interoperability (OSI) at the U.S. Department of Health and Human Services works to:Encourage development of health IT standardsMove toward the seamless exchange of health dataacross all stakeholders: Federal agencies; State, local, and tribal governments; and the private sectorTo achieve these goals, OSI's roles include:Enabling stakeholders to come up with simple, shared solutions to common information exchange challengesCurating (overseeing) a portfolio of standards, services, and policies that accelerate information exchangeEnforcing compliance with validated information exchange standards, services, and policies to assure interoperability among validated systems

Access to additional clinic data through HIE in ED settings is associated with net societal saving.HIE access reduced overall costs by $1.07mHospital admission reductions accounted for 97.6% of total cost reductionsHIE use resulted in 412 fewer admissions than would have been predicted to occur without HIE useSource: Frisse, M.E., Johnson, K.B., et al. (2011) The Financial Impact of Health Information Exchange on Emergency Department Care, Journal of the American Medical Informatics AssociationAcross all insurance types, EHR sites were associated with significantly higher achievement of care and outcome standards and greater improvement in diabetes careThese findings support the premise that federal policies encouraging the meaningful use of EHRs may improve the quality of care across insurance typesSource: Cebul, R.D., Love, T.E., et al. (2011) Electronic Health Records and Quality of Diabetes Care, New England Journal of Medicine.

State-wide P4P programsForecast Prevent OutbreaksTarget InterventionsCoordinate Systems of Care

It is really about ENGAGEMENTColleaguesPolicy MakersProvidersNeighborhoodsConsumersFuture Partners

Identifying OpportunitiesBalancing ScorecardsTargeting CommunitiesPredicting FailuresInteragency Collaboration

Helping consumers take control of their health and health careHelping communities and governments improve the Publics Health

The Louisiana Code-a-thon April 26-28, 2012 University of Louisiana at Lafayette Research Park, Lafayette, LA CREATE, INNOVATE and CELEBRATE with us! $25,000 Grand Prize and U.S. Health Datapalooza Qualifying Entry for Cajun Code Fest2012 Winner!

Joshua HardyState Health IT Coordinator225-571-8274joshua.hardy@la.gov

*Ill also give a brief overview of some of the innovative ways the Department is using health information and its own data to transform the health care delivery system*2005 legislation created the Louisiana Health Care Redesign Collaborative. Out of this collaborative the Louisiana Health Care Quality Forum was formed to be the state designated entity for health information technology initiatives, among other things.*Angola Prison***Improved individual and population health outcomesIncreased transparency and efficiencyImproved ability to study and improve care delivery

**Epic Systems Corporation - EpicCare Inpatient - Core EMR 2010Certifying ATCB: CCHIT|CHPL Product Number: CC-1112-574355-1 Classification: Complete EHR|Practice Setting: Inpatient A Complete EHR or EHR Module designed for an inpatient setting must include and will be required to be tested and certified to all of the clinical quality measures specified by CMS.

The need to leverage information technology in the healthcare industry is huge as the quality of care and efficiency benefits that come with computerization can really make a difference in the overall patient experience.

CMS is to assess the feasibility of collecting data elements for inpatient measures via electronic health records as a future alternative to submission of manually abstracted chart data elements by hospitals, thereby potentially reducing the administrative burden associated with submission of quality measures for quality data reporting programs.

***health information administrators have been described to "play a critical role in the delivery of healthcare in the United States through their focus on the collection, maintenance and use of quality data to support the information-intensive and information-reliant healthcare system.

But the main goal is still to analyze, manage, and utilize the information that is essential to patient care and making sure the providers can access the information when necessary.

*Angola Prison**This is a photo of health records maintenance without the use of technology. Can we really say this is more secure than encrypted electronic data?**Where Standards Matter MostIn creating an interoperable health IT environment, standards are particularly critical in four areas of EHR technology:How applications interact with users (such as e-prescribing)How systems communicate with each other (such as messaging standards)How information is processed and managed (such as health information exchange)How consumer devices integrate with other systems and applications (such as tablet PCs)

***Study consisted of 12 EDs in Memphis over a 13-month periodAccess to HIE data was relatively low (6.8%) because the data were not integrated into and presented through the many different EHR systems within the region.*Appraise innovative services and initiatives health information exchanges are exploring to propelled them into the future:Statewide P4PHIE acts as the neutral convener between providers and payers (BCBS, Medicaid, CMS, etc) to collaborate and design standard metrics by which providers and plans are evaluated for their value-based care. Eliminate 100s of measures for various reporting initiatives. There will now by the essential few metrics that all will evaluate against. Providers can now focus on moving the agreed upon measure and mobilize appropriate QI projects

2. Forecast/Preventive AnalyticsMove from reacting to events (community outbreaks, nosocomial infections, health care never events) to forecasting and prevention through integration information systems available for next generation analytics and scholars3. Targeted InterventionsProviders will be able to see burden of disease for population and build appropriate business ventures to address opportunities for improved care and market dominance. This is moving beyond generic market share analysis

4. Coordinated Systems of CareWorkflows, coverage, gaps, etc can now be systemically addressed through collaboration among players.

*Its What We Do With It That MattersWe Engage to inform decision making, to improve care, and improve outcomes

*Interagency Collaboration*Our new EatSafe site empowers residents to make informed decisions about where they eat and to become partners with us and our state's restaurants to help prevent food-borne illness.Health inspection reports have always been public record, but prior to the release of this website, residents had to request copies from the parish health unit in their area and then go to the health unit to view them.

*Blue ButtonObesityConsumer Survey via exchangeTruly patient centered medical homes*The purpose of Data.gov is to increase public access to high value, machine readable datasets generated by the Executive Branch of the Federal Government. As a priority Open Government Initiative for President Obama's administration, Data.gov increases the ability of the public to easily find, download, and use datasets that are generated and held by the Federal Government. Data.gov provides descriptions of the Federal datasets (metadata), information about how to access the datasets, and tools that leverage government datasets.A primary goal of Data.gov is to improve access to Federal data and expand creative use of those data beyond the walls of government by encouraging innovative ideas (e.g., web applications). Data.gov strives to make government more transparent and is committed to creating an unprecedented level of openness in Government. The openness derived from Data.gov will strengthen our Nation's democracy and promote efficiency and effectiveness in GovernmentWhat is blue button? The blue button approach is a simple concept: A patient is provided with a highly visible, clickable button to download his or her medical records in digital form from a secure website offered by their doctors, insurers, pharmacies or other health-related service. People can log into this secure website to view and have the option to download their health information, so they can examine it, check it, and share it with their doctors and others as they see fit. The blue button download capability is a tool that can help individuals get access to their information so they can more effectively participate in and manage their health and health care.

Out of a collaboration convened by the Markle Foundation, several agencies of the federal government have taken leadership roles in modeling this practice. The U.S. Department of Veterans Affairs, Medicare, and TRICARE already offer hundreds of thousands of individuals a blue button to download their medical records or claims information from their secure websites. Now several other organizations both public and private sector are pledging to offer similar download capabilities for their patients and members.

*The Cajun Code Fest 2012 is a FREE two-day coding competition focusing on transforming "data into health care solutions, specifically addressing childhood obesity. This exciting coding marathon will bring together innovative thinkers and programmers of all types: professional software developers, software designers, undergraduate and graduate students, health care leaders, educators, and entrepreneurs. Participants will organize themselves into teams, either before arriving or during the event, and over a 36-hour period will build exciting new prototypes and tools for improved health care.

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