Alabama’s One Health Record® Update

 Alabama TeleHealth and Rural Summit     Leveraging Electronic Exchange to Benefit Alabama Outcomes

Gary D. Parker, Presenting Director, Alabama Medicaid Health IT Division

October 18, 2013

Today’s Roadmap

• Agenda• Alabama’s One Health Record® – A HIE Review– Current Events– A Look Ahead

• A “Dick Tracy” Demo• Next Steps – “Engagement”• Questions

• Alabama’s state-wide Health Information Exchange (HIE).– The Alabama HIE is not associated with and not part of the Affordable Care Act (ACA)

or the Health Insurance Exchange.

– In April 2012, One Health Record became fully operational for live PHI exchange and now stands ready for large-scale utilization. Alabama state-wide initiative (Multiple Stakeholders)

– Three integrated parts (“Bicycle Wheel”)• HIE Core Framework (“Hub”) • Provider EHR/EMR systems (“Rim”)• Interface links between the Hub and Rim (“Spokes”)

– Information can be exchanged in either of two ways:• “Pushes” patient information using Direct Message (Secured E-mail with

attachments).• “Pulls” PHI using the Patient Search Process (Query – more Robust)

Alabama One Health Record®

• Alabama’s state-wide Health Information Exchange (HIE).

– Serves as the intermediary “Trusted-Provider-in-Fact” for electronic PHI exchange.

– The system and framework to permit all health care providers to securely share patient PHI electronically to improve outcomes through improved care coordination using Electronic Health Record (EHR) systems.

– It is a certified, standards-base technology that is HIPAA and MU2 compliant.– It is connected to Federal Health Information Network (The eHealth

Exchange).– Directly supports the EHR Meaningful Use Incentive Payment program

Money to Providers and Hospitals to buy EHR systems 140 Payments to Eligible Hospitals (EH) totaling : $ 91M 1,566 Payments to Eligible Providers (EP) totaling : $ 25M

Alabama One Health Record®

So….Why One Health Record® Integration?

• Landscape Factors– Patient Care through electronic PHI– Health Payment Reform – Incentivize Community Care to prevent

unnecessary Hospitalization – Better Care Coordination = Better Outcomes– Life cycle of care – Complete Care programs– Tele-health – Telemedicine – continues to grow – MU 2 requires CCDA sharing outside own system (DSM or HIE)

– 29 State HIE’s will be Nodes on eHealth Exchange by mid 2014.

– Ala, Ga, SC, WV, PA all have the same Tech platform.

• Transitions of Care 1. EHR approach – Publish CCDA to the HIE.

2. Use DSM (PHI e-mail) for a point-to-point exchange.

One Health Record® - Today

• In operation since April 2012

• Current patient population: 1,000,000

• Production Node on eHealth Exchange (national network)

• Jackson and EAMC are live; UAB: late October.

• East Alabama Care Network (health home) connected (DSM)

• North Alabama CC Network moving to DSM)

• 8 CMHC’s – 2 more in the Queue (DSM)

• 862+ PHI exchange DSM’s since March 2013, 251 Queries

• We our connected to Fla, SC, WV, Ga for DSM.

• National Provider Directory

• HIE Analytics – Utilization and Population Health.

Alabama One Health Record® Beyond Today…the Next Phase

One Health Record – Phase II (Tomorrow)

• Hospitals moving ahead : Brookwood , Huntsville, Infirmary Health,

Children’s, Eliza Coffee/Shoals, Highlands, Springhill, St Vincent’s, DW

McMillian. CMHC’s and others increasing use of DSM for now.

• IMZ, ELR, Syndronmic reporting to the ADPH Registries .

• Tele-Medicine use will increase – Virtual Travel with Virtual Records

• Patient Portal and expansion of Provider Directory functionality

• Anticipate Interstate HIE connections with Fla and Ga within 12 months.

• Pursuing DSM Interstate connections with Miss, Michigan, and La by early 2014.

• RCO’s home health networks will be connected to One Health Record®

• Quality Rpt Document Architecture (QRDA) component to the CCDA framework – CQM capture.

• Other Services Patient alerts CCDA parsing for

One Health Record – Phase II Challenges of Tomorrow

• HIE Sustainability and Governance– Industry Landscape (CommonWell & EPIC) – All Payers involved– Transition to value-based care models

• Provider Workflow integration– Productivity impact– Engagement ( Adoption and Use)

• Building the “Spokes”– Waiting for True “Plug & Play” Standards– Provider EMR/EHR interoperability – Adapter for each vendor system (61 used

in Alabama).

One Health Record

PCP

PSYCHIATRISTEHR

EHR

MPI

CDA

QUESTIONS?

Gary D. Parker Alabama Medicaid Agency

gary.parker@medicaid.alabama.gov. Phone: (334) 242-5011 Meghan Youngpeter

meghan.youngpeter@medicaid.alabama.gov. Phone: (334) 353-4463

www.onehealthrecord.alabama.gov