State HIE Program

Chris MuirProgram Manager for

Western/Mid-western States

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Medicare and Medicaid Incentives and Penalties

State Grants for Health Information Exchange

Privacy & Security Framework

Standards & Certification Framework

Health IT Practice Research

Improved Individual & Population Health

Outcomes

IncreasedTransparency &

Efficiency

ImprovedAbility to Study &

Improve Care Delivery

HITECH Framework: Meaningful Use

Regional Extension Centers

Workforce Training

ADOPTION

MEANINGFUL USEMEANINGFUL USE

EXCHANGE

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The Federal GovernmentMU StrategyObstacle Intervention Funds Allocated

Market Failure, Need for Financial Resources

• Medicare and Medicaid Incentive Program for “Meaningful Use.” • $27 B*

Addressing Adoption Difficulties

• Regional Extension Centers• Health IT Research/Resource Center

• $643 M• $50M

Workforce Training• Workforce Training Programs • $118M

Addressing TechnologyChallenges and ProvidingBreakthrough Examples

• Strategic Health Information Technology Advanced Research Projects

• Beacon Communities Programs

• $60M• $235M

Privacy and Security• Policy Framework• New Privacy and Security Policies

Addressedacross allprograms

Need for Platform for Health Information Exchange

• NHIN, Standards and Certification• State Cooperative Agreement Program

• $64.3 M• $564M

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Goals for Health Information Technology

• Improved individual and population health outcomes

• Increased transparency and efficiency

• Improved ability to study and improve care delivery

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State HIE Program

• Four year program

• 56 states and territories were awarded

• $548 Million awarded in total

• Funding for HIE planning and implementation

• States need an ONC approved State Plan before federal implementation funding can be used

• ONC does not dictate how health information exchange is to be offered within a state (i.e., HIO model v. other models of exchange)

• Exchange must meet national standards

• Assist 56 states and territories to support providers in meeting the HIE stage 1 and 2 meaningful use requirements for Medicaid/Medicare incentives.

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Key Deliverables and Objectives for 2011

• Ensure that all eligible providers within every state have at least one option available to them to meet the HIE requirements for meaningful use in 2011.

– E-prescribing

– Receipt of structured lab results

– Sharing patient care summaries across unaffiliated organizations

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Core Principles for State HIE Program

• Supports privacy and security

• Focused on desired outcomes & driven by meaningful use

• Open to all, and supports all relevant stakeholder organizations, including providers in small practices, across a broad range of uses and scenarios

• Is operationally feasible and achievable - Builds on and from what is already working

• Adapts to emerging trends and developments

• Fosters innovation

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State Responsibilities for HIEs

States and SDEs shall use their authority, programs, and resources to:

• Convene and coordinate with stakeholders:– Analyze and fully understand the health

information exchange currently taking place within the state

– Determine how the state needs to move HIE forward – State HIE Plan

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State Responsibilities (cont’d)

• Facilitate the availability of HIE services and monitor and track meaningful use HIE capabilities in state (examples):

• % health plans supporting electronic eligibility and claims transactions

• % pharmacies accepting electronic prescribing and refill requests

• % clinical laboratories sending results electronically

• % health departments electronically receiving immunizations, syndromic surveillance, and notifiable laboratory results

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State Responsibilities (cont’d)

• Assure trusted information sharing• Align with Medicaid and other programs • Ensure consistency with national standards

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Recommended Roles for HIT Coordinator

• Develop and advocate for HIT policy to achieve statewide goals . Examples:

– Leverage state purchasing power such as mandates for state providers to e-prescribe and share medical records

– Use licensing requirements to encourage data exchange

– Ensure state policy and regulation protects patient privacy while enabling the data to be shared appropriately

• Coordinate Across the Federally Funded, State Programs. Examples:– Provide state leadership in establishing HIT strategies for reaching

health care outcome goals.– Advance operationally viable strategies to meet meaningful use goals

and assure appropriate use of national standards.– Encourage state program participation in planning and implementation

activities.

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Technical Assistance to States

• State HIE Forum

– All State HIT coordinators and State Designated Entities will participate (Medicaid is welcome)

– Forum acts as a Community of Practice Support Network

• Provides a “hub” for the states

• Provides a venue for shared learning

• Builds knowledge: emerging best practices, cross-cutting issues

• Fosters active collaboration, coordination among states and projects e.g. NGA/State Alliance, the National Academy of State Health Policy, AHRQ, HRSA, CMS etc

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Summary

• Meaningful Use is the policy imperative for HIT in improving the efficiency and effectiveness of health care

• State HIE program is to help providers meet HIE requirements for meaningful use and also support state objectives

• States are strategic partners for HIE across the US

• State HIT Coordinators play a vital role in ensuring the overall success of HIE

• Innovation is allowed across the states

• National standards compliance will enable inter-state exchange

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QUESTIONS?

Thank You