1. Health Information Exchange: Alaska’s Health Pipeline Alaska Bar Association Health Law Section February 2, 2012 Carolyn Heyman-Layne

2. Alaska e-Health Network www.ak-ehealth.org Three Projects: –Regional Extension Center (REC) –FCC Project –Health Information Exchange (HIE) Today’s Presentation Focus: HIE

3. HIE in Alaska: SB133 AS 18.23.300 Created a Designated Entity that: –(i) has an advisory or governing body made up of health system stakeholders –(ii) applies for available federal and state funding for planning and implementation of the system authorized by the commissioner; –(iii) submits an annual budget for approval of the commissioner; –(iv) complies with nondiscrimination and conflict of interest policies; –(v) meets and complies with federal and state health information policies and standards; –(vi) provides cost and cost saving data associated with the development and use of the system to the department.

4. SB133 Continued… HIE planning also to include: –statewide infrastructure to support the HIE and to connect electronic health records (EHRs) to the infrastructure; –statewide technology plan, to promote the implementation and sustained use by public and private health care payors and providers of EHRs and the system established under this section in order to ensure interoperability among government-operated health information systems and other public and private health information and reporting systems; –policies and standards, consistent with federal & state law, to safeguard the privacy and security of health information; –training and workforce development plan for implementing and serving the system; –estimate of costs of the hardware, software, services, and support needed to implement and maintain the technical infrastructure.

5. SB133 Board Requirements DHSS Commissioner; eight other individuals, each of whom represents one of the following interests: –hospitals and nursing home facilities; –private medical care providers; –community-based primary care providers; –federal health care providers; –Alaska tribal health organizations; –health insurers; –health care consumers; –employers or businesses; and –two nonvoting liaison members from the Board of Regents of the University of Alaska and the commission established in the governor's office to review health care policy.

6. AeHN Implementation Efforts Workgroups –Consumer Advisory –Clinical Advisory –Technology –Privacy and Security Compliance (Audit) –Training –Legal Privacy and Security Policies: Network Responsibilities –Governs HIE Users –Separate from Privacy & Security Policies for AeHN Internally

7. Timeline of Events Spring 2010 – State of Alaska awards AeHN contract for $3.14M over 4 years to setup and provide a statewide Health Information Exchange. November 2010 – AeHN enters into contract with Orion for HIE services after RFP process. Spring 2011 – AeHN seeks additional funding for HIE from State legislature. $2.4M is appropriated for the HIE, June 29, 2011 – Governor Parnell reduces funding for HIE to $1.2M. September 2011 – ONC has changes requirements for HIE, no longer correlates to Orion contract.

8. What next? Direct Secure Messaging – ONC Mandated –Need 300 signed up and sending messages –Any healthcare provider can get a secure message box at no cost for first year –Great for referrals, exchange of records, etc. –Community and stakeholder support crucial Other aspects of HIE coming: –Connecting EHRs –EHR Lite –Patient Portal –Lab results –More…

9. Other Relevant Documents/Policies HIE Participant Agreement Secure Messaging Subscription Agreement Opt-Out Procedures and Forms Workgroup Charters (coming soon) www.ak-ehealth.org