Louisiana’s Vision for Health Information Technology Joshua Hardy State Health IT Coordinator

2004 – 2008 Broad strategic goals & principles Early entrepreneurial activity HITECH 2009 Major capacity goals and milestones Authorities, policymaking framework HIT/HIE Infrastructure investments (federal, state, local) PPACA Health Reform 2010 Comprehensive Policy Provisions (requirements, incentives) Investments to drive innovation Goals, milestones for demonstrating value-based system changes (using HIT)

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS 4 Still miles to go…

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

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS 6 The Challenge….

Incentivize adoption of EHRs Securely exchange health information among disparate IDNs/providers Utilize 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 organizations Certified 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 –Stroke –Venous Thromboembolism (VTE)

EHRs are the entry points into LaHIE Electronic Prescribing Laboratory ResultsCare Summaries Exchange of data with Patients/Consumers

11 The Original Health Information Exchange… still going strong.

12 Source: 2012 National eHealth Collaborative Stakeholder Survey

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS 13

Source: 2012 National eHealth Collaborative Stakeholder Survey

LOUISIANA DEPARTMENT OF HEALTH AND HOSPITALS 15

Source: 2012 National eHealth Collaborative Stakeholder Survey

The Office of Standards & Interoperability  To help build nationwide EHR interoperability, the Office of Standards & Interoperability (OSI) at the U.S. Department of Health and Human Services works to:  Encourage development of health IT standards  Move toward the seamless exchange of health data across all stakeholders: Federal agencies; State, local, and tribal governments; and the private sector  To achieve these goals, OSI's roles include: Enabling stakeholders to come up with simple, shared solutions to common information exchange challenges Curating (overseeing) a portfolio of standards, services, and policies that accelerate information exchange Enforcing 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 $1.07m  Hospital admission reductions accounted for 97.6% of total cost reductions  HIE use resulted in 412 fewer admissions than would have been predicted to occur without HIE use Source: 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 Association  Across all insurance types, EHR sites were associated with significantly higher achievement of care and outcome standards and greater improvement in diabetes care  These findings support the premise that federal policies encouraging the meaningful use of EHRs may improve the quality of care across insurance types Source: Cebul, R.D., Love, T.E., et al. (2011) Electronic Health Records and Quality of Diabetes Care, New England Journal of Medicine.

HIE/HIO (clinical) Public Health (surveillance) HBE/HIX (insurance) APCD/Administrative (insurance claims, inpatient, outpatient, ER visits) State-wide P4P programs State-wide Forecast Prevent Outbreaks Target Interventions Coordinate Systems of Care Link clinical to reporting services Link clinical w/ financial, detect FWA Claims, eligibility, non- claim fiscal transactions Safety Net opportunities

It is really about ENGAGEMENT Colleagues Policy Makers Providers Neighborhoods Consumers Future Partners

Identifying Opportunities Balancing Scorecards Targeting Communities Predicting FailuresInteragency Collaboration

Helping consumers take control of their health and health care… Helping communities and governments improve the Public’s 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 Fest 2012 Winner!

Joshua Hardy State Health IT Coordinator