1. Health Information Technology The Texas Landscape Presentation to TASSCC 2010 Nora Belcher Texas e-Health Alliance August 3, 2010

2. Health Information Technology Overview Background Vision for HIE Texas Landscape Future Activities Page 2

3. Background Terminology Most discussion of health IT falls into two categories: – Electronic health records – Promoting the adoption and use of electronic health records (EHRs) by doctors and hospitals. – Health information exchange – Establishing and promoting the use of electronic health information exchange (HIE) networks across which health care providers can share health information electronically The federal government officially makes a distinction between electronic health records and electronic medical records but most people (including the federal government themselves), uses them largely interchangeably. Page 3

4. Page 4 Background Planning and Policy Development – Federal Initiated through April 2004 State of the Union address Furthered through the creation of the Office of the National Coordinator for Health Information Technology Ongoing federal health IT initiatives  Open, deliberative policy development process (Health IT Policy Committee)  Certification and standardization (Health IT Standards Committee)  Health information exchange pilots (Nationwide Health Information Network)  Privacy & security (Health Information Security and Privacy Collaboration)  New health IT initiatives through the ARRA

5. Page 5 Several new health IT initiatives created and funded through the American Recovery and Reinvestment Act of 2009 (ARRA)  Electronic health record incentives (estimated $36-$46 billion)  Health information infrastructure ($2 billion) State grants for HIE planning and implementation Health IT regional extension centers Health IT workforce program Background Planning and Policy Development – Federal

6. Page 6 Electronic health record incentives (estimated $36- $46 billion)  Incentives for the adoption and use of electronic health records by hospitals and physicians through Medicaid and Medicare (estimated $36-$46 million)  HHSC submitted Advanced Planning Document to CMS to support the development of a State Medicaid Health IT Plan (SMHP), which was approved. Background Planning and Policy Development – Federal

7. Page 7 H ealth information technology allows comprehensive management of medical information and its secure exchange between health care consumers and providers. Broad use of health IT will: Improve health care quality; Prevent medical errors; Reduce health care costs; Increase administrative efficiencies; Decrease paperwork; and Expand access to affordable care. * *U.S. Department of Health and Human Services Vision for HIE: Federal

8. Page 8 A healthcare system supported by a technological infrastructure made up of: - Ubiquitous, interoperable, electronic medical records composed of structured data elements; and - A secure network to support the exchange of health information among providers. Vision for HIE: State

9. Common elements and bottom line: – Nationwide, interoperable, electronic health information networks – Secure and private – Right information, right provider, right time – Full geographic and population coverage of HIE capacity Cost/benefits studies – Estimated $77.8 billion annual, national savings from an electronic health information infrastructure. – Estimated $14.2 billion annual, Texas savings from an electronic health information infrastructure. Page 9 Coordinated Vision for HIE

10. Page 10 State HIE Cooperative Agreement Program $28.8 million – HHSC/ Office of e-Health Coordination (OeHC) Medicaid Health IT Plan/EHR Incentive Payment Program $4.5 million planning – HHSC/Medicaid Health IT Regional Extension Centers (REC) $35.7 million – 4 awards Strategic Health IT Advanced Research Projects (SHARP) $15 million – UT Health Science Center, Houston Beacon Community Program 8 Texas applicants, 0 awards Health IT Workforce Grants $5.4 million – Texas State University, San Marcos Texas Landscape: State Funding and Projects

11. Page 11 Alre ady-deployed HIE assets – 16 identified local HIE initiatives at many different stages of planning, implementation, and operation Sometimes called Regional Health Information Organizations (RHIOs) – State (or higher) –level data sources/services, public and private Public (e.g., state immunization registry) Private (e.g., lab ordering portals, eRx networks, payer-based eligibility and benefits portals) Texas Landscape: Additional Components

12. What Does It Mean For You? Major open questions – Funding/sustainability – Achieving population and geographic coverage – network topology – Patient involvement in HIE – consent? How much? – Provider liability Impact on state agencies – Direct impact – Indirect impact Page 12

13. Page 13 Texas Legislative Activity Increasing interest in health IT in the Texas Legislature – Before 2005 – 0 health IT bills filed – 2005 – 1 health IT bill filed – 2007 – 6 health IT bills filed – 2009 – 30 health IT bills filed 81 st Regular Legislative Session (2009 ) – Health passport expansion – Electronic prescribing (also LBB report) – Medicaid-based HIE

14. Page 14 Future Activities The Texas path forward  State HIE planning and implementation grant  THSA and workgroups  Clear role for local HIEs  State Medicaid Health IT Plan development and implementation Other, Ongoing Texas state-level projects  Office of e-Health Coordination  Medicaid HIE Initiative Private-sector developments  Regional initiatives  Stakeholders (employers, payers, etc.)

15. Conclusion Background Vision Texas Landscape Future Activities Open questions Page 15

16. Questions? Nora Belcher Executive Director Texas e-Health Alliance nora@txeha.org (512) 536-1340 Page 16