5/20/2015 Colorado Health Information Technology Overview - - PDF document

5/20/2015 Colorado Health Information Technology Overview - Electronic Health Records and Public Health S ettings May 20, 2015 Chris Wells, CDPHE Public Healt h IT Direct or Topics • Overview of Health IT in Colorado • Health and Health IT timeline • Overview of LPHA EHR initiative • Discussion and Input • Path to EHR • Timeline • Next steps History –Health and HIT Policy State of Health 2013 State of Health 2013 Affordable Care Act 2010 Affordable Care Act 2010 Colorado is building on our collective strengths of innovation Comprehensive health insurance and collaboration to create a reforms improving quality and comprehensive and person- lowering health care costs, protecting centered statewide system to make consumers, and Colorado the healthiest state improving access to care ARRA HITECH 2009 ARRA HITECH 2009 Medicaid Expansion 2012 Medicaid Expansion 2012 The Health Information Technology for Economic and Clinical Health Colorado expanded Medicaid (HITECH) Act established Office of the coverage and established a State- National Coordinator for Health It into based Marketplace, known as law and provides Health and Human Connect for Health Colorado Services with authority to establish programs to improve health care quality, safety, and efficiency through the promotion of health IT 1

5/20/2015 History - HIT portfolio criteria Integration, Interoperability, and Unification Integration, Interoperability, and Unification Int egr at ing t echnology int o key wor kf low Using of t echnology t o suppor t dat a Pr esent ing inf or mat ion in an opt imized envir onment Benefits When fully functional and interoperable, EHRs have the capability to:  Improve quality and patient safety,  Increase patient participation EHR HIE in their care,  Improve accuracy of ordering An Electronic Health and interactions with alerting, Health information exchange Record is a digital version  Increase information to is the mobilization of of a patient’s paper chart improve health outcomes, healthcare information enabling the information to  Improve care coordination, electronically within a region, be available instantly and  Increase practice efficiencies community, network, or securely to authorized and cost savings with reduced among public/private data users. EHRs are built to faxing, paper work, and view systems. share information with into patient’s medical history, other providers in more and than one health  Support discreet data capture. organization, such as labs, imaging settings, and pharmacies. H EALTH I NFORMATION T ECHNOLOGY IN C OLORADO Kate Kiefert State HIT Coordinator, EHR Adoption 84% Governor’s Office Support alignment and coordination of Health Information Meaningful Use (Professionals) 56% Technology policy, strategies, investments, and program implementations Meaningful Use (Hospitals) 96% HIT Programs • HIT Budget Requests •Governance •Interoperability (HIE) ePrescribing 60 % •State Innovation Model •Meaningful Use (ph reporting) •Technology Adoption 2

5/20/2015 Overview Health Information Technology in Public Health • For decades, public health agencies and research institutions have been utilizing information technology (IT) to facilitate data management activities (data gathering, analysis, reporting, etc.). • Public health information systems are created to support specific needs of disease-specific program areas within health departments • These systems deploy various software products that are often custom- made and are not interoperable. • Many of these systems contain redundant data; however, the varying data formats and standards preclude data integration across systems for public health decision support and research. • These systems lack the ability to provide real-time data back to providers for care coordination and disease prevention. History – Health and HIT Investments FY 14-15 HIT Budgets FY 14 15 HIT Budgets State Innovation Model State Innovation Model Center for Medicare and Medicaid • DOC Offender/Parolee Innovation (CMMI) Funding Management & EHR opportunity for a State Innovation • CDPHE EHR for LPHAs Model integrating physical and • HCPF R-5 Maximizing HIE behavioral health, improving • DHS MHI EHR population health, and creating a quality and cost data strategy Waiver of OMB Circular A87 Waiver of OMB Circular A87 CBMS & PEAK CBMS & PEAK Cost Allocation Rules Cost Allocation Rules Investments in Colorado Benefit CMS provide a three-year extension of the Management System, Program A87 waiver authority for cost-allocation Eligibility and Application Kit , and to enable states to complete their work on interfacing with Connect for Health eligibility and enrollment systems Colorado supporting ACA and integration through Medicaid Expansion December 2018 Overview EHR for LPHAs FY 14-15 CDPHE secured funding for elect ronic healt h record (EHR) for Local Public Healt h Agency use Opportunities • S t andardized, elect ronic care delivery dat a capt ure • Direct report ing t o t he st at e public healt h • Elect ronic ordering (labs, eRx) • Analyt ics of populat ion • Immunizat ions document at ion • Document at ion of populat ion • Communicat ions wit h pat ient s – t est result s, follow up • Appoint ment s 3

5/20/2015 Path to EHR Communication Communication Onboarding START Key stakeholder input • S takeholder meetings • S urvey Communication to Directors Build/Design Implementation Testing/Training Leverage program avenues for additional pathway Ongoing communication to Ongoing Support keep LPHAs informed FINISH Discussion Int erest ed? • LPHA wit h no EHR • LPHA need replacement EHR • LPHA no EHR need • LPHA connected to hospital, community health centers, and/ or school based clinics • Differing types of services provided • Clinical care for individual clients • Regional population information • Care coordination Programs • Family Planning • HIV/ STI screening • Breast / Cervical Cancer screening referral • Adult and child immunizat ions • MCH: Healt h Care Program for Children wit h Special Needs, Child Healt h, Perinat al Healt h • Nurse Family Part nership (align wit h ot her st at e programs) – will require mobile access • Ot her communit y specific programs • Communicable diseases (needs report ing t o CEDRS) • TB regist ry • MH/ BH – access t o psychot ropic drugs • May be opport unit y for shared formulary and collect ive purchasing 4

5/20/2015 Requirements (draft as of 01252015) • 2015 Certified EHR Technology • Need to determine if any LPHAs may be eligible for MU • Connect with Tracy McDonald during stakeholder engagement process • Must ensure EHR is available for care management, clinical decision support, operations management and communication, clinical support, measurement, analysis, reports, administrative and financial. • Ordering/ resulting interfaces (Lab, Rad, ePrescribing) (less priority than direct reporting to state registries) • Direct reporting to state public health registries (priorities) • Immunizations (CIIS ) (1) • CEDRS • iCare (req’ d for Title X, family planning) • WIC (and other benefit eligibility programs) • Women’ s Wellness Connection • Breast/ Cervical Cancer S creening • Option 1 –direct reporting interface, S FTP to registries • Option 2 –replace/ supplement registries with EHR capture Requirements (continued) • Integration • Communication with other providers (eConsult) • Access to Community Health Record for longitudinal health view • HIE • Link to other LPHA systems (e.g. accounting) (less priority than reporting to state to reduce dual entry) • S cheduling, billing • Population health analytics (need access to regional data) • S creenings • Developmental • HIV/ S TD • Nurse Family Partnership • MCH: Health Care Program for Children with S pecial Needs, Child Health, Perinatal Health • Must have some flexibility for configuration, but benefit to single platform includes standardized data capture (reemphasized) Requirements (continued) • Technical infrastructure - Application S ervice Provider (AS P hosting) - With a hosted solution, the vendor handles all the technical details and deliver the applications, services, and support • Operational Support • Testing • Training • Implementation • Maintenance/ Operations • Help desk 5

5/20/2015 Timeline EHR implementation timeline April- June 2015 2016 Communication to LPHA stakeholders Communication EHR vendor contract finalized Training Build design sessions planned Implementation/Rolling Go Live Onboarding plan finalized Ongoing Support February –March 2015 Q3 - Q4 2015 Stakeholder input: LPHA Onboarding Programs/Directors Build/design Survey interest in use of EHR Testing/Training Implementation 0 7 Next steps Current ly planning • Ident ify t echnical/ t raining resources • Det ermine subscript ion fees? Per user license fee? • Develop User groups t o help improve usage S urvey • Primary LPHA Cont act s • Int erest • Programs • Priorit ies Communicat ion how t o sign up Quest ions • Kat e Kiefert , kat e.kiefert @ stat e.co.us • Chris Wells, chris.wells@ st at e.co.us • Jean Billingsley, j ean.billingsley@ st at e.co.us • S ubj ect Line: LPHA EHR 6