Blumenthal at HIE Summit: “Information is the lifeblood of medicine”

Blumenthal at HIE Summit:
“Information is the lifeblood of medicine”;
To meet with Alvarez of Canada Health Infoway
Declaring ”Information is the lifeblood of medicine,” National Coordinator of Health IT David Blumenthal spoke before 200+ participants at The College of Physicians of  Philadelphia on November 10, 2009. Blumenthal was continuing his six-month campaign to transform medical practice in the US, speaking at the site of the oldest professional medical society in America and the location for the Health Information Exchange Summit sponsored by the Consulate of Canada and its trade commissioner Vincent Finn.

“Practioners are only as good as their information to make a decision,” Blumenthal maintained. As a primary care physician for 30 years, Blumenthal said it’s “the vision of improved care that informs our policy,” not the implementation of technology.

Richard Alvarez, President & CEO of Canada Health Infoway, equivalent to the US Office of National Coordinator for Health IT (ONC), spoke of his goal of using innovative technology to improve health care delivery with the intention of achieving EHRs for 50% of Canadians by 2010. While a recent national report found that Infoway faced major challenges in reaching that goal (current implementation is 17%), Canada’s Auditor General wrote “Infoway has accomplished much in the eight years since its creation.”

Blumenthal told how he looked forward to meeting with Alvarez to compare notes in the near future and learn from Canada’s experience. Several other Canadian HIT leaders shared their experiences as well.

In addition, privacy and security, interoperability and meaningful use, and HIE sustainability were discussed by three panels of leading area and national leaders. Some highlights from these panels will be summarized in a later post.

Two days before releasing ONC’s fourth letter to the public, this one on information exchange, Blumenthal alluded to two key aspects that are still in the planning stages–a workforce transformation initiative to train as many as 50,000 people to assist in EHR implementation and an initiative on clinical decision support (CDS) sytems.  Closed two-day stakeholder workshop meetings were held in August to inform the direction of each of these initiatives, and reported on recently in e-Healthcare Marketing.

The HIE Summit was produced in conjuntion with Pennsylvania eHealth Initiative (PAeHI) led by Executive Director Mark Stevens. PAeHI’s mission is to provide leadership in the use of information technology to improve healthcare quality. Additional local partners included HIMSS Delaware Valley Chapter and AHIMA Foundation. Seventeen of 23 exhibitors were Canadian Health IT firms seeking business in the US.

Consulate of Canada: www.philadelphia.gc.ca
PAeHI: www.paehi.org
Canada Health Infoway: www.infoway-inforoute.ca
Office of Nat’l Coordinator of Health IT:  http://healthit.hhs.gov
The College of Physicians of Philadelphia: www.collphyphil.org
DV HIMSS: www.dvhimss.org
AHIMA Foundation: http://www.ahimafoundation.org/
PHIMA (PA version of AHIMA): http://phima.org

See Dr. Blumenthal’s November 12, 2009 Letter (#4) to the Public about Information Exchange on previous e-Healthcare Marketing post.

HIE Overview Video from Kansas, Useful for All States

HIE Overview Video from Kansas, Useful for All States
The Kansas e-Health Advisory Council saw an HIE Overview presentation on November 6, 2009,
that was posted earlier this week on the Kansas Health Information Technology Initiative site. The 45-minute presentation (with additional 15 minutes Q&A) appears quite informative for both novices and those involved more closely in the HIE world. Reminded that information exchange is a verb, and that Health Information Organization (HIO) is the entity that governs exchange.

Overview was produced by Greg Smith, instructor at Kansas State University and Greg Smith & Associates, who works on health issues and community health issues in rural communities; and Joe Brisson, of HIT Associates, who has guided HIE implementations at local, state, and federal levels, including a year leading Nationwide Health Information Network Trial Demonstrations under ONC.

Kansas HIT Initiative Multimedia Page
HIE Overview Webinar (wmv)
HIE Overview Slides (ppt)

The Kansas Web site is still in the building stage.

House Health Care Reform Bill includes Health IT Measures

“Affordable Health Care for America Act” (AHCAA) includes Health IT Measures
Bernie Monegain, of Healthcare IT News reported on November 9, 2009, on response of Medical Group Management Association (large and small practices), AMA, and insurance industry to the Health IT and other aspects of bill.
Joseph Goedert, HealthData Management, reports on November 9, 2009, the bill retains ”administrative simplification language to make more uniform the HIPAA transaction sets for claims and related transactions.”

Original summary from e-Healthcare Marketing, Nov 8, 2009: The 1990-page healthcare reform bill (US H.R. 3962), passed by the US House of Representatives late on November 7, 2009, includes several references to Health Information Technology, Electronic Health Records, Health Information Exchange, and the Office of the National Coordinator for Health IT.  Based on an initial scan, this post notes several of those health IT references and serves as a basis for a more thorough review. Comments, additions, and corrections are invited. Page numbers intended to indicate location in pdf file where the Health IT term is shown.

State Health Access Program Grants/Standardize Electronic Administrative Actions (p. 83)
Programs to “expand access to affordable health care coverage for the uninsured population in the State” in programs such as state insurance exchanges, community coverage program, reinsurance plan program, transparent marketplace program, automated enrollment program, innovative stratgies, and purchasing collaboratives.” Administrative Electronic Transactions need to be standardized by HIT Policy and Standards Committees in conjunction with ONC.

Study and Report on Methods to Increase EHR Use
by Small Healthcare Providers
  (p. 153)
Study and report on impact of options to increase use of EHRs such as higher reimbursement, promoting lower cost EHRs (including VA’s VisTa), EHR training, or implementation assistance.

Integration of Physician Quality Reporting and EHR Reporting (p. 407)
HHS Secretary to develop plan to integrate clinical reporting on quality measures relating to meaningful use of EHRs for a patient’s health and to identify gaps in quality and coordination of care.

Institute of Medicine Study of Geographic Variation in Health Care Spending and Promoting High-Value Health Care (p. 505)
IOM to recommend changes for Medicare per capita payments considering 9 elements, including “leveraging the use of health information technology.” 

Center for Comparative Effectiveness Research (p. 756)
Housed in Agency for Healthcare Research and Quality (AHRQ), Center for Comparative Effectiveness Research, will “conduct, support, and synthesize research…with respect to outcomes, effectiveness, and appropriateness of health services and procedures…” including pharmaceuticals, medical devices, medical and surgical procedures, and other medical interventions.” This will involve the use of registries, research data networks from electronic health records, and other electronic health data. The Center will diseminate the information to physicians and EHR vendors to “assist the users of health information technology focused on clinical decision support  to promote the timely incorporation of such findings into clinical practices and promote the ease of use of such incorporation.”

Public Reporting by Hospitals and Ambulatory Surgical Centers on Health Care-Associated Infections (p. 914)
Transmission of this information to be coordinated with ONC and Centers for Disease Control with systems established by HITECH act.

Improving Accountability for Approved Medical Residency Training (p. 943)
Training medical residents for meaningful use for improved patient care and increased quality of the health of the community.

Implementation of Best Practices in the Delivery of Healthcare: Center for Quality Improvement (p. 1324)
Center for Quality Improvement to be charged with identifying, developing, and implementing standards “for health information technology used in the collection and reporting if quality information (including for purposes of the demonstration of meaningful use of certified electronic health record (EHR) technologu by physicians and hospitals under the Medicare program…” 

Assistant Secretary for Health Information (p. 1335)
This new position will be responsible for collecting and reporting on key health indicators regarding the “Nation’s health and the performance of the Nation’s health care.” Will coordinate with “the head of the Office of National Coordinator for Health Information Technology to ensure optimal use of health information technology.”

Community-Based Collaborative Care Network Program (p. 1447)
One of the programs to expand access to healthcare, this one is focused on  reducing unnecessary use of emergency departments through a ”health information technology network to track patients across collaborative networks.”

National Medical Device Registry: Electronic Exchange and Use in Certified Electronic Health Records of Unique Device Indentifiers (UID) (p. 1509)
This amends the Food, Drug and Cosmetics Act to “establish a national medical device registry …to facilitate analysis of postmarket safety and outcomes data on each covered device.” While there may be exceptions, each covered device is to be identified by “type, model, and serial number or other unique identifier,” and indicated in EHRs and via information exchange.

Health Service for Urban Indians (p. 1877)
Grants to support health information technology to improve individual and community health of Urban Indians.

“Affordable Health Care for America Act” (1990 pages):
 (AHCAA) US H.R. 3962  (pdf)

ONC posts Slides/Transcript on Regional Extension Centers Technical Call

ONC posts Slides/Transcript on Regional Extension Centers Technical Call
Accessed on November 5, 2009, ONC posted the transcript and slides from the October 15, 2009  technical assistance call about the Regional Extension Center grant program. With final first-round applications due November 3, 2009 to those who received initial okay from their preliminary applications, the ONC expects to fund 20 to 25 centers according to the transcript. Awards for the first round are expected to be notified on December 11, 2009. Preliminary applications for the second round are due December 22, 2009. According to the transcript, ONC hopes to provide comments to those rejected ahead of that second round deadline, but encourages those rejected to apply again whether or not they have gotten specific comments back on the basis of their rejection.

ONC expects to soon post a list of those 11 REC applicants who have specifically requested they be posted on ONC site, and add others as those REC applicants request it. Meanwhile, e-Healthcare Marketing has posted several applicants that have been publicized, and will be accumulating a list of those from published accounts. Please add locations of those accounts in the comments section or send an email to the address listed in the About section of e-Healthcare Marketing.

ONC Regional Extension Center Program Technical Calls
Slides [PDF]
Transcript [PDF]

REC Deadlines, see e-Heathcare Marketing post.

Regional Extension Center Applicants

Previous e-Healthcare Marketing posts have mentioned REC applications from Oklahoma, Missouri, and University of Central Florida. Additional REC applications were mentioned in the 13 published State HIE Applications and collected on e-Healthcare Marketing. More to come later.

New Jersey Plan for Health IT, HIE Application to ONC Published

New Jersey Plan for Health IT, HIE Application to ONC
Published Oct 27, 2009

On October 27, New Jersey joined the list of states publishing their State HIE application to ONC. The New Jersey Plan for Health Information Technology recognized the readiness of four out of ten regional projects within the state as the foundation of the statewide proposal.

The four regional HIE projects, expected to be the “centerpieces for North, Central, and South Jersey,” are:
1. Camden HIE
2. Health-e-cITI-NJ
3. Northern and Central New Jersey HIE Collaborative
4. South Jersey HIE

Regional HIE Highlights:
1. Camden HIE
The Camden Coalition of Healthcare Providers has built a Citywide Health Database with 8 years of claims data from the three main hospitals within the city: Cooper, Lourdes, and Virtua.
2. Health-e-cITI-NJ
The Health Systems Workgroup of Newark comprised of the University of Medicine and Dentistry of New Jersey, Newark Beth Israel, St. Michael’s and the regional FQHC have adopted the HIE effort of Newwark Beth Israel. This will be opened up to inclooude East Orange, Elizabeth and Jersey City.
3. Northern and Central New Jersey HIE Collaborative
The Collaborative is to-date an ad-hoc collaboration of many hospital systems, provider organizations, and long term care facilities, and has come together to leverage existing Health Information Exchange capabilities used by Atlantic Health System. Members represent 29 facilities within health systems which include Atlantic Health, Saint Barnabas, Robert Wood Johnson, Hunterdon, Solaris, St. Clare’s, Somerset, VISTA IPA, Summit Medical Group, Trinitas, , and Aristacare.
4. South Jersey HIE
The South Jersey HIE is the collaboration between InfoShare, which is the  implementing RHIO and the Electronic Medical Record Exchange of South Jersey. Participing care systems include AtlantiCare, Shore Memorial, Cape Regional and South Jersey Health System hospitals, and Crestview and Seashore Gardnes Nursing Homes.

A state-wide HIE will be established in Phase Two to integrate the regional HIEs and cover the whole state. The plan projects a need for 8,500 additional health IT workers over the next five years to implement planned roll out of EHRs and HIEs in the state. The plan estimates $30 million will be required to implement the first phase of regional HIEs, $15 million to integrate hospital organizations not included initially, plus $8 million as startup costs for the state-wide HIE. The office of the governor has committed to put up to $4 million in the calendar year to get the plan moving.

NJ Plan for HIT Download Page (NJ HIT Commission Page)
NJ Plan for Health IT (785 page–pdf)

Additional notes/analysis to come later.

For other State HIE Plans and Applications to ONC, see this post on e-Healthcare Marketing.

State HIE Apps Published: Alabama, California, Florida, Kansas, Illinois, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Oklahoma, Tennessee, Utah, Washington

State Health Information Exchange Applications Published
Alabama, California, Florida, Illinois, Kansas, Maryland,  Minnesota, Missouri, New Jersey, North Carolina, Oklahoma,  Tennessee, Utah, Washington Start the List
We are collecting a list of State Applications filed with ONC for the State HIE Cooperative Agreement Programs that were due October 16, 2009. Please let us know via comments, or the email listed in the About Page, of any State HIE Applications that were officially published by the States and territories. Missouri added on Nov 11, 2009. Thank you.

STATES ARRANGED IN ALPHA ORDER

Alabama: –Web site –Abstract (pdf) –Governor’s Letter (pdf)  –Project Narrative (pdf) –Budget Narrative (pdf)  –Application (pdf)

California:   –Web site   –Strategic Plan (pdf)

Florida:Web siteApplication (pdf)Strategic and Operational Plans (pdf)HIE Letters of Support (pdf)

Kansas:Web site  –Application (pdf)  –Project Narrative (pdf)  –Budget Narrative (pdf)

Illinois:Web site   –Documents Package (8 pdfs)

Maryland:Maryland Health Care Commission Web site   –Application (pdf)  –Related MD HIT State Plan FY2010-13 (pdf)  –Maryland HIE/CRISP site

Minnesota:Web site  –Application (pdf)

Missouri: Web site  –Abstract (pdf) Project Narrative (pdf) Budget Narrative (pdf)   –Key Staff Resumes (pdf)  –Letters of  Support (pdf)

New Jersey:Web site   –State Plan and Application (pdf)

North Carolina:Web site   –Strategic Plan Narrative (pdf)  NC Web site invites Public Comments by November 15, 2009

Oklahoma: –Web site  –Budget Narrative (pdf)  –Project Narrative (pdf)  –Project –Abstract (pdf)

Tennessee:Web site  –Strategic Plan (pdf)Project Abstract (pdf)

Utah:  –Web site Strategic Plan (pdf)

Washington: –Web site  –Application (pdf)

State HIE Coop Agreement Applications Filed: Alabama First to Publish

Oct 16, 2009 Deadline for State HIE Coop Agreement Filing;
Alabama: First State to Publish Application
Alabama became the first state to publish its Health Information Cooperative Agreement application that was due October 16, 2009, when all 50 states plus territories were to file HIE applications with the Office of the National Coordinator in DC. Congratulations Alabama.

Alabama Medicaid Transformation Grant–HIE Initiatives Web
Alabama HIE Cooperative Agreement Application
Submitted 10-16-09
Abstract (pdf)
Governor’s Letter (pdf)
Project Narrative (pdf)
Application (pdf) 
Alabama HIE Cooperative Agreement Letter of Intent (pdf) - Submitted 9-10-09

Press release (pdf) issued Oct 16, 2009 about Indiana’s filing of HIE Agreement with ONC.

Oklahoma had published a draft version of it HIE Agreement for public feedback.

Thank you to an e-Healthcare Marketing reader for pointing  out Alabama’s application to your devoted blogger!

Please help add to this list.
When you come across any State HIE LOIs that have been published on official state sites, please send me the link either by adding to comments or sending to my email address available on About Page. Thank you.

e-Healthcare Marketing carries links to 16 Letters of Intent from states for the HIE; plus Alabama above is the 17th  LOI. Please let me know if you see any additional LOIs published as well.

Oklahoma HIE Draft Application to ONC; ONC OKs OK Prelim Regional Extension Center App

Oklahoma Health Information Exchange Draft Application to ONC
Oklahoma Chosen (Preliminarily) by ONC as Early Extension Site
Oklahoma posted its draft application for the ONC’s State Health Information Exchange Cooperative Agreement to gather public comment via an online form from October 1 to 9, 2009.  The draft notes that “Oklahoma has been chosen as one of the first 20 applicants of the Extension Program. The early announcement period gives Oklahoma the maximum amount of time to lend technical support to providers and facilities migrating to HIT. The Oklahoma Primary Care Association and OFMQ are leading the efforts where the full application will be submitted on November 3, 2009.” In other words, ONC approved Oklahoma’s preliminary application, which enables it to file a full application in November 2009.
Oklahoma HIE DRAFT Application to ONC (pdf)
Oklahoma’s Letter of Intent for HIE (pdf)
OKHITECH/Oklahoma Health Information Exchange Web site

NOTE: List of Regional Extension Center preliminary approvals: The Oklahoma Center above and the University of Central Florida are the only centers that we’re aware have been published. Should you learn of any additional that have been officially published, please drop a note in the comment box, or email me at the address listed in the About section. Thank you.

Missouri Statewide HIE Shows Us All

Missouri Statewide HIE Shows Us All
Includes View of Status of HIEs in 50 States, DC, and PR
In presentations to Missouri stakeholders and state Senate committee on September 17 and October 1, 2009, the Missouri Statewide Health Information Exchange (HIE) showed its plans and planning process, as well as its consultant Manatt Health Solutions’ view of the status of existing HIE activities as defined by ONC.

Missouri estimates its share of State HIE Program funding from ONC will be $12.9 million. The presentation show a clear explanation and timelines of the HITECH funding process, including Regional Extension Centers, Broadband and Telehealth in addition to HIEs. A detailed and clear process and schedule is shown for the Missouri Statewide HIE program.

Manatt’s analysis shows seven states (out of 50 states, the District of Columbia, and Puerto Rico) as possessing a state HIE operational plan that is in alignment with ONC criteria. Those states with aligned HIE status are Delaware, Maine, New York, North Carolina, Utah, Vermont, and Wisconsin. Fourteen additional states are viewed as having a state HIE which requires alignment with ONC criteria prior to implementation. The remaining states and territories are viewed as needing significant planning efforts prior to implementation or in the initial planning stage.  Since this is in map form, it’s not clear where District of Columbia falls. Missouri may require significant planning prior to implementation based on first reading of the rest of the presentation.

Missouri Statewide HIE Presentations To:
Stakeholders, Sept 17, 2009 (pdf)
Missouri Senate Healthy Missourians Committee, Oct 1, 2009 (pdf) 
Map Analysis of State HIE Readiness for ONC: Slide 18 in either version.
The Senate version has a few introductory slides as overview.

Missouri Office of Health Information Technology http://dss.mo.gov/hie

See e-Healthcare Marketing post for several State HIE Letters of Intent.

17 State HIE Letters of Intent to Office of National Coordinator

Updated List of 17 Published State Letters of Intent to ONC for
Health Information Exchange Programs on Sept 11, 2009
As the October 16, 2009 deadline closes in for the State HIE Applications, at least six more Letters of Intent have been published online. Continuing a list of state letters (17 as of Oct 16, 2009) as they come to my attention, in alpha order below:
Alabama (pdf)
California (pdf)
Florida (pdf)
Illinois (pdf)
Michigan (pdf)    MI Governor’s Press Release (html)
Minnesota (pdf)  MN Governor’s Designation (pdf)
Missouri (pdf)   **Missouri HIE Overview Slides (pdf)**
New Jersey (pdf)
North Carolina (pdf)
North Dakota (pdf)
Oklahoma (pdf)    OK Governor’s Designation (pdf)
Oregon (pdf)
Tennessee (pdf)
Utah (pdf)
Vermont (pdf)
Washington (pdf)
Wisconsin (pdf)

Please help add to this list. When you come across any State HIE LOIs that have been published on official state sites, please send me the link either by adding to comments or sending to my email address available on About Page. Thank you.

Previous post with LOIs listed in order that they came to attention of e-Healthcare Marketing.