Alabama’s One Health Record®
AQAF Health Information Technology Forum
Leveraging Electronic Exchange to Benefit Alabama Outcomes
Gary D. Parker, Presenting
August 13, 2013
Today’s Roadmap
• Agenda
• Alabama’s One Health Record®
– A HIE Primer
– Current Events
– A Look Ahead
• A “Dick Tracy” Demo
• Next Steps – “Engagement”
• Questions
Conflict of Interest Disclosure
Gary D. Parker, MBA, JD
Has no real or apparent conflict of interest to report and I
understand this presentation is for educational purposes only.
• Technology is the making, usage, and knowledge of
tools, machines, techniques, crafts, systems or
methods of organization in order to solve a problem
or perform a specific function…………..to the
collection of such tools, machinery, and procedures.
• Greek (techologia) techne meaning “craft, art, skill”
and logia meaning “the study of”.
Alabama One Health Record®
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Alabama’s state-wide Health Information Exchange (HIE).
– The Alabama HIE is not associated with and not part of the Affordable Care Act (ACA)
or the Health Insurance Exchange.
– In April 2012, One Health Record became fully operational for live PHI exchange and
now stands ready for large-scale utilization. Alabama state-wide initiative (Multiple
Stakeholders)
– Three integrated parts (“Bicycle Wheel”)
• HIE Core Framework (“Hub”)
• Provider EHR/EMR systems (“Rim”)
• Interface links between the Hub and Rim (“Spokes”)
– Information can be exchanged in either of two ways:
• “Pushes” patient information using Direct Message (Secured E-mail with
attachments).
• “Pulls” PHI using the Patient Search Process (Query – more Robust)
Alabama One Health Record®
• Alabama’s state-wide Health Information Exchange (HIE).
– Serves as the intermediary “Trusted-Provider-in-Fact” for electronic
PHI exchange.
– The system and framework to permit all health care providers to
securely share patient PHI electronically to improve outcomes through
improved care coordination using Electronic Health Record (EHR)
systems.
– It is a certified, standards-base technology that is HIPAA and MU2
compliant.
– It is connected to Federal Health Information Network (The eHealth
Exchange).
– Directly supports the EHR Meaningful Use Incentive Payment program
Money to Providers and Hospitals to buy EHR systems
131 Payments to Eligible Hospitals (EH) totaling : $ 80M
1,438 Payments to Eligible Providers (EP) totaling : $ 28M
CORE SERVICE COMPONENTS
• CDA utilization (“Interoperable” EHR systems)
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MPI (Patient HI Locator- 1st “Ping”)
Central Repository (CDA Storage and Access Buffer)
eHealth Exchange Node (National Gateway Point on Feds network)
Query & Response (Patients & Provider Information)
ADPH Queries & Reporting (IMZ’s, Labs, Bio-surveillance – MU2)
Analytics – Population Health
• Web Accounts
– Direct Secure Messaging (Healthcare E-mail w/o encryption)
– Master Provider Directory (allows Provider queries for DSM)
So….Why One Health Record® Integration?
• Landscape Factors
– Patient Care through electronic PHI
– Health Payment Reform – Incentivize Community Care to prevent
unnecessary Hospitalization
– Better Care Coordination = Better Outcomes
– Life cycle of care – Complete Care programs
– Improve Care Delivery (Remember……Technology)
– Tele-health – Telemedicine – continues to grow
– MU 2 requires CCDA sharing outside own system (DSM or Publication)
– 29 State HIE’s will be Nodes on eHealth Exchange by CY 2013.
– Ala, Ga, SC, WV, PA all have the same Tech platform.
• Transitions of Care
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2.
EHR approach – Publish CCDA to the HIE.
Use DSM (PHI e-mail) for a point-to-point exchange.
One Health Record® - Today
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In operation since April 2012
Current patient population: 1,000,000
Production Node on eHealth Exchange (national network)
Jackson and EAMC are live; UAB mid-September.
East Alabama Care Network (health home) connected (DSM)
North Alabama CC Network moving to DSM)
5 CMHC’s – 2 more in the Queue (DSM)
700+ PHI exchange DSM’s since March 2013, 106 Queries
We our connected to Fla, SC, WV, Ga for DSM.
National Provider Directory
HIE Analytics – Utilization and Population Health.
Alabama One Health Record®
Beyond Today…the Next Phase
One Health Record – Phase II (Tomorrow)
• Brookwood , Huntsville, Infirmary Health, connections possible by
1/1/2014
• Children’s, Eliza Coffee/Shoals, Highlands – DSM by September 2013
• All the above plus DW McMillian full exchange w/I 12 months
• Connectivity Grants – July-October 2013
• ADPH Registries connected for queries and reporting
• Tele-Medicine use will increase – Virtual Travel with Virtual Records
• Patient Portal and expansion of Provider Directory functionality
• Interstate HIE connections with Fla and Ga within 12 months.
• DSM connections with Miss, Michigan, and La by Fall 2013.
• RCO’s home health networks will be connected to One Health Record®
• Quality Rpt Document Architecture (QRDA) component to the CCDA
framework – CQM capture.
One Health Record – Phase II
Challenges of Tomorrow
• HIE Sustainability and Governance
– Industry Landscape (CommonWell & EPIC)
– All Payers involved
– Transition to value-based care models
• Provider Workflow integration
– Productivity impact
– Engagement ( Adoption and Use)
• Building the “Spokes”
– Waiting for True “Plug & Play” Standards
– Provider EMR/EHR interoperability – Adapter for each vendor system (61 used
in Alabama).
One Health Record
MPI
CDA
EHR
PCP
CARDIOLOGIST
EHR
The Next Steps…………..
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Review the One Health Record Polices and Procedures. These are available in the documents
section on the One Health Record web site, www.onehealthrecord.alabama.gov.
After the review of the Policies and Procedures, please sign and return the following
documents to via e-mail to [email protected]. We only one set of
documents per provide practice, not for each provider within the practice.
• One Health Record Participation Agreement
• One Health Record BA Agreement
• Qualified Services Organization Agreement (QSOA) (42 CFR part II for sensitive
data).
Please include a list of your top three referring specialist providers. These can be any
providers including community hospitals and mental health providers.
Once we receive the three signed document and a provider list, we will set up a Provider HIE
Administration Web Account and schedule a HIE System Administrator Training session on
how to use the HIE Web account and Direct secure messaging.
After the training session, we can follow up and help you set up your clinician accounts and
help send a DIRECT secure message.
QUESTIONS?
Gary D. Parker
Alabama Medicaid Agency
[email protected].
Phone: (334) 242-5011
Meghan Youngpeter
[email protected].
Phone: (334) 353-4463
www.onehealthrecord.alabama.gov