eHealth Initiative Connecting Communities for Better Health Vermont Information Technology Leaders V - PowerPoint PPT Presentation


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eHealth Initiative Connecting Communities for Better Health Vermont Information Technology Leaders V


eHealth Initiative. Connecting Communities ... Vermont Association of Hospitals and Health Systems ... Data available for unconscious or incapacitated patients ... – PowerPoint PPT presentation

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Title: eHealth Initiative Connecting Communities for Better Health Vermont Information Technology Leaders V

eHealth Initiative Connecting Communities for
Better HealthVermont Information Technology
Leaders (VITL)May 25, 2005
  • Presented ByGregory Farnum, CIO Vermont
    Association of Hospitals and Health
    SystemsProject Director Vermont Information
    Technology Leaders
  • For more information, please visit our website at

Activity Review
  • Nov 04 HIT Summit
  • Dec 04 VAHHS Board Resolution VITL
  • Jan, Feb, Mar, April, May 05 Advisory Group
  • Jan-May 05 Legislative Action
  • Mar 05 Clinical Functionality Survey
  • Apr 05 VAHHS Board Update/eHI (SF)
  • May 05 Stakeholders Meeting/Brailer Panel
  • Today eHI - Connecting Communities Forum (DC)
  • June 3, 2005 Committee will deliver to the VAHHS
    Board a Regional Health Information Organization
    (RHIO) based strategy.
  • June 14, 2005 Presentation to VAHHS Board
  • June 15, 2005 Begin Implementation

Intro and Background - VAHHS Board Resolution
  • By May 31, 2005 Committee will present to the
    VAHHS Board no more than three written options
    for Regional Health Information Organization
    (RHIO) based strategies.
  • Each of the three strategies (demonstration
    projects) would include
  • A description of the specific RHIO project
  • A tactical work plan which includes
  • Cost estimates (one-time and ongoing)
  • Timelines for moving forward
  • Personnel resources (physicians, clinicians, IT
    staff, consultants)
  • Recommendations for governance structure funding
    options and other related issues

Intro and Background -- Strategy development
  • We are developing a short and long-term strategy
    to create a health information exchange in
  • We have analyzed other initiatives around the
    country and have concluded that Vermont should
    start off by implementing a demonstration project
  • The criteria of our first demonstration project
    is one that
  • Supports the development realization of a
    state-wide HIT plan
  • Can be implemented in 12-18 months
  • Provides immediate improvements in care delivery
  • Is financially self-sustainable

Strategy Development Model
Legislative Activity
  • H.524 (Section 20.18 V.S.A. 9417)Language moved
    to budget bill includes
  • Governance BISHCA ? VITL Advisory Group
  • Financing - 250K seed money 750K match funds
  • Deliverables January 2006 Pilot Start up
    January 2007 Technology Plan
  • Senator Leahy Request
  • Pilot project would work to establish
    foundational elements for all Vermont health
    information technology projects and mechanisms
    for sustainable financing.

Description of Pilot Project
  • Medication Medical History Snapshot
  • Create a centrally managed/secure repository of
    electronic claims data (from payors,
    clearinghouses, pharmacy benefits management
    organizations and/or any other data sources
  • Provide medication history and medical history
    snapshots for patients presenting in emergency
    departments across the State of Vermont

Objectives / Benefits of Demonstration Project
  • Clinical
  • Survey results place medication history as the 1
    physician need
  • Potential for reducing adverse drug events by
    having more accurate medication info
  • Ability to receive more than meds a snapshot
    of medical conditions, recent admissions,
    procedures, tests, attending physicians, etc.
  • Data available for unconscious or incapacitated
  • Pilot will be easily expanded to all EDs and
    potentially to all interested physicians
  • Business
  • Potential to lower costs in one of the highest
    acute care cost areas (ED)
  • Opportunity for improving case/care management
    for many people that often use the ED for primary
  • Potential to improve healthcare service to many
  • Provides foundation for the proposed Prescription
    Monitoring legislation

What about HIPAA and Patient Privacy?
Personnel Resources / Governance
  • VITL Inc. Filed articles of incorporation
  • Directors
  • Committees
  • Executive
  • Current VITL Advisory Group
  • Finance - Starting process to raise matching
  • Technology First order of business
    implementation strategy
  • Privacy and Security Ensuring patient trust
  • Nominating
  • Additions to Advisory Group Include -
    Commissioner of Department of Information and
    Innovation- Director of OVHA or his or her
    designee- Commissioner of BISHCA or his or her
  • Starting rulemaking process to provide expedited
    to review for projects that meet VITL technology

Pilot Project - Cost / Benefits/ ROI
  • Estimated Costs 1.75 Million
  • Legal (for privacy, security, etc.)
  • Hardware Software
  • Interface development to payors, TPAs and PBMs
  • Personnel to support operations
  • Strategic and technical consulting (as needed)
  • Potential ROI of 4x Investment of 1.75M 7M
    in return
  • Drug-induced hospitalizations account for 5 of
  • Conservative estimate of 1 avoided admissions
    would yield approximately 7 million in Vermont
    (based on gross charges)

Timeline for Moving Forward
  • Establish VITL Inc. ASAP
  • Seek/Obtain Match Funding
  • Jan 1, 2006 Pilot Launch
  • Jan 1, 2007 Technology Plan

Key issues / Requirements
  • All stakeholders represented
  • Commitment to improving care reducing costs
  • Willingness to collaborate
  • Willingness to share data
  • Commitment to resolving issues through discussion
  • Tolerance for reasonable risk
  • Access to information
  • Access to expertise
  • Willingness to pay reasonable fees for benefits

Key issues / Requirements
  • Privacy
  • Need-to-know access
  • Patient trust
  • Patient access control
  • Transition from paper records
  • Availability of paper records
  • Incentives for clinician EHRs
  • Access to information
  • Access at point-of-care
  • Integration of all patient info
  • Standard encoding of all patient info
  • Public health reporting
  • Availability of info for research
  • Incremental Steps
  • Initial small project
  • Expandable to include all patient information
  • Universal Availability
  • Availability to all
  • Voluntary participation

Key issues / Requirements
  • User Acceptance
  • Easy to use
  • Clear immediate benefits
  • Compatible with workflow
  • Stakeholder acceptance
  • Provides real value (ROI)
  • Technical
  • Simple to implement
  • Done successfully before
  • Rapid deployment
  • Simple to maintain
  • Timing now or later?

Key issues / Requirements
  • Building the System
  • Initial cost
  • Availability of funds
  • Reliability of cost estimates
  • Sustaining the System
  • Ease of allocating costs
  • Likelihood of continuing financial support
  • Maintenance operations costs
  • Stability of financial model

  • Evaluation Framework for Assessing Implementation
  • Requirements
  • Feasibility
  • Financing
  • Needs Additional Discussion and Review
  • Useful to Compare Options
  • Basis for Implementation Decisions