Wyoming Health Information Organization WyHIO

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Wyoming Health Information OrganizationWyHIO

• The mission of the WYHIO is to enhance access,
  quality, safety, and the efficiency of healthcare
  in Wyoming through the implementation of
  electronic health care information exchange and
  interoperability that is secure and confidential
  and utilizes technology that will assure
  interconnectivity within Wyoming and the rest of
  the nation.

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WyHIO

• Formed August 2005, Incorporated as not for
  profit, 501 (c) 3 corporation January, 2006
• Seeking private grants for operations and
  projects
• Working with provider consumer organizations to
  educate on HCIT
• Will take next organizational steps to appoint a
  permanent board

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Health Information Technology

• Studied by the WHCC summer and fall of 2003
• Recommendation made by WHCC October, 2003 to fund
  a feasibility study and plan for statewide
  interoperable HCIT system
• Study and plan funded by legislature in 2004

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Timeline

• 2003 WHCC recommendation
• 2004 HCIT Bill , Enrolled Act 31 Enacted (in
  binder)
• IT-2 Subcommittee/JSI Report
• WHC 2005 recommendation
• WyHIO
• 2005 Bill Draft (in binder)

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WHCC Health Care Information Technology
Recommendation, Fall 2003

• Rationale for the system
• improve effectiveness of service delivery and
  ultimately improve the overall quality of
  healthcare in Wyoming
• increase patient safety reduce medical errors,
• reduce duplication of health services, thereby
  reducing costs
• Improve administrative efficiency

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• The Institute of Medicine in 1999 reported that
  44,000-98,000 people died EVERY YEAR in America
  from medical error
• Secretary HHS called for study of health reform
  measures to address patient safety and error
  reduction.

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• One of the major recommendations was to develop
  an information technology infrastructure. IOM
  defined the framework for an EHR
• HHS estimated a potential savings of 10 of total
  annual spending on healthcare

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• The National Center for Quality Assurance
  reported in 2003 that 50,000 people die EVERY
  YEAR in America because known conditions such as
  high blood pressure or elevated cholesterol are
  not adequately monitored and controlled.
• The healthcare industry spends only 2 of its
  revenue for information technology compared to an
  average 6 share spent by American businesses.

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• By 2003, Wyoming businesses had seen five years
  of double digit increases in insurance premiums
• Little Federal activity on Health IT use and
  delivery system change

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Labor Health and Social Services Committee
Meeting - October 2003

• The Health Technology Center reported in
  testimony that computerized physician order entry
  (CPOE) reduced adverse drug events by fifty-five
  percent (55)
• Nine percent (9) of redundant lab tests at a
  hospital could be eliminated using a computerized
  system.

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Enrolled Act No. 31

• Enacted during the 2004 WY legislative session
• 400,000 appropriation

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Technical Subcommittee

• Dr. Geoffrey Smith, Chair
• Dr. Robert Fagnant
• Laurie Hansen, RN
• Steve Hopkins
• Dr. Joy Lewis

• Dr. James Lugg
• Jeffrey McSchooler
• Matthew Rodosky
• Dr. Brent Sherard
• David Squires
• Dr. Scott Tenney

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Tech Subcommittee Timeline

• Issued RFP July 1, 2004
• Selected John Snow, Inc. in November 2004 to
  conduct study develop plan
• Final report made to WHCC September 1, 2005

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WHCC Recommendation

• Reviewed report with IT-2 JSI
• Data analysis of hospitals, practitioners Cost
  Model
• Sensitivity analysis dial on a radio
• What if ..

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Hub Share Information

• Centralized Network Services electronically
  connects providers enabling sharing of patient
  information
• Architecture and infrastructure allows providers
  to use different software yet share information

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Hub

• Rationale
• Little ROI for providers to install EMR
• Negative business case to share information
• Benefits flow to payers and patients

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Spokes Enabling Technology

• 10 Hospitals
• 250-300 Physicians
• Assessed for Ready/Willing/Able to connect to the
  hub and commence sharing

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Power Behind the Wheel Promote IT

• Four Focused Initiatives
• E-prescribing
• Administrative Transaction Processing
• Continuity of Care Record
• Hospital Portal

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Spokes Power Enable Promote

• Rationale
• Incentives needed to drive adoption
• Loans, matching grants, revised reimbursement,
  other mechanisms

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Technical Support OrganizationManage

• Technical staff to work with providers
• Ensure security of network
• Build, maintain and upgrade network

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Technical Support Organization

• Rationale
• Practitioners want/need technical assistance
• Hub needs ongoing monitoring and maintenance
  24/7/365

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WyHIO Manage

• Wyoming Health Information Organization
• Vehicle steering the wheel
• Negotiate legal, organizational and electronic
  issues
• Requires administrative staff
• Formed August 2005 from stakeholders

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Why Should Wyoming Help Build the Wheel?

• Providers in varying degrees of adoption
• Without infusion of state funds, businesses lack
  financial incentives to install use IT
• Proprietary and legal issues require an
  organization to negotiate them among the
  stakeholders
• Benefits accrue to WY as payer of benefits and to
  its citizens

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WHCC Recommendation Summary

• 41 Million over 5 years
• Builds foundation for functional and
  interoperable electronic health records network
• Builds an organization to bring stakeholders
  together to ESPM

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Bill 06LSO 0261

• The Hub and focused initiatives - 20,094,440
  (appropriation allocated until spent)
• WyHIO (Manage) - 946,471 (two years, partial
  allocation only other funds necessary
• Providers - 37 million (two years, partial
  allocation only local match required)
• Independent Security Audits - 40,000 (full,
  two-year appropriation)
• Wyoming Department of Health - 240,000 (full,
  two-year appropriation)

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Department of Health and Human Services
50 million
75 million
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2005 HHS Actions

• Awarded contracts to address IT adoption barriers
  in 4 areas
• Compliance Certification Process -- Certification
  Commission for Health Information Technology
  (CCHIT) -- 2.7 million
• National Health Information Network 4
  consortiums to develop a prototype -- 18.6
  million
• Privacy and Security NGA and RTI, Inc. --
  11.5 million, 40 state/territory contracts
• Standards Harmonization ANSI -- 3.3 million

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Compliance Certification

• Ambulatory EHRs certification criteria by 3/2006
• Inpatient EHR certification criteria by 3/2007
• Network certification criteria by 3/2008

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National Health Information Network

• Spring 2006 Detailed technical design
  architecture, recommend data technical
  standards security policies
• Fall 2006 - Evaluate 4 functional prototypes,
  live demonstrations

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Privacy and Security

• October 2006 interim assessment of state
  variations
• March 2007 final assessment of variation,
  solutions and implementation of plan

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Standards Timeline

• 2006 implement processes to resolve gaps in
  standards
• Develop business model for Health Information
  Technology Standards Panel
• Ongoing panel necessary because of need for new
  standards due to new procedures and processes in
  the industry

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Medicare Part D

• 4 pilots to test e-prescribing standards
• 6 million
• MMA requires adoption of standards by 2008

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Bipartisan Support at Federal Level Senators
Frist and Clinton op-ed article in Washington
Post

• Businesses in other sectors have embraced the
  information revolution to cut costs and improve
  productivity
• Its time we realize the full potential of the
  information revolution to improve the quality of
  the health care system as well.

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WyHIO Interim Board

• Geoff Smith, MD Interventional Radiologist,
  Chairman
• Andrew Fisher, Great West Life
• Bob Fagnant, MD OB-Gyn, WMS
• Larry Madsen, Black Hills Bentonite Purchaser
• Steve Chasson, WY Primary Care Association
• Dana Barnett UMC, WHA
• Leland Clabots WDH
• Carol Jenkins WHCC Ex-Officio

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WyHIO

• Completed organizational documents and filings
• Seeking funding -- seed money grants to fund
  operating expenses in 2006
• Inform membership and educate the public about
  interoperable EHRs

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Thank You

• Wyoming Medical Center Foundation
• Blue Envelope Health Fund
• Great West Life
• United Medical Center
• Wyoming Medical Center
• Sweetwater County Memorial Hospital
• Wyoming Health Initiative
• Anne Larsen
• Wyoming Department of Health
• Wyoming Department of Administration
  Information

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What happens to health information now? What will
the new network look like?
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Risk Assessment
100
Probability of Success
0
Hub Initiatives
Providers
WyHIO
Dollars