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HIMSS Update on Virginias Health IT Strategy

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Highly-experienced Health IT Council reviews 61 grant ... CIO, AOL Board Member, Harvest Foundation -SVP, Sprint Nextel Board Chairman, Owens & Minor ... – PowerPoint PPT presentation

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Title: HIMSS Update on Virginias Health IT Strategy


1
HIMSS Update on Virginias Health IT Strategy
The Honorable Aneesh P. Chopra Secretary of
Technology October 2007 www.healthitcouncil.vi.v
irginia.gov
2
Agenda for Discussion
I. The Commonwealths Approach to Health IT
II. Three Adoption Levers
III. Vision of the Future Data-Driven Medicine
3
Health IT a Driver of Broader Quality and
Transparency Strategy
Health Reform Commission
Disparities in Outcomes
Health Reform Commission
Infant Mortality Rates
  • Access to Care Focused on the uninsured
  • Workforce Focused on nurses, nursing support
    (direct care workers), and physicians
  • Aging / Long Term Care Focused on services for
    the aging and disabled
  • Quality / Transparency / Prevention Focused on
    Pay-for-Performance in Nursing Homes price,
    quality, information transparency and infant
    mortality, tobacco cessation, obesity

Deaths Per 1,000
Southwest Virginia Drug Deaths
  • Suffered 264 drug related deaths in 2006 (up 22)
  • More than 200 or 75 due to prescription drug
    abuse
  • Rate of drug deaths per 100k more than 5 times
    the state average

4
A Good Start
Early Signs of Progress in Health IT Priorities
2007 October 10th payer-provider summit to sign
charter on administrative exchange Mental
Health hospitals initiate multi-year clinical
reform VDH evaluates strategic
alternatives Select Phase II award recipients
with greater emphasis on innovation Launch
public-private partnership solicitation on
innovative solutions
Topic Administrative Simplification EMR
Procurement Adoption Innovation Accountabi
lity and Transparency
2006 Launched Direct Connect through Medicaid
5 pilot hospitals for eligibility
verification All state institutions voluntarily
committed to procurement activity, collaborate
when appropriate Highly-experienced Health IT
Council reviews 61 grant applicants, awarding
first 750K in 2/07 Governor signs Executive
Order 42 promoting accountability and price
transparency in states role as purchaser and
insurer
5
Three Adoption Levers
Virginias Health IT Approach Extends from Public
to Private Sector
I Organizing Procurement
II Establishing a Policy Framework
III Seeding Innovation
Enterprise-Wide EMR Establish a statewide
contract for EMR services/software for public
sector physicians goal to identify portfolio of
preferred vendors
Public-Private Partnerships Alternative
procurement vehicle for innovative solutions to
advance Health IT Innovation Grants Seed
capital to advance EMR adoption across Virginias
communities
Administrative Simplification A public-private
consortium to lower administrative costs,
targeting smaller providers Accountability and
Transparency Portal to empower Virginia
consumers on high quality, low-cost healthcare
providers
6
A Long Gravel Road to Public Sector EMR Adoption
Enterprise-Wide EMR
Driving Value Through Collaboration HRSA Grants
Seed Capital for Health IT Revised 2007-8
Virginia Budget
Current/Projected Cost
  • Virginia Department of Health
  • Local Health District EMR 0.1M/7M
  • Health IT Council Grants 1.1M
  • Master Patient Index 0
  • Mental Health
  • Pharmacy Management
  • Electronic Medical Records 6.2M/27M
  • Corrections
  • Offender Management 0.3M
  • Veterans
  • Patient Record / Billing 0.1M
  • Dept. Medical Assistant Services
  • National Provider Identifier 14.2M
  • Total 22M/50M

1
2
  • Virginia Acute Stroke Telehealth (VAST) Network
  • VDH awarded 1.1M to create VAST network within
    the Shenandoah Valley to improve quality of care
    to underserved areas

3
4
  • High Impact EMR Adoption for CCNV
  • CCNV awarded 1.4M to defray implementation cost
    for EMRs at all Federally Qualified Health
    Centers
  • Following a two-year procurement process, CCNV
    unanimously selected eClinicalworks system

5
7
Establishing a Policy Framework
In Pursuit of Data Exchange ROI Through
Administrative Systems
Opportunity for Medicaid Reform VHEN
Aligned with a National Strategy CORE
  • Administrative Savings Opportunity
  • 30 providers submit on paper
  • 40 of claims rejected in first pass
  • 40 of rejected claims are eventually paid
  • CAQH Builds on HIPAA
  • CORE rules expand eligibility information
    to include copay rates, network status, etc.
  • Early implementers include nearly 20 national
    organizations covering more than 50 million lives
    in the US
  • Combined with an effective strategy to drive
    increased adoption CORE will improve the quality
    of data available at the point of care
  • NEHEN A Model for Success
  • An insurance plan is saving more than 720K
    annually in transaction fees by switching from
    clearinghouse-based eligibility verification to
    direct verification supported by NEHEN technology

The VHEN Charter
Following an initial summit in Richmond with
Virginia payers and providers discussing scope
and focus for a Virginia Administrative Exchange
modeled on NEHEN, the VHEN workgroup formalized a
charter in October 2007. Charter members include
9 Health Plans and 7 Health Systems including
MCV, UVA, Riverside, Anthem-Wellpoint, Aetna, and
DMAS.
8
Leveraging Commonwealth Resources for VHEN
Deployment
Commonwealth Resources 2007-8 Public Funds
A Framework for VHEN
Grant Summary
NHIN funding to cover e-prescribing use cases
  • Community Care Network of Virginia
  • EMR Deployment 1.4M
  • Innovation Grant Kiosk 0.3M
  • (8/28/2007)
  • NHIN II (CareSpark)
    2.6M
  • (10/5/2007)
  • NHIN II (MedVirginia) 2.5M
  • (10/5/2007)
  • HRSA TeleStroke 1.1M
  • (9/17/2007)
  • Health IT Council (Remaining Funds) 0.3M
  • Pending FCC Telemedicine Grant
  • Virginia Telehealth Network 1.7M
  • VTN Matching Funds 1.6M
  • Total 8.2M/11.5M

1
2
3
4
5
6
Tobacco Commission funding available now for
broadband build-out
DMAS considering funding request to cover
Virginias contribution to portal
9
Opportunity for HIMSS Low-Cost Broadband
21st Century Infrastructure Critical to Realize
Promise of Health IT
Case Study
Physician Broadband Access 2007 TN Survey
Description Following merger with Centra Health,
SCH saves 48K in telco bill and secures 45
rural health funding by leveraging
MBC Virginias Tobacco Commission approves
750k towards broadband access for rural
clinics Virginia launches Virginia Telehealth
Network to increase services that elevate care
quality through broadband access
Only 18 of one rural Virginia hospitals medical
staff have access to high-speed broadband service
40
14
Urban TN
Rural TN
The Opportunity
In 2007, Governor Kaine formalized the Broadband
Roundtable to better understand emerging
technologies, applications, and financial models
to encourage communities to provide broadband
access. Interested parties should encourage HIMSS
to contact Gene Sullivan at the UVA Telemedicine
Center.
Represents T-1 Level Service or Above
10
Opportunity for HIMSS ePrescribing
Two NHIN Awardees Positioned for Clinical
Exchange Leadership
The Opportunity
In 2007, Governor Kaine awarded three Health IT
Innovation Grants two winners, CareSpark and
MedVirginia secured NHIN funding with several
use cases that would involve physician
participation in data exchange. Interested
parties should encourage HIMSS to contact Liesa
Jenkins at CareSpark and Michael Matthews at
MedVirginia.
11
Opportunity for HIMSS Web-Based Billing
Medicaid Committed to Low-Cost Web-Based
Transactions Portal
MA-based consortium of payers offer single portal
to conduct HIPAA transactions
The system simplifies existing payer
functionality to minimize overhead costs
The Opportunity
DMAS is considering a proposal to Governor
Kaines Productivity Investment Fund
(applications due November 9th) to build a
low-cost web-based claims application VHEN would
consider an all-payer solution. Interested
parties should encourage HIMSS to write a letter
of support for this initiative to the Governor.
12
Kaine Leads in Adopting Federal Policy on
Standards, Transparency
Executive Order 42
Accountability and Transparency Executive Order 42
Data Interoperability Standards HB 2198 (Nixon)
HB 2198 requires that all Health Records Systems
purchased by the Commonwealth adhere to accepted
standards of interoperability.
Governor signs Executive Order 42 calling for
standards compliance for all public health IT
procurements and improved transparency on pricing
and quality
Combined with the national effort to certify
Health Records systems and Executive Order 42, it
creates a environment where data can be shared
easily.
Virginias Hospitals through the VHHA support
Transparency through open access to charge
information through PricePoint.
A Federal Priority
President Bush signed an Executive Order
directing Federal Agencies that administer or
sponsor health insurance programs to increase
transparency in pricing and quality while
encouraging the adoption of Health IT.
13
Virginias IT Transformation Legacy a Strong
Foundation
Public-Private Partnerships
Community Grants Health IT Council
Public-Private Partnerships VITA Model for
Healthcare
  • Encourage the adoption of EMR by Virginia
    physicians, lower costs for the state, and ensure
    interoperability
  • Successful model in IT transformation for state
    government

Mission
  • Creative financing possible to achieve goals with
    limited capital
  • Awarded 750,000 to three regional organizations
    to extend Health IT

Round 1
  • Bring all stakeholders to the table consumers,
    both public and private payers and providers
  • Goal to drive innovative solutions with remaining
    350,000

Round 2
14
Innovation Grants
Building a Strong Foundation to Pursue Creative
Partnerships in 2007
Phase I Winners
CareSpark EMR adoption through
incentives MedVirginia e-prescribing for state
employees Community Care Network EMR
connectivity between free clinics, CSBs
Over 60 Proposals valued at more than 30M are
submitted from all 8 regions of the Commonwealth
Blue-ribbon Health IT Council makes
recommendation members include -CIO, AOL
Board Member, Harvest Foundation -SVP,
Sprint Nextel Board Chairman, Owens
Minor -Chief Privacy Officer, Revolution Health
Chief Operating Officer, Riverside HS
15
Eligible Candidates for Current Round of
Innovation Grant Funds
Innovation Grants Round II
Valley Health- Shenandoah IPA Inova-Erickson
Retirement Communities NOVA RHIO Carilion
Clinic SeniorNavigator, Bath County Hospital
Centra Health System NOVA Health Information
Collaborative Professional Health
Resources MedEncentive Riverside
ePrescribe Riverside-Google Northern Neck Middle
Peninsula Telehealth Consortium
Joan Roscoe jroscoe_at_valleyhealth.com Geoffrey
Brown Geoffrey.brown_at_inova.com Mark R. Meiners,
Ph.D. mmeiners_at_gmu.edu Brent Lambert, M.D.
blambert_at_carilion.com Katie Roeper
kroeper_at_seniornavigator.com Terri Ripley
Terri.Ripley_at_centrahealth.com Jane Woods
jwoods8_at_gmu.edu Linda Scott lscott_at_phri.com Jeff
Greene jgreene_at_medencentive.com Charles
Frazier charles.frazier_at_rivhs.com John Stanley
john.stanley_at_rivhs.com Ed Bostick
edat1218_at_yahoo.com
Health IT Council
Governor Kaine signed Executive Order 55
re-establishing the Health IT Council which led
the selection process for Round 1 awardees
information available at www.healthitcouncil.vi.vi
rginia.gov
16
Missing Clinical Information Affects Care
Vision of the Future Data-Driven Medicine
17
Physicians Increasingly Reluctant to Seek
Information
18
Supporting the Diagnosis Decision
A Virginia Story
"One of the things I try to model for my
residents is that I'm trying to learn new things
even though I've been doing this for a long
time."  Pediatrician Stephen Borowitz
  • When presented with unusual symptoms that do not
    match the current diagnosis doctors can turn to
    Isabel which is easily accessible on all clinical
    units at UVAHS.
  • Isabel can provide a list of diagnoses, some of
    which might be outside the normal pattern doctors
    can fall into.
  • It does not replace the decision-making of the
    Doctor but it does provide powerful tools to
    augment the memory of each doctor.

19
Generating a List of Likely Suspects
20
Hand-washing Mining Data to Save Lives
Identifying the Value of Hand-washing Through
Data Analytics
A 19th Century Super-Cruncher
Institute for Healthcare Improvement
Goal Save 100,000 lives a year Method Look at
how people are dying in hospitals and then
determine if there are any large-scale
statistical evidence that could point the way
towards a solution
As far back as the 1840s, doctors have worked to
analyze data to improve healthcare
interventions. Dr. Semmelweis noticed an
alarmingly high mortality rate for infants born
in his division (18) compared to only 4 in
another OB group.
Results Dr. Berwick found that systematic
hand-washing along with a few other changes could
account for as many as 25,000 lives a year in
just ICU patients.
After careful review, he instituted a mandatory
hand-washing program and observed the mortality
rate fall to 1.8 Unfortunately, his work was
not accepted by his peers, delaying data-driven
medical efforts for over a century
Central Line Catheters Infection Rates
gt125,000
Reduced infections by 90
10
Recommended
Current Practice
21
Are We Heading Towards Google-Powered
Self-Diagnosis?
Kasparov vs. Deep Blue
Google announces Google Health to help store and
organize personal information
Microsoft launched HealthVault to organize
information, personal records
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