Health Information Health Information Technology:Technology:

Moving North Carolina Moving North Carolina ForwardForward

Vandana Shah, Executive DirectorVandana Shah, Executive Director

September 2, 2009September 2, 2009

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The Biggest Challenge? The Biggest Challenge? Silos of Silos of InformationInformation

The Tipping Point: Hurricanes Katrina and Rita

“…the disaster demonstrates a broader need to computerize individual health records nationwide and make them available throughout the medical system.”

Washington Post, 9/14/05

How did we get here?How did we get here?

A Call to Action in 2006A Call to Action in 2006 Creation of the National Health Information Network

To avoid dangerous mistakes, reduce cost, and improve care by leveraging technology to create a health care “e-highway”

NHIN

H.R. – 1The American Recovery and Reinvestment Act of 2009(ARRA) The Health Information Technology for Economic and Clinical Health Act(HITECH)

$19 billion allocated to $19 billion allocated to Health ITHealth IT$17 Billion +

incentives for providers meeting “Meaningful Use” requirement [$’s to “prescribers”]

$2 Billion to HHS / ONC standards development, evaluation and

validation infrastructure for Health Information

Exchange (HIE) grants to states for the purpose of furthering

EHR adoption improvements in HIT manpower the establishment of Regional Health IT

Resource Centers, Extension Programs, Enterprise Integration Research Centers, etc.

ONC FOAs for Grants ONC FOAs for Grants Released Aug. 20Released Aug. 20thth

3012 – HIT Regional Extension Centers Program EHR Adoption Assistance Preliminary application due Sept. 8th

NC AHEC Program leading application development NOT $s for EHR purchases

3013 – State HIE Cooperative Agreement Program Application due October 16th

One application per state $4 up to $40 million grant over four years NC Health and Wellness Trust Fund will apply for NC NCHICA expected to assist in developing application NOT $s for EHR purchases

3012 – HIT Regional 3012 – HIT Regional Extension Centers ProgramExtension Centers Program

Summary of Funding Type of Award: Cooperative Agreement Total Amount of Funding Available in FY2010

$598,000,000 Average Award Amount $ 8,543,000 Award Floor $ 1,000,000 Award Ceiling $ 30,000,000 Approximate Number of Awards 70

Project Period Length four-year project period with two separate two-year budget periods

Estimated Start Date: January 15, 2010

3013 – State HIE 3013 – State HIE Cooperative Agreement Cooperative Agreement

ProgramProgram Type of Award: Cooperative Agreement

Total Amount of Funding Available: $564,000,000

Award Floor: $4,000,000

Award Ceiling: $40,000,000

Approximate Number of Awards: 50

Program Period Length: 4 years

Anticipated Project Start Date: January 15, 2010

$ = EHR + HIE + Quality Reporting

Incentive Incentive Payments to Payments to

ProvidersProviders

Enabled by “Meaningful Use”

““Meaningful Use”Meaningful Use” Governed by CMS, administered by Medicaid and Medicare

Definition expected to include:

Use of a “certified product” with ePrescribing capability

The EHR technology is connected for the electronic exchange of PHI

Submission of reports on clinical quality measures

CMS to issue Notice of Proposed Rule Making in late 2009

Regulation defining “Meaningful Use” issued in early 2010

Focus on health outcomes, not software & networks

NC HIT Strategic Planning NC HIT Strategic Planning Task ForceTask Force

Established by Governor Bev Perdue as part of NC Recovery Office - March 2009

Task: Develop a Strategic Plan for ARRA Healthcare Stimulus Funding investment

Weekly meetings in April and May 2009

Draft Outline of plan submitted for public comment - June 2009

Final NC HIT Action PlanNC HIT Action Plan delivered - July 2009

Governor announces NC HWTFC NC HWTFC

as

“Qualified State-Designated Entity”

on July 16th and

has appointed NC HIT Collaborative NC HIT Collaborative

to make recommendations on

implementing the NC HIT Action PlanNC HIT Action Plan.

Governor’s Executive Governor’s Executive OrderOrder

North Carolina Health Information Technology Collaborative

Members:• Chair• NC Medical Society (Vice Chair)• NC AHEC Program (Vice Chair)• NC Dept. of HHS• NC Nurses Assn.• NC Hospital Assn.• Community Care of NC• NC Assn. of Health Plans• NC Health Quality Alliance• NCHICA

Ex-Officio Members:

• NC HWTFC Chair• NC HWTFC Executive Director• Rep. from Office of the Governor• NCHICA Executive Director

NC Health and Wellness Trust NC Health and Wellness Trust FundFund

Created in 2000 by the NC General Assembly and funded through 25% of NC’s share of the Tobacco Master Settlement Agreement (MSA)

Commission appointed in May 2001 The NC Health and Wellness Trust

Fund Commission (HWTF) invests in programs and partnerships to address access, prevention, education and research that help all North Carolinians achieve better health

HWTF has provided: Over $ 287 million in funding

for over 400 grants and programs

$109 million for access to care programs

$178 million for preventive health initiatives

Deliver critical health information services reliably, securely, and affordably to clinicians; patients; state, county, federal health agencies; local exchange efforts throughout NC.

Create a secure, electronically connected North Carolina population of providers, patients, and consumers.

Offer an information infrastructure that supports optimum care delivery methodologies, transparency, patient empowerment, and integrated healthcare records.

Facilitate regional health information exchangesand interconnections among them.

Statewide HIE Program: Critical Statewide HIE Program: Critical ObjectivesObjectives

State Designated Entity (SDE)

Facilitate HIE initiatives across NC Establish a common approach to governance,

processes, technology Support Regional initiatives Ensure inclusion of safety providers and underserved

populations Ensure consistency with national HIE objectives Identify and support legislation and regulation

Statewide HIE Program: Critical Statewide HIE Program: Critical ObjectivesObjectives

Tentative Timeline for Tentative Timeline for NC EffortsNC Efforts

NC HIT Strategic Planning Task ForceMarch – July 2009

NC HWTF HIE Proposal Development & SubmissionJuly 2009 – October 2009

NC HWTF HIE Stimulus Fund Management for StartupJanuary 2010 - 2014

Ongoing Governance & Management [Structure TBD]January 2010 - ongoing

Clients/Patients

The Overarching Goal: Integrated Data The Overarching Goal: Integrated Data FlowFlow

Pharmacy

Laboratory

DiagnosticHospital Emergency

Homecare

Community Care Center

Clinic Emergency Services

Specialist Clinic

www.HealthWellNC.com