Kansas Public Health AssociationIntegrating Systems for HealthIntegrating Systems for Health

Public Health and Health Information ExchangesSeptember 19, 2013

Michael McPhersonProject Manager/Meaningful Use Coordinator

Offi f H lth I f ti T h lOffice of Health Information TechnologyKansas Department of Health & Environment

To protect the health and environment of all Kansans by promoting responsible choices.

Objecti esObjecti esObjectivesObjectives

Introduce Meaningful UseIntroduce Meaningful Use Review Kansas HIO EnvironmentReview Kansas HIO Environment Review Kansas HIO EnvironmentReview Kansas HIO Environment Review Public Health DataReview Public Health Data

To protect the health and environment of all Kansans by promoting responsible choices.

BackgroundBackgroundBackgroundBackground American Recovery and Reinvestment Act American Recovery and Reinvestment Act

Health Information Technology for Economic Health Information Technology for Economic and Clinical Health Act (HITECH)and Clinical Health Act (HITECH)

b f d h ff d blb f d h ff d bl Not to be confused with Affordable Care Act Not to be confused with Affordable Care Act and/or the term “Health and/or the term “Health InsuranceInsuranceExchange”Exchange”ExchangeExchange

HITECHHITECHf lf l ff Meant to incentivizeMeant to incentivize meaningful usemeaningful use of of

interoperable EHR adoption in the health care interoperable EHR adoption in the health care system as a critical national goalsystem as a critical national goal

To protect the health and environment of all Kansans by promoting responsible choices.

system as a critical national goalsystem as a critical national goal

HITECH GoalHITECH GoalHITECH GoalHITECH Goal Improve healthcare outcomesImprove healthcare outcomes Improve healthcare outcomes, Improve healthcare outcomes, Facilitate access to care, and Facilitate access to care, and

Si lifSi lif Simplify careSimplify care

All via a certified electronic health record All via a certified electronic health record (EHR) system in a (EHR) system in a meaningfulmeaningful mannermanner( ) y( ) y gg

To protect the health and environment of all Kansans by promoting responsible choices.

What is Meaningful UseWhat is Meaningful Usegg Financial incentiveFinancial incentive Through use of certified EHRThrough use of certified EHR End goal:End goal:gg

Incentive ($$)Incentive ($$) Reduction medical errorsReduction medical errors Reduction medical errorsReduction medical errors

Prominent themeProminent themeEHR incentive paymentEHR incentive payment EHR, incentive, paymentEHR, incentive, payment

To protect the health and environment of all Kansans by promoting responsible choices.

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To protect the health and environment of all Kansans by promoting responsible choices.

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Achieving Meaningful Use

2014

2016

Ph 32011

2014

Phase 2 (Advanced care

Phase 3 (Improved Outcomes)

2011

Phase 1 (Capture/share data)

care processes with decision support)

2009

HITECH Policies

data)

To protect the health and environment of all Kansans by promoting responsible choices.

Stage 1Stage 1 Stage 2Stage 2

Eligible ProvidersEligible Providers 15 core objectives15 core objectives

Eligible ProvidersEligible Providers 17 core objectives17 core objectivesjj

5/10 menu objectives5/10 menu objectives 20 total objectives20 total objectives

jj 3/6 menu objectives3/6 menu objectives 20 total objectives20 total objectives

6/44 CQMs6/44 CQMsEligible Hospitals & Eligible Hospitals &

CAHSCAHS

9/64 CQMs9/64 CQMsEligible Hospitals & Eligible Hospitals &

CAHSCAHSCAHSCAHS 14 core objectives14 core objectives 5/10 menu objectives5/10 menu objectives

CAHSCAHS 16 core objectives16 core objectives 3/6 menu objectives3/6 menu objectives 5/10 menu objectives5/10 menu objectives

19 total objectives19 total objectives 15/15 CQMs15/15 CQMs

3/6 menu objectives3/6 menu objectives 19 total objectives19 total objectives 16/29 CQMs16/29 CQMs

To protect the health and environment of all Kansans by promoting responsible choices.

Stage 2 Meaningful Use Stage 2 Meaningful Use Improve Population and Public HealthImprove Population and Public Healthp pp p

Objective Ambulatory Measure Hospital measure

Immunization Registries

Ongoing Submission to Public Health Authority (Core)

Ongoing Submission to Public Health Authority (Core)

Reportable Lab Results(ELR)

N/A Ongoing Submission to Public Health Authority (Core)

SyndromicSurveillance

Ongoing Submission to Public Health Authority (Menu)

Ongoing Submission to Public Health Authority (Core)

Cancer Registries

Ongoing Submission to Public Health Authority (Menu)

N/A

Specialized Registry

Ongoing Submission to Public Health Authority or National Specialty Society (Menu)

N/A

9

Clinical Quality Clinical Quality Measures Measures (CQMs)(CQMs)

Help measure and track quality ofHelp measure and track quality ofHelp measure and track quality of Help measure and track quality of healthcare serviceshealthcare services

Measure many aspects of patient care:Measure many aspects of patient care: Measure many aspects of patient care:Measure many aspects of patient care: Health outcomesHealth outcomes

Clinical processesClinical processes Clinical processesClinical processes Patient safetyPatient safety

Effi i t fEffi i t f Efficient use of resourcesEfficient use of resources Care coordinationCare coordination

P l i d bli h l hP l i d bli h l h

To protect the health and environment of all Kansans by promoting responsible choices.

Population and public healthPopulation and public health

Examples of PH CQMsExamples of PH CQMsExamples of PH CQMsExamples of PH CQMs Weight Assessment and Counseling for Children Weight Assessment and Counseling for Children

d Ad l td Ad l tand Adolescents,and Adolescents, Preventative Care and Screening: Tobacco,Preventative Care and Screening: Tobacco, Chlamydia Screening for Women,Chlamydia Screening for Women, Childhood Immunization Status,Childhood Immunization Status, …… Number of chronic disease measures that fall Number of chronic disease measures that fall

outside of population and public health domain.outside of population and public health domain.

To protect the health and environment of all Kansans by promoting responsible choices.

MU2 Public Health SpecificationsMU2 Public Health Specifications

CriteriaContent

Exchange Standard

Vocabulary Standard Applicability Core or Menu

Immunization Registry

HL7 2.5.1170.205(e)(3) CVX EP & EH Core for EH &

EP

Reportable LabReportable Lab Results(ELR)

HL7 2.5.1170.205(g)

SNOMED-CT & LOINC EH only Core for EH

Syndromic HL7 2 5 1 Core for EHSyndromic Surveillance

HL7 2.5.1170.205(d)(3) EP & EH Core for EH

Menu for EP

Cancer CDA( )

SNOMED-CT & EP only Menu for EPRegistries 170.205(i) LOINC EP only Menu for EP

Specialized Registry TBD TBD EP only Menu for EP

To protect the health and environment of all Kansans by promoting responsible choices.

Registry

ONC State Cooperative ProgramONC State Cooperative ProgramONC State Cooperative ProgramONC State Cooperative Program Promotes innovative approaches to the Promotes innovative approaches to the

secure exchange of health information secure exchange of health information within and across stateswithin and across states

Works to ensure that health care providers Works to ensure that health care providers and hospitals meet national standards and and hospitals meet national standards and ppmeaningful use requirementsmeaningful use requirements

March 2010, ONC granted 50 awardsMarch 2010, ONC granted 50 awards March 2010, ONC granted 50 awardsMarch 2010, ONC granted 50 awards facilitate the exchange of health information facilitate the exchange of health information

among health care providers and hospitalsamong health care providers and hospitals

To protect the health and environment of all Kansans by promoting responsible choices.

among health care providers and hospitals among health care providers and hospitals within their jurisdictionswithin their jurisdictions

Kansas HIO ActivityHow we got here…

To protect the health and environment of all Kansans by promoting responsible choices.

Kansas HIO ActivityCurrent

To protect the health and environment of all Kansans by promoting responsible choices.

To protect the health and environment of all Kansans by promoting responsible choices.

Kansas HIOsKansas HIOsKansas HIOsKansas HIOs

Kansas Health Kansas Health Information Network Information Network

Lewis and Clark Lewis and Clark Information Exchange Information Exchange

(KHIN)(KHIN) Technology Vendor Technology Vendor

Informatics CorporationInformatics Corporation

gg(LACIE)(LACIE)

Technology Vendor Technology Vendor CernerCernerInformatics Corporation Informatics Corporation

of America (ICA)of America (ICA) http://www.khinonline.orhttp://www.khinonline.or

CernerCerner http://www.laciehttp://www.lacie--

hie.com/hie.com/p //p //g/g/

Live since 8/2012Live since 8/2012

// Live since 5/2013Live since 5/2013

To protect the health and environment of all Kansans by promoting responsible choices.

P blic Health DataP blic Health DataPublic Health DataPublic Health Data

New Data SourcesNew Data Sources HospitalsHospitals HospitalsHospitals Private ProvidersPrivate Providers

Policy RequirementPolicy Requirement Policy RequirementPolicy Requirement Minimum Data Set must include Immunization Minimum Data Set must include Immunization

DataDataDataData

To protect the health and environment of all Kansans by promoting responsible choices.

Public Health ParticipationPublic Health ParticipationPublic Health ParticipationPublic Health Participation

SG CHD Disease InvestigatorSG CHD Disease InvestigatorSG CHD Disease InvestigatorSG CHD Disease Investigator Kansas Public Health Workshop on Kansas Public Health Workshop on

Electronic Health Records and HealthElectronic Health Records and HealthElectronic Health Records and Health Electronic Health Records and Health Information ExchangeInformation ExchangeKALHD HIE ProjectKALHD HIE Project KALHD HIE ProjectKALHD HIE Project Does the LHD need an EHR?Does the LHD need an EHR?

h b fi b i i i i ?h b fi b i i i i ? Does the LHD benefit by participating in HIE?Does the LHD benefit by participating in HIE? Assessment toolAssessment tool

To protect the health and environment of all Kansans by promoting responsible choices.

Kansas HIT Pa tne sKansas HIT Pa tne sKansas HIT PartnersKansas HIT Partners

To protect the health and environment of all Kansans by promoting responsible choices.

In S mmaIn S mmaIn SummaryIn Summary

Meaningful use incentivizing EHR useMeaningful use incentivizing EHR use Kansas HIOs < 1 year of exchangeKansas HIOs < 1 year of exchange Kansas HIOs < 1 year of exchangeKansas HIOs < 1 year of exchange

Potential wealth of dataPotential wealth of data

KDHE working with HIOs and partnersKDHE working with HIOs and partners KDHE working with HIOs and partnersKDHE working with HIOs and partners Workgroup devoted to identifying data usesWorkgroup devoted to identifying data uses

To protect the health and environment of all Kansans by promoting responsible choices.

Contact InformationContact Information

Michael McPhersonMichael McPherson785785--296296--13191319

mmcpherson@kdheks.govmmcpherson@kdheks.govKanHIT orgKanHIT orgKanHIT.orgKanHIT.org

To protect the health and environment of all Kansans by promoting responsible choices.

Video Inte l deVideo Inte l deVideo InterludeVideo Interlude

http://www.healthit.gov/patientshttp://www.healthit.gov/patients--families/video/healthfamilies/video/health itit youyou givinggiving youyoufamilies/video/healthfamilies/video/health--itit--youyou--givinggiving--youyou--accessaccess--youryour--medicalmedical--recordsrecords

To protect the health and environment of all Kansans by promoting responsible choices.

AcronymsAcronymsAcronymsAcronymsARRA ARRA –– American Recovery and Reinvestment ActAmerican Recovery and Reinvestment ActCAH CAH –– Critical Access HospitalCritical Access HospitalEE EE –– Eligible EntityEligible EntityEH EH –– Eligible HospitalEligible HospitalEHR/EMR EHR/EMR –– Electronic Health/Medical RecordElectronic Health/Medical RecordEPEP –– Eligible ProviderEligible ProviderEP EP –– Eligible ProviderEligible ProviderHITECH HITECH -- Health Information Technology for Economic and Clinical Health ActHealth Information Technology for Economic and Clinical Health ActHIE HIE –– Health Information ExchangeHealth Information ExchangeHIO HIO –– Health Information OrganizationHealth Information OrganizationggONC ONC -- Office of the National Coordinator for Health Information TechnologyOffice of the National Coordinator for Health Information TechnologyKHIN KHIN –– Kansas Health Information Network (khinonline.org)Kansas Health Information Network (khinonline.org)LACIE LACIE –– Lewis and Clark Information Exchange (lacieLewis and Clark Information Exchange (lacie--hie.com)hie.com)KDHE KDHE –– Kansas Department of Health & Environment (kdheks.gov & kanhit.org)Kansas Department of Health & Environment (kdheks.gov & kanhit.org)MU2 MU2 –– Meaningful Use Stage 2Meaningful Use Stage 2PHI PHI –– Personal Health InformationPersonal Health InformationRCMTRCMT –– Reportable Conditions Mapping TableReportable Conditions Mapping Table

To protect the health and environment of all Kansans by promoting responsible choices.

RCMT RCMT –– Reportable Conditions Mapping TableReportable Conditions Mapping Table

ReferencesReferencesReferencesReferences Kansas Office of Health Information Technology Kansas Office of Health Information Technology –– http://KanHIT.org/http://KanHIT.org/ Office of the National Coordinator for HIT Office of the National Coordinator for HIT -- http://www.healthit.gov/http://www.healthit.gov/ Sedgwick CHD Disease Investigation Sedgwick CHD Disease Investigation -- http://www.khinonline.org/news/januaryhttp://www.khinonline.org/news/january--

februaryfebruary--2013/1872013/187--guestguest--articlearticle--sedgwicksedgwick--countycounty--healthhealth--departmentdepartment ONC Health IT Buzz ONC Health IT Buzz -- http://www.healthit.gov/buzzhttp://www.healthit.gov/buzz--blog/blog/ Syndromic SurveillanceSyndromic Surveillance -- Syndromic Surveillance Syndromic Surveillance

http://www.cdc.gov/Mmwr/preview/mmwrhtml/su5301a3.htmhttp://www.cdc.gov/Mmwr/preview/mmwrhtml/su5301a3.htm KALHD HIE Project KALHD HIE Project -- http://kalhd.org/projects/hie/http://kalhd.org/projects/hie/ Meaningful Use Stage 2 Final Rule Meaningful Use Stage 2 Final Rule -- http://www.healthit.gov/policyhttp://www.healthit.gov/policy--researchersresearchers--

i l t / i f li l t / i f l tt 22implementers/meaningfulimplementers/meaningful--useuse--stagestage--22 Clinical Quality Measures Clinical Quality Measures -- http://www.healthit.gov/policyhttp://www.healthit.gov/policy--researchersresearchers--

implementers/clinicalimplementers/clinical--qualityquality--measuresmeasures KHIN KHIN –– http://www.khinonline.orghttp://www.khinonline.orgp gp g LACIE LACIE –– http://www.laciehttp://www.lacie--hie.comhie.com

To protect the health and environment of all Kansans by promoting responsible choices.