Update on Statewide HIE Activities and 2015 HIT/HIE-Related Legislation

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1 Update on Statewide HIE Activities and 2015 HIT/HIE-Related Legislation

2 Presentation Summary THSA Background 2015 HIT/HIE-Related Legislation Legislative Interim Activities HIETexas Update Discussion of Challenges and Open Questions 2

3 About THSA The THSA was created in 2007 by the Texas Legislature as public/private entity to promote and coordinate electronic health information exchange in the state. Will become a private nonprofit entity in Targeted mission and vision supported by four core principles: Patient Centric Market-Based Leverage Existing Resources Focus on Regional Solutions THSA provides support and coordination for local HIE development including creation of HIETexas. 3

4 2015 HIT/HIE-Related Legislation

5 How many bills? 5

6 Positive HIE/HIT-Related Legislation in 2015 SB 203 (Sen. Nelson) Continues the THSA in statute through September 1, 2021 and sets the stage for the THSA becoming fully private after that date. Updates the makeup of the THSA board by adding one member representing local HIEs, and changing the board s two ex-officio members from the Texas Department of State Health Services (DSHS) to two members representing health and human services agencies as state agency data resources. 6

7 Positive HIE/HIT-Related Legislation in 2015 HB 2641(Rep. Zerwas, MD) Implements standards in IT systems at the HHS agencies. Clarifies that DSHS may exchange health information with health care providers via HIE. Creates an HIE incentive program at Medicaid, if found to be feasible and cost-effective. Provides a safe-harbor for physicians participating in HIE by shielding them from liability related to other parties data errors. 7

8 HB 2641 Coalition

9 Positive HIE/HIT-Related Legislation in 2015 SB 195 (Senator Schwertner, MD) Transitions the state s prescription drug monitoring program from the Texas Department of Public Safety (DPS) to the Texas State Board of Pharmacy in The bill permits Texas to connect with other state s PDMP programs through the National Association of Boards of Pharmacy s PMP InterConnect. 9

10 Unfinished HIE/HIT-Related Legislation in 2015 SB 1937 (Senator Kolkhorst) DID NOT PASS Converts completion of THSA s Privacy and Security Certification Program (i.e., SECURETexas) under the Health and Safety Code from a mitigating factor to safe harbor in case of a breach; comparable to HIPAA safe harbor on encryption 10

11 Interim Activity HHSC and DSHS Sunset Implementation Contracting Reform (SB 20) 1115 Waiver Renewal Legislative interim charges 11

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13 HIETexas: A statewide network of local HIEs The Texas Health Services Authority is building a statewide network of local HIE networks, called HIETexas, to ensure a patient s health information follows them regardless of where they receive treatment or where the information is stored. These HIEs enable secure electronic exchange of patient data and immediate access, which improves health outcomes, saves lives and reduces costs. At the heart of HIETexas is a strong security framework that protects patient data and ensures that patient preferences and privacy are respected. 13

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15 HIETexas Local HIE Connectivity Status TEST ENVIRONMENT PROD ENVIRONMENT EHEX Local HIE EHEX Local HIE Preparation Local HIE Steps Completed Greater Houston Healthconnect (GHH) 4 of 4 Integrated Care Collaboration (ICC) 4 of 4 Health Information Network of South Texas (HINSTx) Healthcare Access San Antonio (HASA) 3 of 4 Paso del Norte HIE (PdN HIE) 2 of 4 Rio Grande Valley HIE (RGV HIE) Rio One Network Southeast Texas Health System (SETHS) Level 1 Level 2 Level 3 Level 1 Level 2 Level 3 Level 1 Level 2 Level 3 Level 1 Level 2 Level 3 Level 1: Connectivity Level 2: Interoperability Level 3: Use Case Le Note that Texas Local HIEs cannot yet query ehealth Exchange Participants, but they are able to successfully respond in production. Local HIE ehealth Exchange query capability is under construction. Color Legend Completed In Process Not Started Not Responding 15 Directional Testing Legend Bi-Directional Can Initiate to Texas Can Respond to Texas

16 HIETexas ehealth Exchange Connectivity Level 1: Connectivity Level 2: Interoperability Level 3: Use Case Color Legend Completed In Process Not Started Not Responding 16 Directional Testing Legend Bi-Directional Can Initiate to Texas Can Respond to Texas

17 HIETexas State Agency Connectivity TEST ENVIRONMENT PROD ENVIRONMENT State Agency Level 1 Level 2 Level 3 Level 1 Level 2 Level 3 Texas Department of State Health Services (DSHS) sftp Interface Texas Department of State Health Services (DSHS) Web Services Interface Texas Department of Public Safety Prescription Drug Monitoring Program (PDMP) Level 1: Connectivity Level 2: Interoperability Level 3: Use Case Color Legend Completed In Process Not Started Not Responding 17 Directional Testing Legend Bi-Directional Can Initiate to Texas Can Respond to Texas

18 Local HIE Landscape: Community-Based HIE Networks o o o o o o Received start-up funding from the state Diverse governing board 501(c)(3) non-profit Clinical summary exchange Many offer other value add services Varies by HIE but participants include physicians, hospitals, health plans, public health, and other health care organizations 18 18

19 Local HIE Landscape: Current and Evolving 19 19

20 HIETexas Statewide HIE July 2015 Metrics QUERY (PULL) DIRECT (PUSH) 3,744 PHYSICIANS ACTIVE 67 HOSPITALS ACTIVE 558 OTHER PROVIDERS ACTIVE 17,693 PATIENT RECORD QUERIES 4,188 PHYSICIANS ACTIVE 82 HOSPITALS ACTIVE 227 OTHER PROVIDERS ACTIVE 25,851 DIRECT TRANSACTIONS 20

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22 Rural West Texas HIE Planning The THSA re-released a Request for Application (RFA) on January 30, 2015 to award up to $300,000 to fund the development of up to four Business and Operational (B&O) Plans in rural West Texas. HASA is working under contract to develop a West Texas HIE Readiness Assessment and B&O Plan to offer its technical services to parts of West Texas. HASA s Readiness Assessment, which included a survey and focus groups, focused on Amarillo, Abilene, Lubbock, San Angelo, and Wichita Falls. B&O Plan is anticipated in September

23 Ongoing Challenges/Open Questions Challenges Sustainability/Achieving Critical Mass of Participants EHR-to-HIE Interface Costs and Implementation Delays Level of Physician and Other Provider Participation Integrating HIE into EHR Workflow Post 2014 Changes in HIE Geographic Coverage (SETHS, FirstNet, and ICC) Rural Texas Open Questions Should additional services, such as event notification, lab, medication history, provider directory, and connectivity to other state and/or regional data sources be enabled through HIETexas to augment and increase the value of community-based HIEs connected to HIETexas? Should HIETexas build connections to cloud-based EHR vendors? What is the best way to connect with and receive data from the long-term care industry? Will industry align behind a standard to support automated consent management? What additional strategies should be pursued to increase rural participation in information exchange? 23

24 For more information on THSA/HIETexas 24

25 Questions? Tony Gilman CEO Texas Health Services Authority (512)