Wednesday, March 17, 2010

PHIX Plan Submitted to ONC

The Pennsylvania Health Information Exchange (PHIX) Strategic Plan was submitted to the HHS Office of the National Coordinator in March 2010. To take advantage of federal resources, the state is required to submit a comprehensive plan for approval to address governance, finances, technical infrastructure, business and technical operations, and legal and policy decisions.

The draft Strategic Plan was completed in November 2009 and was open for public comment. During this time, the plan was presented at more than 25 healthcare provider group meetings, advisory committee meetings, to the Department of Aging, Department of Health, consumer groups, and others for their ideas.

The Strategic Plan presents a detailed review of HIT adoption issues in the state. Some of the fast-facts are that in 2009, 84 percent of Pennsylvania’s acute care hospitals were using some functionalities of an EHR. The high adoption rate in hospitals is in part because 98 of 165 acute care hospitals are part of larger health systems. Even though efforts to move HIT are underway in most hospitals, progress still needs to be made.

According to the information in the Strategic Plan, physician practices are adopting EMR/EHRs slowly and the rate of adoption is still standing at 19.7 percent as in 2007. Of the physicians using EMRs in 2007, 63 percent ordered labs or radiology results electronically, while 84.4 percent viewed lab results electronically, and 80.8 percent viewed radiology results electronically.

It is estimated that up to 5,000 of the state’s physicians work in small and often rural practices. Twenty eight percent of Pennsylvania’s population or approximately 3.4 million people live in 48 rural counties where broadband access may not be presently available.

There are a number of examples of HIE related activities across the state such as:

• Pinnacle Health System—Connects the hospital and community physicians
• Vale-U Health—Connects Monongahela Valley Hospital, 140 medical staff members and several regional ancillary providers
• 6 Bridges—Six health systems in Western Pennsylvania have formed an alliance to create an HIE
• UPMC—Connects 20 academic, community, and specialty hospitals
• Reading Hospital—Discussing a regional HIE
• Harrisburg HIE—In the early stages of formation in Central PA
• Southeast Pennsylvania—Efforts are underway to establish a regional HIE
• KeyHIE—Connects eight hospitals in Northeastern PA
• Commonwealth Medical College—Organizing a health information exchange in Northeastern PA

HIT and HIE adoption are occurring in the state and making some progress. However, according to the plan, it is very important to integrate PHIX with other initiatives within the Commonwealth. In particular, the State Medicaid Health Information Technology Plan and the Department of Health data sharing and registry projects need to be included in PHIX planning. Also, PHIX should be coordinated with the Regional Extension Center.

The ARRA 17.1 million funding with a state match will pay for the backbone of PHIX. Long term funding options for PHIX operations are now under consideration and include various combinations of legislative action and voluntary participation by stakeholders. Potential funding models may include public sector funding, voluntary contributions by insurers, subscription, membership and transaction fees, and value-added services such as offering a scaled down version of an EMR.

A Request for Proposals is being developed with representatives from the Department of Health, the Department of Public Welfare, Office of Aging, the Department of General Services, and the Office for Information Technology. The RFP is expected to be released April 2010.

To download the Strategic Plan, go to