Sunday, May 23, 2010

State Releases Draft Plan

Last August, ONC created the State HIE Cooperative Agreement Program but in order to receive funding, each state was required to develop both Strategic and Operational Plans. The state of Tennessee just updated their Strategic Plan and on May 17th, the state released the Draft “Tennessee Health Information Exchange Operational Plan for Public Comment.”

The draft Operational Plan details how the Strategic Plan will be executed to establish a statewide HIE. The plan outlines specific actions and the role of the various stakeholders needed to implement the HIE, and defines an approach for continuous improvement and evaluation. The plan addresses governance, finance, technical infrastructure, business and technical operations, plus legal and policy issues.

Tennessee has two well developed and operational regional initiatives. The MidSouth eHealth Alliance originated in Memphis emergency departments and the system is now used in safety net clinics, among hospitalists, and is currently extending access to ambulatory providers.

The second regional initiative CareSpark serves 34 counties spanning Northeast Tennessee and Southwest Virginia. In 2008, CareSpark launched its community health record and is now actively exchanging demographic data and clinical data. In addition, CareSpark currently is able to exchange both the Tennessee and Virginia immunization registries and is in discussion with several other states to exchange this data.

Many regions of the state that lie between the areas served by CareSpark and MidSouth eHealth Alliance are not served by HIEs. Steps are being taken to build HIE capacity in a number of areas to include groups such as Middle Tennessee eHealth Connect, Innovation Valley Health Information Network, Middle Tennessee Rural Health Information Network, and West Tennessee Healthcare.

Public health reporting and surveillance is actively taking place in Tennessee and includes collecting data on reportable and notifiable diseases, obtaining birth and death data from healthcare providers, along with ambulance emergency run records from licensed EMS providers in Tennessee. The Tennessee Department of Health (TDOH) manages multiple registries for immunization, cancer, traumatic brain injuries, and controlled substances.

Laboratory reports are received from state laboratories, commercial laboratories, and healthcare providers. About 200,000 lab reports are received electronically in the state per year. The State Lab will be sending electronic laboratory results reports to the TDOH surveillance system in the immediate future with the estimate that 100,000 additional reports will be sent.

The State government has contracted with Shared Health, a for-profit venture of BCBS to make Medicaid data available statewide. The Shared Health platform provides a clinical viewer for data, ePrescribing, a clinical decision application offering problem lists, care opportunities, along with a clinical analytics application.

Tennessee’s Office of eHealth Initiatives has approved 1,961 healthcare providers and more than 420 treatment sites, has trained more than 350 grant recipients statewide on the process of ePrescribing and on understanding the pharmacy workflow process, best practice models, workflow adoption, and what to know when choosing a vendor.

Coordination is also ongoing with other states on HIE activities. The State wants to see data exchanges flow across state borders, find opportunities to share HIE infrastructure design and development, provide for cross border Medicaid determinations, and work on new approaches to encourage providers to adopt EHRs.

Tennessee’s eHealth efforts will continue to be coordinated with federal programs. Federal matching funds of $2.7 million were awarded to the state so that Tennessee’s Medicaid program could perform state planning activities to implement the EHR. The state also received $11.7 million in Recovery Act Awards to help healthcare providers increase the adoption and meaningful use of electronic health information technology in the state.

In addition, efforts are being made to continue efforts to extend connectivity between Veteran Administration facilities and local providers plus the VA has been involved with a number of Tennessee’s regional HIOs.

Also, CareSpark has been working with the Social Security Administration and in 2010 received a $1.3 million contract from SSA to develop, test, and implement a capability to gather and relay medical records as authorized by patients applying for disability benefits.

To download the draft Tennessee Health Information Exchange Operational Plan for Public Comment, go to