Saturday, January 21, 2012

North Carolina's HIT Initiatives

According to the recent quarterly legislative report prepared by the North Carolina Department of Health and Human Services, health IT partners have received grants totaling about $630 million across all federal HIT funding categories. This figure includes funding for EHR incentive payments to individual eligible hospitals and providers over the next four years with the total funding approaching $1 billion in federal investments to support HIT in the state.

The state is involved in a number of HIT initiatives such as their Health Information Exchange where the state received $12.9 million in a Federal grant plus $1.7 million from a supplemental Challenge Grant to enable the secure exchange of patient health information between providers and hospitals statewide.

So far, the selection of the vendor and development of the core HIE infrastructure continues under the North Carolina HIE (NC HIE) and Capgemini/Orion Healthcare Consortium. The NC HIE is scheduled to launch during the first quarter of 2012.

The state has $144 million in federal dollars available for Broadband Technology Opportunities Program for Round 1 and Round 2, $40 million available in a private match, $7.7 million available from MCNC Endowment, and $24 million is available from the Golden Leaf Foundation. The funding is being used to expand the North Carolina Research and Education Network and is expected to be completed by July 2012.

In 2011, Blue Cross and Blue Shield of North Carolina (BCBSNC) working with the North Carolina HIE and Allscripts launched the “North Carolina Program to Advance Technology for Health” (NC PATH). This program was created to equip 750 North Carolina independent physicians including over 150 physicians in 39 free clinics with Allscripts EHR software to connect healthcare providers across the state through the North Carolina exchange.

For in-network providers, BCBSNC will cover 85 percent of the software, maintenance costs, and the NC HIE connectivity and membership fee for a period of 5 years while the provider is responsible for the remaining 15 percent.

The NC Area Health Education Center’s Regional Extension Centers (NC AHEC REC) program at the University of North Carolina, Chapel Hill received an award for $13.6 million over 2 years and presently has enrolled over 3700 primary care providers. The NC REC was designated one of five vanguard states by ONC.

The North Carolina Beacon Community Grant operating with the lead agency Southern Piedmont Community Care Plan, is working with funding of $15.9 million. The overall goal is to leverage Community Care of North Carolina’s patient-centered medical home model, health IT, and innovative interventions to improve care coordination, encourage patients to be involved in their medical care, and to improve health outcomes.

The Cabarrus Health Alliance has scanned all of their medical records to prepare for EMR implementation. They have implemented a child health module and have incorporated a new evidence-based program “Bright Futures” into their EMR.

The Rowan County Health and the Stanly County Health Departments are also upgrading their EMR software and scanning medical records in preparation for EMR implementation. The next phase is to develop a public health portal to view demographic and community health data.

The lead agency for telehealth is the North Carolina Telehealth Network which was awarded a federal grant of $12.1 million through the FCC Rural Healthcare Pilot Program. They were also awarded $125K in one time state dollars in 2008 from the North Carolina Division of Public Health for the initial development for telehealth.

So far, the NC Telehealth Network has been successful in building up broadband telehealth capacity particularly in rural and underserved communities in the state. Phase 1 has completed telehealth connectivity to virtually all public health sites and free clinics in North Carolina. Phase 2 will focus on small public and non-profit hospitals in cooperation with the North Carolina Hospital Association.

In the field of pediatrics, Community Care of North Carolina is working with CMS and the American Academy of Pediatrics on developing and evaluating a Pediatric EHR model. North Carolina and Pennsylvania are the only two states selected for this pilot grant program.

The CHIPRA Category-D Pediatric EHR Consultant has been meeting with vendors, practices, and stakeholders since late August 2011 to introduce the Pediatric Electronic Health Record model. The state is evaluating the model among smaller independent healthcare providers and across a variety of EHR vendors. So far four vendors have conducted Pediatric content-specific product demonstrations for the project team.

The evaluation design phase in this grant project is well underway and five areas of quality improvement have been selected to be the primary focus and include obesity, oral health, developmental and behavioral health, early periodic screening, diagnosis and treatment, and asthma.

Go to to view the complete quarterly legislative report distributed January 1, 2012.