Sunday, April 22, 2012

Maryland's Telemedicine & HIT Actions

On April 17th, the Maryland State Legislature approved HB 1149 and SB 781 mandating that health insurers pay for telemedicine services. Governor O’Malley is expected to sign the bill into law in May and upon signing, Maryland will join 12 other states that have passed similar legislation.

Leaders in the telemedicine field including Jennifer Witten, Government Relations Director for MD-DC, for the American Heart and Stroke Association, Gary Capistrant with the American Telemedicne Association, and Dr. Karen Rheuban Medical Director for the Office of Telemedicine at the University of Virginia, Senator Catherine E. Pugh, Delegate Susan C. Lee, and a number of other advocates and experts have worked very hard to pass the legislation. 

Important and specific steps are also taking place to move HIT forward at a rapid rate in the state. According to an update provided for the March Maryland Health Care Commission meeting, the Center for Health Information Technology is continuing to evaluate the responses received from the “2011 Hospital HIT Survey” from all 46 acute care hospitals in Maryland. The survey was administered at part of the “Maryland Freestanding Ambulatory Surgical Center Survey.”

Questions were included on adoption of technologies such as CPOE, EHRs, eMARs, infection surveillance software, e-prescribing, electronic data interchange, and for the first time telemedicine. In general, health IT adoption increased in all nine HIT categories with the highest increase in the adoption of CPOE at around 63 percent and e-prescribing which increased by roughly 58 percent.

The Center’s staff is in the preliminary stage of working with the Maryland-National Capital Homecare Association to explore opportunities to advance HIT with home healthcare agencies. The staff has also collaborated with the University of Maryland-Baltimore County, Department of Information Systems to assess the current HIT implementation activities among home healthcare providers. They are identifying ways to improve care delivery and coordination, reduce costs, and improve access to care using technology.

Over the next three months, the staff plans to convene focus groups, conduct interviews, and evaluate literature to identify a framework for advancing HIT in home health. A webinar was held on the use of telemedicine within an HIE for chronic disease management.

The Center’s staff has evaluated strategies to assess progress achieved toward the adoption and meaningful use of EHRs in the state. The staff is also making recommendations for any changes in state law that may be necessary to achieve optimal adoption and use as required by House Bill 706. A report on this issue is due to the Governor and the General Assembly in October 2012.

The Center’s staff is also working with state designated Management Service Organizations (MSO) and EHR vendors to continue discussions on interface development with the statewide HIE as interfaces are required to connect EHRs to the HIE infrastructure.

So far, the staff has met with five vendors and the staff thinks that the MSOs, are well positioned to serve as the technology hub to connect EHRs to the HIE. Over the next month, the staff plans to continue meeting with EHR vendors to develop timelines and affordable pricing models for HIE connectivity.

A quote was requested to identify a vendor to implement a Direct Pilot in regards to the statewide HIE “Chesapeake Regional Information System for Our Patient” (CRISP). A Maryland-based vendor, Secure Exchange Solutions was selected to complete the work.

CRISP and the Abell Foundation are sponsoring a contest to find ways to identify innovative and practical ideas for using clinical information on a patient population to drive advances in public health. The contest is trying to stimulate innovations on potential data sources, both within and outside the healthcare domain, and find new solutions to address public health challenges. The winning applications for the $5,000 prize will be selected in May 2012.

Last month the staff participated in the Finance Committee meeting to discuss HIE connectivity pricing models for ambulatory providers. In the near future, the staff plans to meet with nearly 50 ambulatory practices to identify barriers to HIE connectivity and make recommendations regarding pricing for ambulatory practice connectivity. Another committee, the Technology Committee discussed implementing a small demonstration project to exchange diagnostic images.