Tuesday, August 24, 2010

Developing the HIE

Kansas has been developing and using telemedicine and telehealth to reach rural populations for a number of years. Today, the telemedicine program at the University of Kansas Medical Center and the Kan-Ed network reaches across the state. Also, for the past decade, the state has been exploring the use of health IT and working to establish a health information exchange.

The Kansas Department of Health and Environment (KDHE), the state designee for health IT, is working on the states strategic and operational plans for the statewide HIE. KDHE convened the e-Health Information Advisory Council (eHAC) to provide guidance on policy issues related to health IT and to help develop the plans for the state level HIE.

The state and KDHE have a long history of leading public health informatics initiatives and uses web-based technologies to share information throughout the state. For example, the Kansas Health Alert Network enables local and state emergency health and safety entities to share public, mental health, and general emergency preparedness information. Also, the Kansas Public Health Information eXchange enables the rapid exchange of information between public health providers.

In addition, KDHE’s system “EMResource”, a web-based program, provides real-time hospital emergency department status, information on hospital patient capacity, availability of staffed beds, and available specialized treatment capabilities. The system also communicates public health and bioterrorism/terrorism alerts.

KDHE’s immunization and disease registries have proved to be effective. The Kansas Immunization Registry has enrolled more than 1.3 million patients, and tracks more than 9 million immunizations across 205 provider offices statewide. KDHE also supports two state disease registries such as the Kansas Cancer Registry a population based source of information and the Kansas Diabetes Quality of Care Chronic Disease Electronic Management System in more than 90 healthcare clinic sites across the state.

KDHE has released their draft “Strategic & Operational Plan” along with what will be done to publicly report on key measures. According to the plan, the measures to be reported quarterly will include the number of stakeholders accessing the exchange and increases, the increase in the number of Kansans with their care coordinated through a medical home, and the number of Kansans participating in chronic disease management programs.

eHAC participated with a number of state agencies to include not only KDHE, but also regional health information exchange participants on advisory committees, the Kansas Health Policy Authority, Foundations, KanEd, KanWin, the State Information Technology Office, plus other state agencies.

A broad range of other Kansas stakeholders and other interested parties from both the public and private sector participated in eHAC meetings via workgroup meetings, and stakeholder outreach sessions. The groups worked on a variety of communication efforts and looked in detail at the key elements of the strategic and operational plans and participated in discussions pertaining to the future of the statewide HIE.

The stakeholders discussed ideas such as:

• Limited resources have long prevented the implementation of prior HIE plans. Stakeholders continue to believe that future efforts must be sensitive to the limited resources available in the state, and employ as many diverse and creative funding and implementation strategies as feasible

• The need for collaboration to assist state level planners and health organizations in meeting the challenges that result from limited resources. Collaborative efforts among HITECH-funded efforts, as well as between participating organizations will be key to HIE success in the state

• Stakeholders in several workgroups were adamant that the current HIE project maintain a focus with well-defined parameters, rather than broaden services or areas of attention. An example of concern was that the HIE should not offer an electronic health record to providers, but should rely on the Regional Extension Center and vendors to address EHR needs that do not involve health information exchange. The stakeholders do not want the HIE to enable quality reporting because the consensus was that to provide any services in this arena was outside the scope of the current project

Recently, in July 2010, the Governor issued an Executive Order to establish the Kansas Broadband Advisory Task Force as a result of the state securing $400 million from ARRA. The task force’s goals are to have the state to support strategic partnerships in the public, private, and non-profit sectors, implement a strategy to support universal state-wide availability and adoption of broadband services, and also work to coordinate input obtained from key stakeholders in both the public and private sectors

To download the Kansas draft “HIE Strategic & Operational Plan” go to www.kanhit.org.