California s ehealth Planning Approach June 30, 2010 National Governor s Association Webinar
2 Three Cornerstones 1.Communication 2.Collaboration (and Trust) 3.Coordination
3 Communication Listserv, bulletins, send comments and questions: ehealth@chhs.ca.gov Website: www.ehealth.ca.gov Twitter: http://twitter.com/caehealth Operational and strategic plan (public comment): http://www.ehealth.ca.gov/ehealthplan/tabid/72/default.aspx Monthly Public Webinars: July 8, 2010, 1pm 2pm Pacific Daylight Time webinar sign-up: https://www1.gotomeeting.com/register/819375232
4 Purpose To dramatically improve safe and secure patient and provider access to personal and population health information and decision-making processes, benefiting the health and wellbeing, safety, efficiency, and quality of care for all Californians.
5 Goals 1. To ensure patients have safe, secure access to their personal health information and the ability to share that information with others involved in their care 2. To engage in an open, inclusive, collaborative, public-private process that supports widespread EHR adoption and a robust, sustainable statewide health information exchange 3. To improve health care outcomes and reduce costs 4. To maximize California stakeholders collective access to critical ARRA stimulus funds 5. To integrate t and synchronize the planning and implementation ti of HIE, HIT, telehealth and provider incentive program components of the federal stimulus act 6. To ensure accountability in the expenditure of funds 7. To improve public and population health through stronger public health program integration, bio-surveillance and emergency response capabilities
Collaboration - Operational Planning Co abo at o Ope at o a a g Organization Chart 6
Request for Information (RFI) - HIE Governance Entity 7 Purpose: To determine if an organization(s) might qualify to be the State s Health Information Exchange (HIE) Governance Entity State evaluated responses to the RFI to determine if any of the respondents were qualified to be the State s HIE Governance Entity: The State may or may not designate that Governance Entity to be the State-Designated Entity Responses fell short of requirements Asked leading two applications to consider a joint proposal
8 Cal econnect Governed by Cal econnect non-profit with diverse stakeholder board Develop and support a trust framework Securely route health information between authorized entities Provide a thin layer of core services Allows for additional business services to be built on top of core services: Core services represent the platform (think iphone) Business services are specific functions that derive value to the users (think iphone apps ) Supports and leverage existing i infrastructure where it exists Proposed funding for viable HIOs in California if they can meet criteria Can support or run along side existing and exchange capabilities
9 Board of Directors Constituencies 1. California Assembly Committee on Health Chair 2. California Senate Committee on Health Chair 3. California Secretary of the Health & Human Services Agency 4. California State Administrator (determined by State, may include the Department of Health Care Services, Department of Managed Health Care or other departments) 5. CEO of the HIE-GE 6. Co-chair (at-large 1) 7. Co-chair (at-large - 2) 8. Consumer (1) 9. Consumer (2) 10. Employer/Purchaser 11. Health Informatics 12. Health information exchange organization 13. Health information exchange organization ation 14. Health Plan private 15. Health Plan - public 16. Hospital - private 17. Hospital - public 18. Labor 19. Physician Independent 20. Physician Medical Group 21. Public health (local public health officer) 22. Safety net clinic
Proposed Technical Architecture Non-Core Cooperative Shared HIE Services TBD, as needed Lab Result Router/Translator Eligibility Determination Hub NHIN Gateway Others Other HIE Services HIOs PHRs 10 Core Cooperative Shared HIE Services Entity Registry Service Provider Directory Service Provider Identity Service SureScripts EHR-Specific Networks Secure Messaging IDN Legend Others Solo Practice Physician Principal-1 Principal-2 Laboratory Principal-3 Enterprise-A IPA Principal-4 Physician Principal-5 Hospital Enterprise-B IDN Principal-6 Physician Transactions involving CS-HIE Services and using the protocols and standards required by these services Transactions not involving CS-HIE Services and not necessarily using the t l d t d d required by these services Hospital Group Practice protocols and standards
11 Supporting Programs Program Health Information Exchange Recipient CHHS Funds $38.8 million States Cal econnect Health IT Extension Program LA Care, CalHIPSO $46.6 million Workforce Training Grants Los Rios Community College $5.4 million Nonprofits Priority Primacy Care Providers California Telehealth Network UC Office Higher Education of the $22.1 million Medical/Graduate d Schools President Beacon Communities UC San Diego $15.3 million
12 Coordination California ehealth Coordinating Committee $1.4 billion in Medi-Cal EHR incentives + ~$25-$30M Overall EHR Medicaid admin, plan, promotion, payment, consumer education, quality reporting, oversight Rural $4 billion Re egional Ex xtension Centers Workforce $38.8M Support and infrastructure to make information exchange between sectors faster, more efficient and more secure $46M+ On the ground implementation support to physicians, hospitals and community health centers
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