State Moves Forward with IT Network on Louisiana Medical News

State Moves Forward with IT Network

By: TED GRIGGS

Cindy Munn

Louisiana took another in a series of steps that will eventually lead to a statewide network where healthcare providers can share patients’ records electronically.

The Louisiana Health Care Quality Forum, a state-created nonprofit overseeing the effort, has asked the U.S. Department of Health and Human Services to approve the draft of the health information exchange.

“Everything we’re doing ultimately is about the patient and improving outcomes,” said Cindy Munn, executive director of the forum.

The main goal of the health information exchange is to be able to have and provide relevant, clinical data to providers when they are treating patients, Munn said.

State and federal officials, employers, healthcare providers and consumers want to improve healthcare quality and efficiency, Munn said. Health information technology and exchange are critical elements in achieving that goal.

The draft plan is 138 pages long and includes proposals to take advantage of existing electronic health records systems, such as the Louisiana Rural Health Information Exchange in North Louisiana, as well as strategies to overcome gaps in delivering lab results electronically, e-prescribing, and sharing clinical records.

Louisiana and the Quality Forum have been in the forefront of a number of efforts to improve healthcare quality and the state is expected to benefit from the experience. Those projects included a website allowing providers to check the medication histories of Hurricane Katrina evacuees; a demonstration program showing providers in New Orleans and Baton Rouge could share medical records; the Louisiana Rural Health Information Exchange, which will allow 24 rural hospitals to teleconsult with LSU Health Science Center; and a $15.9 million Federal Communications Commission grant the state Department of Health and Hospitals won to provide broadband connectivity to rural hospitals statewide.

DHHS has set aside $10.5 million to assist Louisiana in the health information exchange effort, with the state providing a percentage of the total that increases each fiscal year. The federal fiscal year begins in October.

Munn said the Quality Forum held four days of planning sessions to get the opinions of major stakeholders – physicians, hospital administrators, consumers and so forth – on each part of the proposed plan.

Jenny Smith, health information exchange program manager for the Quality Forum, said the state will have to provide a 10 percent match during the first fiscal year.

For the year beginning October 2011, the state will have to provide a one-seventh match, Smith said. The following year, the state will have to provide a one-third match, and after that the health information exchange will not receive federal assistance.

Smith said the Quality Forum is estimating the cost of the program at $12.8 million over the first four years.

“The problem is we don’t know what we will get year two, year three and year four because the feds haven’t decided,” Smith said.

For example, the Quality Forum knows only what it has estimated for equipment costs, but that could vary depending on what bids are submitted.

Meanwhile, Munn said DHHS will provide $1 million in the first year for planning.

The matching funds can include in-kind contributions, such as the time a hospital administrator spends in planning sessions, Munn said. At one point, there were as many as 60 people in the room discussing the proposal.

“We kept track of who was in there so we can show the Office of the National Coordinator (for Health Information) that we are fulfilling the requirements,” Munn said. “It would be tough to come up with the entire amount in-kind, but our goal is to get as much in-kind as possible.”

Smith said the Quality Forum knows about what a chief information officer, chief medical information officer or that level of executive would cost per hour.

The forum averages that cost and multiplies it by the hours the executive spent discussing the plan, she said. However, the forum is being very conservative with those figures.

Munn said the Quality Forum is also being frugal during the planning year because any money not spent on planning rolls over and can be put toward the health information exchange’s infrastructure.

The second phase of the program will be to develop an exchange that focuses on sharing information inside the state’s borders, Munn said. Some $5.8 million has been set aside for intrastate health information exchange activities.

The next phase will focus on sharing information across state lines, which fits into the Office of the National Coordinator’s national health information exchange plan, Munn said. Some $3.8 million has been set aside for interstate HIE.

“They’ve got it pretty mapped out,” Munn said.

The Quality Forum is following the blueprint, but nothing happens until the ONC approves the state’s proposal, Munn said. Approval is expected anywhere from six to 12 weeks of the Aug. 31 submission deadline.