lisa k. rawlins, bureau chief florida center for health information and policy analysis

Florida Center for Health Information and Policy Analysis

Agency for Health Care Administration

Integrating the Florida Health Information Network with Florida’s Regional Health

Information Organizations

Lisa K. Rawlins, Bureau ChiefFlorida Center for Health Information and Policy Analysis


Presentation to the House Committee on Health Quality

January 9, 2007

Florida Center for Health Information and Policy Analysis 2


Health policy decisions in the Florida Legislature and Governor’s Office endorsing the Florida Health Information Network

Funding from the Legislature for grants to Regional Health Information Organizations

Leadership from the Governor’s Health Information Infrastructure Advisory Board

The Florida Health Information Network is the Result of:



Health Policy Background to the Florida Health Information Network

and the FHIN Grants Program



Select Committee on Affordable Health Care for Floridians, January 2004

Proposed promoting “compatible information technology that permits secure, private information sharing throughout health care” and the “use of technology to create a single medical record that belongs to the patient and families”



Executive Order Initiates the Florida Health Information Network

Florida’s Governor Jeb Bush signed Executive Order Number 04-93 on May 4, 2004 addressing the need for state leadership in the area of health information technology infrastructure development



Health Information Networks Included as an Innovative Idea

Idea 85 of Speaker Rubio’s 100 Innovative Ideas addresses health information exchange

“Improve patient care through technology by expanding electronic health records and regional health information networks.”



The Governor’s Health Information Infrastructure Advisory Board

Advisory Board formed to create “a plan to promote the development and implementation of a Florida health information infrastructure”

The Board’s 2005 Interim Report of the GHIIAB called for the creation of the Florida Health Information Network



Strategy for the Florida Health Information Network

Develop a network to enable the sharing of meaningful electronic patient data

Promote the exchange of electronic patient data on the network by: Driving the adoption of electronic medical records

systems by individual providers and Developing regional health information

organizations



Building the Florida Health Information

Network



Definition of the Florida Health Information Network

The Florida Health Information Network is the statewide network that will integrate the Regional Health Information Networks to enable statewide health information exchange



Geography of the FHIN

1. BBRHIO

6. PBCCHA

9. SF HII

3.CHIO

8. SC HIN

5. Jax HIN

4. ESSHIN

7. Pinellas

RHIO

FHIN EMPI and

RLS Server

10. TB RHIO

2. CF RHIO

Florida’s Health Information Networks

1. Big Bend RHIO

2. Central Florida RHIO

3. Community Health Information Organization

4. Escambia HIN

5. Jacksonville Health Information Network

6. Palm Beach County Community Health Alliance

7. Pinellas RHIO

8. Space Coast Health Information Network

9. South Florida HII

10. Tampa Bay RHIO



The Florida Health Information Network Begins at the Local Level

The Florida Health Information Network is being built from the local community up

An essential element of the strategic plan is to empower local stakeholder collaborations focused on health information exchange

The drivers of this plan are the Grants Program and Regional Health Information Organizations in the local community



Legislation Passed in 2006 Authorizes a Health Information Network

House Bill 7073 amended § 408.05 (4)(a) 9, F.S. to address a statewide health information network, directing the Florida Center to:

Monitor innovations in health information technology, informatics, and the exchange of health information and maintain a repository of technical resources to support the development of a health information network.



Legislation Passed in 2006 Authorizes Integration of Health Care Datasets

House Bill 7073 also directed AHCA to: … initiate, oversee, manage, and evaluate

the integration of health care data from each state agency that collects, stores, and reports on health care issues and make that data available to any health care practitioner through a state health information network.(§ 408.05 (4)(c), F.S.)



Specifying the Network Architecture through a White Paper

The Florida Health Information Network White Paper was written to address: The technical architecture of the FHIN The requirements of interoperability among the

RHIOs and the FHIN The needed security precautions to ensure

confidentiality of data exchange in the FHIN For a copy of the White Paper, visit:

http://ahca.myflorida.com/dhit/FHIN_White_Paper.shtml



Architecture of Florida Health Information Network

FHIN EMPI and

RLS Server

RHIO Server: Maintains Minimal Clinical Dataset,

Authenticates Users, Handles Queries

DOH Physician Licensing Database

Data

Provider EMR/EHR System

Clinical Data from Providers, Labs, Pharmacies, etc.

AHCA & DOH Databases

Data

Other RHIO Servers

Data

Payor Databases

Desktop PCsPDAs

End-User Clinicians

Desktop PCs

Patients

Medicaid Florida Center DOH SHOTsVital Statistics

Certification of Physicians with DOH Licensing Database



Developing Florida Regional Health Information Organizations

through the Grants Program



2006 Legislation Authorizes the Grants Program

House Bill 7073 amended § 408.05 (4)(b), F.S., directing the Agency to:

… administer, manage, and monitor grants to not-for-profit organizations, regional health information organizations, public health departments, or state agencies that submit proposals for planning, implementation, or training projects to advance the development of a health information network.



What is a Regional Health Information Organization?



Grants Program to Develop Regional Health Information Organizations

Planning Grants: Support engaging local health care stakeholders to develop a strategic plan for health information exchange

Implementation Grants: Support projects that demonstrate health information exchange among two or more competing providers

Training Grants: Support practitioner training designed to increase physician and dentist use of electronic health record systems



Grants Program, FY 2005-2006

The Agency awarded nine grants with $1.5 million in appropriation from the Legislature Five Planning Grants Three Implementation Grants One Training Grant



Grants Program, FY 2006-2007 The Agency awarded seven grants with a

$2 million appropriation from the Legislature

Big Bend Regional Health Information Organization

Tampa Bay Regional Health Information Organization

Palm Beach County Community Health Alliance

South Florida Health Information Infrastructure

Escambia Health Information Network

JaxCare, Inc.

Community Health Information Organization



An Example of a Florida Regional Health Information Organization:

Big Bend RHIOTallahassee, Florida



Region Served by the Big Bend RHIO

Tallahassee



Big Bend RHIO is Anchored in the Community Board members represent local providers

Most clinical Board members have sophisticated Electronic Medical Record systems in use

FSU College of Medicine, Tallahassee Community College included on Board

Capital Health Plan covers 37% of patients

Optical Fiber medical area network (pMAN), currently providing connectivity



CRMC

Community Repository&

Record Locator

VPN

DisasterRecovery Site

Rx Claims

Big Bend RHIO RHIN Architecture

TMH

Small organizations can connect either directly to the RHIN or through a VPN gateway

Organizations can connect bi-directly to feed their data and receive data directly into their EMR

In the early Phases CHP, CRMC & TMH will provide a one way feed of their data. They have the largest repositories and the priority is to make their data available ASAP

CHP

FHIN Labs & Radiology



Health Information Exchange Services

Big Bend RHIO will establish a community repository for the storage and retrieval of:

Demographic/encounter dataMedication claims data and e-prescribingDocument viewer including lab/radiologySecure messaging

Disaster recovery

Remote data backup outside service area



Future of the Grants Program

Leverage the development of more Regional Health Information Organizations in Florida to create the base for health information exchange

Develop the Florida Health Information Network by interconnecting local health information networks



Next Steps for the Florida Health Information Network

Establish a statutory entity, the Florida Health Information Network Corporation to implement the state level network

As a not-for-profit organization, the Florida Health Information Network Corporation would be accountable to the public and responsive to health care providers



The Florida Health Information Network Corporation will:

Specify standards to ensure interconnectivity and maintain security

Develop uniform policies regarding confidentiality of patient records and patient authorization

As a public-private partnership, will develop the critical mass of information resources to achieve a sustainable statewide system of regional networks



The Future of the Florida Health Information Network

The Florida Health Information Network vision will integrate clinical health information exchange in Florida through a network architecture that will empower physicians to access timely and accurate medical records in order to deliver high quality medical care for their patients.

Florida Center for Health Information and Policy Analysis


Lisa K. Rawlins, Bureau Chief

Agency for Health Care AdministrationFlorida Center for Health Information

and Policy Analysis2727 Mahan Drive

Tallahassee, FL [email protected]

lisa k. rawlins, bureau chief florida center for health information and policy analysis

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