Ohio Health Quality Improvement Plan

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He a l t h In f o r m a t io n Te c h n o l o g yDevelop a technology infrastructure that supports the adoption of electronic medical records andsupports the medical home concept through a robust health information exchange.A non-profit organization will be designated to achieve these goals by:• Creating a statewide health information network• Developing a center of excellence to provide health care information technology integration and education servicesdirectly to health care providers• Improving electronic medical record (EMR) adoption• Coordinating and leveraging the outstanding higher education system and research and development activities withinthe state of OhioBenefits and Outcomes• Lower health care costs. A study released by the Ohio Business Roundtable in December 2008 estimates that $6billion can be saved by improving information sharing between patients and clinicians.• Improved health care outcomes through better care management. One example is a reduction in adverse druginteractions by providing health care providers access to current and recent prescriptions for their patients.• Improved population health by aggregating statewide health data in a timely, accurate and electronic method.TacticsThe PartnershipThe State of Ohio will designate a non-profit entity to create and manage the statewide health information network.This non-profit will also act as Ohio’s center of excellence for health information technology. The non-profit will workcollaboratively with the Ohio Health Care Coverage and Quality Council.Action Steps• Create or designate non-profit• Create or modify articles of incorporations and governance structure• Implement ethics, management and financial controlsThe Ohio Health Information NetworkThe health information network will be the primary tool to share data from the individual EMR tools used by Ohio healthcare providers. The network will allow authorized providers to see an individual’s care history regardless of the settingof care. This will facilitate better care coordination across the care continuum (including at handoffs and transitions) aswell as a reduction in redundant tests. The network will facilitate improved population health by providing researchersand policy makers access to a broad set of health data. The network will provide enhanced patient security by providingaccess to patient authorization, roll-based requester privileges, and automatic data access tracking. The network willpromote patient participation by allowing integration of a number of personal health record tools.The network exchange will be managed in a federated model. This model will support a variety of users accessing thenetwork in the most effective manner based on their role.As the name implies, data partners are those network members whose primary role revolves around the management ofdata. There are two types of data partners. One type is a member of the network who has patient data available for accessby other network members. Examples of this type of data partner include health care providers, labs, or state government.The other type of data partner would be a member who is authorized to access or extract large quantities of data, typicallyfor population health purposes. Examples of this type of data partner include state government, research organization orthe federal government.Providers are network members who are accessing data for the primary purpose of patient care. In this role, providershave view-only access to the data available. Providers may also be data partners, but have different access andpermissions based on the role in which they are accessing the data.12
He a l t h In f o r m a t io n Te c h n o l o g yPatients can only access their own data. This access could be enhanced by using a personal health record such asMicrosoft HealthVault, Google Health, etc. Patients can also access the audit and query database to see who has accessedtheir data.Action Steps• Apply for federal stimulus funds• Develop network requirements• Create and issue a request for proposals (RFP)• Award RFPThe Ohio Center of Excellence for Health Information TechnologyThe center of excellence will provide a variety of services to help health care providers maximize the benefits ofelectronic medical records and health information exchanges. One of the center’s initial objectives will be to provideEMR integration services to health care providers. These integration services will help providers modify their work flowto take advantage of the EMR tools. Integration services will also help providers integrate their EMR systems with theirpractice management tools. The center of excellence will also provide toolkits and publish best practices to help providersmaximize the benefits of implementing EMRs. Ohio envisions these objectives to be accomplished through strongrelationships with Ohio’s system of higher education and other qualified experts.Action Steps• Develop specific services• Apply for federal stimulus funds• Develop criteria for integration service providers• Create a integration service provider certification process• Develop best practices toolkit• Develop health care provider communication strategyImproving Electronic Medical Record AdoptionThe value of the statewide health exchange depends critically on the number of providers using EMRs. Special attentionneeds to be paid to improve adoption by small providers and nonprofit clinics. This segment of the market may not havethe financial or resource capability to adequately implement or manage an EMR solution. The partnership may provide anEMR tool as a service to this market segment. Alternatively, the partnership may facilitate a purchasing collaborative toallow a large number of small providers access to better pricing for one or more EMR solutions.Action Steps• Survey provider community to determine interest in collaborative versus service approach• Develop detailed plan based on service decision• Release and award RFPProposed Milestones/Metrics• Partnership designated – June 1, 2009• EMR service strategy finalized – August 1, 2009• Loan program strategy finalized – August 1, 2009• HIE RFP awarded – January 1, 2010• Center of excellence service provider certification program completed – August 1, 2009• Establish realistic adoption targets for EMR and health information exchange usage – January 1, 2010Decision Points1.2.3.Should the state designate a newly formed non-profit or designate an existing non-profit to manage health ITinitiatives?Should the non-profit provide an EMR as a service or facilitate a purchasing collaborative?What services need to be provided through the center of excellence?13
Page 1 and 2: Ohio Health QualityImprovement Plan
Page 3 and 4: Introduc tionIn November 2008, more
Page 5 and 6: In t r o d u c t io nimplementation
Page 7 and 8: Oh io He a l t h Qu a l it y Im p r
Page 9 and 10: Pa t ie n t Centered Me d ic a l Ho
Page 11: Pa t ie n t Centered Me d ic a l Ho
Page 15 and 16: Pa y m e n t Re f o r m◦◦◦◦
Page 17 and 18: In f o r m e d a n d ActivatedPa t
Page 23 and 24: Me a s u r in g Su c c e s sPropose
Page 25 and 26: Ne x t StepsOhio Health Care Covera
Page 27 and 28: Appendix II — Response to Questio
Page 29 and 30: Appendix III — Su r v e y Results
Page 31 and 32: Appendix IV — Co m m e n t s f r
Page 45: CORE PLANNING TEAMAmy Rohling McGee

Ohio Health Quality Improvement Plan

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