Transcript Title or Topic

Provider Education Toolkit
New York State
Background
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Health Information Security & Privacy Collaboration (HISPC) established in
2006 by the U.S. Department of Health and Human Services.
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Initially comprised of 34 states and territories, the project expanded in
2008 to involve 42 states and territories.
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Seven multi-state collaboratives were formed to effectively address the
privacy and security challenges presented by electronic health information
exchange.
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The HISPC Provider Education Toolkit Collaborative comprised of 8 states
(FL, KY, LA, MI, MO, MS, TN, WY) was formed to educate providers and
increase awareness of the privacy and security benefits of health
information exchange.
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As part of the HISPC Phase III extension period work, NY adapted the
Provider Education Toolkit to meet the needs of its providers.
www.nyehealth.org
Welcome to the New York State Provider Education Toolkit, adapted
from materials created through the HISPC Provider Education
Collaborative. Found at www.nyehealth.org, this resource was
created specifically to assist the NY health care community…
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Get the facts about electronic health information exchange (HIE)
Access the current HIE initiatives within the state
Identify state laws applicable to HIE and privacy of personal
health information
Learn about the tools and resources you need to safely and
securely get connected in your region to share patient
information with other health care stakeholders
New York eHealth Collaborative
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The New York eHealth Collaborative (NYeC, pronounced "nice") is a State designated
public-private partnership and statewide policy body playing an integral role in the
implementation of New York State's health IT strategy through a consensus-based
approach. Key responsibilities include:
– Convening, educating and engaging key constituencies, including health care and health
IT leaders across the state, Regional Health Information Organizations, Community
Health Information Technology Adoption Collaboratives ("CHITAs"), and other health IT
initiatives
– Developing Statewide Policy Guidance through a transparent governance process
– Evaluating and establishing accountability measures for New York's health IT strategy
New York State Department of Health
The New York State Department of Health, Office of Health Information
Technology Transformation is charged with coordinating health IT
programs and policies across the public and private health care sectors.
Its goal is to enable improvements in health care quality, increase
affordability and improve health care outcomes for New Yorkers.
As part of its commitment to the public-private infrastructure evolving to
support statewide interoperability, the State of New York has committed
funding to NYeC to manage the statewide collaborative process.
What is Health Information Technology
(Health IT)?
Health IT refers broadly to electronic methods for
storing and processing clinical data.
Electronic health records allow for quick searching,
tracking, analyzing, and retrieval of patient
information by physicians and qualified staff in a
safe and secure manner at the point of care.
How do I get connected?
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– Regional Health Information Organizations (RHIOs)
• RHIOs get and share information about patients from such
places as hospitals, physicians, pharmacies, clinical
laboratories, health insurers, and the Medicaid program
– Community Health Information Adoption
Collaborations (CHITAs)
• A CHITA is a health IT services and support organization
What is a RHIO?
A RHIO is a non-profit corporation that brings together health care stakeholders within a
defined geographic area and facilitates and governs the electronic movement of health
related information among participating stakeholders. It does this with the purpose of
improving health and access to care in that community. RHIOs make up the larger health
IT network the Statewide Health Information Network for New York (SHIN-NY). New York
has funded the start up of RHIOs through the Healthcare Efficency and Affordability Law
for New Yorkers (HEAL NY).
RHIOs enable clinicians and patients to share a patient's medical information electronically
with such places as hospitals, physicians, pharmacies, clinical laboratories, health insurers,
and the Medicaid program.
To locate a RHIO in your region, go to: http://www.nyehealth.org/nys-hit-projects
For more info on the criteria for defining RHIOs and NY’s health IT strategy, go to:
(http://www.health.state.ny.us/funding/rfa/0903160302/health_it_strategic_plan.pdf)
As a physician or a hospital, what support can I get
from RHIOs for Health Information Exchange
implementation?
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Governance
Standardizing Clinical Requirements
Standardizing Technical Policies
Financing HIE
Patient Privacy
Standardizing Confidentiality and Security
Policies
Patient Engagement
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Authentication, Authorization, Access
Controls, Auditing
Consent Management and other Fair
Information Services
Data Aggregation
Data Reporting
Data Access
Standardized Participation Agreements
What is a CHITA?
A CHITA is a health IT services and support organization (service
bureau/extension center) to promote the implementation, adoption, training
and effective use of interoperable electronic health records and other health IT
tools by providers. CHITAs are also responsible for coordination of the support
necessary for practice transformation, reimbursement changes and patient
engagement, to vastly improve the availability and use of health information
and help ensure that the expected quality and efficiency goals are realized
from interoperable health IT.
A CHITA may be a not-for-profit, for-profit corporation or local government
agency, dedicated to promoting interoperable electronic health record
adoption and effective use, provided that the organization demonstrates the
competence and ability to provide directly or through partnerships low cost,
high value health IT adoption and support services to providers and patients.
More info: http://www.nyehealth.org/nys-hit-projects
As a physician or a hospital, what support can I
get from CHITAs for EHR implementation?
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Readiness assessment
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Vendor/product selection
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Organizational development
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Implementation and configuration support
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Change management
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Interoperability services
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Workflow re-design
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User training
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Practice transformation including the
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Ongoing support/help desk services
implementation of new reimbursement •
models
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Project management
Process and quality improvement services to
achieve patient care improvements
How is care going to be affected by
health IT?
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Having immediate access to key information, such as patients' diagnoses,
allergies, lab test results, and medications;
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The ability for all providers participating in the care of a patient in multiple
settings to quickly access new and past test results and diagnosis and
treatment information;
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The ability to enter and store orders for prescriptions, tests, and other
services in a computer-based system;
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Using Clinical Decision support tools such as reminders, prompts, and alerts
to improve compliance with best clinical practices, ensure regular screenings
and other preventive practices, identify possible drug interactions, facilitate
diagnoses and treatments, and reduce the frequency of adverse events.
How is care going to be affected by
health IT?
• Having patient support tools that give patients access to
their personal health records and provide interactive
patient education.
• Computerized administrative tools, such as scheduling
systems, would greatly improve efficiency and provide
more timely service to patients.
• Using reporting tools to enable health care organizations
to respond more quickly to federal, state, and private
reporting requirements, including those that support
patient safety and disease surveillance.
How do you pay for it?
The American Recovery and Reinvestment Act of 2009 (aka theFederal Stimulus
Package) contains Medicare and Medicaid incentive payments to eligible
providers, including physicians and hospitals, in order to increase the adoption of
Electronic Health Records (EHRs). To receive the incentive payments beginning in
2011, providers must demonstrate “meaningful use” of a certified EHR. There is
also a federal EHR loan program that will be made available in the near future.
Funding through HEAL NY health IT capital grants program has been available for
health IT implementation since 2006. HEAL 5 projects are currently being
implemented across the state. In addition, HEAL 10 projects will be focused on
the Patient Centered Medical Home model in the coming months. Resources are
available and opportunities exist in communities awarded HEAL funding for
providers to adopt health IT. Other funding through the HEAL NY program and
other state initiatives may be available in the future.
What is a certified EHR product and
why do I need it?
A certified EHR is one that is approved and certified by the
Certification Commission for Healthcare Information
Technology (CCHIT). CCHIT is a private, nonprofit initiative
and a recognized certification body for electronic health
records and their networks. NYS requires the use of EHR
products that have been certified by CCHIT. NY will continue
to evaluate the certification process on the federal level to
assure consistency with future recommendations.
How will a provider demonstrate
“meaningful use” of a certified EHR?
Meaningful use of a certified EHR is still being defined by the federal HIT Policy
Committee of the US Department of Health and Human Services. Final
recommendations are expected to be released in July and federal regulations
around meaningful use are expected to be in place by year’s end. Some of the
earlier draft criteria focused on:
- Use of a certified product complete with ePrescribing
capability
- The EHR technology is connected for the electronic exchange
of Protected Health Information
- Compliant with submission of reports on clinical quality
measures
What are providers required to do to qualify for
federal incentives?
There are two incentive payment programs available:
one through Medicare and another through Medicaid.
Both require that a provider prove "meaningful use" of a
"qualified" EHR product to be eligible for the incentives.
Physicians have to choose one program, but hospitals
can qualify for both programs.
What is the impact of delay in
implementing an EHR?
Beginning in 2015, financial penalties can be
incurred for failure to use EHRs. CMS will
mandate that the Medicare physician fee
schedule payments for non compliant
providers be reduced by 1% for 2015; by 2%
reduction for 2016; and by 3% for 2017 and
subsequent years.
How do I maximize the potential for
federal incentives?
Commencing in 2011 and for the first five years,
the Act will compensate physicians and hospitals
who are “meaningful EHR users” in decreasing
increments, with the largest incentives in 2011
and 2012. Beginning in 2015, health care
providers will be penalized if they don’t have
EHRs. No incentive payments will be available
to those adopting EHRs after 2014.
What are the implications of
HIPAA?
NY law is more stringent than HIPAA for patient treatment, payment and health
care operations. NY law requires providers to obtain patient consent for
treatment. A patient centered affirmative consent policy was developed for the
exchange of personal health information in NY through RHIOs. A
state approved consent form was also developed to allow patients to choose
who has access to their health information.
At the federal level, the Health Information Technology for Economic and Clinical
Health Act (HITECH) includes provisions affecting the exchange of data, including:
• Extension of HIPAA to Business Associates
• Security Breach Notification Mandate
• New Restrictions on the Use and Disclosure of Protected Health
Information
• Additional Patient Rights
• Increased HIPAA Penalties
Federal regulations are expected to be released later this year.
For additional information…
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Please visit:
www.nyehealth.org
www.health.state.ny.us/technology/
www.secure4health.org
The NYSDOH worked with the following organizations to produce
this toolkit:
Healthcare Association of NYS (HANYS)
NY Chapter of the American College of Physicians (NYACP)
Medical Society of the State of NY (MSSNY)