A Discussion on Wisconsin’s A Discussion on Wisconsin’s eHealth InitiativeeHealth Initiative

Department of Health and Department of Health and Family ServicesFamily Services

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Welcome to….

The Wisconsin eHealth Action The Wisconsin eHealth Action Plan Implementation SummitPlan Implementation Summit

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Overview of Summit

8:30 a.m. Welcome and Overview: Wisconsin’s eHealth Action Plan

9:00 a.m. Address by Governor Jim Doyle

9:30 a.m. The National Landscape and Wisconsin’s Role

10:40 a.m.

State Level Implementation of eHealth Initiatives

11:20 a.m.

State Leadership Perspectives on Achieving eHealth

1:00 p.m. Regional and Cross-Border Considerations in eHealth

1:40 p.m. Break-out Sessions (not webcast)

2:45 p.m. Next Steps: Panelists from Wisconsin’s eHealth Board

3:30 p.m. Closing Remarks

3:45 p.m. Adjournment

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WI’s eHealth Action Plan

What is the Wisconsin eHealth What is the Wisconsin eHealth Initiative?Initiative?

Executive Order #129Executive Order #129 eHealth Care Quality and Patient eHealth Care Quality and Patient

Safety Board Charter, Members, Safety Board Charter, Members, StructureStructure

eHealth Action Plan/Next StepseHealth Action Plan/Next Steps Medicaid Transformation GrantMedicaid Transformation Grant DiscussionDiscussion

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The Health Care Environment 1999 “To Err is Human”1999 “To Err is Human”

Human impact and health care costs of Human impact and health care costs of errorserrors

““Crossing the Quality Chasm”Crossing the Quality Chasm” Roadmap for health care redesignRoadmap for health care redesign

Wisconsin’s provider and payer Wisconsin’s provider and payer responseresponse Wisconsin Collaborative for Healthcare Wisconsin Collaborative for Healthcare

Quality (WCHQ)Quality (WCHQ) eHealth Care Quality and Patient Safety eHealth Care Quality and Patient Safety

BoardBoard Wisconsin Health Information Wisconsin Health Information

Organization (WHIO)Organization (WHIO)

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Wisconsin eHealth Initiative Public-private collaboration for Public-private collaboration for

widespread adoption of HIT/HIEwidespread adoption of HIT/HIE Wisconsin’s eHealth Action Plan includes:Wisconsin’s eHealth Action Plan includes:

Create a technical infrastructureCreate a technical infrastructure Establish a governance structure for health Establish a governance structure for health

information exchangeinformation exchange Develop options for addressing privacy and Develop options for addressing privacy and

security issuessecurity issues Support the acquisition of EHR systems by Support the acquisition of EHR systems by

small provider groups and safety-net small provider groups and safety-net providersproviders

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Executive Order #129November 2005

Governor Jim Doyle created the Governor Jim Doyle created the eHealth Care Quality and Patient eHealth Care Quality and Patient Safety Board to:Safety Board to:

Ensure health information is Ensure health information is available at the point of careavailable at the point of care Reduce medical errors and duplicationReduce medical errors and duplication Improve coordination of careImprove coordination of care Further health care researchFurther health care research Engage consumers in their health careEngage consumers in their health care

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eHealth Care Quality and Patient Safety Board

Charged with:Charged with: Identifying existing and potential Identifying existing and potential

eHealth resourceseHealth resources Identifying technology options Identifying technology options Identifying options for serving Identifying options for serving

consumer information needsconsumer information needs Ensuring privacy and security in the Ensuring privacy and security in the

exchangeexchange Facilitating statewide adoptionFacilitating statewide adoption Creating an infrastructure for Creating an infrastructure for

statewide adoptionstatewide adoption

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eHealth Board MembersChair:Chair:    Kevin HaydenKevin Hayden, Secretary, Department of Health and Family Services, Secretary, Department of Health and Family ServicesBetsy AbramsonBetsy Abramson, Elder Law Attorney and Consultant , Elder Law Attorney and Consultant Christopher Alban, MDChristopher Alban, MD, Clinical Informaticist, Epic Systems Corporation, Clinical Informaticist, Epic Systems CorporationBevan BakerBevan Baker, Commissioner of Health, City of Milwaukee Health Department, Commissioner of Health, City of Milwaukee Health DepartmentEdward Barthell, MDEdward Barthell, MD, Executive Vice President, CIO, Infinity Healthcare, Executive Vice President, CIO, Infinity HealthcareGary BezuchaGary Bezucha, Administrator, Boscobel Area Health Care  , Administrator, Boscobel Area Health Care  Patricia Flatley BrennanPatricia Flatley Brennan, Professor of Nursing and Industrial Engineering  , Professor of Nursing and Industrial Engineering  Catherine HansenCatherine Hansen, Director, Health Information Services, St. Croix Regional , Director, Health Information Services, St. Croix Regional

Medical CenterMedical CenterRavi KallaRavi Kalla, CEO and President, Symphony Corporation, CEO and President, Symphony CorporationDon LaydenDon Layden, Executive Vice President, Corporate Development, Metavante , Executive Vice President, Corporate Development, Metavante

Corporation Corporation Michael L. MorganMichael L. Morgan, Secretary, Department of Administration, Secretary, Department of AdministrationLois MurphyLois Murphy, IT Specialist, Veterans Administration, IT Specialist, Veterans AdministrationCandice OwleyCandice Owley, RN, President, Wisconsin Federation of Nurses and Health , RN, President, Wisconsin Federation of Nurses and Health

ProfessionalsProfessionalsDebra RislowDebra Rislow, CIO and Director of Information Systems, Gundersen Lutheran, CIO and Director of Information Systems, Gundersen LutheranPeg SmelserPeg Smelser, Chief Operating Officer, Wisconsin Education Association Trust, Chief Operating Officer, Wisconsin Education Association TrustEric StanchfieldEric Stanchfield, Secretary, Employee Trust Funds, Secretary, Employee Trust FundsJustin Starren, MD, PhD,Justin Starren, MD, PhD, Director, Biomedical Informatics Research Center, Director, Biomedical Informatics Research Center,

Marshfield Clinic Marshfield Clinic Lon Sprecher, Lon Sprecher, Senior Vice President and COO, Dean Health InsuranceSenior Vice President and COO, Dean Health InsuranceJohn Toussaint, MDJohn Toussaint, MD, President and CEO, ThedaCare, President and CEO, ThedaCareHugh ZettelHugh Zettel, Director, Government and Industry Relations, GE Healthcare, Director, Government and Industry Relations, GE Healthcare

Technologies Technologies

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eHealth Care Quality and Patient Safety Board 2007

Steering Committee for Security and Privacy Project

eHealth Board Workgroup

Security and Privacy Project Ad-hoc Workgroup

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eHealth Action Plan December 1, 2006

1.1. Establish the eHealth technology Establish the eHealth technology platformplatform

2.2. Value-based purchasing policies Value-based purchasing policies and actionsand actions

3.3. Link HIT and HIE plans to Link HIT and HIE plans to prevention and disease prevention and disease management activitiesmanagement activities

4.4. Take an incremental approach – Take an incremental approach – growing thoughtfully over time with growing thoughtfully over time with frequent evaluation of progressfrequent evaluation of progress

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eHealth Technology Platform HIT adoptionHIT adoption

Encourage adoption and investment in Encourage adoption and investment in electronic health record systemselectronic health record systems

Regularly monitor adoption progressRegularly monitor adoption progress Regional health information exchangeRegional health information exchange

Foster creation of regional health Foster creation of regional health information exchangesinformation exchanges

Simultaneously focus on statewide health Simultaneously focus on statewide health information exchangeinformation exchange

Focus early on providing patient Focus early on providing patient information timely and at point of careinformation timely and at point of care

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Value-based purchasing Develop standard requirements for Develop standard requirements for

reimbursementreimbursement Leverage purchasing power of state Leverage purchasing power of state

government to align incentives that government to align incentives that promote high quality, safe, and promote high quality, safe, and efficient careefficient care

Seek funding to develop these Seek funding to develop these systemssystems

Participate in development of the Participate in development of the WHIO data repository to track WHIO data repository to track quality and cost across episodes of quality and cost across episodes of carecare

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Link HIT and HIE to prevention and disease management

Develop a routine health risk Develop a routine health risk assessment and member agreementassessment and member agreement

Promote chronic disease management Promote chronic disease management tools by safety-net providerstools by safety-net providers

Improve coordination of care across Improve coordination of care across health settingshealth settings

Research ways to engage patients in Research ways to engage patients in the health decision-making processthe health decision-making process

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Link HIT and HIE to prevention and disease management (cont.)

Establish biosurveillance Establish biosurveillance capabilities for rapid detection, capabilities for rapid detection, management, and recovery across management, and recovery across health settingshealth settings

Assure interoperability of HIT/HIE Assure interoperability of HIT/HIE with public health systemswith public health systems

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Take an incremental approach

Address HIT and HIE simultaneouslyAddress HIT and HIE simultaneously Establish benchmarksEstablish benchmarks Start with projects that build Start with projects that build

infrastructureinfrastructure Use standards consistent with Use standards consistent with

national developmentsnational developments Create incentives for interoperable Create incentives for interoperable

systemssystems

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Take an incremental approach (cont.)

Build on existing assetsBuild on existing assets Establish effective communications Establish effective communications

strategies strategies Monitor progress and adjust Monitor progress and adjust

activities as necessaryactivities as necessary

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eHealth Action Plan Next Steps

Activate eHealth Board advisory Activate eHealth Board advisory groups to begin action plan groups to begin action plan implementationimplementation

eHealth Implementation Summit, eHealth Implementation Summit, March 15, Fluno Center, MadisonMarch 15, Fluno Center, Madison

Medicaid Transformation Grant—Medicaid Transformation Grant—resource option to jumpstart resource option to jumpstart Wisconsin’s eHealth Action PlanWisconsin’s eHealth Action Plan

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Medicaid Transformation Grant

January 2007: CMS 2-year grant January 2007: CMS 2-year grant award to DHCF to fund Wisconsin award to DHCF to fund Wisconsin Medicaid’s Health Information Medicaid’s Health Information Exchange InitiativeExchange Initiative

Activities to include creating:Activities to include creating: A regional information exchange A regional information exchange

frameworkframework Infrastructure and system to enable Infrastructure and system to enable

multiple health care settings in Milwaukee multiple health care settings in Milwaukee County to securely exchange medical County to securely exchange medical information about patients enrolled in information about patients enrolled in Medicaid and the General Assistance Medicaid and the General Assistance Medical Programs (GAMP) Medical Programs (GAMP)

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Security and Privacy Project – Implementation Plans

Verification of patientVerification of patient Develop model polices and procedures for a Develop model polices and procedures for a

standard method to uniquely identifying a patient standard method to uniquely identifying a patient Modification of Wis. Stat. 146 to mirror Modification of Wis. Stat. 146 to mirror

HIPAA:HIPAA: Documentation requirements Documentation requirements Re-disclosure restrictionsRe-disclosure restrictions Limitation on disclosure to familyLimitation on disclosure to family

Modification of Wis. Stat. 51.30 to allow the Modification of Wis. Stat. 51.30 to allow the exchange of health information for exchange of health information for treatment purposes. treatment purposes. Identification of the key elements to be Identification of the key elements to be

exchanged without patient consentexchanged without patient consent Changing the statute, if necessaryChanging the statute, if necessary

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Next Steps

We continue to seek advice and We continue to seek advice and feedback on:feedback on: How to proceed on any of the aspects How to proceed on any of the aspects

of the eHealth Action Plan and of the eHealth Action Plan and Medicaid TransformationMedicaid Transformation

Concerns Concerns SolutionsSolutions Identification of best practicesIdentification of best practices

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For more information on the WI eHealth Initiative

Go to:Go to:

http://ehealthboard.dhfs.wisconsin.gov/http://ehealthboard.dhfs.wisconsin.gov/

DHFS Contacts:DHFS Contacts:

Kathy Farnsworth, eHealth Chief of StaffKathy Farnsworth, eHealth Chief of StaffFarnsK@dhfs.state.wi.usFarnsK@dhfs.state.wi.us(608) 267-2802(608) 267-2802

Denise Webb, Policy Initiatives Advisor,Denise Webb, Policy Initiatives Advisor,Health Care ITHealth Care ITwebbdb@dhfs.state.wi.uswebbdb@dhfs.state.wi.us(608) 267-6767(608) 267-6767