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National Initiatives
The Office of the National Coordinator for Health Information Technology was created by Presidential Executive Order in 2004 and charged with leading in the development of a National Health Information Network (NHIN). The overall goal is to for most all Americans to have access to an interoperable electronic medical record by 2014.
The federal Health Care & American Recovery and Reinvestment Act (ARRA) enacted by Congress in 2009 had several significant provisions to advance this national agenda. Provisions included:
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$2 billion in discretionary funds for grants and loans for technical assistance for providers in converting to electronic records, to states for planning and provider loan programs, to educational institutions for workforce training and curriculum development, and to other institutions for new technology research.
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Nearly $30 billion in Medicare and Medicaid financial incentives for hospital and physician conversion to electronic medical records.
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New Policies & Standards to expand HIPAA to include health information technology vendors as business associates and establish more stringent breach notification requirements and penalties.
More information about the Office of the National Coordinator for Health Information Technology is available at http://healthit.hhs.gov/
Several other national offices, commissions and public private collaboratives play key roles in shaping NHIN. Information on these efforts is available at http://nyehealth.org/links |
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A recent report of the US Congressional Budget Office concluded that new medical technology, devices and specialty drugs are the primary factors driving health care costs nationally, not the aging of the population or increased access to health insurance.
Medicare data for Central New York suggest a similar trend. While the region is among the lowest nationally in inpatient and ambulatory health care costs, levels of medical technology costs appear to be high.
The Health Advancement Collaborative of Central New York is working to analyze and address drivers of health care costs through a multi-stakeholder committee of providers, insurers and business. One objective is to pilot test a mechanism for reviewing technology costs that is data-driven and consistent with four guiding principles:
- be focused on optimizing, not artificially limiting new and innovative uses of technology;
- be open and objective and driven by evidence-based scientific and community data;
- provide for two-way evaluation of new and new use technology and payer coverage policies; and
- generate data to support the adoption of best practice standards.
Articles and other resources related to capacity management and technology costs are available in the resources section of this web site.
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Most every developed country in the world except the United States has the ability to exchange clinical information electronically on patients across providers and treatment sites in a secure manner. Developing this ability in the US is the newest frontier of health care. This ‘ATM’ of health care will allow a patient and the providers he/she authorizes to have immediate access to their clinical information no matter where or when they are seen. This can lead to more accurate and timely treatment, a reduction in duplicate tests and procedures, more efficient referrals to other providers, and less paper work for all concerned. In the emergency room, having immediate access to patient information can be life-saving.
Most all states and hundreds of local communities are working to create the ability to exchange clinical information electronically. Developing the technology (software and hardware) is just part of the story. Policies and standards are also needed to ensure that different software solutions can ‘talk’ to one another and that a patient’s information and privacy are secure. Having the right technology and policies are essential, but not sufficient to realize the benefits of an information exchange. Providers also need to make the switch to electronic records and incorporate them into their daily treatment routines, which can be costly and disruptive. Many believe that financial incentives and changes in how providers are reimbursed will be needed for a majority of providers to leap the digital divide.
The focus of the Collaborative's work initially is on the electronic exchange of lab, radiology and medication information.
Several articles and surveys are included in the resource section of this web that talk about the history of clinical information exchange, about current initiatives and issues related to building successful networks.
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Health Advancement Collaborative of CNY Initiatives
HAC-CNY’s highest priority is creating the ability for health care providers across Central New York to exhance patient information exelctronically in a secure, protected manner. This ‘health information exchange’ is one of many across New York working collaboratively to create common standards and policies that, ultimately, will allow data to be shared statewide. HAC-CNY functions as the Regional Health Information Organization (RHIO) that oversees all aspects of the growing Central New York exchange.
Federal, State and local funds are being used to fund the initial capital costs of a CNY exchange. Beginning in 2011, HAC-CNY will be conducting a three-year pilot that spreads the costs of the RHIO across the commercial population.
The initial providers sharing patient information include the four local hospitals, four large physician practices, and a large lab in Onondaga County. The focus of the Collaborative's work initially is on the electronic exchange of lab, radiology and medication information. Beginning in 2011, the intent is to expand the exchange to include providers in other CNY communities. |
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In 2007, a new ‘Office of Health Information Technology Transformation’ was created within the New York State Department of Health to lead in developing a Statewide Health Information Network of New York or SHIN-NY (pronounced ‘shinny’). The state’s investment in health information technology is part of the Health Care Efficiency Affordability Law (HEAL) that provides funds for projects to reform and reconfigure health care delivery.
More information on the state’s program is available at: http://www.health.state.ny.us/technology/
A public/private collaborative has also been formed to support and oversee the State’s work in information technology -- the New York eHealth Collaborative or NYeC (pronounced ‘nice’).
Additional information on NYeC is available at: http://nyehealth.org/
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Initiatives
