eHealthConnecticut, Inc. Programs and Accomplishments as of April 9, 2010

Background

• Incorporated in January, 2006.
• Not-for-profit, transparent, focused on serving the public good.
• Governed by a volunteer board of directors representing all key health care stakeholders.
• Mission: to implement and sustain a statewide Health Information Exchange (HIE) to improve health care quality, safety, and efficiency for Connecticut’s residents.
• Funds have been raised from private and public sources to plan the HIE, develop awareness of it, and initiate projects. In 2006, the State of Connecticut appropriated $300,000 toward this effort.
• Designated as a Chartered Value Exchange (CVE) in 2008. CVEs are a select group of twenty four entities in the United States recognized by the Agency for Healthcare Research and Quality (AHRQ) of the Department of Health and Human Services (HHS) as communities of health care providers, employers, insurers, and consumers working to improve care and make quality and value information available.
• Engaged in three funded programs:

Programs

In 2006, the State of Connecticut appropriated funds administered by the Department of Public Health for eHealthConnecticut to convene health care stakeholders throughout the state to provide education about the features and value of HIE, gather information about related efforts throughout the state, and to initiate planning. The effort resulted in recommendations to implement key programs, including the development of the HIE, statewide quality reporting, and programs to increase awareness and help providers adopt the HIT systems necessary to interoperate with the HIE.

1. Health Information Exchange

In January, 2009, eHealthConnecticut was contracted by the state’s Medicaid agency, the Department of Social Services (DSS), to implement an HIE pilot. The funding was provided by the Centers for Medicare & Medicaid Services (CMS) of the US Department of Health and Human Services via a Medicaid Transformation Grant. The pilot project will be operational in spring of 2010. The HIE will connect Federally Qualified Health Centers, acute care hospitals, and private physicians who will interoperate using standards promulgated by the Office of the National Coordinator. Primary care, emergency, and inpatient data will be shared via “Continuity of Care” documents stored in secure, private computers. These documents contain structured data including patient problems, allergies, medications, laboratory results, and physician notes. While the project is being funded by DSS with a focus on Medicaid recipients, the system will benefit all patients, regardless of payer. The HIE platform is being implemented as a shared service “utility” that could be scaled statewide.

Project assets have been developed that can be leveraged statewide:

• A technology platform providing central HIE services, enabling interfaced EHR systems to interoperate. The system has been developed by Hartford Hospital and Misys Open Source Solutions. The system is being hosted at the Connecticut Hospital Association, and complies with interoperability standards being promulgated by the federal government. The system has the capability to be the statewide “network of networks,” enabling individual providers to interface directly, or via local HIE’s, that will exist in various communities throughout the state. The vision is that the eHealthConnecticut HIE will in turn link to the National Health Information Network being championed by the federal government.
• Privacy policies and a Universal Medical Records Release Authorization (UMRRA) form that can be used by physicians, hospitals, and other providers throughout the state. These have been developed by eHealthConnecticut’s Privacy Committee comprised of consumer advocates, providers, DSS representatives, and legal advisors. The policies are posted on the web site. The UMRRA is for patients to sign giving authorization for the inclusion of their information in the eHealthConnecticut system.
• A Data Use and Reciprocal Support Agreement (DURSA) and Business Associate Agreement (BAA), to be signed by all entities that participate in the HIE. These documents clarify the responsibilities of all parties, including commitments to security and privacy practices. These contracts meet the current requirements of the federal HITECH legislation, and the same standard documents are executed by all HIE participants.
• Online education modules and written materials to help providers and consumers understand how HIE works, and the benefits and risks of participating in the HIE.

2. Quality Reporting and Improvement

In August, 2008, eHealthConnecticut was designated a Chartered Value Exchange (CVE) by HHS’ Agency for Healthcare Research and Quality (AHRQ). eHealthConnecticut’s featured CVE program is the Connecticut Health Quality Cooperative (CHQC). It is funded jointly by the Connecticut State Medical Society, the Connecticut State Medical Society IPA, Aetna, Anthem, ConnectiCare, HealthNet, and UnitedHealthcare. The purpose of CHQC is to improve quality of care by aggregating administrative and clinical data and sharing it via a secure web site with physicians. Plans call for similar information to be shared with the public at some time in the future.

This is the first time that such in-depth information from the multiple payers named above and Medicare is available to Connecticut physicians. The usefulness of the reports is being enhanced through an online education program to help physicians understand the reports and implement best practices to improve patient care outcomes. The system has been live since September, 2009, with reports available for 3,700 of the state’s primary care providers.

CHQC collaborators also include Qualidigm (the state’s Quality Improvement Organization) and Bridges to Excellence. We hope to add additional collaborators, including the state’s remaining private and public payers, over time.

3. Health Information Technology Adoption

On April 6, 2010, eHealthConnecticut was designated as the statewide Health Information Technology Regional Extension Center (HITREC), with a $5.75 million federal grant awarded by the Office of the National Coordinator (ONC), Department of Health and Human Services, Grant Number 90RC0053. The goal of eHealthConnecticut’s HITREC is to help the state’s providers, mainly physician office practices and Federally Qualified Health Centers, select, implement, and achieve meaningful use of Electronic Health Record (EHR) systems. This includes connecting them to a statewide Health Information Exchange (HIE) to enable sharing of patient data. The commitment is to help a minimum of 2,500 of the state’s 8,000 practicing physicians over the next four years.

Our approach is to charge providers a fee for HITREC services. In the first two years, we will charge a fee of $500 per provider for selection, implementation, and meaningful use assistance. Enabled by the federal 9:1 match available through the HTREC grant, this initial $500 fee will enable a provider to receive a full complement of services valued at $5,000 per provider, so a provider will realize significant value from engaging with the HITREC.

eHealthConnecticut staff, including the Executive Director, are being hired at this time to provide the core services of the HITREC. Direct services to the physician practices will be provided by a team of local contractors, all experienced in selecting, implementing and supporting EHR systems.

eHealthConnecticut’s plan is to be self sufficient by 2012-13, with three revenue streams to complement and eventually replace the federal subsidy: service fees from provider customers, membership dues, and special projects for paying customers.

Summary

eHealthConnecticut has worked since 2005 to build trust and capability throughout Connecticut. Designation as Connecticut’s HIT Regional Extension Center creates strong synergy with our Health Information Exchange and Quality Improvement programs, which together provide a solid foundation to deliver value to Connecticut’s 3.5 million residents.