Connecting Pennsylvanians for Better Health: Recommendations from the Pennsylvania eHealth Initiative Approved by PAeHI Board of Directors April 25, 2007 www.paehi.org This document was made possible in part by the assistance the of eHealth Initiative and drawing on their work in development of the Michigan Health Information Network’s Conduit to Care, December 2006

PAeHI – Guiding Principles Guiding Principle 1: Patient’s come first. Guiding Principle 2: Consumer privacy, security and confidentiality are paramount. Guiding Principle 3: Multi-stakeholder collaboration is needed to implement achievable and measurable initiatives in order to show early progress and value. PAeHI view it’s big steps in: Planning session in January Multi-year plan Strategic Plan Create a formal Operating Entity Addressing the objectives Watching the Landscape Summit in the spring of 07 Continue to publish it’s newsletter Survey of Capabilities

Evolution Requirements of the Electronic Aggregate Health Record PAeHI view it’s big steps in: Planning session in January Multi-year plan Strategic Plan Create a formal Operating Entity Addressing the objectives Watching the Landscape Summit in the spring of 07 Continue to publish it’s newsletter Survey of Capabilities

Choosing our Building Blocks Source : AHIMA

PAeHI - Roles Identify opportunities for Pennsylvanians to use HIT and HIE to improve healthcare. Educate the public providers and policy makers regarding the benefits and challenges of HIT and HIE. Coordinate the efforts of all Pennsylvania HIT and stakeholders. Identify opportunities to coordinate with and benefit from federal initiatives. Develop statewide consensus on established and emerging standards (e.g., data, communication and reporting). Work with providers, payers, policy makers to define business cases for HIT and HIE. PAeHI view it’s big steps in: Planning session in January Multi-year plan Strategic Plan Create a formal Operating Entity Addressing the objectives Watching the Landscape Summit in the spring of 07 Continue to publish it’s newsletter Survey of Capabilities

Privacy and Confidentiality Important Area of Focus Increasingly, this is becoming an issue It is imperative, that state and regional initiatives tackle these issues responsibly on the front end, with great care, to build and maintain public trust PAeHI will work with eHI and Connecting Communities to take on this issue in 2007 and support responsible practices and policies in the field, to build and maintain public trust Health Care is Experiencing a spiritual journey like no other time before Caused by the gap between Technology Changing face of Health Care caused by the 9/11 effect and the high cost of Health Care. Truly exciting times We can reap the benefits of HIT to improve the quality of care and reduce costs. Never been a time in US Healthcare So much effort has been on Technology Catalyst for transformation of care and involving Patients in their own care. RHIOs are forming at a remarkably rapid rate across the country. 2 years ago - fewer than a dozen of these organizations in the formative stages. 1 year ago, there were approximately 110 RHIO Last count, there were just over 200 The journey has begun Much uncertainty and debate exist toward a truly sharable and interoperable EHR Doubt Is slowly eroding Momentum building More than 30 Ambulatory EMR products certified. Recognition who acquired and implemented EHR - good for relationship patients Worth the eventual investment. The Pennsylvania's HC community is working collectively – like no other time before Increase interest in EMR use and adoption While Pennsylvania may lag in physician EMR adoption rates today Providers are focusing and making the investment

Barriers PAeHI role still evolving-few in advanced stage Federal IRS Status still pending Sustainable value proposition Financing & operations still questionable Achievable technical architecture Still in process of defining value Diversity and size of PA Progress – never fast enough Architectural debate 42% of efforts focus on governance & policy Increase involvement at local & provider levels PAeHI view it’s big steps in: Planning session in January Multi-year plan Strategic Plan Create a formal Operating Entity Addressing the objectives Watching the Landscape Summit in the spring of 07 Continue to publish it’s newsletter Survey of Capabilities

Opportunities for PAeHI Positioned for statewide HIT collaboration Education – Standards/Certification/Funding Sources Catalyst for informing providers & citizens on HIT Collaboration will increase need for local efforts and providers A Private-Public sector opportunity– less government A single neutral convener Organizationally positioned for a HIT utility Serve as institute for HIT Bridge between public health & personal care sectors HIT Facilitator - patient care mostly paper Leader for Collective Medical trading area analysis Can fill the Gaps that currently exist in PA for NHIN Can build a HIE If – Not if but WHEN the PAeHI is successful : Can facilitate faster adoption of EHRs in PA Without adoption – cannot influence interoperability We see the value in : Universal Care through HIT Positive affect on Premiums Positively affect Quality Statewide connectivity can reduce rate of infections Reduce health disparities Can help Pennsylvania Manage chronic disease Leverage HIT & education Improve data reporting Faster identification of disease

PAeHI - Next Steps Actualize Multi-year Strategic Plan New goals for standing committees Charter Policy Committee (includes legal issues) Support local HIE special interest group Follow up on findings of ePrescribing Discovery Group Identify specific operational HIT priorities Seek Operating and Project-specific Funding Engage dedicated staff Continue Quarterly Newsletter Education Events Maintain a pulse on PA’s HIT landscape Serve as conduit eHI/Connecting Communities Expand involvement of members PAeHI view it’s big steps in: Planning session in January Multi-year plan Strategic Plan Create a formal Operating Entity Addressing the objectives Watching the Landscape Summit in the spring of 07 Continue to publish it’s newsletter Survey of Capabilities

What Does All of this Mean? Continued interest in state and regional health information exchange initiatives Likely a combination of national, regional and local approaches Seeing more alignment now coming from Administration on how national standards and policies work syncs up with efforts at the state and regional effort Alignment of quality and health information exchange is a sweet spot Privacy and confidentiality a key, key issue! Health Care is Experiencing a spiritual journey like no other time before Caused by the gap between Technology Changing face of Health Care caused by the 9/11 effect and the high cost of Health Care. Truly exciting times We can reap the benefits of HIT to improve the quality of care and reduce costs. Never been a time in US Healthcare So much effort has been on Technology Catalyst for transformation of care and involving Patients in their own care. RHIOs are forming at a remarkably rapid rate across the country. 2 years ago - fewer than a dozen of these organizations in the formative stages. 1 year ago, there were approximately 110 RHIO Last count, there were just over 200 The journey has begun Much uncertainty and debate exist toward a truly sharable and interoperable EHR Doubt Is slowly eroding Momentum building More than 30 Ambulatory EMR products certified. Recognition who acquired and implemented EHR - good for relationship patients Worth the eventual investment. The Pennsylvania's HC community is working collectively – like no other time before Increase interest in EMR use and adoption While Pennsylvania may lag in physician EMR adoption rates today Providers are focusing and making the investment