1. Connecting California
Good morning, I would like to spend the last 10 minutes of the call updating you on the work that HealthTech has been comissioned to do in California.
Lori Hack, Interim CEO
Third Annual Connecting Communities Learning Forum & Exhibition
Washington, DC 4/10/06

2. The Vision
When I go to see my doctor, she or he will have all the information needed right on the spot.
I won't have to fill in any more forms, lab tests won't be repeated.
My doctor will know if I've been to see another doctor, or to a hospital, and what medicines I'm taking.

3. The Vision
I have my own personal health record, that I can access on my home computer or as a printed record.
It has all the latest information needed about
my medical history
current conditions
medicines I'm taking
the doctors caring for me
information about my medical conditions

4. The Vision
If I'm taken to the hospital in an emergency, all the information needed to take care of me will be available - within seconds.

5. The Vision
If there is a public health emergency.…my records will be available to treat me or my family at any location.

6. National HIT Picture Federal advocacy for health care IT
Secretary Leavitt a strong proponent
Limited federal funding
Re-structuring the market
Establishing standards
Privacy and security legislation
Safe harbor
Accrediting products as standard-compatible
Stimulating national ‘highway’
Congressional stampede
10 bills
Congress – Bi-partisan Support for HIT
10 bills introduced
-Sen. Finance and HELP jointly introduced bills
Ways and Means Committee bill
-Bi-partisan sponsors: Frist/Clinton; Reps Kennedy (D) /Murphy (R); Reps Gonzalez (D)/McHugh (R)
-Legislative themes:
Need to accelerate adoption through key policies related to interoperability and data standards, privacy and security, the role of the Federal government, and funding.
-Legislation introduced on Katrina relief and electronic health records (EHRs)
-Previously $10.8M to eHealth Initiative Foundation

7. Mission
A collaborative statewide initiative to improve the safety, quality, and efficiency of health care through the use of information technology and the secure exchange of health information.

8. Purpose Independent umbrella organization
Incrementally build a statewide HIE
Establish a common approach
Sponsor pilots and demonstration projects
Ensure inclusion of safety providers and underserved populations
Build on regional and national efforts; ensure consistency with national technology platforms
Identify and support legislation and regulation necessary

9. Statewide Highway for Patient Query and Record Locator
Large RHIO A
Found 3
National Health Information Network
CalRHIO
A - 18
Payers found 15
B - 7
Routes to NHIN:
Direct connect
Via RHIO
Via Tool kit
Little RHIO B Found 1
Medical Groups/ IPA/ MSO 6
Community A
Community B
Multi-Community RHIO Found 12
C -1 2
Community C

10. Privacy and Security RFP: California’s Response
CalRHIO with CalOHI (Office of HIPAA Implementation) developed joint response to RTI
Funding from RTI to California will total $350,000 - matching funds needed
Steering Committee made up of State and CalRHIO stakeholders
Project to cover 12 months with 3 reports and 1 national meeting to discuss results

11. CalRHIO Statewide Projects
Emergency Department Linking Project
Enable EDs to access vital information
Medication Management
Medication history – first to EDs, then to Personal Health Records
Personal Health Records
Starting with key populations
Infrastructure
Statewide eMPI
Administrative Efficiencies
Assist safety net, rural providers
Emergency Department Linking Project
Electronically link CA’s 359 hospital EDs using statewide eMPI and sharing lab and pharmacy results starting pilot data exchange in first quarter (ED Project Team/Clinical WG)
Administrative Efficiencies
Improve connectivity and data exchange among business partners –hospitals, plans, physician offices, registries, public health departments. (Business & Finance WG)
Medication Management
Explore collection and display of medication history to EDs by 2006, then roll out to PHR for every Californian by (Clinical WG)
Personal Health Records
PHR for every Californian by 2007, starting with key populations (Dept of Corrections, Child Services, ED “Home” Projects.) To support giving consumers direct access to their health information. (Clinical WG and Consumer Council)
Infrastructure
Explore statewide eMPI. Additionally: Support regional efforts for HIE and RHIO formation; define how stakeholders can connect and exchange information statewide; support EHR adoption; connect to NHIN. (Technology WG)

12. Emergency Dept Linkage
Testing assumptions on a manageable scale
Objective: Enable EDs to access critical clinical information from key data sources
Issued RFI – February 9; due March 15 – see
Seeking broad technology solutions, little prescription
Pilot test, three or more business associates in two to three regions/communities
Test ground for the larger CalRHIO effort, and an early demonstration of success that is meaningful to patients, providers, and hospitals. The knowledge and technology solutions will be leveraged for other projects and our broader goal. The ED Linking Project enables us to test technology assumptions on a manageable scale, and identify problems that will need to be addressed in the larger RHIO effort. We also will demonstrate patient privacy and security solutions necessary for any larger effort to succeed and begin to model the establishment of service level requirements and service expectations. Importantly, we will demonstrate our commitment and ability to work together across organizations to address data sharing needs for improving patient care.
 An RFI will be issued in February 2006 to better understand the potential approaches and solutions available in the marketplace, as well as cost. From the RFI, vendors will be selected to participate in a technology test and run pilots. Results of the pilots will be analyzed to determine the best statewide approach(es) to providing the kinds of information emergency physicians need at point of care.

13. Standalone Project Scope
California Participant Overview
State-wide
Standalone Project Scope
Participant Type
Universe
ED LInk
Med Mgmt
Admin Efficiency
Physicians
50,000
Hospitals
370
Emergency Departments
277
Independent Labs
500
Independent Radiology
503
Chain Pharmacies
3,098
Independent Pharmacies
2,082
Nursing Homes
1,084
Home Health Agencies
834
Insurers 22
Rx data will be obtained from insurers and PBMs (requiring one interface)

14. Action Items: A Full Plate!
Privacy and Security CalRHIO working w/CalOHI
Publish HIE data and message standards
Complete data sharing agreement template
Complete business case analysis
ED Linking Project - launch pilot “solution”
PHR consumer comparison tool
Define technical highway “infrastructure” incrementally
Education: state, county, consumers
Maintain initiative inventory

15. Resources available to you
Web site
All mtg minutes and presentations for first year
Governance documents for options to organize
Data standards recommendations
Clinical minimum data set
Technology strategy “road map” (coming)
Architectural options
Personal Health Records – evaluation criteria (coming)
Business cases/ROI (coming)