1. Florida’s Health Information Exchange and Electronic Health Record Incentive Program CHIPRA Part C Meeting January 18 and 24, 2012 Carolyn Turner and Pam King Policy Lead, HIE Project HIE Adoption Coordinator

2. Medicaid Electronic Health Record Incentive Program

3. The Florida Medicaid Electronic Health Record Incentive Program was established by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. The program provides financial incentives to health care professionals and hospitals for the adoption and meaningful use of electronic health records.

4. Eligible Professionals Eligible professionals (EPs) are non-hospital- based physicians, dentists, nurse practitioners, and certified nurse midwives. Additional EPs include physician assistants practicing predominantly in a Federally Qualified Health Center (FQHC).

5. Payments Eligible Professionals and Hospitals must have sufficient Medicaid volume to qualify for incentive payments. Eligible Professionals (physicians and dentists) may receive an incentive payment from either Medicaid or Medicare, but not both. Hospitals can receive both Medicaid and Medicare incentive payments.

6. Timeline for Payments Florida opened registration for Medicaid eligible professionals and hospitals on September 5, 2011. Medicaid is currently making first year payments for electronic health record adoption, implementation, or upgrade. Meaningful use is required for Medicare incentives, but is not required for Medicaid incentives in the first year.

7. Status of Registration As of January 11, 2012 2,614 eligible professionals had registered and 964 had been approved for payments totaling $18.8 million. There were 141 hospitals registered and 96 approved for payments totaling $77.3 million.

8. Goals for Incentive Program Make initial Medicaid incentive payments to 50% of eligible hospitals in 2012. Make initial Medicaid incentive payments to 25% of estimated eligible professionals in 2012. Complete preparations for meaningful use administration and program oversight requirements.

9. Florida Health Information Exchange

10. Florida HIE Governance AHCA is the State Agency responsible for administering the HIE Cooperative Agreement. Public Advisory Groups HIE Vendor Contract – Harris Corporation Subscription Agreements

11. Two Services Direct Secure Messaging (DSM) is a secure e- mail system that allows participants to push encrypted health information to other participants. Patient Look-Up and Delivery allows clinicians to access patient records from participating organizations or other sources as needed when treating patients.

12. Onboarding to HIE Patient Look-Up Services The Harris contract will provide 20 network implementations including FQHC networks and Florida Department of Health. Large hospital systems, FQHC networks, RHIOs and Florida DOH are expected to onboard.

13. Onboarding to HIE Patient Look-Up Services Onboarding will occur over a 4 year period. The first group of early adopters began implementation September 2011 –Big Bend RHIO, Florida Hospital – Adventist, and Strategic Health Intelligence (Pensacola) Second group begins onboarding January 2012.

14. Florida HIE Direct Secure Messaging

15. Initial DSM Participants Provider types (hospitals, physicians, and others) eligible for Medicare or Medicaid EHR incentives may register for DSM. Clinical laboratories, community mental health centers, rural health clinics, hospices, and skilled nursing facilities may register. Florida County Health Departments and FQHCs are also included.

16. Permissible Purposes Permissible purposes include treatment, health care operations related to quality of care, public health, and quality metric reporting. An online subscription agreement is part of registration process. Security best practices for mobile devices are part of the registration process.

17. DSM Registration The Florida HIE vets registrants using NPI and Florida licensure data. Health care providers will first register as an organization aligned with the NPI organizational information. Other individuals within the organization can then register for an individual account upon approval by the organization’s DSM administrator.

18. Provider Directory Registrants compose the Provider Directory which can be used by participants to look up other registrants. Taxonomy codes are included for searches, but credentials and specialty are not. Optional information about participation in the Patient Look-Up services may be included.

19. DSM Provider Benefits More secure than FAX for exchange of Protected Health Information. Providers are able to transfer structured or unstructured data. Coordination of care is improved. Meaningful use is met through exchange of Key Clinical Information.

20. DSM Growth DSM is part of a national ONC initiative to establish Direct nationwide. DSM adheres to national Direct standards. The Florida HIE will eventually connect with other states, national organizations, and electronic health record vendors implementing Direct.

21. DSM Goals Increase awareness and encourage registration in DSM during 2012. Expand use of DSM allowing additional providers, state health programs, and payer participation. Support additional meaningful use HIE objectives: labs, transfers of care.

22. Websites www.Florida-HIE.net www.FHIN.net www.ahca.myflorida.com/medicaid/ehr

23. Questions