1. Georgia Health Information Exchange Georgia Rural Health IT Forum January 26, 2012

2. Georgia HIE Mission & Vision Revisited Facilitate a statewide health information exchange for Georgia that is trusted and valued by all stakeholders in order to improve health care coordination, reduce costs, and establish a solid foundation for long-term financial sustainability. Mission Foster a healthier Georgia through the use and exchange of electronic health information by improving patient-centered health care, increasing efficiency and promoting the health status of the entire state population. Vision 2

3. Vision: Coordinated Care in Georgia 3

4. Georgia’s Objectives to Achieve HIE 4 Build awareness & trust Produce a low cost, scalable & interoperable infrastructure Enable Georgia providers to achieve MU Safeguard privacy & security Ensure sustainability Build clinical exchanges Monitor/evaluate progress & outcomes

5. Georgia HIE Governance 5

6. Provides input Provides input Georgia HIE Governance Structure Georgia Medicaid Committees & Workgroups eHealth State Agency Council eHealth State Agency Council HIT Coordinator GHIE Inc. GA-HITREC Local/Regional HIEs Data Contributors (Providers, Payers, Others) Data Contributors (Providers, Payers, Others) GHIE Board Recommends Georgia State Government Actual & Potential Participants Georgia Public/Private Collaborative Statewide HIE Policies & Requirements 6 DCH Approves & Enforces Policies DCH Approves & Enforces Policies

7. GHIE Committees and Workgroups 7 GHIE, Legal & Privacy Secondary Use (On Hold) Service Area Health Information Exchanges (SAHIEs) Technology Act and Get Involved Clinical –E-prescribing –Lab results exchange –Patient care summary exchange Finance To get involved inquire at hitt@dch.ga.gov hitt@dch.ga.gov

8. Stay Engaged & Spread the Word Quarterly DCH Town Halls Monthly eNewsletter: DCH-I Coming Soon Follow us on Facebook and Twitter Regular webcasts and roundtable events 8

9. Georgia’s Story: Progress 9

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12. 12

13. Recent Progress 13 Technical & Policy Readiness Assessment Environmental Scan Legal & Privacy Services Financial Modeling Services Advertising & Marketing Services

14. Georgia HIE Development Status 14 Phase 1 –Direct (Secure Messaging) –Active RFP; responses due Jan 31 st –Q2 deployment Phase 2 and 3 –Core and Value-Added Services –RFP expected to post in Q1 –Deployment Phase 2: Q3 Phase 3: Q4

15. Potential Phasing of Georgia HIE Services 15

16. By September 30, 2012 Georgia providers will share at least 1 million electronic health information messages using Direct 16

17. Connecting more than 17

18. Connecting more than 50 counties 18

19. Connecting more than 50 counties 40 healthcare organizations 19

20. Connecting more than 50 counties 40 healthcare organizations Tens of thousands of clinicians and patients 20

21. In 2012, Georgia will… 21 Enter Top 10 of states using Direct Enter Top 20 of ePrescribing states Have one of the most robust statewide health information exchanges in the country ONC stated that with Phase 1, Georgia will “leap frog most other states” in its progress to establish a statewide health information exchange.

22. Upcoming Events March 12, 2012 Georgia eHealth Summit June 2012: Georgia Health IT Town Hall Provider registration for the Georgia HIE Measurement framework Phase 2 implementation progress 22

23. Questions 23

24. Appendix 24

25. Health Information Exchange What is HIE? –Enables secure exchange of patient health information between providers and healthcare organizations Why is HIE important? –HIE saves lives and improves health care outcomes by enhancing communication between providers, allowing for improved decision support and enabling patients to access information and better manage their personal healthcare 25

26. Health Information Exchange What are the benefits of HIE? –When clinical records are available at the point of care, patients receive more accurate and timely service. Reduced likelihood of dangerous drug interactions Avoidance of duplicate testing and unnecessary procedures Improved provider-patient communication and coordination of care Enhanced security for personal health information 26

27. Georgia & Interoperability 27 Payor Organizations Specialty Facilities EMS Providers Community Service Boards Primary Care Physicians Personal Health Records SAHIEs Health Systems Radiology Federal Agencies Telemedicine FCHCs Nursing Homes State Agencies Laboratories Pharmacies Georgia Hospitals & Health Centers

28. HIE Phase 1: Direct Secure Messaging 28 Georgia’s Health Information Exchange Model (Phase 1)

29. What is Direct? b.wells@direct.aclinic.org h.elthie@direct.ahospital.org Simple. Connects healthcare stakeholders through universal addressing using simple push of information. Secure. Users can easily verify messages are complete and not tampered with en route. Scalable. Enables Internet scale with no need for central network authority that must provide sophisticated services such as EMPI, distributed query/retrieve, or data storage. Standards-based. Built on well-established Internet standards, commonly used for secure e-mail communication; i.e.,. SMTP (or XDR) for transport, S/MIME for encryption, X.509 certificates for identity assurance 29

30. What you need for Direct HIE Participant –Individual or organization that has a demonstrated need to exchange health information Certificate Authority (CA) –Issues digital certificates to HIE Participants Registration Authority (RA) –Verifies identities of HIE Participants HISP (Health Information Service Provider) –Provides and manages Direct addresses, publishes certificates, routes (possibly storing) Direct messages –HISPs can offer other HIE services 30

31. Direct Addresses Direct Addresses are used to route information –Look like email addresses –Used only for health information exchange b.wells@direct.aclinic.org An individual may have multiple Direct addresses EndpointDomain Direct Address 31

32. Georgia Statewide HIE: Use Case #1 Referral to Specialist (Example of “Push”) Patient visits primary care provider; provider needs to refer patient to a specialist 1. Provider uses EHR to initiate referral message and locate specialists Provider’s EHR system looks up specialist practices in GA’S HIE provider directory 3. GA HIE Network documents access to Network in audit log 4. Specialist receives referral request and sends response to referring physician through the GA HIE Network 5. Specialist sees patient 2. Referring provider sends referral and reference clinical documents to the specialist system Provider Directory Security Services & Authorization Framework Secure Message Exchange via Direct Project Secure Message Exchange via Direct Project Transaction Audit Log & Reporting Georgia Statewide Health Information Exchange Phase 1