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Legislative UpdateTxHIMA Annual Convention and Expo
Nora Belcher, Executive Director
Texas e-Health Alliance
June 9th, 2014
What is the Texas e-Health Alliance?
• State’s leading advocate, from local communities to the national level, for the use of health information technology to improve the health system for patients
• 501(c)6 non-profit started in 2009
• Serves as a trade association for HIT companies
Slide 2
Background
This presentation will:
– Assess the state of Texas in the context of the implementation of e-Health,
– Provide an overview of HIT trends, and
– Preview which e-health issues might be at play in the 2015 Texas Legislative Session
Slide 3
Overview
Internet Revolution: Value to Users
Internet use exploded once content became accessible
and useful.
0
10
20
30
40
50
60
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1930 1950 1960 1970 1980 1990 1995 1997 2000 2001 2003 2007
© Ingenix, Inc. 4
Computer developed - IBM ARPANET
Mosaic Web Browser
Today, health care information technology (HIT) is at the “1997” of the Internet age
Prodigy
WWW HTML
TCP/IP Standard
Source: U.S. Census Bureau, Population Division, Education & Social Stratification Branch, “Reported Internet Usage for Households, by Selected Householder Characteristics,:2007”
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.S.
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HIT Today
First e-mail sent
State Level Activities
• Electronic Health Record and Health Information Exchange Initiatives
– HHSC administered EHR Incentive Program and local HIE grant program (over $ 1 billion)
– Texas Health Services Authority and local HIEs moving into implementation
• Telemedicine, Telehealth and Home Monitoring
– TMB adopted 2 models of telemedicine in Fall 2010
– SB 293 (2011) expanded telemedicine and telehealth in FFS Medicaid and set up a remote monitoring benefit
– SB 7 (2013) encouraged the use of telemedicine in nursing homes by managed care plans
Specific Trends in eHealth-Health Information Exchange/ER
Page 6
• 2014 study from New York looked at HIE use in the ER • lowered admissions by 30% by providing ED physicians with data on
existing patient conditions and test results
• Indiana HIE sends daily alerts to health plans on admission, discharge and transfer • A 320,000-member managed health plan reduced non-urgent ED
visits among members served by these hospitals by 53 percent, while simultaneously increasing primary care office visits by 68 percent.
• 2013 study from the American College of Emergency Physicians reported improved quality of care and cost savings when accessing an HIE
• Laboratory/microbiology: (187 patients) $2,073• Radiology: (298 patients) $476,840• Consultations: (61 patients) $6,461• Hospital admissions: (56 patients) $551,282
http://bit.ly/1gHIwlo, http://1.usa.gov/1hVMliK, http://bit.ly/1hKBuwX
Specific Trends in eHealth-Wearables
Page 7
Via CircleSquare: http://tcrn.ch/189dZuw, http://bit.ly/1hMcBBS, http://bit.ly/1nc5sgf
Specific Trends in eHealth-Arkansas ANGELS Pre-Natal Care
Page 8http://angels.uams.edu/files/2010/12/Angels-Annual-report-2012.pdf
Specific Trends in eHealth-Mental Health
Page 9http://bit.ly/1j24Zbd
In rural East Texas, a comprehensive psychiatric emergency service is providing
100% of its psychiatric care via telemedicine.
Program outcomes include:
Only 15% of patients needed transfer to a higher level of care compared to
100% before program implementation
Only 30% of patients in the locked unit needed to be sent to a hospital
compared to 100% before program implementation
Reduction in state hospital utilization in the 12 county region by 32%
By using telemedicine, emergency psychiatrists are always available to this
large rural Texas region, and response times are typically shorter than
emergency programs with onsite psychiatrists.
Specific Trends in eHealth-Social Media and Gaming
• The University of Iowa Children's hospital launched a Facebook application to improve medication adherence among teenage kidney transplant patients.
• The Minnesota-based Mayo Clinic provides a way for patients to ask questions in its Online Health Community. Patients can also share their own health-related stories and post videos.
• Officials at the Office of the National Coordinator for Health Information Technology (ONC) developed the"What's in Your Health Record??" video challenge, a project aimed at spurring patient involvement with their personal health record data.
Page 10
http://ubm.io/1ncv1xG, http://bit.ly/Qeh9oY, http://cpo.st/1hMMhYh
Texas Legislature
• Before 2005 – 0 health IT bills filed
• 2005 – 1 health IT bill filed
• 2007 – 6 health IT bills filed
• 2009 – 30 health IT bills filed
• 2011- 3 health IT bills filed– Electronic prescribing
– Privacy
– Telehealth/remote monitoring
• 2013 – 1 health IT specific bill filed– Driver’s license mag swipes
• THSA funding
• DPS drug database access
• Telemedicine in nursing homesPage 11
Topics for 2015
• Interoperability and use of standards in state agency IT systems
• Access to public health registries for HIEs
• Provider/HIE “safe harbors”
• Remote monitoring
• Consumer telemedicine
Page 12
Sunset Process
• HHSC, DADS, DARS, DSHS, DFPS, and the Texas Health Care Information Council are all under review
• Self-evaluation reports are available for all agencies
• Sunset staff reports are available for DADS, DFPS, DARS, and DSHS
• HHSC and HHS enterprise reports will be out in November
Page 13
Page 14
“Patient Engagement is the blockbuster drug of the 21st Century”
-Leonard Kish, August 28, 2012
