The Future of HIT in Texas Presentation to the Texas Council of Community Centers

Transcription

1 The Future of HIT in Texas Presentation to the Texas Council of Community Centers Nora Belcher, Executive Director Texas e-health Alliance June 27 th, 2013

2 Overview This presentation will: Assess the state of Texas in terms of implementation of the HITECH Act, Discuss how legislation and public policy involving HIT have evolved, and and provide an overview of HIT trends and assessment of the future of HIT in Texas. Slide 2

3 HITECH Texas Status Pre-HITECH Privacy protections in chapter 181 Health and Safety Code in 2001 Texas Health Services Authority created in 2007 Most statutes and processes geared toward paper/fax HITECH passage in 2009 included 3 key components: EHR Adoption Incentives and Penalties HIE Planning and Implementation Strengthening HIPAA to Protect Patient Privacy

4 HITECH in Texas State Level Implementation HHSC administered EHR Incentive Program and local HIE grant program THSA implementing white space strategy and state-level shared services Local HIEs completed planning and moving into implementation Federal Implementation HIPAA final rules implementing HITECH final in January 2013 FDA guidance on mobile medical devices coming ONC working through the stages of

5 Texas Legislature and HIT Before health IT bills filed health IT bill filed health IT bills filed health IT bills filed health IT bills filed Electronic prescribing Privacy Telehealth/remote monitoring Page 5

6 2013 Texas Legislature SB 1367 (Duncan/Smithee)- winds down the risk pool at TDI, and provides THSA with $5 million dollars in bridge funding. SB 1643 (Williams/Alvarado)- includes the changes needed to allow HIEs to access the prescription drug monitoring program at DPS. Page 6

7 2013 Texas Legislature Medicaid SB 7 (Nelson/Raymond)- Medicaid delivery and quality reforms, including managed care expansion for long term care SB 8 (Nelson/Kolkhorst)- Medicaid fraud and abuse program changes HB 300 Technical Corrections SB 1609 (Schwertner/Kolkhorst)- training clarifications SB 1610 (Schwertner/Kolkhorst)- breach notification clarifications Page 7

8 2013 Texas Legislature Providers SB 166 (Deuell/Larson)- allows providers to read and store mag stripe data from driver's license SB 406 (Nelson/Kolkhorst)- allows for limited but extended prescriptive authority for ANPS under physician delegation SB 945 (Nelson/S. Davis)- mandates that hospital employees involved in direct patient care wear photo IDs Page 8

9 2013 Texas Legislature Department of Insurance SB 644 (Huffman/Zerwas)- creates a standardized prior authorization form for prescription drug benefits SB 1216 (Eltife/S. Davis)- creates a standardized prior authorization form for medical care and health care services Cancer Prevention and Research Institute of Texas (CPRIT) SB 149 (Nelson/Keffer)- CPRIT reforms Page 9

10 2013 Texas Legislature Department of Information Resources HB 2738 (Elkins/Ellis)- DIR to study state agency technology efficiency SB 1102 (Van de Putte/Larson)- Creates a new position at DIR for a cybersecurity director Tax Policy HB 800 (Murphy/Deuell)- research and development tax credit HB 1133 (Otto/Estes)- sales tax exemption for telecom manufacturing Page 10

11 EHR Adoption Robust participation in the EHR incentive programs. Hospitals: >85% participating; >75% got incentives Physicians: 73% registered (388,000); 44% got incentives (230,000) HIT market: 941 vendors; 1,700 certified products Economic impact. 50,000 HIT jobs; 17,049 trained; $12.6 billion in incentives.

12 HIT Trends- Adoption

13 HIT Trends- Challenges /stakeholder-survey-2013

14 HIT Trends- EMR Changes /2013/2/prweb htm

15 HIT Trends- Patient Concerns

16 HIT Trends- Patient Safety

17 HIT Trends- Patient Engagement content/32/2/376.abstract

18 Conclusion Texas was well positioned for success with the passage of HITECH. The legislature and the related state agencies have been identifying- and making- needed changes to foster the adoption of HIT. Progress is being made in EHR adoption at the physician and hospital level; work remains to be done in long term care and mental health. Significant barriers still exist to EHR and HIE adoption, which will need to be overcome for HIT to be successful. Policymakers are concerned about privacy and security, costs, quality, and the rate and volume of changes that providers have to react to. Policymakers in the future will be responding to growing concerns about patient access to their records and consumer engagement.

19 % U.S. Households Using the Internet at Home Internet Revolution: Value to Users Internet use exploded once content became accessible and useful TCP/IP Standard Mosaic Web Browser Prodigy HIT Today 10 Computer developed - IBM 0 ARPANET First e- mail sent WWW HTML Today, health care information technology (HIT) is at the 1997 of the Internet age Source: U.S. Census Bureau, Population Division, Education & Social Stratification Branch, Reported Internet Usage for Households, by Selected Householder Characteristics,:2007 Ingenix, Inc. 19

20 Patient Engagement is the blockbuster drug of the 21 st Century -Leonard Kish, August 28, 2012 Page 20

21 Nora Belcher Texas e-health Alliance 512/ HIMSS