Arizona’s Health IT Roadmap 2.0:

December 6, 2013

- 2 -

Background for Roadmap 2.0

• Where have we been? What are key influencers?

– Health-e Connection Roadmap 1.0 (2006)

– HIE Cooperative Agreement findings

– Stakeholder comments

– Changing federal landscape

– Questions about role of the State

• How can we drive the pathway forward for health IT success in Arizona? How can we make the biggest impact?

- 3 -

Purpose of Roadmap 2.0

• Develop a 2014 – 2016 strategic plan and roadmap for HIT/HIE in Arizona

• The Roadmap will show how Arizona will enable sustainable HIT/HIE across multiple providers to: improve patient safety, improve health care quality, and decrease health care costs.

• Content areas of focus will include summaries for: Public Health AHCCCS HINAz

• How the Roadmap will be used – What are the steps that we should take to ensure that the widest

numbers of providers have access to HIT & HIE?– How can the capability of statewide health information exchange

support the changing health care landscape?

- 4 -

Fundamental Shifts Are Occurring

- 12 -

- 5 -

Arizona Health IT Roadmap 2.0

Project MissionDetermine the Roadmapfor Arizona to establish

effective, efficient health information technology

and exchange.

Vision

Arizonans will experience an improved quality of health

enabled by robust health information technology

and exchange.

- 16 -

- 6 -

Project Team

Arizona Strategic Enterprise Technology Office (ASET)• Funder of Roadmap 2.0 project• Coordinator of state agency participation• Lorie Mayer - State IT Coordinator

Arizona Health-e Connection (AzHeC)• Convener for Health IT in Arizona• Lead for Stakeholder Engagement and Communication• Melissa Rutala - CEO

Mosaica Partners • Consultants and subject matter experts in HIE and health IT• Lead for Project Design and Implementation• Laura Kolkman - President

- 7 -

Roadmap 2.0 Key Stakeholders

Health Care Providers Hospital Systems Physicians Other Providers Behavioral Health Long Term / Post Acute Care

Health Care Ancillary Providers Laboratories Imaging Pharmacy

Health Care Payers AHCCCS Commercial Payers

Government Agencies Public Health – ADHS County Health Agencies Federal Partners – IHS VA

Other Organizations AzHeC HINAz Legal Counsel Consumers

- 8 -

Project Scope

Three year outlook 2014 - 2016

Health Information Exchange (HIE)− HINAz− Bi-directional electronic exchange with

State agencies− ACOs− “Direct” exchange− Robust exchange− Exchange with IHS and VA− Exchange outside of Arizona

Health Information Technology (HIT)− EHR adoption and use− Personal Health Records (PHR)

Telemedicine/ Telehealth− Mobile Health and apps (mHealth)

Meaningful Use Requirements

Data Access and Use− Access to State-held information− Use of information for exchange

Legislation, Regulation & Policy

- 9 -

Project Process

Open and transparent with broad stakeholder participation

• Hold pre-project workshops with AHCCCS and Public Health focused on Meaningful Use Stage 2 readiness

• Hold project Kick-Off to introduce and explain the project• Conduct 7 envisioning workshops – with key healthcare stakeholders – to

describe Arizona’s HIT/HIE desired future state COMPLETE Hospitals Providers Payers AHCCCS Public Health - ADHS

• Validate workshop findings through a survey of the broader stakeholder community. COMPLETE

• Convene public meeting to review progress and solicit feedback OCTOBER 1, 1-3pm

- 10 -

Roadmap 2.0 – Development

Enablers

Provide consumers with their own health

information to encourage greater

participation in their own care decisions

Enable patients to be willing and able to participate in their

care

Involve patients and families in health

care decisionsPromote patient

accountability

Provide timely, relevant patient

educationProvide patient with

their information

Provide consumers with their own health information to encourage greater participation in their own care decisions xEnable patients to be willing and able to participate in their care Involve patients and families in health care decisions xPromote patient accountability xProvide timely, relevant patient educationProvide patient with their informationInform patient fully about their careProvide patients timely alerts and actionsCoordinate care (easily) across care settings

Capabilities

Capabilities

Enablers

Provide consumers with their own health

information to encourage greater

participation in their own care decisions

Enable patients to be willing and able to participate in their

care

Involve patients and families in health

care decisionsPromote patient

accountability

Provide timely, relevant patient

educationProvide patient with

their information

Provide consumers with their own health information to encourage greater participation in their own care decisions xEnable patients to be willing and able to participate in their care Involve patients and families in health care decisions xPromote patient accountability xProvide timely, relevant patient educationProvide patient with their informationInform patient fully about their careProvide patients timely alerts and actionsCoordinate care (easily) across care settings

Capabilities

Enablers

Enablers

Provide consumers with their own health

information to encourage greater

participation in their own care decisions

Enable patients to be willing and able to participate in their

care

Involve patients and families in health

care decisionsPromote patient

accountability

Provide timely, relevant patient

educationProvide patient with

their information

Provide consumers with their own health information to encourage greater participation in their own care decisions xEnable patients to be willing and able to participate in their care Involve patients and families in health care decisions xPromote patient accountability xProvide timely, relevant patient educationProvide patient with their informationInform patient fully about their careProvide patients timely alerts and actionsCoordinate care (easily) across care settings

Capabilities

Initiatives

Objectives

Roadmap 2.0

What we want to achieve

What we must be able to do to achieve

objectivesWhat needs to

be in placeProjects or programs to put the enablers in

place

- 20 -

- 11 -

Summary of Barriers Identified During Workshops

Access Lack of access to appropriate technology

Change Fear or unwillingness to adapt to something new

Competition Competition among providers motivates them to keep information within their own organizations

Confusion Lack of clarity in understanding how all the HIT activity fits together. (Who's in charge?)

Cost of EMR Cost of EMR adoption too high

Cost of HIE Cost of HIE connection and interfaces

Culture Cultural barriers

Data Lack of general agreement on the most important data to be shared

Education Lack of education on the sharing of patient information

Governance Lack of clear statewide governance and direction for HIT / HIE

Infrastructure Lack of viable statewide HIT/ HIE infrastructure

Patient Identification

Lack of efficient and sure means to identify patients and providers

Payment Lack of aligned incentives for wellness among payers, providers, and consumers

Priorities Too many competing priorities

Privacy Uncertainty regarding privacy and security regulations and the associated risks.

Process Lack of a known repeatable process for sharing health information

Regulation Regulations that inhibit the full exchange and use of health information

Resources Lack of provider resources to support adopting HIT / HIE

Standards Lack of consistent, adopted technology standards for interoperability

Sustainability Unknown if statewide HIE is sustainable

Technology Lack of suitable technology acceptable to providers

Trust Lack of trust

Value Difficult to calculate and communicate the

economic value of Health IT and exchange

- 7 -

- 12 -

Barriers Identified as Most Important to Address174 Respondents

Cost of HIE: Cost of HIE connection and interfaces 41.38%

Confusion: Lack of clarity in understanding how all the HIT / HIE activity fits together. (“Who's in charge?”) 40.80%

Infrastructure: Lack of viable statewide HIT/ HIE infrastructure 37.93%

Standards: Lack of consistent, adopted technology standards for interoperability 36.78%

Cost of EMR: Cost of EMR adoption too high 33.33%

Payment: Lack of aligned incentives for wellness among payers, providers, and consumers 30.46%

Priorities: Too many competing priorities 29.31%

Access: Lack of access to appropriate technology 27.01%

Trust: Lack of trust 25.86%

Change: Fear or unwillingness to adapt to something new 25.29%

Governance: Lack of clear statewide governance and direction for HIT / HIE 25.29%

Resources: Lack of provider resources to support adopting HIT / HIE 24.14%

Value: Difficult to calculate and communicate the economic value of Health IT and exchange 23.56%

Sustainability: Unknown if statewide HIE is sustainable 22.41%

Privacy: Uncertainty regarding privacy and security regulations and the associated risks 20.69%

Regulation: Regulations that inhibit the full exchange and use of health information 20.69%

Competition: Competition among providers motivates them to keep information within their own organizations 17.24%

Data: Lack of general agreement on the most important data to be shared 17.24%

Education: Lack of education on the sharing of patient information 16.67%

Patient ID Lack of efficient and sure means to identify patients and providers 14.37%

Process: Lack of a known repeatable process for sharing health information 13.79%

Technology: Lack of suitable technology acceptable to providers 10.92%

Culture: Cultural barriers 7.47%

% of Respondents That Chose This BarrierBarriers

Survey

- 13 -

Barriers Identified as Most Important to Address174 Respondents

Cost of HIE: Cost of HIE connection and interfaces 41.38%

Confusion:Lack of clarity in understanding how all theHIT / HIE activity fits together. (“Who's in charge?”)

40.80%

Infrastructure: Lack of viable statewide HIT / HIE infrastructure 37.93%

Standards:Lack of consistent, adoptedtechnology standards for interoperability

36.78%

Cost of EMR: Cost of EMR adoption too high 33.33%

Payment:Lack of aligned incentives for wellnessamong payers, providers, and consumers

30.46%

Priorities: Too many competing priorities 29.31%

Access: Lack of access to appropriate technology 27.01%

% of Respondents That Chose This BarrierBarriers

- 14 -

Barriers Identified as Most Important to Address174 Respondents

Trust: Lack of trust 25.86%

Change: Fear or unwillingness to adapt to something new 25.29%

Governance: Lack of clear statewide governance anddirection for HIT / HIE

25.29%

Resources: Lack of provider resources tosupport adopting HIT / HIE

24.14%

Value: Difficult to calculate and communicate the economic value of Health IT and exchange

23.56%

Sustainability: Unknown if statewide HIE is sustainable 22.41%

Privacy: Uncertainty regarding privacy and security regulations and the associated risks

20.69%

Regulation: Regulations that inhibit the full exchange anduse of health information

20.69%

% of Respondents That Chose This BarrierBarriers

- 15 -

Barriers Identified as Most Important to Address174 Respondents

Competition: Competition among providers motivates them to keep information within their own organizations

17.24%

Data: Lack of general agreement on themost important data to be shared

17.24%

Education: Lack of education on the sharingof patient information

16.67%

Patient ID Lack of efficient and sure means toidentify patients and providers

14.37%

Process: Lack of a known repeatable process forsharing health information

13.79%

Technology: Lack of suitable technology acceptable to providers 10.92%

Culture: Cultural barriers 7.47%

% of Respondents That Chose This BarrierBarriers

- 16 -

Next Steps

• Use the feedback received so far to draft initiatives

• Vet initiatives with stakeholders via workshops and October 1st public meeting

• Incorporate feedback on initiatives and draft Roadmap 2.0

• Publish Roadmap 2.0 in December 2013

June July August Sept Oct Nov Dec Jan 2014

Public Health & Medicaid

Pre-WorkshopsJune 11-12

Executive Council Meetings

Project Kick-Off Meeting June 24

Envisioning Workshops

July 22 – Aug 2

Healthcare Stakeholders

Survey

Enablers Workshop

Sept 6

AzHeC SummitSept 10 - 11

Initiatives Workshop

Sept 30

General Stakeholder

MeetingOct 1

Release Final Roadmap

January 2014

Consumer Campaign

• State HIE Cooperative Agreement Grant- Awarded to HINAz in collaboration with AzHeC- Timeframe: June-December 2013

• Consumer Health IT Education & Awareness Campaign - Phase IA: HIE acceleration- Phase IB: HIE/HIINAz awareness- Phase II: General health IT community awareness

Consumer Connections Task Force

• Health Plans Blue Cross Blue Shield of Arizona, Aetna/Mercy Care, United Health Care, Care 1st, Cigna, Health Choice, Phoenix Health Plan, University of Arizona Health Plan

• Health Care Organizations Banner Health, Carondelet Health Network, Tucson Medical Center, Northern Arizona Healthcare, El Rio Community Center, Jewish Family and Children Services, Sonora Quest Laboratories, Marana Health Center

• Government Agencies AHCCS/ASET, AZDHS, AZDES/DDD, Pima County, Governor’s Advisory Council on Aging & Office on Aging, Arizona Chamber of Commerce

• Non-Profit Community Organizations (partial list)Arizona Heart Association, Arizona Cancer Society Action Network, Arizona Diabetes Association, Arizona Partnership for Immunization (TAPI), Arizona Leukemia & Lymphoma Society, Arizona Council of Human Services Providers, Arizona Pharmacy Association, children’s Action Alliance, Tucson Osteopathic Medical Foundation, Pima Council on Aging, and many others.

Consumer Campaign Strategy

• Message Strategy - Create a consumer health IT organization and brand. - Describe EHRs, E-Prescribing & HIE as one movement. - Link eHealth Technology to other consumer technology, i.e. banking, retail.

• Distribution Strategy - Engage a broad-base of community organizations in message development for consumer campaign. - Develop a consumer health IT website sponsored by HINAz/AzHeC as focal point with broad base of support. - Utilize the distribution channels of consumer task force plus a PR/advertising campaign to maximize total impressions.

Consumer Consent Toolkit

• Overview of legal requirements - Three step Consent Process: Notice/Signature/Change of Consent - Patient rights under Arizona law - Critical points to understand

• Key documents for consent process - Notice of Health Information Practices - Change of Consent Form

• Patient education materials - Consumer Fact Sheet - Sample script - Nurse video

• Consent and ROI (request for information) Policies

Elements of General Consumer Campaign

• Create Consumer Campaign Brand

• Develop Messages & Materials

• Execute Public Relations & Advertising Campaign

• Launch Consumer Campaign Website

Campaign Logo

Web site:eHealth4az.orgeHealthforAZ.org

Print Ad

Advertising Buy

PRINT• Arizona Parenting• The Arizona Republic

• Section A, Wednesday, Sunday

• The Arizona Republic • Living Well monthly section

• Phoenix Business Journal • Arizona Daily Star• Lovin' Life After 50• Daily News - Sun Publishing• Independent Newspapers-Sun City • Sun Lakes Splash

ONLINE• AZ Central.com• AZStar.net• Latino Perspectives

RADIOPhoenix Public Radio• KJZZ• KBACH

Tucson• KUAZ • KUAT FM

Provider Poster

Arizona eHealth Provider_________________________

has been recognized for achievements in advancing eHealth technology to improve health care quality and delivery

eHealth4AZ represents more than 50 Arizona stakeholders, including hospitals and health care systems, health plans, state and county governments and non-profit organizations. We recognize providers who are effectively using eHealth tools such as electronic health records, electronic prescribing, patient portals, and health information exchange. We educate consumers on how to become more active and engaged in their own health and wellness through eHealth technology.

Find out more about eHealth in Arizona at www.eHealth4AZ.org.