The State of Tennessee’s “Draft Health Care Innovation Plan” released in December for stakeholder review, discusses the state’s approach to health IT in order to identify where the state’s demand for health IT or HIE expansion exists or is needed.
The next step according to the plan is to determine how to meet the demand and how to engage stakeholders in designing solutions to help expand the use and adoption of health IT. The draft Plan was submitted to the Center for Medicare and Medicaid Innovation at the end of January 2014 as a condition for Tennessee’s State Innovation Model design grant award.
The state of Tennessee realizes from the state’s past experience with HIE, that it is better to begin with an HIT use case than with a “build it and they will come” philosophy. There is an increasing need for providers to communicate electronically because of a shift from a fragmented healthcare delivery system to one that is accountable for holistic population care.
Today, the state’s current HIE landscape includes two regional public HIEs and a dozen private HIEs associated with large healthcare systems. The MidSouth eHealth Alliance currently exchanges data among 16 hospital emergency departments and 16 ambulatory clinics.
The East Tennessee Health Information Network (etHIN) reaches 17 counties with a base of more than 2,200 physicians, 4,500 hospital beds, and 11 hospital systems. etHIN has adopted the Health Provider Directory web service created by Michigan Health Information Network Shared Services to provide a Common Provider Directory with etHIN member organizations. The directory is accessible both statewide and nationally for participating East Tennessee and Michigan healthcare providers to use to coordinate care for their patients.
There are 12 HIEs in development across Tennessee by major integrated healthcare provider networks. These private networks will ultimately connect to a majority of the major hospitals and employed physicians that is expected to significantly contribute towards increased HIE adoption.
The State plans to utilize two existing HIEs, the MidSouth eHealth Alliance in the greater Memphis region and the East Tennessee Health Information Network in eastern Tennessee as the Patient Centered Medical Home (PCMH) model is rolled out in these regions.
It is expected that the PCMH model will encourage providers to use health IT to promote a continuous and coordinated healthcare experience for patients. Consideration will have to be given as to how to support primary care practices and the need to increase the use of health IT as a key design consideration for PCMH strategies.
Also, changes in Long Term Services and Support will drive additional new health information technology needs for the PCMH. It will be necessary to develop a new survey instrument in order to collect quality data along with the patient’s experience with care. The initiative will choose a method for this type of data collection in the second quarter of 2014.
To meet these needs, the Tennessee Office of e-Health is working with the Tennessee Health Care Innovation Initiative to anticipate and respond to the new provider needs that payment and delivery system reforms will create for additional health technology.
In 2013, the state conducted pilots to roll out a Directed Exchange-based model. To encourage adoption, the state deployed a Health Information Service Provider (HISP) for state government departments that now provides patient care to over 1.2 million each year.
The state also created a financial incentive program for providers to use to adopt direct technology with 4,000 available licenses/incentive payments. Currently, the state is evaluating the effectiveness of the Directed Exchange.
To view the plan, go to www.tn.gov/HCFA/forms/SHIP.pdf.