According to the “Nevada State Health System Innovation Plan” released January 29, 2016, Nevada is the 7th largest state in the U.S covering 110,567 square miles but is only the 35th most populous state. As a result, Nevada has fewer people residing in a much larger geographical area than the majority of other states.
Therefore the state needs to support strong efforts through health IT. HealthHIE Nevada http://healthienevada.org, operated by HealthInsight http://healthienevada.org serves as the State’s HIE. Today all FQHCs, all major urban acute care hospitals, and about one half of the Critical Areas Hospitals and rural hospitals are connected in the state.
The HIE also connects all major diagnostic laboratories and testing facilities. However, only an estimated 18 percent of physician offices are connected to the HIE and only two EMS agencies are connected.
Several actions are planned such as convening an HIE Collaborative to develop a plan to expand HIE connectivity, increase direct messaging and notification systems, improve capacity for providers to exchange treatment information, and develop a provider portal with single sign-on capabilities.
The next step is to link an All Payer Claims Data Repository (APCDR) with the statewide HIE and state registries. After this is accomplished, Nevada will procure or create a population health analytics tool that “sits on top” of the APCDR, HIE, and state registry data sources.
The state wants to develop a population health analytics tool to permit the measuring, tracking, and reporting of population health metrics, so that detailed sub-analysis can be done to identify trends, opportunities, and disparities.
The population health analytics tool will enable a public-facing dashboard and reporting portal to increase public transparency regarding population health status and the results of population health improvement efforts. The portal will evolve over time into a website that will include provider-level quality and outcome metrics.
Telemedicine and telehealth in the state is largely championed by the University of Nevada’s School of Medicine (UNSOM) http://medicine.nevada.edu. The services offered include behavioral health for online counseling and therapy, ophthalmology, radiology, and additional subspecialties. There are approximately 83 telemedicine sites in the state currently able to participate in direct consultations.
Since the State has too few licensed healthcare providers, Nevada has approved the Interstate Medical Licensing Compact allowing for reciprocity of physicians from other states using an expedited license process for eligible physicians.
There is a clear need for more behavioral health providers in the state. To address the number of behavioral health providers needed, the state is exploring the administrative simplification of the licensure reciprocation for behavioral health providers.
Another successful telehealth project operated by the UNSOM is Project ECHO http://medicine.nevada.edu/echo. The project was pioneered in New Mexico and has been replicated over 40 sites worldwide. Project ECHO is a simple telehealth linkage connecting university-based faculty specialists to primary care providers in rural and under-served areas to extend specialty care to patients with chronic very often costly and complex medical illnesses.
Go to http://dhcfp.nv.gov/Resources/Rates/SIMMAIN to read the entire document. Click on Nevada State Health System Innovation Plan.