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| − | '''Introduction and Background''': The American Recovery and Reinvestment Act (ARRA), through provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act, provides nearly $2 billion in incentives for “meaningful use” of electronic health records (EHR’s) by physicians and hospitals, as well as the support infrastructure to achieve it [1]. More than $560 million in HITECH Act monies are being channeled to state governments to develop health information exchange capabilities [1]. According to the Centers for Medicare & Medicaid Services (CMS), this “meaningful use” is tied to five goals for the healthcare system: 1) Improving quality, safety, efficiency, and reducing health disparities, 2) Engaging patients in their care, 3) Improving coordination of care, 4) Improving population and public health, and 5) Ensuring privacy and security protections for personal health information [1].
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| − | “Information and data exchange is critical to the delivery of quality patient care services and effectiveness of healthcare organizations” [2]. Health Information Exchange (HIE) is the system of exchanging medical information from one EHR to another. A Regional Health Information Organization (RHIO) is a multistakeholder not-for-profit group that manages the HIE [3]. The RHIO is the essential element of the proposed National Health Information Network (NHIN) in the United States. Regional Extension Centers (REC’s) are funded by HITECH as a local or regional resource to help physicians, especially in small practices, to achieve meaningful use criteria [4].
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| − | '''New York eHealth Collaborative''' http://www.nyehealth.org/: The New York eHealth Collaborative (NYeC), supported by the New York State Department of Health, was founded as a public-private partnership. Key strategies and activities include: 1) Promoting and assisting with health IT adoption across New York state, 2) Developing health IT and HIE policies and standards, 3) Evaluating and establishing accountability measures for New York’s health IT strategy, and 4) Convening, educating, and engaging key constituencies [5]. NYeC works with a statewide network of highly qualified organizations, serving as outreach agents [6]. A practice is eligible for regional extension center services if an MD, DO, NP, or PA practicing as a primary care provider and the practice site is ten clinicians or fewer with prescriptive privileges, or the practice is a federally-qualified health center, public hospital, or critical access hospital, or primarily serves medically underserved populations [6].
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| − | The “purple line solution” includes nine steps: 1) Assess and plan, 2) Select an EHR, 3) Design infrastructure, 4) Purchase, 5) Prepare for launch, 6) Implement, 7) Use, 8) Achieve meaningful use, and 9) Receive federal incentives. The REC assists with each step, for example by providing a preferred vendor list and negotiating with them, by evaluating infrastructure and workflow and assisting with choice and design of IT infrastructure, and assisting with purchases of hardware and software and training of staff [6].
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| − | '''Southern Tier HealthLink (STHL)''' http://www.sthlny.com/: STHL is the RHIO and REC for five counties in the south central region of the state, encompassing about 470,000 residents, 5 hospitals, and over 800 physicians. It began with funding from New York State ($3.5M from HEAL 1 in 2006 and $7.8M from HEAL 5 in 2008), and was founded initially as a partnership between the two major healthcare systems and local physicians [7]. At this time it is the only RHIO in NY using a Central Data Repository model - patient data is deposited and sealed until the patient consents to have records shared or accessed [3]. STHL provides a wide variety of products, services, and emerging interoperability services.
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| − | '''References''':
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| − | 1. Blumenthal, D. Launching HITECH. N Engl J Med. 2010 Feb 4;362(5):382-5.
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| − | 2. HIMSS. RHIO/HIE. [cited 2010 Nov 21]. Available from: URL:http://www.himss.org/asp/topics_hie.asp
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| − | 3. Galanis, C. HIE, RHIO’s and EHR interoperability. [cited 2010 Nov21]; Available from: URL: http://www.nyecrec.org/images/Summit/sthl%20nyec%20presentation.pdf
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| − | 4. HIMSS. State HIT dashboard. [cited 2010 Nov21]; Available from: URL:http://www.himss.org/statedashboard/hitDefinitions.aspx#REC
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| − | 5. New York eHealth Collaborative. Who we are. [cited 2010 Nov21]; Available from: URL: http://nyecrec.org/index.php/who-we-are
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| − | 6. The New York eHealth Collaborative Purple Line Solution. [cited 2010 Nov21]. Available from: URL: http://www.nyecrec.org/images/Summit/purplelineslides9-14%20-%20print%20version.pdf
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| − | 7. Southern Tier HealthLink New York. About us. [cited 2010 Nov21]. Available from: URL: http://www.sthlny.com/About-Us.asp
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| − | Submitted by: Wayne Teris, MD
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| − | [[Category:BMI512-FALL-10]]
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