02 Oct Work on eHealth Action Plan includes breaking down barriers
Madison, Wis. – In November 2005, Gov. Jim Doyle created the eHealth Care Quality and Patient Safety Board (the eHealth Board) by Executive Order. The purpose of the Board is to create the Wisconsin eHealth Action Plan in order to take advantage of health information technology to improve healthcare quality and safety, while reducing overall costs in the system.
The eHealth Action Plan is a key component of the Governor’s plan for economic development – making Wisconsin a great place to do business and enjoy good health.
The primary activities under the Action Plan include:
• Establishment of an eHealth technology platform through adoption and use of electronic medical records.
• Development of health information exchanges.
• Identification and development of statewide health information exchange services.
• Development of options and policies for addressing privacy and security issues which arise in the exchange of health information.
Between May 2006 and May 2007, Wisconsin was one of 33 states and Puerto Rico that was awarded funds through the Health Information Security and Privacy Collaboration Project (HISPC) to consider issues that pose barriers to interoperable health information exchange.
In phase one of the HISPC project, more than 50 individuals served on four workgroups. The people who volunteered represented advocates, clinics, consumers, law enforcement, health care organizations, health care providers, health care quality organizations, hospitals, industry, laboratories, pharmacies, professional associations, public health, research, schools, payers, and state government.
The workgroups identified variation in organization-level business policies and procedures, as well as state and federal laws that affect health information exchange in Wisconsin. They proposed practical solutions to protect privacy and security of health information while permitting interoperable health information exchange. Finally, they developed plans to implement each solution in Wisconsin and made recommendations for policy change at the federal level.
Recommendations were made in four areas:
• Amend Wisconsin Statute 51.30, governing mental health, AODA, and developmental disability healthcare information to allow for the exchange of specific information among providers for treatment purposes without consent. It was recommended that a broadly representative workgroup be convened to develop policy to guide such a change, as well as identify specific elements for exchange.
• Amend Wisconsin Statute 146.82, governing general health information so as to remove re-disclosure prohibition, remove documentation requirements beyond HIPAA, and to allow disclosure to family and individuals involved with care and treatment with a patient’s agreement, as opposed to formal consent currently required by state law.
• Standardize patient identifiers by creating model policies and procedures to capture, verify, and match patient identifiers with patient information in a healthcare system. Also prepare Wisconsin to adopt national standards in this arena.
• Propose changes to the HIPAA Privacy Rule to clarify the minimum necessary standard and alter requirements related to research and business-associate agreements.
In July 2007, Wisconsin was awarded additional funds to continue a second phase of the HISPC project. Although all areas of recommendation from the first phase of HISPC are important, phase two will focus on recommendations that would have the greatest impact on improving patient care and facilitating exchange.
In this second phase, we are focused on work related to amending Wis. Stat. 51.30 and Wis. Stat. 146.82 and launching a focused effort to educate and engage WI consumers in eHealth.
Wis. Stat. 51.30: the proposed change intends to eliminate barriers to exchange; improve providers’ ability to make optimal patient care decisions; and reduce variation within Wisconsin law, and between Wisconsin law and HIPAA.
A workgroup of stakeholders has been convened. It consists of mental health advocates, AODA advocates and administrators, developmentally disabled advocates, physicians, privacy officers and legal experts, information technology experts, data use organizations, payers, large provider systems, representatives of WHA and WMS, Mendota Mental Health Institute, Waukesha County Department of Health and Human Services, and the Central Wisconsin Center for Developmentally Disabled.
This workgroup is expected to develop recommendations in October on information that can be exchanged among providers for treatment purposes without patient consent and other key areas for consideration going forward.
• Wis. Stat 146.82: proposed changes intends to eliminate barriers to exchange; bring Wisconsin law more in line with current practice; and increase consistency with HIPAA. HISPC staff is in the process of holding discussions with selected stakeholder groups to gather input on the impact, appropriateness, and feasibility of changes proposed in the first phase of the privacy project for consideration by the eHealth Board. Stakeholders include, but are not limited to: consumer advocacy organizations; HIPAA Collaborative of Wisconsin, Wisconsin Hospital Association, and the Wisconsin Medical Society. This work is expected to be completed by November.
Town Hall comfort
Town Hall meetings will be conducted and will focus on increasing consumer comfort and understanding of electronic health records and health information exchange and its privacy and security capabilities. These meetings will be held around the State in late fall of 2007.
Proposals developed in HISPC phase two of the project will be vetted by many groups of interested parties including the eHealth Board.
A great deal of work has already been done and will continue in order to align privacy and security protections with the goals of health information exchange in Wisconsin and across the country. The Department is dedicated to accomplishing this work in the best interests of all parties affected.
• DHC 2007: Hayden says technology creates magic moment for healthcare delivery
• Digital Healthcare Conference 2007: Mounting obstacles for health IT
• Doyle seeks $30M for e-medical record adoption
• WHIE receives state eHealth Initiative contract
• Doyle asks health professionals to overcome barriers
• Thompson announces ‘Decade of Health Information Technology’
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