Purdue University Florida Health Information Network Telehealth Services Case Study

Agency for Health Care Administration The Florida Health Information Network Promoting Telehealth Services to Rural Hospitals in Florida’s Panhandle Georgia HITT Advisory Board Health Information Exchange Standing Committee February 21, 2007 Christopher B. Sullivan, Ph.D. Florida Center for Health Information and Policy Analysis Agency for Health Care Administration Florida Center for Health Information and Policy Analysis Agency for Health Care Administration The Proposed Florida Health Information Network | The Florida Health Information Network vision will integrate clinical health information exchange in Florida through a network architecture that will empower physicians to access timely and accurate medical records in order to deliver high quality medical care for their patients. Florida Center for Health Information and Policy Analysis 1 Agency for Health Care Administration Executive Order Initiates the Florida Health Information Network | The impetus for the Florida Health Information Network came from the Legislature and Governor Bush | In 2004 Governor Jeb Bush signed Executive Order Number 04-93, which addressed the need for state leadership in the area of health information technology infrastructure development Florida Center for Health Information and Policy Analysis 2 Agency for Health Care Administration The Governor’s Health Information Infrastructure Advisory Board | Advisory Board formed to create “a plan to promote the development and implementation of a Florida health information infrastructure” | The Board’s 2005 Interim Report of the GHIIAB called for the creation of the Florida Health Information Network Florida Center for Health Information and Policy Analysis 3 Agency for Health Care Administration Health Information Networks Included as an Innovative Idea | In 2007 House Speaker Marco Rubio’s 100 Innovative Ideas listed health information exchange as idea number 85 | “Improve patient care through technology by expanding electronic health records and regional health information networks” Florida Center for Health Information and Policy Analysis 4 Agency for Health Care Administration Functions of the Florida Health Information Network | The Florida Health Information Network will facilitate communications and data exchange among providers and Regional Health Information Organizations by coordinating their requests for medical records inside and outside of Florida Florida Center for Health Information and Policy Analysis 5 Agency for Health Care Administration Geography of the Florida Health Information Network Florida’s Health Information Networks 1. Big Bend RHIO 2. Central Florida RHIO 3. Community Health Information Organization 4. Escambia HIN 5. Jacksonville Health Information Network 6. Palm Beach County Community Health Alliance 7. Purdue University Florida Health Information Network Telehealth Services Case Study.  Pinellas RHIO 8. Space Coast Health Information Network 9. South Florida HII 10. Tampa Bay RHIO Florida Center for Health Information and Policy Analysis 6 Agency for Health Care Administration Vision for the Florida Health Information Network The FHIN could integrate health care data from: | Medicaid | Inpatient /Outpatient / ED | SHOTS | Physician. Purdue University Florida Health Information Network Telehealth Services Case Study.  Licensing data | Payers, like Availity | Department of Defense | Medicaid Data Data Data AHCA & DOH Databases Payer Databases Federal Databases Data DOH Physician Licensing Database FHIN EMPI and RLS Server Florida Center for Health Information and Policy Analysis RHIO Servers 7 Agency for Health Care Administration 3. The FHIN Server collects patient records from RHIOs and other participating servers and sends them to the authorized user. Projected Workflow of the FHIN: FHIN Server RHIO Server RHIO 2. RHIO servers pass on authorized and authenticated queries to the FHIN Server. RHIO Server RHIO 1. Users request patient records from their RHIO. Other Servers State Agencies, Health Plans, and other Databases Florida Center for Health Information and Policy Analysis 8 Agency for Health Care Administration The Florida Health Information Network Begins at the Local Level | The Florida Health Information Network is being built from the local community up | An essential element of the strategic plan is to empower local stakeholder collaborations focused on health information exchange | The driver of this plan is the FHIN Grants Program and Regional Health Information Organizations in the local community Florida Center for Health Information and Policy Analysis 9 Agency for Health Care Administration Connectivity Issues of the Florida Health Information Network A key to the success of the Florida Health Information Network is the connectivity among providers and local health information exchanges. Unless a provider has a broadband connection, health information exchange services will have little value. An example is given on the following slide. Florida Center for Health Information and Policy Analysis 10 Agency for Health Care Administration Example of Connectivity: Big Bend RHIO Optical Fiber pMAN Network TMH Radiology CRMC CHP. TDI BBRHIO RHIN CHP VSA CHP. The Big Bend RHIO pMAN is a 1 Gigabit fiber ring with highspeed connections to providers VPN NFWC Urology Remote & VPN Users TNC Florida Center for Health Information and Policy Analysis 11 Agency for Health Care Administration Connectivity in Rural Areas of Florida While urban areas have high speed connections, rural areas of the state have limited broadband access. The Florida Panhandle has the largest rural areas in Florida, as shown by the purple sections in the map. Florida Center for Health Information and Policy Analysis 12 Agency for Health Care Administration Developing Connectivity through a Telehealth Pilot Program The Florida Health Information Network is pursuing a grant from the Federal Communication Commission to provide broadband connections to rural hospitals. The goal is to facilitate the creation of a nationwide broadband network dedicated to health care, health care providers in rural and urban locations. Florida Center for Health Information and Policy Analysis 13 Agency for Health Care Administration FCC Telehealth Pilot Program The pilot program will fund 85% of the costs of deploying a dedicated broadband network connecting health care providers within a state or region. The broadband network will provide the health care communities access to telehealth facilities and to medical specialists in other parts of Florida. Florida Center for Health Information and Policy Analysis 14 Agency for Health Care Administration FCC Telehealth Pilot Program The FCC grant will cover deploying transmission facilities and advanced telecommunications and information services, including any associated nonrecurring and recurring costs. The pilot program will also support construction of telehealth audio-visual facilities. Participants will be free to use available technology. Florida Center for Health Information and Policy Analysis 15 Agency for Health Care Administration Collaborators on the FCC Proposal The grant proposal includes many collaborators: • • • • • •Purdue University Florida Health Information Network Telehealth Services Case Study.  • • • • • • • • Agency for Health Care Administration Department of Health Department of Management Services Office of the Governor Florida Hospital Association Florida Medical Association Florida State University University of Florida Association of Community Health Centers Rural Health Network – Big Bend North Florida Medical Centers, Inc. Big Bend RHIO Community Health Informatics Organization Florida LambdaRail Florida Center for Health Information and Policy Analysis 16 Agency for Health Care Administration Proposed Objectives of the Project: Connect rural hospitals located in the Big Bend and Panhandle with urban providers and pediatric specialists. Extend Florida Health Information Network applications to rural providers. Employ telehealth applications for chronic disease monitoring in the home. Develop a funding formula for sustainability of services to eligible providers in rural counties or underserved areas. Florida Center for Health Information and Policy Analysis 17 Agency for Health Care Administration Target Rural Areas in Florida’s Panhandle Measures of population density, urbanization, and daily commuting are used to identify urban cores and adjacent territory that is economically integrated with those cores – Rural-Urban Commuting Areas, shown in purple. Florida Center for Health Information and Policy Analysis 18 Agency for Health Care Administration Hospitals Considered for the Telehealth Pilot Hospital Capital Regional Medical Center Bay Medical Center Gulf Coast Medical Center Tallahassee Memorial Hospital Big Bend Rural Health Network Gadsden Community Hospital Madison County Memorial Hospital Doctor’s Memorial Hospital, Inc. Panhandle Area Health Network Calhoun Liberty Hospital Doctors Memorial Hospital Campbellton Graceville Jackson Hospital Northwest Florida Community Hospital George E. Weems Memorial Hospital Zip Code RUCA 2 32308 1 Metropolitan area core 32401 1 Metropolitan area core 32405 1 Metropolitan area core 32308 1 Metropolitan area core 32353 32340 32348 4.1 7 7 Secondary flow 30-49% Small town core Small town core 32424 32425 32440 32446 32428 32320 7 9 10.6 8 7 8 Small town core Small town low commute Secondary flow 10-29% Small town high commute Small town core Small town high commute Florida Center for Health Information and Policy Analysis 19 Agency for Health Care Administration Connecting Rural Hospitals to the Florida Health Information Providing optical fiber connections to rural hospitals will bring them into the Florida Health Information Network. Rural clinics and physicians can benefit from the high bandwidth connection by using excess bandwidth for their own connection. An example is shown in the map following. Florida Center for Health Information and Policy Analysis 20 Agency for Health Care Administration Proposed Florida Health Information Network Connection to Rural Hospitals The FCC Grant could provide 1 Gigabit connectivity to nine rural hospitals. Clinics and physicians’ offices would follow. Purdue University Florida Health Information Network Telehealth Services Case Study. Florida Center for Health Information and Policy Analysis 21 Agency for Health Care Administration Benefits of Connecting Rural Hospitals to the Florida Health Information Bringing high speed data connections to rural hospitals will create opportunities for telehealth care services that do no exist today. By engaging this proposal to build broadband connections to rural hospitals, the Florida Health Information Network is establishing an integrated health care network across Florida. Florida Center for Health Information and Policy Analysis 22 Agency for Health Care Administration Christopher B. Sullivan, Ph.D. Agency for Health Care Administration Florida Center for Health Information and Policy Analysis 2727 Mahan Drive Tallahassee, FL 32308 sullivac@ahca.myflorida.com Florida Center for Health Information and Policy Analysis