HIEs used by Medicaid must coordinate with others

Any Health Information Exchange (HIE) system utilized by Medicaid will need to coordinate with others in the state, including those developed by public health programs and private health plans. "Medicaid can't operate in a vacuum, and neither can the other programs," says Rhonda M. Medows, MD, FAAFP, commissioner of the Georgia Department of Community Health (DCH). "It sounds tough, but it's doable. Like any major challenge, you have to take it step by step, in logical sequence."

Georgia's Medicaid Health Information Technology (HIT) planning grant of about $3 million will address the coordination of HIE systems statewide. The next step is implementation. "So, after we finish coming up with a plan and get CMS to approve it, the next thing we compete for is an HIT implementation grant," says Dr. Medows. "That will be very important, because that is the money to actually make it real. Medicaid will be able to plug in on one side, state health employee plans on another side, and payers will plug in as well. Information will be exchanged across all of those for an individual patient."

The capability to obtain aggregate information on public health community assessments is going to be built in from the beginning, as this can be used for emergency planning. "That will give us important information on the health status of our community," says Dr. Medows. "That is going to be a really, really exciting area. We are going to be getting all the folks together at a table, so this actually becomes a reality."

Single infrastructure

Perry Yastrov, project director of EHR Systems and Services for Arizona Health Care Cost Contain- ment System, the state's Medicaid program, says it has become painfully clear that the state lacks resources for multiple HIEs with functionally redundant infrastructures. Therefore, a collaborative effort is under way with the Southern Arizona Health Infor- mation Exchange and other stakeholders. The goal is to build a single HIE infrastructure, as opposed to multiple, interoperable HIEs.

The objective is to leverage the Arizona Medicaid Information Exchange, which was funded by a Medicaid Transformation Grant, as much as possible, as well as incorporating work that has been accomplished by other HIE initiatives in the state. "Health information will be easily reused for treatment and care management purposes," says Mr. Yastrov. "The benefit to Medicaid will be a healthier membership, lower cost, and improved outcomes for its members."

The Regional Extension Center funds will be used to support and accelerate the adoption of interoperable EHRs. Mr. Yastrov adds that the Purchasing & Assistance Collaborative for Electronic Health Records, another product of the Medicaid Transformation Grant, is in a good position to deliver the services required.

Ultimately, the HITECH funds "will allow the initiatives that were germinated by the Arizona Health Care Cost Containment System, Arizona's Medicaid agency, to continue, and to broaden their scope to health care providers across all of Arizona," says Mr. Yastrov.