AHCCCS Health Information Exchange

Shaping tomorrow's managed care from today's experience, quality, and innovation.

The Health Information Exchange Electronic Health Record (HIeHR) Utility Project, under a Federal Medicaid Transformation Grant, will develop and implement a statewide, secure, online Health Information Exchange (HIE) and Electronic Health Record (EHR) system.

AHCCCS was awarded the Medicaid Transformation Grant on January 25, 2007 to develop and implement a web-based health information exchange (HIE) utility to give all Medicaid providers instant access to patients' health records at the point of service. The Federal funds are being used to support the planning, design, development, testing, implementation, and evaluation of the AHCCCS Health Information Exchange and Electronic Health Record (HIeHR) Utility.

Our goal is to achieve:

• Better coordination of care for members with acute and chronic diseases
• Better coordination between behavioral and physical health services
• Enhanced opportunities for self-management through personal health information and integrated wellness applications
• Improved quality of care oversight and transparency by timely performance information
• HIeHR use by 90% of providers by 2011
• Reduction in Medicaid program medical costs by ~ 3% and in administrative costs by ~2%

Benefits include:

• Creating a "virtual medical home" that makes critical healthcare information available when and where it is needed
• Enhancing coordination of healthcare across the continuum
• Improving quality and controlling costs by reducing duplicative services, medication problems, delays in care, and the likelihood of medical errors
• Reducing administrative costs and minimizing delays in provider payments

The HIeHR web portal will feature electronic medical record functions and integrated clinical decision support tools for better care management. Automated reporting for diseases and syndromes will enhance public health and bio-surveillance activities.

Phase 1, which will begin a proof of concept in the Fall of 2008, is a federated health information exchange (HIE) with a secure web-based viewer through which authorized AHCCCS registered healthcare providers will be able to match patients, locate relevant information, and view individual documents. This exchange will include:

1. Hospital Discharge Summaries (from three major hospital systems in the metro Phoenix area)
• These are clinical notes written by the discharging physician at the time of patient release from the hospital or clinic. These notes outline the course of treatment, the status at release, and the post discharge instructions.
2. Laboratory Test results (from one major commercial laboratory service provider in Arizona )
• These are records presenting the results of patient laboratory tests over a period of time.
3. Medication History (from a pharmacy information exchange company)
• This allows physicians to access patients' medication histories during routine care as well as in an emergency.

The Health Information Exchange testing will be conducted in three phases:

Phase 1, incorporates a proof-of-concept and a pilot, which will automate the time-consuming, manual processes currently being used by clinicians and their staff to obtain information via fax, phone, courier, or mail. This initial phase provides AHCCCS and our partners the time and focus to develop the agreements, policies, procedures, and processes that are integral to the subsequent Phases.

Phase 2, known as the "AHCCCS CCR System," will include the AHCCCS member data exchanged through the Phase 1 HIE, augmented by clinical and financial information. A "virtual medical home" will be created for each AHCCCS member and accessed by authorized AHCCCS registered health care providers through a secure web-based viewer. The viewer will support patient matching and a patient-centric display of the standard continuity of care record (CCR) elements. The tentative delivery date for Phase 2 is April 2008-February 2009.

Phase 3, features the population and use of the AHCCCS clinical data warehouse from which AHCCCS will perform analytics, track disease and syndrome trends, and facilitate population level studies to improve the adoption rate of best practices which improve the quality, safety, and cost-effectiveness of care. The tentative delivery date for Phase 3 is January 2009-November 2009.

The HIeHR Utility Project is aligned with the goals of Arizona Health-e Connection (AzHeC), a nonprofit organization formed in 2007 to implement HIE and to coordinate the deployment of HIT in Arizona, and the Arizona Health Privacy Project, which is developing solutions to HIE privacy and security issues. HIeHR is also working closely with other HIE initiatives in the state. Foremost is the Southern Arizona Health Information Exchange (SAHIE), a nonprofit organization sustained by a coalition of healthcare institutions and aligned stakeholders in the region.

HIeHR Core Team

The AHCCCS HIeHR Utility Project Core Team, recruited and on-boarded during the second quarter of 2008, is responsible for the delivery of the Health Information Exchange and Electronic Health Record system. The Core Team has assembled an array of internal and external resources to complement and augment each phase.

For more information, contact:

Additional Information

• Medical Transformation Grant Proposal [PDF, 182Kb]
• Health Information Exchange Physician Brochure [PDF, 328 Kb]
• Health Information Exchange Consumer Brochure [PDF, 741Kb]
• HIeHR Technical Overview, April 2008 [PDF, 4.2 Mb]

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