SustiNet Health Partnership

Health Information Technology
Advisory Committee

Health Information Technology Committee Regular Meeting

February 19, 2010

 Meeting Minutes

Teleconference Participants:  Mark Boxer, Co-chair; Alex Hutchinson; Enrique Juncadella; John Brady; Victor Villagra; Dr. John Blair; Ryan O’Connell

Office of the Healthcare Advocate:  Michael Foy Mitchell

Mark Boxer opened the teleconference by welcoming all participants. 

Victor Villagra introduced Dr. John Blair, a nationally recognized healthcare leader in technology and other aspects of the healthcare industry.  He is President and CEO of Taconic IPA, a 500 physician IPA in the Hudson Valley.  Dr. Blair gave the following presentation.

https://www.ct.gov/sustinet/lib/sustinet/committeeinformation/hit/developing_a_regional_hie_in_the_hudson_valley.pdf 

Victor opened the discussion for questions.  Ryan O’Connell asked Dr. Blair what the business model is for this, and how to get payors to recognize the value of the clinical and IT transformation.  Dr. Blair answered that the 500 physicians who initially participated wanted to convert to EHRs.  Some of them took advantage of grant dollars, which dropped total costs by 25 - 30%.  He said that many of these practices are solo, but they were assisted by a regional extension center precursor with a very capable implementation team.  The business model has not been analyzed by Taconic IPA, but rather by the individual practices.  There has been much interest shown in communicating with other practices, and he feels that the integrating and connecting to other EHRs will expand.  As far as payors go, this is being closely watched, but initially it’s been a leap of faith.

Mark asked Dr. Blair if any academic centers have launched studies about his work, and if there are studies available.  Dr. Blair said that there is a study of several years’ duration with Weill Cornell Medical Center.  They are acting as third party evaluators, looking at costs involved, patient satisfaction and physician satisfaction among other things.  There will be results published within four – six weeks, comparing a practice using paper records to one using EHRs.  The results are impressive, particularly regarding medication errors.

Alex Hutchinson asked from a provider’s point of view, what Dr. Blair projects the implementation curve to be as far as future practices and timing, and what the resource impact will be.  Dr. Blair said that there are three separate organizations that have been instrumental in this effort, one is the regional center discussed previously, the Taconic Health Information Network Community.  The second one is Taconic IPA, which has worked with providers who already have EHRs, and additionally works on medical home care coordination and partners with Cornell on research.  The third one is Med Allies, an information service provider that was put into place to begin the integration of systems but now also implements EHRs.  Approximately 41 - 43% of primary care providers in Hudson Valley are using EHRs.  Dr. Blair said that over the next three to five years, he feels that most physicians will convert to EHRs.  Alex said that in CT, this effort isn’t even in its infancy.  Dr. Blair said that the first step should be to map out a strategy and set realistic goals, then figure out how to achieve those goals and then tap into resources with proven track records.  He said that he believes EHRs are inevitable, but that there needs to be a strategy for interoperability. 

Victor asked Dr. Blair two questions from Marie Smith, first, what the role is of pharmacists in the medical home.  Second, if the work of Taconic IPA is projected to the entire state of NY, how would the various community infrastructures and entities connect with each other?  Regarding the role of pharmacists, Dr. Blair said that his organization has not yet integrated pharmacists into medical homes, but that it is being considered.  Regarding the second question, Dr. Blair said that this is still not yet an emerging market.  There may be national or local approaches and he said that it will take many years to see how this plays out.  He also said that these investments can be significant, so it’s essential to consider sustainability.  Unless the offering is fully sustainable on its own with ongoing revenue, he’d be leery of it.

Minutes from the 1/22/10 meeting were approved.

Workgroup reports:

Financing - Nothing at this time. 

Market Research and Outreach - This group has not met yet, but is hoping to meet within the next week.

Logistics – Ryan said that he had spoken with John Brady, who described data that CHA has gathered on hospital usage of EHRs in CT.  Hopefully this information will be shared with the Committee.  The workgroup has also discussed the concept of statewide vs. regional HIEs, and feels that since most healthcare is provided regionally, data shared within a community would be of the greatest value.

Reform ARA - Nothing at this time.

Organization – Has not met yet.

Integration With Other Teams – Nothing at this time.

Mark asked that each workgroup nominate one member who will provide reports at Committee meetings.  Victor said that his workgroup decided to rotate the responsibilities of setting agendas and drafting minutes, and that this is working well for them.  Mark also asked the workgroups to plan on meeting before the next Committee meeting.  Michael Mitchell recommended conference calls as a way to meet, thus accommodating various schedules.   

New Business – Alex said that he’d hoped Ken Lalime would participate in the next meeting, but that he is not available at that time.  Mark said that if folks are interested in hearing about HIEs and EHRs from other markets outside of CT, he knows of persons who could be invited.  Ryan said that he’d like to invite Jess Kupec. 

Michael spoke of an email he had received regarding funding that had been released by HHS for HIT and asked if anyone else had received it.  He said he’d forward to email to the co-chairs.

Victor asked if this Committee should put together a timeline for submissions of reports.  Mark said that he and Marie would work on this and present it to the Committee at the March meeting.  Victor also asked if there would be an in person meeting, and suggested that it would be good to determine a date for this soon.  Michael suggested that the Committee could perhaps meet at CHA in Wallingford.  Michael also reminded the group that Stan Dorn from the Urban Institute would be available to meet with interested Committee members.

Meeting was adjourned.

Next meeting will be March 5, 2010 at noon.