Utah Digital Health Commission Meeting Minutes
Friday January 4, 2008
10:00 a.m. -12:00 p.m.
Utah Department of Health
288 North 1460 West
Salt Lake City, Utah
Members Present: Joseph Cramer, Scott Barlow, Rulon Barlow, Deb LaMarche, Brad LeBaron,Via Video Conferencing Dennis Moser and Michael Jenson
Members Absent: Terry Holmes, Mark Munger, and Chet Loftis
Staff Members: Wu Xu and Humaira Shah,
Guests: Barry Nangle (UDOH), Don Beckwith (UDOH), Darrell Martin (Intermountain Healthcare), Kyle Anderson (Intermountain HC), Jan Root (UHIN), Libbey Chuy (AUCH), Kevin Coonan (Health Data Security), Jonathan Hove (Resilient Networks), Shauna Wozab (UHIN), and Steven Lund (Resilient Networks) Via Telephone: Mark Fotheringham (UMA Vice President of Communication)
Welcome and Update: Dr. Joseph Cramer, UDHS Commission Chair, opened the meeting and introduced the public guests. The commission members introduced themselves. Dr. Cramer updated the commission that Utah sponsored the first Region 8 HIT meeting in last May, and Colorado hosted the second one in December 2007. He then welcomes comments and approval of the November meeting minutes. The members pointed out a misspelled name and then got a question about if the nominations in the minutes were listed in a certain order.
Dr. Cramer clarified that there was no any intended order in the nominees’ names. He asked for Motion for approval of the minutes with required revisions.
Scott Barlow moved to accept the changes. Deb LaMarche seconded the motion.
Brad Lebaron, Joseph Cramer, Dennis Moser, Rulon Barlow and Michael Jensen were in favor of the motion.
An attendance roster was passed around for members and guests to update their information.
Medicaid EMR Project: Progress and Next Step: Wu Xu explained that the project was the Health Departments contract with Health Insight. Sharon Donnelly is working on it but couldn’t make it so Wu’s going to talk about it. She explains that not everyone adopts EMR so they want to give more training so more clinics will adopt it. They want to promote and provide technique assistance and training for Medicaid providers to adopt EMR. The reason they are still targeting higher than the requirements is when they gave their technique assistance not everyone adopted EMR so they want to give more training so maybe 40 practices will adopt EMR. They want to build on the future for more outreach and projects and bring more Medicaid providers to the use of EMR and that’s their target. They’ll be able to tell what percentage of providers use EMR and learn it. Mark Fotheringham (UMA Vice President of Communication) then gives an update on the HealthInsight CMS project saying that it’s probably going to be winding down for the next five months and the focus is going to change from helping physicians adopt EMR’s to helping those who already have EMR’s use them better.
Joseph Cramer proposed a motion: The Utah Digital Health Service Commission would view it as sound public policy for the state legislature to invest in seed money to continue the support of the training and recruiting of Medicaid clinics to obtain electronic medical record systems. Scott Barlow seconded the motion and it was voted in favor of by the rest of other members.
Tele-health Grant and Digital Health Service in Rural Utah: Requested by Joe, everyone gives Deb LaMarche a round of applause as a gesture of their appreciation, and congratulates her on getting the FCC grant award, a project called Utah ARCHES, The Arches stands for Advancing Rural Connections for Healthcare and E-health services. The FCC (Federal communications commission) has a universal service program that was based on the 1996 Tele-communications act. It has a few components to it. First is the E-rate program for schools and libraries. The second was a rural Healthcare program. The FCC became interested in seeing if they could have a successful program and want to improve utilization of the program. The FCC came out with an order to facilitate the creation of a nationwide broadband network dedicated to Healthcare. The order was awarded $417 million for the construction of 69 statewide or regional broadband Tele-health networks in 42 states and 3 U.S. territories. Utah was awarded a maximum of $9 million. The project hasn’t been able to start yet because there is still a lot of detail to be figured out. Originally they wanted to do a 2 year project that turned into a 3 year project, and it could end in 2010 or even 2013 or 2014. The purpose of the project in Utah is to improve the quality of Healthcare for citizens in Utah by building upon existing IT infrastructure and increasing broadband capacity in order to advance innovative E-Health services. She then talks about some of Utah’s strengths, the biggest one being that we have a history of working together. She then discusses Utah’s needs. There’s growing shortages of specific Healthcare providers, increasing adoption of HIT throughout Utah and the need for sharing of patient information, and this means increasing the bandwidth and reliability requirements and make the network as reliable as we could possibly make it. The University of Utah is financially responsible for this project and Intermountain Healthcare will share leadership of the project. She explains that she will be the program manager along with Kyle Anderson. They have many project goals and ultimately what they want is to foster collaboration between health networks within the state and region to improve patient care, health professions education and training, and public health. They are trying to expand Tele-health and Tele-medical services throughout rural Utah. They have key strategies like wanting to redesign the existing infrastructure and expand it and increase broadband capacity to rural Healthcare facilities and increase network reliability. She continues to talk about the next steps towards the project. Utah Arches is going to be a large, complex project, but will begin to provide the physical infrastructure for Utah’s Healthcare community to meet our broader goals.
Brad LeBaron moved for a motion: The commission congratulates the Utah Tele-health network and the consortium, the work together to get the ARCHES project funded. We support their request to the legislature for matching funds. Motion is seconded by Scott Barlow and then discussed and passed by the rest of the members.
Legislation Update: Barry Nangle starts off by calling attention to a couple of pieces of legislation that have Digital Health Services Commission’s implications. He talks about House Bill 47 in his handout, saying it’s the most significant standards for exchange of electronic health information, sponsored by Representative Menlove. This authorizes Department of Health to adopt standards for the exchange of electronic health information. It authorizes the department to require voluntary participants to use the standards. It requires a report to the legislature about the cost and the savings and it requires coordination between health and insurance commission. This is the most significant thing that the Department of Health is trying to do. He says he included something that’s less central to digital health services. There’s another vehicle control prevention of sexually transmitted diseases. He discusses how this would provide some information about the treatment and prevention of sexually transmitted diseases to healthcare providers.
Develop Utah Clinical Information Exchange Standards: Jan Root starts off by saying that she wants to thank the commissions for letting them talk about this idea for developing standards. The basic idea is no matter where someone gets care that they could see the basic health information about you, with your permission.
Shauna Wozab discusses the community health information exchange (CHIE), saying that it will be a system that will compliment and add to our existing data exchange structure. Some requirements that have been identified and established has been through the cHIE task force. They have divided themselves because healthcare and the requirements are based on multiple users, and to determine their priorities, they subdivided and created their priority list. It then assembled and now have been incorporated into an RFP that has been finalized. They have a list of vendors who have asked for the RFP and she explains that they have also published it on their website.
Jan mentions a committee they had that was called the Healthcare consumer committee to look at privacy and security issue from a consumer perspective. She mentions that Dennis is a part of this committee and has attended every meeting.
Overview of Electronic Health Records Banking Initiatives In Other States: Innovations and Challenges: Kevin M. Coonan, MD in emergency medicine, thanks everyone for letting him talk. He says he has a broad background and talks about emerging paradigm shifts going on in healthcare information and about alternative approaches to our traditional assumptions and that may provide simpler solutions to problems. He then talks about challenges such as Healthcare quality being an ongoing issue. Other challenges include accessibility and cost of care. He talks about people who lack health insurance coverage. He talks about transfers of care and how there can be miscommunication; getting the right information is hard and primary care providers can get left out of the loop. He talks about patients with missing clinical information. He talks about the peoples privacy concerns and confidentiality and how one in six adults withhold information due to these concerns; one in four feel privacy rights aren’t handled properly and one in two feel like they have lost control over their health information. He highlights the fundamental concepts, talking about individual control and managing individual health record and how the individual has access to everything. He then talks about lifetime repository and secondary use and how everybody has a choice of which uses get used in their secondary information and the individual can revoke it. Then he mentions how the bank as a custodian and agent of the individual and patient and how the bank does not own the information and fiduciary responsibility to the individual. He then gives a brief summary.
Meeting Evaluation and Next Steps: Dr. Cramer wraps it up by inviting comments and thoughts from commission members on how the meeting went and their view on it.
Michael Jenson: The meeting is pretty interesting. I think the direction and the scope of what we are doing is very beneficial. I appreciate the efforts of the other commission members.
Dennis Moser: I appreciate being involved. Deb should be commended on the grants and the effort. The grant will be a big help in the rural part of the state. I’d commend Jan on the work she’s doing with the CHIE Project.
Scott Barlow: I am pleased to see all the things happening like the CHIE Project, excited to see these things move.
Rulon Barlow: I am impressed by what is going on. There’s a lot of things happening and a lot of people deserve credit.
Deb LaMarche: The commissions coming into it’s own because there are a lot of efforts going on and it’s great to have a central place to report on it and understand what other people are doing.
Brad LeBaron: I just come here to learn, I learn a lot. I am glad to be involved.
Dr Cramer then talks about the upcoming March meeting the retreat in May. He thanks the committee and proclaims the meeting adjourned.