An initial $106 million will be invested in the health care community during 2007-2008 to support the implementation of health IT tools to allow portability of patients' medical records and new tools to assess and target improvements in health care quality.
The commissioner has charged his new Office of Health Information Technology Transformation with coordinating health IT programs and policies across the public and private health care sectors. These programs and policies will establish the health IT infrastructure and capacity to support clinicians in quality-based reimbursement programs and new models of care delivery.
"Our goal is a health care system oriented around the patient, with strong privacy protections, reporting on quality of care and outcomes," Daines said. "The opportunities for improving health care quality, affordability and outcomes are limited by New York's paper-based, error-prone and fragmented health care system. Health IT is part of our strategy to help improve health care quality for all New Yorkers."
Daines added, "As a past president of a large urban hospital, I've seen the technology advances that have streamlined billing and personnel management, but what's been missing is using information technology on behalf of patients, including measuring the quality of care provided so that we can improve it. Doctors and nurses need facts at their fingertips as they care for their patients. This will help prevent medical errors, and I believe this will serve as a model for other states to follow."
DOH's effort is part of Governor Spitzer's 'Patients First' health care agenda to improve the quality of health care as it shifts from institution-based care to community care. The following key objectives will drive DOH's investment in a community-based health information infrastructure, including:
- Ensuring the privacy and security of patients' individually identified health information, and supporting the right of New Yorkers to have greater control over and secure access to their personal health information.
- Providing public information about the quality and cost of care by payers and providers so consumers can compare costs and value.
- Using health IT as a tool to support better management of chronic disease, community-based long-term care, improved public health surveillance and reporting, and a modified certificate-of-need process to advance health care reform.
- Providing health IT tools required for validated quality measurement and reporting to support reimbursement reform, which is under way in the Medicaid program - the largest health care insurance payer in the state.
- Helping prepare New Yorkers for health care emergencies by developing the capacity to receive and exchange health care information, such as medications and lab test results.
- Helping clinicians and providers in small practices, community health centers and rural and under-served areas close the health IT gap between them and larger or urban institutions. This requires development of a sustainable financing plan, which includes public- and private-sector investment in health IT.
- Increasing the use of telemedicine, remote monitoring devices and other medical device applications to exchange information regardless of the venue where the patient receives services.
A strategic health IT implementation plan. The plan -- a guide for implementing an interoperable health information infrastructure in New York -- will be submitted to Daines within 90 days and available publicly on the DOH Web site, nyhealth.gov. The plan, to be updated regularly, will include key clinical, patient, technical, organizational, financial and policy components
required to advance statewide interoperable health IT.
A health IT coordinating council. The council will bring together internal DOH programs and policies involving health IT to align strategies, avoid duplication and streamline programs. The council will also serve as a liaison for health IT among health-related state agencies and the New York City Department of Health and Mental Hygiene. The council's first priority will be a children's health care initiative to align programs with corresponding information systems for immunization registries, lead and newborn screening, and vital records to support improvements in children's health.
The health IT public-private partnership. The partnership will help DOH collaborate with public and private health care leaders on health IT. DOH has asked the New York eHealth Collaborative (NYeC), based in New York City, to coordinate this effort in an inclusive and open manner. NYeC is a non-profit organization dedicated to improving health care quality, safety and efficiency through health IT.
Because of this new health IT program, Daines said DOH will re-bid the proposals sought in 2006 to grant $53 million through the third phase of the Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY) for health IT projects. A new RFP will be issued later this summer for $106 million to advance the technology required to achieve an interoperable health information exchange and a quality measurement and reporting capability.
"The first phase of HEAL grants for health IT helped many regional collaborations of health care providers advance governance structures and clinical priorities to inform health information exchange approaches," Daines said. "Our longer-term approach is more comprehensive than HEAL 3's original goals, so we feel taxpayers will be better served by a re-bid that will help us achieve a seamless health information exchange capability that has strong protections for patient privacy."
