As of September 2006, the DHHS and the local health departments were conducting a gap analysis to determine which features in Saber Corp.'s proposed system needed customization. The DHHS and its vendor will establish an implementation timetable once they've agreed on the scope of the customization, Reed said.
The state will also pilot the system for three months with five local health departments, and then roll it out to the other 80. The pilot, however, will be more than a test.
"The day the pilot counties come up," Reed said, "we will flip the switch on the old system and put them on the new system, and they will never go back to the old one."
The local health departments have been earmarking funds for several years for a new statewide system, and those funds have allowed the state to sign a contract with the vendor.
"They're stepping up to the plate because they want to make sure that this time, the system we get is really driven by local needs, but then also allows the state to get the data it needs," Reed said.
But developing and implementing the system will require state funds as well. "That is one of our No. 1 legislative priorities this year, to get that additional state money," Reed said, adding that participants have not yet discussed how they will fund ongoing maintenance and support.
It's appropriate for the state and local health departments to share the costs because both benefit from the collaboration, Staley said. Local health departments don't need to individually evaluate and procure new health-care information systems, and the state doesn't need to build interfaces to a plethora of solutions using different technologies and formats.
"I'm sure the state would love to have to go through 85 different systems to figure out what apples are apples," he observed.
Besides transmitting data to the state and doing Medicaid billing, local health departments will use the new system to determine patient eligibility, capture patients' personal data and medical histories, schedule appointments, and run a variety of management reports tailored to their own needs.
Hosted by the state's Office of Information Technology Services, the HIS will include a central database with records for anyone who visits one of the 85 local health clinics. All patient information will become available to anyone with the security credentials to view it. That's important in public health, because it serves a fairly mobile population, Reed said.
"In the current system, if you are seen in one health department today, and then you're seen in another health department tomorrow, they have to create a whole new record for you. There's no master patient information that can be shared from county to county."
For the health departments, a unified database will reduce data entry, saving labor and decreasing error rates. For patients, it will mean better continuity of care.
"If mental health and rural health come online down the road, we're hoping that will also help with continuity and integration of care across different types of county-level providers," Reed said.
As a Web-based system, the HIS will let health department employees enter data from any location with Internet access. "Right now, most of our health departments have one to five people who do nothing but enter information into the current system," Reed said. "If the health department lab does a test, they write those results down on paper and it still goes to the data entry person."
With the new system, anyone who performs a service can enter the related data, alleviating duplicated data entry and helping ensure accuracy. Since the new system will be integrated with other medical databases that health departments use, such as the state's immunization registry, employees will no longer have to enter the same data twice. State and local users will also be able to generate a broad range of reports, designing them as needed.
"So it should also help productivity," Reed said.
One notable element of the HIS project is the way the 85 autonomous local health departments have collaborated with the state, committing money, local resources and people, developing the RFP, reviewing vendor proposals and participating in the gap analysis.
"In a local autonomy state," Reed said, "that's critical for success, and we have had just tremendous support from our locals through this process."