Panel Discussion

1. Panel Discussion TLC (Think Like Consumers) Raising Public Awareness to Achieve Sustainability

2. Moderators Carol Selvey, MHSA,FHIMSS Principal for The Revere Group, business and IT solutions consulting firm HIMSS Fellow, and member of the HIMSS Board of Directors, HIMSS Chapter Leader since 2000, served on Advocacy and Public Policy Steering Committee crselvey@yahoo.com Carladenise Edwards, Ph.D. Chief of Staff, Georgia Department of Community Health HIMSS Chapter Leader, Founding Executive Director, South Florida Health Information Initiative, Former Project Coordinator and Technical Writer, Florida HISPC project edwardshc@earthlink.net

3. Learning Objective 1Benefits of developing collaborations among regional health information exchanges. Learning Objective 2Engaging public and private entities in the promotion of HIE. Learning Objective 3Designing a public awareness and education campaign to increase consumer understanding of and support for electronic health records, personal health records, and to increase physician adoption of health information exchange (HIE). Learning Objectives

4. Significance of Public Awarenessand Education • Need patients/consumers involved in the use electronicrecords • Create “demand” (supply and demand theory) • Influence public policy to improve incentives • Empower patients to be engaged in health and wellness

5. Florida HIMSS Chapters Key: Central and North Florida HIMSS www.cfhimss.org South Florida HIMSS www.sfhimss.org

6. Florida Association of RHIOs (FAR) http://www.fl-rhio.org

7. Panelists Christopher Sullivan, Ph.D.(sullivac@ahca.myflorida.com) Administrator of the Office of Health Information Technology in the Agency for Health Care Administration (AHCA); Steering Committee for the State Level Health Information Exchange Project of the American Health Information Management Association (AHIMA); RHIO Co-Chair for the Central and North Florida HIMSS Chapter Ebe Randeree, MBA, PH.D. (eranderee@ci.fsu.edu) Assistant Professor at Florida State University College of Information; 10+ years Consulting (Medical Practice Management, IT Implementation) William (Bill) Dillon, Esq.(WDillon@lawfla.com) Legal Consultant, Florida’s Health Information Security and Privacy Collaborative; Board Certified Health Law Attorney, Messer, Caparello, and Self, P.A.

8. Panelists Zach Finn (zfinn@avocarehealth.com) Project Director for the Big Bend RHIO; VP Operations for Avocare, a healthcare IT company Lonnie Draper, MD (ldraper@avocarehealth.com) CEO of Avocare, a medical software and hardware company; Practicing Emergency Physician at Tallahassee Memorial Hospital; Professor of Emergency Medicine at Florida State University College of Medicine Jose Lantigua (Jose.Lantigua@EpiTech.com) Community volunteer and IT Committee Co-Chairman with the Northeast Florida Health Information Consortium; Former Executive Vice President of Enterprise Banking Solutions Systems; Founder of Veritec Solutions, a financial transaction authorization and processing company.

9. Why is Public Awareness and Education so Important?

10. 1: Combating Key Concerns with HIE & EHR HIPAA Patient consent, privacy and control Policy and procedures System security and reliability Access to patient records The simple fact is you face these same concerns in the paper world and the sharing of electronic medical records is safer and more compliant than paper

11. 2: Explaining Value of HIE & Interoperability Providers Providers The Value of Health Care Information Exchange and Interoperability" http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.10/DC1, January 2005.

12. 3: Empowering Consumers and Increasing Transparency Giving Consumers informationleads to: Consumer empowerment and engagement in managing their health care. Reduced health care spending. Improved coordination of care Increased accountability among health care providers Competition among payors and providers

13. Identify Target Audience, including but not limited to: Patients and their Families Health Care Providers Government Officials Professional Associations Employers Researchers Educators Policy Makers Where Do We Begin?

14. Identify Messages, including but not limited to: Rules governing HIE Benefits of electronic HIE and E-Prescribing Consumer rights and obligations Enhancements to the quality of care Demystifying HIPAA Cost benefit of EMR adoption and HIE Concerns related to data privacy and security Create demand among consumers that will drive provider adoption Where Do We Begin?

15. The Florida Health Information Network Beginsat the Local Community Level Since 2005 the FHIN Grants program has provided funds for Planning Grants, Operations Grants and Training Grants to promote and develop health information exchange in Florida. All grants funds are matched dollar for dollar at the local level, indicative of a tremendous level of local passion and volunteerism within Florida’s Regional Health Information Organizations (RHIOs). Each RHIO is responsible for working with local providers to initiate the exchange of medical records through its health information exchange portal. The Florida Health Information Network (FHIN) is a collaboration of Regional Health Information Networks (RHIOs) funded in part by the FHIN Grants Program. 15

16. The Florida Health Information Network FHIN Grants Program Funded Grantees from FY 2005 – 2008

17. Benefits of Government Participation • Creates access to key policy makers at the local, state, and federal level • Ability to formulate public policy that will raise awareness • Capacity to organize regional and statewide initiatives through local delegations • Access to public sector resources that will advance the messages and initiatives • Most RHIOs are government funded creating incentive for RHIO collaboration

18. Approach to Patients/Consumers • Key concerns about HIE: • Privacy and Security of Data • Access and portability of health information • Raising costs of health care and transparency • Solutions: • Educate them on the differences and similarities between paper and electronic health records and allow them to make their own decision • Offer realistic solutions to a patient’s need and desire to have access to their personal health information or the PHI of a loved one • Promote existing efforts to increase transparency and reduce health care costs using technology

19. Benefits of Private Sector Partnerships • Creates access to financial resources and human capital • Increases access to a broad range of consumers who are affiliated or have an affinity for the private entity • Capacity to organize local, state, and national initiatives through associations, chambers of commerce, and other business affiliates • Increases visibility and credibility

20. Inconsistent state laws (FL) §395.3025 (hospitals) § 456.057 (providers) – broader approach to permitting consent §458 and §459 (Medicine and Osteopathy) Inconsistent federal laws 42 CFR Part 164 less stringent than 42 CFR Part 2 (substance abuse) Lack of education at every level of health care Misconception that HIPAA is the only HIE law Need for a single comprehensive statutory resource Legal Work Group Findings

21. Technology Barriers to HIE Adoption Zach Finn VP Operations Avocare

22. The Wrong Implementation

23. How Technology Can Drive HIE Adoption • Introduce the use of electronic records to healthcare providers & staff. • Model services to lineup with the prerequisites required for EMR implementation. • Provide simple to use affordable technology that solves a specific business need. • Support a community driven ground up approach that engages the local users of the system.

24. What Physicians Want The Right Information at the Right Time Lonnie Draper M.D. CEO Avocare

25. Approach to Providers • Key Concerns about HIE • Costs of adopting technology • Data Security and Integrity • Loss of control in terms of patient population and communication of health care information with payors, patients, and other providers • Solutions • Offer educational seminars on affordable technologies • Promote EMR adoption incentive plans among policy makers • Compare paper to electronic transmission of data and breaches of security and risk to provider • Create demand among consumers that will drive provider adoption

26. Physician Perspective The right information on the right patient at the right time with one logon • That Reduces Errors • That’s Compliant • That Improves Productivity • That Saves Dollar$ • That Makes Patients and Staff Happy • Increases Patient Convenience • Reduces Time to Diagnosis • Reduce Frustration • Prevent Repetitive Testing

27. Physician Perspective

28. Community Collaborationfor HIE Adoption Jose Lantigua Northeast Florida Health Information Consortium

29. NEFHICConsortiumSteering Committee Membership Duval Co. Medical Society Potential other participants JaxCare NEFRHO Duval Co. Health Dept. Rhonda Poirier,DrPH President & CEO Mark Renfro Robert Harmon, MD, MPH Steering Committee Chairman and FHIN grant Project Director Hospitals Jay Milson, Executive Director Other county health departments Francis Koster, EdD, C0-Chair JHIN Advisory Committee William Carrier, MD Bill Livingood, PhD Steering Committee Vice Chairman and FHIN grant Project Manager John Montgomery, MD, Board Chairman Other county medical societies Technology partners Susan Coughlin Research Robert M. Walters, Co-Chair JHIN Advisory Committee Employers Radley Remo Research Health plans Norm Turnbull IT Others Jesse Bradlee, IS Manager Catherine Berry Legal Jose Lantigua

31. So what do consumers really Think and want to know about HIE?

32. Consumer Support for Secure ElectronicHealth Information Exchange 73% 70% 67% Support Across Party Lines http://www.ehealthinitiative.org/news/CommToolkit.mspx

33. Americans Eager for PHR Functionality • More than seven in ten Americans (72 percent) are eager for the new functionalities PHRs offer McInturff, B (2005) Public Opinions Strategies; Markle Foundation, RWJ Foundation and Connecting for Health

34. Americans Eager for EHR Functionality 60% of Consumers want Physicians to provide online access to medical records and test results 1 in 4 people are willing to pay more for online access to medical records and test results. Deloitte’s 2008 Survey of Health Care Consumer:http://www.deloitte.com/dtt/article/0%2C1002%2Ccid%25253D192702%2C00.html

35. Questions for Panelists • What are the patients’ concerns that can be addressed in a PA&Ed campaign? • What legal barriers can be addressed? • What do providers need to know about HIE to increase adoption? • What is the state’s responsibility in promoting HIE and raising awareness? • How can we use technology to promote the use of HIT? • How do we foster meaningful public-private partnerships aimed at raising public awareness and education?

36. Open Discussion one laptop per child SUPPORT PLEASE http//www.laptop.org/