Issued: January 7, 2010

HHS CIRCULAR C-032

Health and Human Services Enterprise Office of e-Health Coordination

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Purpose

To establish an Office of e-Health Coordination (OEHC) within the Office of Health Services (OHS) and a governance structure to coordinate health information (HI) initiatives enterprise-wide.

Definition

Health Information Technology (HIT) refers to the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making.

The goal of HIT is to allow comprehensive management of medical information and its secure exchange between health care consumers, providers, and payers. HI initiatives include, but not limited to, electronic health records, electronic prescribing, and health information exchange systems.

Background

There is an increased focus on HI at the national, state, regional, and local levels as a means of improving health care quality and containing costs. Given the size and scope of recent federal and state legislation, current HI initiatives are already underway in the health and human services (HHS) enterprise. The HHS enterprise needs a single point of coordination of health information initiatives.

The HHS enterprise agencies are working on multiple fronts to use HI to better coordinate care for Texans enrolled in Medicaid and other state programs. Examples of such projects include the Health Passport for Medicaid children in foster care, the Clinical Management for Behavioral Health Services (CMBHS) system at the Department of State Health Services (DSHS), and the planned use of the Medicaid Electronic Health Information Services (MEHIS) for a Medicaid electronic health record. H.B. 1218, 81st Legislature, Regular Session, 2009, directed the Health and Human Services Commission (HHSC) to develop an electronic HI exchange system to improve the quality, safety, and efficiency of health care services provided under Medicaid and the Children’s Health Insurance Program (CHIP).

The American Recovery and Reinvestment Act (ARRA) of 2009 provides substantial funding opportunities to assist physicians and other health care providers in the adoption of electronic health record (EHR) systems and to further advance health information exchange in the public and private sectors. By promoting HI exchange at the federal, state, and local levels, HI initiatives will directly impact Medicaid programs and other state health programs that collect and store HI on individuals receiving care through state and federally supported programs.

At the state level, Texas recognized the importance of statewide HI coordination in establishing the Texas Health Services Authority. The authority is a public-private corporation chartered by the Texas Legislature to improve patient safety and quality of care by coordinating the development of a voluntary and secure electronic HI infrastructure for the state health care system.

Directive

Office of e-Health Coordination (OEHC)

The OEHC is established within the Office of Health Services under the direction of the Deputy Executive Commissioner for Health Services. The office will ensure that HI initiatives relating to HHS programs (Medicaid, the Children’s Health Insurance Program, and other HHS health care programs) are coordinated across the HHS enterprise. In this capacity, OEHC will be responsible for:

• creating a formalized enterprise-wide collaboration and coordination infrastructure on OHS related HI policy and technology and, in particular, cross-divisional and multi-agency projects;
• identifying and prioritizing HI initiatives that can help improve health outcomes;
• serving as the single point of contact and lead for the HHS enterprise in regard to state funding opportunities under Title XIII of ARRA;
• supporting the state-level HI infrastructure efforts of the Texas Health Services Authority;
• acting as a single point of contact for HI policy for the health and human services system;
• staffing the HHS Health Information Steering Committee;
• collaborating with the Electronic Health Information Exchange System Advisory Committee established in Section 531.904 of the Government Code; and
• serving as a business partner to agency and Enterprise IT staff to coordinate overlapping IT and HI projects.

OEHC will not directly manage HIT initiatives across the enterprise. In particular, the Medicaid/CHIP Division will remain the lead for the state Medicaid HIT plan and Medicaid provider incentives under Title IV of ARRA, and staff the Electronic Health Information Exchange System Advisory Committee.

Health Information Strategic Initiative

The Health Information Strategic Initiative will consist of a working group or groups that deal with a particular HI topics or projects. The initiative will be guided by the HHS Health Information Steering Committee, chaired by the Office of Health Services, and will include representatives designated by the commissioners of each HHS agency and major programs within HHSC, including administrative and legal services. The steering committee will provide strategic direction on issues that may arise about individual projects or policy concerns regarding HI. The committee will meet as needed.

The steering committee will provide HHS enterprise oversight and guidance on issues such as strategic planning, data governance, interagency data sharing, project dependencies and HI standards.

Inquiries

Inquiries regarding the content of this circular should be directed to Stephen Palmer, Director of the Office of e-Health Coordination, Office of Health Services, at (512) 487-3308 or by e-mail at Stephen.Palmer@hhsc.state.tx.us.