Medicaid Health Information Network Project
The Agency for Health Care Administration (Agency) launched a Medicaid Electronic Health Record (EHR) pilot In November 2007 that ran through the close of February 2008. The primary objective of the pilot was to generate an EHR for the Medicaid population using Medicaid Management Information System (MMIS) data and to provide information that would enable the Agency to determine solution requirements for provider acceptance and a statewide deployment. Volunteer Medicaid providers that chose to participate in the pilot viewed the Medicaid EHR application to assess the information provided.
The pilot objectives included:
- Clinical and administrative evaluation of the prototype;
- Assess how best to position or adapt an MMIS generated EHR application in light of other EHR and health information exchange efforts in Florida;
- Identification of the application requirements, functionality, data sources, and supporting services that would best encourage end-user adoption; and
- Creation of methodologies for a statewide rollout.
The pilot focused on the provider population in Leon County of the north Florida “Big Bend” region. The project received comments from Medicaid practitioners who volunteered to participate and a Physician Advisory Group (PAG) that included selected high volume providers. The Big Bend Regional Healthcare Information Organization assisted in encouraging physicians to participate in the pilot. In addition to the technical accomplishments of the pilot, the project was successful in adapting to the expectations of local stakeholders.
Possibly the most useful aspect of the Medicaid pilot is that it afforded the State an opportunity to work across government program lines both internally and externally in collaboration with a local Regional Health Information Organization. The Agency had an opportunity through the pilot to explore how Florida Medicaid and local health information organizations could function as part of a statewide health information network.
Based on the experience with the Medicaid EHR pilot, in late 2008 the Agency issued a Request for Information (RFI) to determine the current capability of vendors to offer a statewide multi-payer health information exchange (HIE) in which Florida Medicaid could participate on a no cost basis. The RFI outlined desirable features for the HIE including requirements for a provider and a consumer personal health record portal. After reviewing the RFI submissions, the Agency contracted with Availity L.L.C. to implement a demonstration project to provide physicians and patients with access to Medicaid patient-specific, claims-based health information via a secure Web portal. The web portal allows providers to look-up patient eligibility and benefit information and beginning in 2009, medical and prescription claims history from all of participating payers including Florida Medicaid. In year two, Availity will integrate eligibility, benefits and claims history data from multiple payers into a patient-centric view to ease provider access to this information. To access the data, providers must have explicit authorization from the patient, except in a medical emergency where the patient or family is unable or unavailable to consent.
Availity will also offer a secure portal to give Medicaid recipients access to a personal health record (PHR), provided by Health Trio which will allow them to record information about their health care. Health content, useful in patient self-management, will be provided by Healthwise. The PHR will help Medicaid recipients organize their health information, and provide care management tools to assist them in coordinating their overall health care. Initially, the PHR will offer infant and well-child health management tools, including immunization schedules, appointment reminders, and health education materials. In year two, patient-specific claims-based health information will be available to Medicaid recipients, as well. The exchange of health information via the consumer and provider portals will comply with the confidentially regulations of the Health Insurance Portability and Accountability Act (HIPAA) and Florida Law.
Health Information Exchange Collaboration RFI (.pdf 53KB)
Availity Contract (.pdf 1.5MB)
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