As the role of Health Information Exchanges (HIE) grows across the state, the Texas Health Services Authority (THSA) has completed an update to its strategic roadmap to promote and coordinate the continued development of a seamless electronic health information infrastructure. The 2014 Texas State HIE Strategic Plan builds on a decade of developing efficient and effective Health Information Exchange networks in Texas.
THSA developed the strategic plan over months of intense planning and research, and gave it final approval in June of this year. THSA designed the 2014 plan to move forward from the strategic and operational plan developed in 2010 for the state’s HIE program.
Future goals of the strategic plan include:
- increasing the size, scope and services supported through the Texas statewide HIE network by improving core state-level HIE technical operations, rural HIE planning and development, and state and federal agency connectivity;
- continuing to build confidence and trust in the state’s HIE through policy initiatives, governance structure, HIE accreditation and covered entity certification;
- empowering patients through Health IT and HIE, including communications marketing, provider adoption, patient education and engagement; and
- supporting contingency planning through both technical and financial programs.
The updated strategic plan continues the efforts of state legislators, which began in 2004 when the Texas Senate recommended creation of the Texas Health Information Technology Advisory Committee to develop a long-range health information technology plan for the state.
In 2006, following the Senate’s recommendation, Governor Rick Perry created the Texas Health Care System Integrity Partnership (THCSIP), a blue-ribbon commission charged with identifying health care reform recommendations. Its key recommendation was that legislators establish THSA to promote and coordinate health information technology initiatives throughout the state.
The Texas Legislature agreed and in 2007 established the THSA. It served as an advisory body to the governor’s office for two years until the passage of the HITECH Act in 2009, which provided regulatory support and funding for the creation of the Health Information Exchange Program. In March 2010, the Texas Health and Human Services Commission (HHSC) received a four-year, $28.8 million federal grant to fund the development and implementation of HIEs in Texas.
In December 2010, HHSC issued a call for funding under the Local HIE Grant Program and made planning grant awards to qualifying community-based HIEs to develop business and operational plans. After input from consumers, hospitals, payers, physicians and other stakeholders, THSA brought forward its plan for the development of HIE in Texas.
The 2010 HIE plan included three key strategies, including general state-level operations, a local HIE grant program and the white-space program for areas of the state without local HIE organizations. The general state-level operations included the development of state-level HIE policy, governance and technical services for the creation of a statewide HIE infrastructure connecting local HIE operators and other HIE participants.
The THSA signed a contract with InterSystems in April 2013 to assist with development and implementation of state-level shared services, including a clinical document exchange (treatment); a federated trust framework (security/confidentiality/accuracy); patient consent management; and an eHealth exchange.
In support of the statewide exchange of health information, the THSA developed interoperability guidance, privacy and security guidance, a state-level trust agreement, and a model business associate agreement.
Interoperability guidance included the adoption of a Technical Standards Landscape Review, an Enterprise Architecture Blueprint and a Technical Implementation Specification. The privacy and security guidance included Model Privacy Policies and Procedures, and Model Security Policies and Procedures. The THSA developed the Texas State-Level Trust Agreement through a stakeholder process to serve as an agreement among the THSA, the state’s grant-funded local HIEs, applicable state agencies and others who wish to participate.
In addition, THSA partnered with the Electronic Healthcare Network Accreditation Commission (EHNAC) to provide HIE accreditation for Texas HIEs.
While initially supported by federal funds, the THSA has also received some state funds, and to ensure its sustainability has begun exploring additional sources of revenue. These include HIETexas connectivity fees, the SECURETexas “covered entity” certification program and the HIE accreditation program.
Through innovative programs and leadership, THSA’s strategic plan will allow Texas to lead the way in building an HIE infrastructure that will connect Texans, enhance the quality of care, reduce costs and save lives.