Wisconsin’s health information exchange plan development underway
The Wisconsin Relay of Electronic Data (WIRED) for Health Board (see News & Views, Spring 2010) has set a goal of completing the development of a strategic and operational plan for health information exchange for the state of Wisconsin by the end of this summer. The Board is required to submit the plans to the Office of the National Coordinator for Health Information Technology in the Department of Health and Human Services by August 31, 2010 in order for the state to be eligible to receive federal Recovery Act funding for the implementation phase of the project.

“The Board’s most important developmental work will occur over the course of the summer. As you can guess, given the timeline, the plan will probably be fairly high-level and more directional than highly specified in terms of details and operational plans,” said Chris Queram, WCHQ president and CEO, and WIRED for Health Board member.

This spring, the Board endorsed a vision and mission statement and a set of overarching principles to guide development of the plan. The stated vision is to “Promote and improve the health of individuals and communities in Wisconsin through the development of health information exchange that facilitates electronic sharing of the right health information at the right place and right time” with an accompanying mission to “Develop and sustain a trusted, secure statewide HIE (health information exchange) that provides value to participants.”

Five committees were also established to assist the Board with the development of the strategic and operational plan, help with transitioning to the operational phase, engage stakeholders, and lead workgroups. The five committees and their responsibilities are:

• Legal and Policy Committee – Ensures the design and development of the strategic and operational plan is consistent with both federal and state statutes as they relate to privacy and security and other legal requirements.
• Standards and Architecture Committee – Designs operational characteristics of health information exchange and determines what will be operated centrally and what will be operated on a decentralized basis. The committee also will clarify the meaning of “health information exchange” as it relates to the project. It is commonly understood to mean the exchange of point-in-time, necessary clinical and administrative information to support point-of-care decision-making regardless of where the patient is receiving treatment.
• Communications, Marketing and Education Committee – Helps build public awareness and support for the idea of health information exchange. The committee will also look more broadly at communication and education strategies for additional stakeholders such as providers, consumers, health plans, regulators and others.
• Finance and Audit Committee – Determines ways in which to fund and support the project so that it is sustainable. A number of ideas and approaches have been pursued in other states which will be explored by the Committee.
• Governance Committee – Upon approval of a strategic and operational plan, determines what type of organizational structure will be needed going forward operationally and oversees the implementation and modification of the plan as time goes on. There are two basic approaches that can be followed under the established federal regulatory framework:
• Public sector – the state designs and operates the health information exchange.
• State-designated entity (SDE) – a private sector organization, designated by the state as a 501(c)(3) private/public model, designs and operates the health information exchange. This approach would still include a strong public sector role because of the state’s need to maintain governance on behalf of the public’s interest.

“Currently, many stakeholders have expressed a clear preference for a private/public sector model using a state-designated entity. The Governance Committee will utilize a transparent and criteria-based process to identify and select an organization to serve as an SDE,” said Queram.

“It would be premature and speculative to indicate who that entity may be. However, there are only a handful of organizations in the state that include this work as part of their core value proposition” Queram added.

As plan development works gets underway, the WIRED for Health Board will soon begin to address major policy questions brought forward through the five Committees. “The timeline for the project can seem breathtaking and the questions are very significant and broad in scope, so we are committed to an incremental process. In fact, one of the Board’s guiding principles is that ‘Rome was not built in a day.’ This allows us to not try to anticipate every question imaginable which can lead to a ‘boil the ocean’ approach that becomes immobilizing and too ambitious to be effective,” Queram explained.

Because of the transparency axiom by which the Board and committees are doing the work, a significant amount of information about the project and ongoing activities can be found on the e-health website that Department of Human Services has created (http://dhs.wisconsin.gov/ehealth/WIREDforHealth/index.htm). Look for project updates in future editions of this newsletter as well.

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