Louisiana Health Information Exchange DesignSession

Tom Lloyd: My name is Tom Lloyd, welcome to the Vanderbilt Center for Better Health. We always like to start these sessions with a word from our sponsor.

Janet Marchibroda Janet Marchibroda: Thanks Tom, and thank you everyone for joining us today. We are excited to support your efforts. We are delighted you are here. I trust everyone got a good’s night sleep as we will be working hard today. This is my fourth time at the Center, which is such a creative place that really helps groups think out of the box and create action. Thank you, Roxane Townsend and Mark Frisse, for your hard work.

Roxane Townsend: Thank you for joining us and trekking here from Louisiana. Thank you to Janet Marchibroda, Mark Frisse and your team. I cannot imagine the amount of hours they have put into this project. I am so thankful. Fred Cerise sends his apologies that he couldn’t be here Roxanne Townsend for the next two days. He was scheduled to attend until last Wednesday but some work came up for the Governor so he had to stay behind.

I want to take a few minutes to level the playing field. Jeannine Hinton is the person I blame for instigating all of this. Fred and I worked together in our previous jobs. He was then selected to be the Secretary of HHS and I was in mourning. We got involved in submitting a proposal for a Healthy Communities Access Program (HCAP) grant; it is a healthy communities program based in IT.

“HCAP grants help communities link services delivered by local safety-net health care providers into coordinated networks serving uninsured and underinsured residents. The grants are designed to increase access to health care by eliminating fragmented service delivery, improving efficiencies among local providers, and encouraging greater private-sector involvement.”

Louisiana became the second state to join the eHealth Initiative Foundation's (eHI) State Health Information Technology (HIT) Policy Summit Initiative, a program bringing state policy officials together with healthcare, and consumer and business leaders to help improve healthcare through IT. These guys are very interested in making this stuff happen. This group managed to pull off the first Summit meeting for The Louisiana State HIT Policy Summit Initiative in July 2005 in Louisiana; we had almost 300 people join us for this very successful event.

During this time we got introduced to Janet Marchibroda and eHI. They helped us set the agenda for the Summit meeting, where we focused on what kind of issues Louisiana hasand what we can do about them. At that time we had several HCAPs funded, as well as some Agency for Healthcare and Quality (AHRQ) grants putting electronic health records (EHR) in hospitals. We had multiple programs going on. Then of course it was August 2005 and Katrina hit.

Our world became very different and I think most of us feel like it will never be the same. When you take the largest city in the state, evacuate it and have it under water for several weeks, life as you know it changes. It makes me realize how the work we are doing today is very important. While we were in the Superdome, Mark Frisse wrote an email, and I still have not seen the email, that eventually generated KatrinaHealth.org. http://www.katrinahealth.org

It blows my mind that Mark, eHI, the Markle Foundation, etc. got involved, we had sixty plus people on the first conference call, and within two weeks we had a website. The system was not perfect, but we learned a major lesson: if we can all get on the same page, look how much we can accomplish. I think the base for really good patient care is health information technology. We had a proposal into HHS, so David Brailer called Fred about the proposal to ask if we would consider moving forward with the proposal or did we want to back off? The response was yes, we are still interested. Now more than ever we realize how important it is.

I want to share a few experiences with you from my time at the Superdome. Imagine a 50-year old diabetic walking out of the water, with a Wal-Mart bag containing her prescriptions. The labels are peeled off from the water and her pills are almost non-existent as well. This was her medical record. The nursing home patients were dropped off with a piece of paper taped to their chest, with their name and cryptic medical information. We are in the 21st century, and this is what we have resorted too.

We have taken on the challenge from HHS, and a lot of you are integral in that process. We want to make sure that the next time this happens, and it will happen, we are prepared. We need to know what people need from a healthcare standpoint and not recreate the wheel every time. This prototype involves two different markets, Baton Rouge and Southeast Louisiana, because St. Mary’s Parish has some advanced things going on and we want to encompass the Louisiana area.

You will hear more from the technical people today, but the top layer is to create a continuity of care record with basic information about patients. For example, if someone presented in your emergency room, you would be able to pull up information in the emergency period to identify quick needs. The second layer is the part that is really exciting, showing true inter-operability between the systems. So if Stephanie at Out Lady of Lakes can query a patient she has never seen before, it would tell her this patient has multiple medical records in different sites. She would have access to this because we would make the record truly inter-operable. Everyone will maintain their own database and own their information but they will let the care providers view the information.

I am very excited about the safety aspect for patients. The safety implications are huge, medical errors are the hot topic but this is one of the ways we truly can make a difference. I think at the end of the day we will have a roadmap for how we get from today’s world to pushing a button and accessing real patient information.

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