Speaker 1: Well as we're getting done with those, I think it just makes sense top to bottom, left to right if you will. We had one team that did want to use their boards to have centered themselves on their work. So team A. They made you write it and they're going to make you say it.

Speaker 2: Team A was the continuation of looking at the relationship between consumers and providers. And what role the state of AHCA might link towards that. As most people know, we used to post-it notes as well as we use the boards. But for visibility purposes, we just included that the boards would perhaps be easier for conditions that follow along. Another thing we did is, we identified what we meant by short-term and long-term.

We also worked within the fiscal year. As most of you probably know that the fiscal year starts with the state on July 1st and ends on June 30th. And the appropriation of dollars is tied into that.

In the developing of legislative language request that the LDR process is also regulated into that. And that process quite frankly is starting now. They're already into that. I mean that's not dream world, that's now. What do we want to do for the next fiscal year if you begin the process of developing a legislative request in identifying whatever budgetary needs are for the next year, etc.So it's not a type of thing like a stoplight where the light changes and then you can go. There's a lot of incremental lead-in if you're going to be successful in moving forward.

And in all our dates for playing purposes, as opposed to splitting completions doing of a fiscal year, we just planned on the close of business as of the fiscal year. So when we say for example FY2010-11, what we're basically saying is June 30th at the end of that fiscal year. And so that's simplest purpose of how we did it.

The other thing we did is of the goals that we, given more time might have addressed, we reduced it to basically three. To establish statewide use of electronic health records by close of business 2012-13. The second was to establish a statewide especially provider locator network like close of business 2010 or 2011 but not emergency care requirements.

The third goal is to establish a state healthcare agency coordination group through true cooperation between agencies to eliminate implication and cost by folds of business 09-10. The other challenge we had was to create valuation. We interpret valuation to mean, of these three goals which would be the greatest important to the consumers as well as to the abiding community.

So what we did is we identify subjectively. That the one that had the greatest value would be the 3rd which is to establish a state healthcare agency coordination group to improve coordination between the agencies and eliminate duplication and cost overruns by close of business this particular year.

And the reason for suggesting this one, this one perhaps has the greatest 'bleed-over' effect into some of those other areas. If we can eliminate duplication, redundancy, unnecessary waste, etc. If we can streamline the system, we envision we can save a lot of dollars. And those dollars may be re-allocated for other purposes.

The second one was the first. To establish statewide use of electronic health card. We're already moving in that direction. The benefits for that are already published and talked about. And we can see it except we're not there yet. We're certainly committed to move in that direction.

And the last, of course... I mean third, I mean the last doesn't simply mean it's not important. It just simply mean in our scheme that was just to establish a statewide especially provider locator network. Okay. So these are the rest folks. On the each goal we establish our objectives in our task. And the way we did it is we set for each objective, the objective needs to be measurable and may be quantifiable so far as an amount.

But that hypothetical we didn't have available for us now in the sense of qualifying by what percent? By 2%, by 20%, a thousand people, by a million people, in result to zero. I mean during this discussion today, we don't have a back up at the agency and sort of re-do that. So what we chose today was use time.

So the dealing with objective 1-A which is our second priority. The objective to support this, to establish a statewide use of electronic health record. The first objective was increased public awareness about reals, electronic health workers, personal health records to direct at communication, campaigns, websites, advanced medium, mail outs and to complete these stuffs by close of this is 2009-10.

The second objective would be to develop incentives for healthcare providers. To invest in a real developments and use of electronic health technology by close of business 09-10. We use the same year. We thought it was appropriate to use the same year because maybe these activities going to be going on concurrently. We don't have to go at a concurrent sequence. Proposed legislative language to adopt statewide use of electronic health records.

Now this is a drastic shift maybe from certain areas because the goal would ultimately be becoming an electronic environment. And moving towards that to improve efficiency, to reduce cost that expedite the transfer of information.

Work for providers, consumers and legislative groups to develop benchmark in the centers. This stuff costs money. Who's going to pay for? Where should they be when in adoption of electronic health records? We're going to transition in that environment. Where should the state be? Where should providers be a year from now? Where should they be two years from now? Where should they be three years from now? Is it subjective? Is it arbitrary? Or is it a requirement?

If we establish it as a requirement, what becomes of penalties for non-compliants? Becomes a matter how serious we are about doing it. If that's the case then we suggest working with our consumers, working with our provider community, working with policy makers, legislators, working with other components of state government to make this happen. This is not something the AHCA can do by itself.

Refine the technological requirements. What are the challenges associated with electronic health workers now is the diversity of opinions about what it should look like. One size does not fit all. You have your federal standards. You have your corporate standards. You have your independent standards. And you have many individuals or organizations who are siding on the sidelines with no standard. They're waiting to see what direction the wind blows so they can come in later and make an investment.

So what role does the state have? And we envisioned that the state's role with the merge through collaboration with other providers with this process.

Refine the budget requirements. This gets stuck into the incentives. We're proposing incentives for adoption of electronic health records, our training providers, the small physician networks, the role communities. That how much that should be? What type of order sets should be suggested? A list of dialogues we need to have. And that would be rolled into and that's why it's to re-establish the legislators schedule. What could be done within what time period to get this by?

And lastly to establish standardization throughout the system. And then there are some others but those are the key words .

To establish the second goal we pick up our objective. To accomplish that goal was to establish a network link to the Department of Health websites to alternative out-patients' sites and physicians by specialty by 08-09. That's a short-term goal. What we're saying in 10 here, we're talking about department of health but we're really talking about other health keeper. It might be children or families, might be elder affairs, might be veteran's affairs, in addition to Department of Health.

What we are talking about is defining that partnership between our sister agencies. But we are not duplicating our efforts where our systems can talk to one another. And that our systems report information and align it with the standard procedures in agencies and not competing with one another. Put necessary dollars in order to expand information that the public can use.

Make Department of Health website information user-friendly and compatible in format with AHCA's website, same year. It's another one of those activities we're looking at not doing in sequence but simultaneously closed business 08-09 next year. This is our next fiscal year. So we're saying, "Let's not do it by next fiscal year because we think it's a unrealistic expectation." We're saying, "Let's make it a goal for completion in this fiscal year." Where are we?

[Silence]

Audience: Displaying...2-C

Speaker 2: Display individual provider quality information. This is across together. This is consistent with the statutory requirement that we spoke of earlier that AHCA has already in place. It doesn't have to be legislative anymore. It's already in place, the coordinate, the display, the collection to display of health information. And make that information available to the public. But having to afford to do something and doing it is two different things.

And so through this process that we're proposing is let's make it happen. Let's actualize it to make it happen and make that information available to the public, that compatibility factor

So we get out of the problems that we spoke of earlier where we might have a leak to another departments' websites. We're leaving out a leak to our website. Imagine if you will, that all the websites spoke the same language. It was not necessary to transfer, translate between one in another. The simplicity that might be in improving in one website would be reflected in another website, so far as the display of information.

Task associated with that. It violates the Department of Health Work for information technology, information note here, etc. A lot of work to be done. I'm not only simplifying the task. That's a herculean task. But it can be done as normal.

To establish and revise rules necessary to facilitate the collection, sharing and display of Department Health data in AHCA's website. And again I'm using DOH as a... of gradually talking about all these. Make Department of Health data comparable with AHCA's website requirements. I mean, we're heavily gained as far as websites are concerned. We're in the front of the race but we don't win this race alone. This is a state game. We all win or we all lose.

Request funds from the legislature to support data transfer. Who's going to pay for it? Things go around in this exercise in the Department of Health and the question came out, "Oh this is real great! Now who's going to pay for it?" But we have our budget and you have yours. No, who's going to pay for it? Our budget is for purposes. You are suggesting something for your purposes. So who's going to pay for it?

[Cross-talk]

That those issues has to be resolved. And needed to be resolved in the front-end not at the back. My third goal is to establish a state health care agency support. Okay. The first objective, conduct a statewide healthcare summit to discuss coordination of its services, etc. We proposed and the governor convinced us.

AHCA has the statutory fortunately, but this has such statewide potential to it. That it should not be done at each station under the mouth we feed. He needs the chair. And quite frankly advise the President, the Senate and the Speaker of the House be co-chairs. That's how important this stuff is and we're serious about it.

Create website links to sister agencies by a close of business. Identify and eliminate data collections, storage, dissemination....

Audience 2: Duplication, we got it.

[Laughter]

Speaker 2: Yes. Pass. Governor's office coordination we talked about that. Request budget through legislative budget request, LBR process, right to issue RP to develop and refine a system to share data between government health organizations, select the vendor, and of course we can go on and on. Those are the high points. Questions?

[Applause]