The Louisiana Health Care Quality Forum is a private, not-for-profit organization dedicated to reshaping health care for Louisiana residents. Led by a volunteer Board of Directors, the Quality Forum serves as a neutral convener, bringing together providers, purchasers, payers and consumers to drive improvements in health care quality, safety and value.
The Quality Forum is not a state agency. It is a private, not-for-profit, 501(c)3 organization. In 2009, it was named the State Designated Entity to plan, develop and implement the Louisiana Health Information Exchange, or LaHIE.
Under the American Recovery and Reinvestment Act (ARRA) of 2009, the U.S. Department of Health and Human Services, Office of the National Coordinator for Health Information Technology was authorized to award grants to facilitate and expand the electronic movement and use of health information among organizations according to nationally recognized standards. The Health Information Technology for Economic and Clinical Health (HITECH) Act, a part of ARRA, promoted the adoption and meaningful use of health information technology and addressed privacy and security concerns associated with the electronic transmission of health information.
Under the HITECH Act, federal funds were awarded to states and/or qualified State Designated Entities (SDEs) to
establish health information exchange (HIE) capacity among health care providers and hospitals at the state level. A qualified State Designated Entity was required to meet several criteria:
be designated by the State as eligible to receive awards; be a not-for-profit entity with broad stakeholder representation on its governing board; demonstrate that one of its principal goals is to use information technology to improve health care quality and efficiency through the authorized and secure electronic exchange and use of health information; and adopt nondiscrimination and conflict of interest policies that demonstrate a commitment to open, fair and nondiscriminatory participation by stakeholders.
In 2009, the Louisiana Department of Health and Hospitals named the Louisiana Health Care Quality Forum as the qualified State Designated Entity to apply for and receive the state’s share of health information technology grant funds.
LaHIE is an initiative of the Quality Forum. In 2009, the State of Louisiana named the Quality Forum as the State-Designated Entity to lead the planning and implementation of health information technology grants contained in the American Recovery and Reinvestment Act of 2009. In 2010, the organization received a $10.6 million grant from the Office of the National Coordinator for Health Information Technology (ONC) to establish a statewide health information exchange. Since then, the Quality Forum has brought together hundreds of stakeholders to develop LaHIE’s Strategic and Operational plans.
The governing requirement states that LaHIE provide the functionality needed for providers and hospitals to meet the ongoing HIE requirements of Meaningful Use (MU). Many of the MU requirements are met by electronic health records (EHRs), but the HIE is intended to be the exchange mechanism between the EHRs.
Participation in LaHIE is completely voluntary.
Pricing for hospitals is tiered, based on the hospital’s net patient revenue.
If a physician is credentialed/affiliated with a participating hospital, there are no costs for basic LaHIE services. For non-affiliated providers, there is a nominal annual per provider cost.
Providers and hospitals that sign up before June 30, 2012 and connect by December 31, 2012, will pay no fees for the first year. As LaHIE adds features, additional services may be available for an additional charge.
Interface costs are one-time fees based on the type of facility that is connecting and are negotiated at a nominal cost with each participant.
LaHIE is governed by the Quality Forum’s Board of Directors. This volunteer board represents a cross-section of providers, purchasers, payers and consumers. In addition, the Health IT Advisory Council provides strategic direction for LaHIE.
Louisiana is considered an “opt-in” state. LaHIE providers/hospitals should include language in their privacy policies that references the exchange of health information through LaHIE.
A patient’s consent is required for his/her information to be accessed via LaHIE. If the consent has not been obtained and the patient presents in an emergency situation, his/her information may be accessed in LaHIE for emergency treatment purposes. If a patient explicitly opts out of LaHIE, his/her information cannot be accessed whether or not it is an emergency.
By design, LaHIE consolidates multiple medical records from multiple sources to provide a comprehensive, longitudinal view of a patient’s medical history. LaHIE has an Enterprise Master Patient Identity Management system built into its application. LaHIE’s identity management team works closely with participating partners to confirm patient matches.
The nature of the security breach will determine the liability.
LaHIE has developed policies and adopted technologies that meet state and federal requirements and continuously works to ensure the highest security standards remain in place throughout the process.
LaHIE has processes in place to create and authorize user accounts. However, participating providers and hospitals are responsible for assuring appropriate access by their authorized staff.
LaHIE supports several key elements required for Meaningful Use including the facilitation of public health reporting and exchange of clinical information. Support to facilities regarding requirements for Meaningful Use attestation and technical assistance in this area may be obtained through the Louisiana Health Information Technology Resource Center.
At this time, there is no payer support. The Quality Forum is currently pursuing grant
opportunities to support implementation of LaHIE.
The outreach efforts of LaHIE are initially focused on providers and hospitals throughout the state. In addition, we partner with associations such as the Louisiana State Medical Society, the Louisiana Hospital Association and Louisiana Academy of Family Physicians and are expanding our relationships with key groups that represent providers across the health care continuum (e.g., nursing homes, home health, hospice, emergency medical services, etc.).
We also recognize that since most patient care occurs in a geographic region close to the patient, it is essential to connect as many care providers as possible within each region. Where we have LaHIE adoption occurring, we will build upon those synergies to maximize the footprint in that region.
- Provides a vehicle to support improved patient care, quality and safety.
- Enhances coordination of care between and among other health care providers.
- Enables integration of sick (illness)-care with well-care.
- Links first-responder teams with trauma care teams.
- Facilitates operational and administrative efficiencies resulting in reduced operational costs.
- Enables public health to meet its commitment to the community through improved reporting.
- Facilitates efficient deployment of emerging technology and health care services such as e-prescribing and Meaningful Use.
- Provides the backbone technical infrastructure for leverage by the NwHIN HIT initiatives.