AHCCCS - 2007 Medicaid Transformation Grant Final Report

1.0 Introduction

In January 2007, the Arizona Health Care Cost Containment System (AHCCCS), was awarded a Medicaid Transformation Grant (MTG) to develop and implement three major deliverables; 1) an electronic web based health information exchange (HIE) to give all Medicaid providers instant access to patients' health information at the point of care, 2) a clinical data repository for the storage and aggregation of Medicaid member clinical information and continuity of care records, and 3) web based electronic health record system for Medicaid providers.

This report will describe what was accomplished with the funding provided by the MTG.

2.0 Phase and Goal Definition

The three deliverables were setup to be worked sequentially rather than all at once, and hence were defined as three phases for the grant. Phase 1 being the HIE, Phase 2, the clinical data repository, and Phase 3 a web based electronic health record system. Practicality dictated the manner in which each of the three phases would be addressed.

Phase1. The HIE was clearly the biggest challenge and the most important concept to be proven. The plan was developed to implement and operate an HIE on an initial small scale to begin the process of introducing health information exchange in Arizona, and eventually lead to larger scale expansion.

Phase 2. The Clinical Data Repository being limited by resource allocation the deliverables would only include requirements and design.

Phase 3. Needs analysis resulted in the conclusion that an array of electronic health record systems (EHRs) were commercially available, and that providers had different requirements for EHRs. The pressing need that providers have is help in selecting a product, negotiating with the vendor, and implementation of the system into their practice. System implementation requires significant change management and process reengineering, skills which providers do not possess, and are costly to acquire. This lead to the development and eventual realization of a concept to bring providers together in a collaborative fashion to deliver the services required to successfully acquire and implement EHRs in small and medium sized practices. The Purchasing & Assistance Collaborative for Electronic Health Records (PACeHR) non-profit organization was created to fill this need.

To Section 3.0