Trailblazer of the Health IT
Manu Tandon serves as the Chief Information Officer (CIO) at the Executive Office of Health and Human Services (EOHHS), Commonwealth of Massachusetts where he is responsible for IT for 17 state agencies including Medicaid, public health programs, disability services, means based programs and children and youth services. Serving the IT needs of 26,000 EOHHS employees, 37,000 providers and millions of Massachusetts citizens, EOHHS IT provides mission critical support for key business initiatives. In addition, Manu Co-Chairs the Massachusetts HIT/HIE Advisory Council and is the Principal Technology Lead on the New England Health Insurance Exchange innovator program.
We recently sat down to discuss the leadership role that Massachusetts is playing as a trailblazer state in health IT implementation as well as the impact the state had in shaping the Accountable Care Act.
Zach Urbina: Could you tell me a little more about your role for the state of Massachusetts and the selection process to participate as one of the HIT Trailblazer States?
Manu Tandon: Massachusetts was the model for President Obama’s health care reform law, and now thanks to Governor Deval Patrick, we are leading the way on the next phase of health care reform: cracking the code on costs.
In the National Academy for State Health Policy (NASHP) selection process for HIT Trailblazers, Massachusetts was recognized as a leader in tackling healthcare system challenges and in implementing reform initiatives years ahead of the national curve. Additionally, Massachusetts’ application for participation was supported by state leaders’ commitment to conscientious stewardship of, and investment in the structures necessary to ensure access to high-quality, affordable, well-coordinated healthcare for all residents of the Commonwealth.
ZU: Can you comment on state financial support for these healthcare reform initiatives?
MT: The Governor’s budget includes money to facilitate implementation of the groundbreaking health care cost containment legislation signed last summer.
The budget also supports the Health Information Exchange we launched last fall to allow providers to increase the timeless and accuracy of health information, by sharing electronic patient records over a secure network. In addition several pilot programs related to ACOs and Patient Centered Medical Homes are supported by the budget.
ZU: As part of the Trailblazer initiative four dimensions of reform activity were identified, provider and plan measurement and feedback, payment reform, care delivery innovation and consumer engagement, when Massachusetts was assessing the alignment of your HIT efforts to these reform goals what were some of the lessons learned and take aways from the assessment process?
MT: The Trailblazer initiative has highlighted the way in which many state activities, including HIT, are generally constructed with reform activity in mind, but in different ways. This initiative is an opportunity to align and unify quality measurement data collection and reporting. We are seeing patient centered medical care and other initiatives increase the demand for measurements and related data. At the same time the development of technical standards, technical innovation, and federal funding in the HIE increase the potential mechanisms supplying data. Our take away is that the time is right to invest and focus on this arena.
ZU: Each Trailblazer state is developing an action plan to be shared with others in an effort to accelerate learning and implementation of technology-enabled delivery system reforms, what are some of the highlights of Massachusetts action plan and when will they be implemented?
MT: Massachusetts’ action plan is focused on bringing state agencies into better alignment on quality metrics, and the data that inform those metrics, so that key healthcare actors can rely on consistent and actionable information. Short-term goals include launching a coalition of state programs to identify solutions to duplicative reporting requirements for providers, more efficient data pathways and processes, and specific quality improvement goals. In the long-term, the action plan will leverage the data tools and infrastructure being built to enable state and private partners to coalesce around a core set of performance objectives that can be used in value-based purchasing, consumer engagement, care coordination, and other activities.
ZU: Many State leaders recognize HIT as a key building block that will both an enabler and driver of system change. As new care delivery models such as ACOs and PCMHs proliferate, is HIT sufficiently pervasive in Massachusetts for ‘HIT investments to connect with outcomes’?
MT: Many Massachusetts providers have been early adopters of HIT and EHR capabilities. Those organizations that are partnering with the Commonwealth in current implementation programs have appropriate technology in place already to be able to use HIT as part of ACO and PCMH delivery models. We believe that the growth of HIT adoption is ahead of the growth of ACOs and PCMH thus are confident that HIT will be an enabler and will not become an obstacle to deployment of new delivery models.
ZU: What impact do you see the intersection of ACOs and Medical Homes having on sustainability models for federally funded program such as HIEs, Beacon Communities and RECs moving forward?
MT: Massachusetts has structured its HIE, known as Mass HIway (Massachusetts Health Information Highway) to be self-sustaining via an innovative approach to funding which included HITECH funding, Medicaid funding, and funding from private and commercial participants.
ACOs and medical homes add to the business case for practices’ investing in high-quality data as this data enables them to succeed in the new models both clinically and financially. Moreover, these models frequently require bidirectional transmission of clinical data, again increasing the return on private investments in technology.
ZU: What role are private HIEs playing in Massachusetts’ and do you think there is potential for delaying the transformation of the health delivery system overall?
There are several private HIEs in place in MA. Mass HIway is designed to be a network of networks so it will be possible to interface these existing networks to Mass HIway. It is likely that this will happen in short order so that all necessary communication between providers will be enabled on a schedule that is consistent with the various transformation efforts underway.