Health and Human Services Enterprise Office of e-Health Coordination
To establish and maintain an Office of e-Health Coordination (OeHC) within the Health Policy and Clinical Services (HPCS) division and governance structure to coordinate Health Information Technology (Health IT) and health information exchange (HIE) initiatives. These initiatives are referred to as health information (HI) strategic initiatives and coordination occurs across the health and human services (HHS) enterprise.
Health IT refers to the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making.1
The goal of Health IT is to allow comprehensive management of health information and its secure exchange between health care consumers, providers, government, and payers. Health IT initiatives include, but are not limited to, electronic health records, electronic prescribing, and health information exchange systems.
There is an increased focus on Health IT at the national, state, regional, and local levels as a means of improving health care quality, safety, and efficiency (reducing costs). Given the importance and breadth of Health IT for HHS agencies, and related federal and state legislation, the HHS enterprise needs a single point of coordination for HI initiatives.
The HHS enterprise is working in multiple ways to use Health IT to transform and better coordinate care for Texans enrolled in Medicaid and other state programs, as well as improve the overall health and well-being for all Texans. Examples of such projects include the Health Passport for Medicaid Children in foster care, Electronic Health Records or Life Records Systems for state hospitals and state supported living centers, Medicaid Electronic Health Records Incentive Program and public health reporting in support of Meaningful Use, and the Clinical Management for Behavioral Health Services System.
As early as 2009, H.B. 1218, 81st Legislature, directed the Health and Human Services Commission (HHSC) to develop an electronic health information exchange system to improve the quality, safety, and efficiency of health care services provided under Medicaid and the Children’s Health Insurance Program (CHIP). The American Recovery and Reinvestment Act (ARRA) of 2009 provided substantial funding opportunities to assist hospitals, physicians, and other health care providers in the adoption of certified EHR systems and to further advance health IT and HIE in the public and private sectors. Most recently, H.B. 2641, 84th Legislature, 2015, directs the HHS enterprise to engage in interoperability planning, and enables both Medicaid and public health to further engage in health information exchange-related activities.
Coordinating and promoting Health IT and HIE initiatives at the federal, state, and local levels will directly impact Medicaid and other state HHS programs that collect, store, and exchange HI on individuals in Texas, especially those receiving health care through state and federally supported programs. At the state level, one of the ways in which Texas recognized the importance of statewide HIE, was through establishing the Texas Health Services Authority (THSA). The THSA is a public-private nonprofit corporation established by the Texas Legislature to improve patient safety and quality of care by coordinating the development of a voluntary and secure electronic HIE infrastructure for the state health care system. The OeHC serves as the primary point of contact and HHS liaison to the THSA.
Office of e-Health Coordination (OeHC)
The OeHC is under the direction of the Deputy Executive Commissioner for Health Policy and Clinical Services. The OeHC Director serves as the State Health IT Coordinator and HHS liaison with the Office of the National Coordinator for Health IT. The office ensures that Health IT and HIE initiatives relating to HHS programs (Medicaid, the Children’s Health Insurance Program, and other HHS programs) are coordinated across the HHS enterprise. In this capacity, OeHC is responsible for:
- creating and managing a formal, enterprise-wide collaboration and coordination infrastructure to support HHS-related HI policy and technology activities, and, in particular, activities involving multiple HHSC divisions and multi-agency projects;
- serving as the single point of contact and lead for the HHS enterprise in regard to state funding opportunities under Title XIII of ARRA;
- acting as a single point of contact for HI policy for the HHS system;
- coordinating the development of interoperability planning required by H.B. 2641, 84th Legislature, 201, and HHS Circular C-044;
- staffing the HHS Health Information Steering Committee;
- serving as co-chair of the Health Information Management (HIM) Committee;
- working with the HI and HIM committees in identifying and prioritizing HI initiatives that can help improve health outcomes;
- collaborating with the Medicaid Electronic Health Information Exchange System Advisory Committee established in Section 531.904 of the Government Code, and other state-level health IT stakeholders and leadership bodies;
- serving as a business partner to agency and Enterprise IT staff, Office of the Chief Data Officer (CDO), and HHS Privacy Office to coordinate overlapping IT, CDO, Privacy, and HI projects; and
- supporting the state-level HI infrastructure efforts of the Texas Health Services Authority.
The OeHC will not directly manage Health IT initiatives across the enterprise. The Medicaid-CHIP Division will also remain the lead for the state Medicaid Health IT plan and Medicaid provider incentives under Title IV of ARRA.
Health Information Strategic Initiatives
The Health Information strategic initiatives that deal with particular HI topics or projects will be governed through the HHS Health Information (HI) Steering Committee, Health Information Management (HIM) Committee, and HIM workgroups.
The HHS HI Steering Committee provides HHS enterprise oversight and guidance on issues such as Health IT and HIE strategic planning, data governance, interagency data sharing, project dependencies, Health IT and HIE standards. The committee also provides strategic direction on issues that may arise about individual projects or policy concerns regarding HI. The HI Steering Committee is chaired by the Deputy Executive Commissioner for Health Policy and Clinical Services and Deputy Executive Commissioner for Information Technology and Chief Information Officer. The HI Steering Committee includes representatives designated by the commissioners of each HHS agency and major programs within HHSC, including the Office of the Chief Data Officer, HHS Privacy Office, administrative, and Legal Services. The HHS HI Steering Committee meets as needed.
The Health Information Management (HIM) Committee and its workgroups are guided by the HI Steering Committee, and includes representation from all HHS agencies. HIM work groups address particular Health IT and HIE topics, policy issues, or projects charged by the HI Steering Committee or requested by HHS agencies. The HIM Committee is chaired by the Director of the Office of e-Health Coordination and the HHSC Chief Technology Officer. The HIM Committee and its work groups meet as needed.
Inquiries regarding the content of this circular should be directed to Melanie Williams, Ph.D., Director of the Office of e-Health Coordination, Health Policy and Clinical Services, at (512) 490-3105 or by e-mail at OEHCStateHIEProgram@hhsc.state.tx.us.
1 Brailer, D. (2004). The decade of health information technology. HHS Report, July, 21.