Texas, Accenture Team on Health Information Exchange

The Texas Health Services Authority (THSA) has entered a new phase in its efforts to develop a statewide health information exchange (HIE) by completing an assessment and a plan to support implementation and interoperability standards that healthcare stakeholders in the state's health delivery network will utilize.

Developed in collaboration with IT consulting firm Accenture, the project, which took five months to complete and was unveiled in late August, is part of THSA's three-pronged approach, which includes local and regional HIE networks in Texas, support for HIE connectivity in rural Texas, and strategies to encourage stakeholder input and governance on key policy questions. Those questions concern technical interoperability, privacy and security, and patient and provider engagement that will guide the exchange of patient information among healthcare delivery organizations to improve the quality of care in the state.

"What Accenture brought to us was a set of very specific technical expertise to help facilitate the dialog on interoperability standard guidelines and procedures with our stakeholders," Tony Gilman, THSA's CEO told InformationWeek Healthcare.

[Health IT is making it harder to keep protected health information secure and avoid federal fines. To learn more, read HIPAA Pain: How To Cope.]

With a population of 25 million spread across 254 counties, Texas will have one of the largest HIEs in the country; it will serve approximately 600 hospitals as well as pharmacies, physician group practices, and other healthcare delivery organizations. To support its goals, the THSA has allocated over $19 million of the $28.8 million that the Office of National Coordinator for Health Information Technology (ONC) allotted to Texas last year to fund state planning and implementation of electronic health information networks.

According to Rick Ratliff, who is taking the lead on connected health at Accenture Health, the Texas HIE Strategic and Operational Plan is guided by technology standards and policies such as those developed under the Nationwide Health Information Network (NWHIN), which enables secure health information exchange over the Internet.

"Consistent with guidelines and standards adopted by the U.S. Department of Health and Human Services, the THSA required an assessment of interoperability standards and a plan to support interoperable, secure exchange of health information among unaffiliated organizations," Ratliff told InformationWeek Healthcare.

To that end, Accenture developed four documents that will guide the development of the state's HIE. THSA's description of each document is as follows:

-- A Technical Standards Landscape Review document that assessed the Texas, federal government, and industry healthcare IT landscapes to identify the relevant architecture, interoperability, and security standards being used (or proposed to be used) to support the secure exchange of health information among unaffiliated and (technically) heterogeneous organizations. Texas HIEs can use this document as a reference tool to understand the overall technical standards landscape within the United States.

-- A Technical Implementation Specifications document that will serve as a technical reference guide for local and regional HIEs to use in implementing their networks. Standards and profiles are documented for the messaging and data flows required for communication between components.

-- An Enterprise Architecture Blueprint (EAB) document that describes the architecture vision for the Texas HIE space for the next six years, divided into three two-year increments. The EAB includes a set of high-level use cases chosen to reflect the Texas HIE vision and desired capabilities for the next two years. It also includes planning considerations for the third and fourth years, and very high-level strategic direction for years five and six.

-- The EAB Lifecycle Management Plan is intended to identify the processes for managing the lifecycle of the enterprise architecture as it evolves. This includes identifying the appropriate parties to implement change management, such as monitoring and updating as appropriate the standards used to establish interoperability between the local, regional, and state level HIEs, as well as the standards utilized for the identified use cases in order to facilitate the continued support of Texas HIE and its connecting organizations.

In producing the EAB and EAB Lifecycle Management Plan, Ratliff said Accenture relied on its experience developing the Accenture Connected Health Architecture, which is a standards-based platform that includes access channels; services layer; security and participation control; core clinical data management; and warehousing, reporting, and analytics.

Find out how health IT leaders are dealing with the industry's pain points, from allowing unfettered patient data access to sharing electronic records. Also in the new, all-digital issue of InformationWeek Healthcare: There needs to be better e-communication between technologists and clinicians. Download the issue now. (Free registration required.)