Hawaii OpenVista ASP (Application Service Provider) Network Abstract
In 2007, 27 states received Medicaid Transformation Grants under Section 6081 of the Deficit Reduction Act of 2005. The grants were rewarded to states that proposed innovative methods which in the end of the two years are designed to produce better health outcomes at lower cost.
The Center for Health Transformation is highlighting states that have received these Medicaid Transformation Grants, and will be following their progress for the next two years. In order for key decisionmakers and industry leaders from around the country to learn from others’ successes, it is our intention to provide this resource in order to showcase innovative practices from across the nation. In the future, this site will be interactive, allowing program directors to submit updates and comments regarding their program.
In 2004, President Bush signed an Executive Order calling for the implementation of interoperable Electronic Health Records (EHRs) in 10 years. EHRs are viewed as critically important to improving patient care, lowering healthcare costs, and providing the means to better monitor public health outbreaks. However, as identified in a 2004 report issued by the National Health Information Technology Coordinator, the adoption of EHRs was low and cost is one of the major barriers to widespread adoption.
Consistent with national studies, most of the healthcare providers servicing Medicaid and native Hawaiian populations in Hawaii do not have EHRs. The State of Hawaii seeks to facilitate the use and adoption of EHRs by clinics and clinicians through the establishment of the Hawaii OpenVista ASP (Application Service Provider) Network (HOVAN). The HOVAN is based on the use of HUI OpenVista, and open source version of the U.S. Dept. of Veterans Affairs Information Systems and Technology Architecture (VistA) system developed by the Pacific Telehealth and Technology Hui (“Hui”), a program of the VA and Dept. of Defense.
The primary goal of the HOVAN is to implement an innovative organizational and technical approach and model for providing and supporting HER capabilities to Medicaid healthcare providers. This will lessen medical errors; provide and improve medication risk management; implement e-prescribing /pharmacy filling of orders to lessen costs; and implement lab interfaces to reduce redundant tests.
Specifically, the State Hawaii, through a partnership of the Department of Human Serves (DHS), the Department of Health (DOH), the University of Hawaii (UH) Telecommunications and Information Policy Group (TIPG) and UH John A. Burns School of Medicine (JABSOM) will establish a partnership to provide and support a low-cost model for EHR adoption by FQHCs, Native Hawaiian healthcare providers, and others.
The HOVAN will be established as s non-profit collaborative providing technical and clinical HER support based on the Hui OpenVista software. During the project period, six clinics (including a federally funded HIV clinic, a federally funded geriatric center, two Federally Qualified Health Centers (FQHC) and three Native Hawaiian Health System providers) will be interconnected to the HOVAN through telemedicine links funded in part by the Universal Service Administrative Company. The ASP model will be used to maintain individual clinic EHRs on centrally located servers which can be accessed via each clinic’s computer workstations. The HOVAN will interface with Practice Management Systems of clinics and automated pharmacy, laboratory, and imaging data will be implemented using (if available software from CMS and other VistA developments. This innovative solution provides the clinic sites with access to a fully integrated EHR based on shared clinical applications and technical staff for implementation, maintenance, and enhancements to the system. Training in the use of Hui Open Vista will be provided by University of Hawaii physicians and clinical application coordinators. The total cost of the project is projected at $3.18 million budgeted over two years.
The HOVAN will establish a means by which FQHCs and Native Hawaiian Health Care providers will be able to provide improved healthcare to Medicaid patients, incorporate the use of EHRs in clinical practices, establish a non-profit collaborative to improve patient care, and lessen costs. HOVAN will provide a model for implementation across the nation.
