Kentucky Health Information Partnership 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.
- Clinicians often lack basic medical information on patients, such as medications taken, previous inpatient or outpatient encounters, diagnoses, and labs and diagnostic tests ordered. By improving the amount of clinical information available, more appropriate care, fewer errors and complications, lower costs and improved outcomes could result.
- Health care is characterized by a great deal of inefficient administrative processes. This is evidenced by the continued labor-intensive use of phone and fax, where other industries have expanded automated communications. e-Health has the potential to improve quality, safety, value and efficiency in Kentucky’s health care system. But, today, few health information processes are routinely conducted through in an electronic format and the functions that are electronic have limited accessibility to those outside the organization. To improve productivity in health care, the ability to exchange electronic health information is critical.
- Claims and prescription data comprise a category of health information that is already stored electronically by payors. Access to this data could increase the amount of information clinicians have available at the point of care. Several health plans around the country and the Centers for Medicare and Medicaid Services have announced plans to utilize claims data to develop a patient health summary for clinicians.
- In Kentucky, the Cabinet for Health and Family Services has convened a group of payors including Medicaid over the past six months to discuss ways to utilize health information technology (HIT) and health information exchange (HIE) collaboratively to achieve system-wide quality improvement and productivity gains.
- Kentucky Health Information Partnership (K-HIP) has agreed to develop a common web portal for payor- provider communications in Kentucky. This portal will include two main areas of functionality:
- a claims-based patient health summary with clinical information for providers at the point of care and
- a site for standardized electronic administrative transactions, including eligibility verification and benefits, claim submission and prior authorization verifications and requests.
- By increasing provider access to clinical information and simplifying the administrative environment, the K-HIP initiative could serve to:
- Improve quality by providing more complete medical histories, avoiding misdiagnoses, decreasing adverse drug interactions, improving provider understanding of patient compliance, and reducing harmful medical errors, more than 50 percent of which are attributable to insufficient clinical information.
- Reduce unnecessary and inefficient health care spending by reducing duplication of tests and services, improving quality of care and increasing the productivity of administrative staff
