1. Alabama’s One Health Record® Update
Alabama TeleHealth and Rural Summit
Leveraging Electronic Exchange to Benefit Alabama Outcomes
Gary D. Parker, Presenting
Director, Alabama Medicaid Health IT Division
October 18, 2013

2. Today’s Roadmap
• Agenda
• Alabama’s One Health Record®
– A HIE Review
– Current Events
– A Look Ahead
• A “Dick Tracy” Demo
• Next Steps – “Engagement”
• Questions

3. Alabama One Health Record®
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Alabama’s state-wide Health Information Exchange (HIE).
– The Alabama HIE is not associated with and not part of the Affordable Care Act (ACA)
or the Health Insurance Exchange.
– In April 2012, One Health Record became fully operational for live PHI exchange and
now stands ready for large-scale utilization. Alabama state-wide initiative (Multiple
Stakeholders)
– Three integrated parts (“Bicycle Wheel”)
• HIE Core Framework (“Hub”)
• Provider EHR/EMR systems (“Rim”)
• Interface links between the Hub and Rim (“Spokes”)
– Information can be exchanged in either of two ways:
• “Pushes” patient information using Direct Message (Secured E-mail with
attachments).
• “Pulls” PHI using the Patient Search Process (Query – more Robust)

4. Alabama One Health Record®
• Alabama’s state-wide Health Information Exchange (HIE).
– Serves as the intermediary “Trusted-Provider-in-Fact” for electronic
PHI exchange.
– The system and framework to permit all health care providers to
securely share patient PHI electronically to improve outcomes through
improved care coordination using Electronic Health Record (EHR)
systems.
– It is a certified, standards-base technology that is HIPAA and MU2
compliant.
– It is connected to Federal Health Information Network (The eHealth
Exchange).
– Directly supports the EHR Meaningful Use Incentive Payment program
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Money to Providers and Hospitals to buy EHR systems
140 Payments to Eligible Hospitals (EH) totaling : $ 91M
1,566 Payments to Eligible Providers (EP) totaling : $ 25M

5. So….Why One Health Record® Integration?
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Landscape Factors
– Patient Care through electronic PHI
– Health Payment Reform – Incentivize Community Care to prevent
unnecessary Hospitalization
– Better Care Coordination = Better Outcomes
– Life cycle of care – Complete Care programs
– Tele-health – Telemedicine – continues to grow
– MU 2 requires CCDA sharing outside own system (DSM or HIE)
– 29 State HIE’s will be Nodes on eHealth Exchange by mid 2014.
– Ala, Ga, SC, WV, PA all have the same Tech platform.
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Transitions of Care
1. EHR approach – Publish CCDA to the HIE.
2. Use DSM (PHI e-mail) for a point-to-point exchange.

6. One Health Record® - Today
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In operation since April 2012
Current patient population: 1,000,000
Production Node on eHealth Exchange (national network)
Jackson and EAMC are live; UAB: late October.
East Alabama Care Network (health home) connected (DSM)
North Alabama CC Network moving to DSM)
8 CMHC’s – 2 more in the Queue (DSM)
862+ PHI exchange DSM’s since March 2013, 251 Queries
We our connected to Fla, SC, WV, Ga for DSM.
National Provider Directory
HIE Analytics – Utilization and Population Health.

7. Alabama One Health Record®
Beyond Today…the Next Phase

8. One Health Record – Phase II (Tomorrow)
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Hospitals moving ahead : Brookwood , Huntsville, Infirmary Health,
Children’s, Eliza Coffee/Shoals, Highlands, Springhill, St Vincent’s, DW
McMillian. CMHC’s and others increasing use of DSM for now.
IMZ, ELR, Syndronmic reporting to the ADPH Registries .
Tele-Medicine use will increase – Virtual Travel with Virtual Records
Patient Portal and expansion of Provider Directory functionality
Anticipate Interstate HIE connections with Fla and Ga within 12 months.
Pursuing DSM Interstate connections with Miss, Michigan, and La by
early 2014.
RCO’s home health networks will be connected to One Health Record®
Quality Rpt Document Architecture (QRDA) component to the CCDA
framework – CQM capture.
Other Services Patient alerts CCDA parsing for

9. One Health Record – Phase II
Challenges of Tomorrow
• HIE Sustainability and Governance
– Industry Landscape (CommonWell & EPIC)
– All Payers involved
– Transition to value-based care models
• Provider Workflow integration
– Productivity impact
– Engagement ( Adoption and Use)
• Building the “Spokes”
– Waiting for True “Plug & Play” Standards
– Provider EMR/EHR interoperability – Adapter for each vendor system (61 used
in Alabama).

10. One Health Record
MPI
EHR
CDA
EHR
PCP
PSYCHIATRIST

11. QUESTIONS?
Gary D. Parker
Alabama Medicaid Agency
gary.parker@medicaid.alabama.gov.
Phone: (334) 242-5011
Meghan Youngpeter
meghan.youngpeter@medicaid.alabama.gov.
Phone: (334) 353-4463
www.onehealthrecord.alabama.gov