A draft version of the State of Oregon Strategic Plan for Health IT provides high-level priorities, guidance, and direction for health IT over the next five years, with a focus on interoperability and community information exchange.
The draft strategic plan was developed by the Oregon Health IT Oversight Council (HITOC), which was created to ensure health system transformation efforts are supported by health IT.
Maintaining a health equity lens, the plan noted that Oregon still needs to work on prioritizing supporting groups with lower EHR adoption rates in order to close gaps that contribute to health inequities. This will require filling gaps in data collection on EHR adoption and usability and supporting actions to address barriers.
The plan said the state should encourage more participation in HIE networks and broader use of HIE solutions and provide funding and support. The report notes that currently providers typically need multiple HIE tools to meet their needs, and significant gaps remain, particularly for behavioral health, oral health, small providers, rural providers, and long-term post-acute care. The state can clarify standards, provide clear guidance, and share best practices on data-sharing priorities and HIE options to make interoperability easier, and make more data available for HIE, especially state data.
It also stated that the state should promote data-sharing models and approaches that are compatible across all systems (i.e., vendor agnostic) and improve insight into HIE adoption and continue to monitor the landscape.
There are several factors causing the state to focus on community information exchange (CIE) efforts that link healthcare systems and community-based organizations (CBOs). “Connecting healthcare and social services sectors through health IT can support better health outcomes and help decision-makers better understand health and social needs gaps so resources can be allocated to meet these needs,” the report says. “Information sharing can help organizations better understand and address disparities for populations facing health inequities. Additionally, there are new drivers for electronic information sharing, including value-based payment, Oregon’s 1115 Medicaid Waiver, and the need to modernize the public health system.”
Although CIE efforts are still in development, they have grown rapidly across Oregon. All 16 Coordinated Care Organizations (CCOs) contract with CIE vendors; adoption and use by providers, CBOs, and other partners varies. So far, integration of HIE and CIE into provider EHRs or electronic workflow is often limited.
To accelerate, and improve statewide CIE efforts, the report says the state should:
• Provide support for CBOs and additional partners to participate in
CIE.
• The Oregon Health Authority and Department of Health Services should play roles in statewide CIE efforts.
• Aggregate CIE data so it can be used for policy recommendations and resource allocation.
• Ensure communities have access to the data and inform how it is managed and analyzed.
• Align privacy and security efforts with principles that center community/individual decision-making around their information, applicable laws and standards, equity, transparency, and inclusivity.
In the realm of governance, the plan suggests the need to explore new models of governance for CIE, HIE, and other cross-sector health IT governance in Oregon. “New models with new partners are needed as more sectors are involved in exchanging information to improve health outcomes,” the report said. The state could look at advancing inclusive, neutral statewide CIE governance, using a neutral convener or public/private partnership, driven by priorities of individuals and communities with representation across social service, health, and government sectors with equal CBO to non-CBO representation and a multi-tiered structure.
