Two-Month Report, Vol. 13
From: T. Chris Muirhead, Chairman
For Period: April 1 – May 30, 2005
To: Governor Dave Freudenthal
Joint Labor, Health and Social Services Committee
Senator Charles Scott, Chairman
Representative Doug Osborn, Chairman
Items attached to report:
- April and MayWyoming Healthcare Commission meeting agendas
- April and MayWyoming Healthcare Commission meeting minutes
- Wyoming Rural Healthcare Study Report
- A Community Based Health Promotion Program Evaluation
- Electronic Health Records Study Draft Executive Summary for Public Comment
Activities
In March and April, the Wyoming Healthcare Commission’s four primary committees worked in the following directions:
Medical Errors
Committee Chair Dixie Roberts and Project Coordinator Fran Cadez traveled to Washington, D.C., to participate in a two-day presentation of health courts and their use as an alternative to the tort system. Harvard professor and medical errors expert Dr. Michelle Mello graded the tort system’s effectiveness and efficiency in comparison to a health court, with the health court receiving better marks as a means of administering justice for those who have been injured as a result of medical treatment. Commissioner Roberts has suggested that Wyoming is well positioned nationally to be a pilot or model for other states looking at shifting away from the tort system to distribute compensation for medical injuries. The concern about Wyoming as a pilot site is the relatively few malpractice cases compared to other states with larger populations.
Health Information Technology Technical Management Committee
Public Comment Meetings on the potential for electronic health records inWyoming were held during May in Buffalo, Casper, Cheyenne, Cody, Gillette, Rock Springs, and Sheridan.Another public meeting is scheduled in Jackson June 12. Key issues noted by participants have been:
- Electronic health records are likely to improve the quality of care of care in Wyoming
- Will the information contained in the records be secure and private, and what information will employers be able to obtain?
- Information should be available particularly when the person receiving treatment is elderly, indigent and/or receiving care from a federal entity (the VA, or Indian Health Services), already using electronic health records;
- The cost of implementing electronic health records in physician offices;
- Electronic health records implementation will be challenging, a multi-year process to achieve and will be contingent on provider willingness to participate.
A structure is being developed for implementation of an electronic health records plan to be proposed by JSI to the Information Technology Technical Management Committee and the Healthcare Commission. A vision statement has been drafted and organizational structure materials are being reviewed. A “key stakeholders” meeting is planned for July 18 in Lander to discuss the organization’s formation,and to solicit support and willingness to participate in moving it forward.
Discussions have been taking place with Dr. Hank Gardner to assist in mapping referral pathways as precisely as possible for Wyoming’s medical community. The information will assist JSI in making more detailed recommendations around health information exchange initiatives.
Purchasing Pools Subcommittee (Demand Side)
Consultant Claire Brockbank has been working with George Bryce, Carol Jenkins and Ken Vines, Wyoming Insurance Commissioner, to facilitate action steps toward creation of multiple solutions to the uninsured and potential increasing uninsurance in Wyoming.
A Request for Proposals was issued to solicit actuarial input on best possible models for reinsurance mechanisms in the state to broaden the coverage for small businesses and the individuals who are the sickest but not eligible for Medicaid or Medicare coverage.
Research into the legal issues attached to pooling funds from multiple sources to be used to purchase healthcare coverage for individuals who are low-income and not eligible for, not able to afford or not offered employer health benefits is breaking ground for “Wyo Care” accounts.
Additional Purchasing Pools Committee work is focused on “Total Health Management,” a means of coordinating care to improve the quality and reduce costs.
Supply Side Committee
Four meetings have been held with those interested in a Provider Database to gather input on the data elements relevant to the various stakeholders and to introduce the staff of the Nebraska Health Professions Tracking Center (HPTC). WHCC has been told by several reputable parties, including the Centers for Disease Control, that HPTC has the best provider database in the country and WHCC is in the process of contracting with HPTC to build a database of Wyoming providers. Two issues need to be resolved: 1) What role do other stakeholders wish to play in developing this database and 2) Where will the database be housed once HPTC transitions it to Wyoming. Entities under consideration include the Department of Employment, the Department of Health, and the University of Wyoming among others.
The committee is also involved in developing a myriad of legislative proposals related to increasing access to healthcare in Wyoming, improving the quality of healthcare delivered in the state and containing/reducing the cost of care delivered. The proposals should be ready to present to the Governor and the Legislature this summer. Some proposals under consideration include:
- Developing a quality/cost report card for Wyoming providers;
- Recommendations for improving the recruitment and retention efforts aimed at healthcare providers in Wyoming, and
- Developing a plan to outline the model delivery system for Wyoming providing policy makers a framework in which to make decisions.
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