Cal ifornia State Medi-Cal Health Information Technology Plan October 2018 California Medi-Cal Health Information Technology Plan TABLE OF CONTENTS CONTENTS 1.1 California's Cal Healthiforni Informationa’s He Technologyalth Inf Landscapeormation Technology Landscape ....................................4 4 1.1 EHR1.1 Adoption EH andR A Usedo Bypt Professionalsion and Use By Professionals............................................................6 6 1.1.1 Medi-Cal1.1. 1EHR IncentiveMedi Program-Cal E ParticipationHR Incentive Program Participation .........................................6 6 1.1.2 EHR1. Adoption1.2 E HandR Use Adop in Californiation anby Professionalsd Use in California by Professionals ..................................10 10 1.2 EHR1.2 Adoption EHR and Ado Usept byi onHospitals and Use by Hospitals ...................................................................14 14 1.3 EHR1.3 Adoption EH andR A Usedo bypt Communityion and Clinics Use by Community Clinics ..................................................16 16 1.4 EHR1.4 Adoption EH andR A Usedo bypt Indianion Healthand ClinicsUse by Indian Health Clinics ...............................................20 20 1.5 EHR1.5 Adoption EH andR A Usedo bypt Veteransion an Administrationd Use by facilities Veterans Administration facilities ............................22 22 1.6 Education1.6 E andduc Outreachation and Outreach ...................................................................................24 24 1.6.1 Provider1.6. Education1 P androv Outreachider Education and Outreach ............................................................24 24 1.6.2 Hospital1.6. Education2 H andos Outreachpital Education and Outreach ............................................................27 27 1.7 Regional1.7 ExtensionRegional Centers Extension Centers ..............................................................................28 28 1.8 California1.8 CTechnicalalifor Assistancenia Tec Programhnical Assistance Program ..........................................................30 30 1.9 Vulnerable1.9 V Populationsulnerable Populations .....................................................................................33 33 1.9.1 Children1.9. in1 FosterC Carehil drin Californiaen in Foster Care in California ........................................................33 33 1.9.2 Improving1.9.2 Psychotropic Impr Medicationoving P Usesy inc hotFosterropi Carec Medication Use in Foster Care ..........................36 36 1.9.3 Mental1.9. Health3 andM Substanceental H Useeal Disordersth and Substance Use Disorders ..........................................39 39 1.10 Broadband1.10 B rInternetoadban Accessd Internet Access ...............................................................................43 43 1.10.1 California1.10.1 Telehealth Cal Networkifornia Telehealth Network ..................................................................45 45 1.10.2 Digital1.1 0395.2 Middle Dig Mileit Projectal 395 Middle Mile Project ................................................................47 . 47 1.10.3 Digital1.1 0299.3 Broadband Digit Projectal 299 Broadband Project ................................................................48 . 48 1.11 Telehealth1.11 Telehealth .........................................................................................................48 48 1.11.1 Telemedicine1.11.1 Telemedicine ...........................................................................................51 51 1.11.2 Teledentistry1.11.2 Teledentistry ............................................................................................52 52 1.12 Health1.12 InformationHealth Exchange Information Exchange ............................................................................54 54 1.12.1 State1.1 Designated2.1 S Entitytate Designated Entity ...........................................................................55 55 1.12.2 Community1.12.2 HealthCom Informationmunity Exchanges Health Information Exchanges .................................................62 62 1.12.3 Enterprise1.12.3 Health E Informationnterpris Exchangee Heal Organizationsth Information Exchange Organizations ..........................66 66 1.12.4 Health1.1 2Information.4 H ealTechnologyth In fGrantsormation Technology Grants ....................................................67 67 1.13 E-Prescribing1.13 E-Prescribing ....................................................................................................70 70 1.14 Public1.14 Health Publ Reportingic He andal tSurveillanceh Reporting and Surveillance ........................................................75 75 1.14.1 California1.14.1 Public C Healthalif orHIEni Infrastructurea Public Overview Health HIE Infrastructure Overview ...............................75 75 1.14.2 Laboratory1.14.2 and DiseaseLabor Reportingatory and Disease Reporting ..........................................................78 78 1.14.3 Specialized1.14.3 Specialized Registries..............................................................................80 80 1.14.4 Syndromic1.14.4 Surveillance Syndr Reportingomic Surveillance Reporting ...........................................................84 84 1.14.5 Immunization1.14.5 RegistriesImmunization Registries ...........................................................................84 84 1.15 Information1.15 Inf Technologyormation Infrastructure Technol andog Medicaidy Infr Informationastructur Technologye and ArchitectureMedicaid Information Technolog87 y ...... Architecture ....................................................................................................... 87 1.15.1 Medicaid1.15.1 Enterprise Medi Systemcaid Enterprise System ....................................................................87 87 1.15.2 Medicaid1.15.2 Information Medi Technologycaid In Architectureformation Technology Architecture ........................................89 89 SMHP v3 1 California Medi-Cal Health Information Technology Plan 1.16 Information Technology Workforce Development 92 1.16 Information Technology Workforce Development ............................................ 92 1.17 Interstate1.17 ExchangeInterst atActivitiese Ex change Activities ..........................................................................93 93 1.18 The1.18 Legal TLandscapehe Leg al Landscape .......................................................................................95 95 1.19 Clinical1.19 Quality Clinical Quality ................................................................................................97 . 97 2. 2California's Ca lFutureiforni HITa Landscape’s Future HIT Landscape .....................................................................98 98 2.1 California's2.1 CaNewlif 5-Yearorn iaPlan’s (2017-2021)New 5-Year Plan (2017-2021) .......................................................98 98 2.1.1 Meaningful2.1.1 Use Meaningful Use ........................................................................................98 98 2.1.2 Health2. 1.Information2 H Exchangeealth Information Exchange ...................................................................99 99 2.2 IT2 Architectural.2 IT AChangesrchitectural Changes ................................................................................115 115 2.2.1 MITA2. Architecture2.1 MITA Architecture ..................................................................................115 115 2.2.2 State2. Level2.2 RegistryState Level Registry ...............................................................................117 117 2.2.3 Existing2.2. Paper3 FormsEx andist iElectronicng Paper Health F Recordsorms and Electronic Health Records ...........................118 118 2.3 Education2.3 Eandduc Outreachation and Outreach .................................................................................118 118 2.3.1 Provider2.3. Education1 P androv Outreachider E Planduc ation and Outreach Plan ..................................................118 118 2.3.2 Hospital2.3. Education2 H andos Outreachpital E Planducation and Outreach Plan ..................................................120 120 2.4 The2 .4Future T Legalhe LandscapeFuture Legal Landscape ..........................................................................120 120 3. 3Administration Adm i&ni Oversightstrat iofon the &Program Oversight of the Program ....................................................123 123 3.1 State3.1 Level SRegistrytate Level Registry .......................................................................................123 123 3.1.1. Overview3.1.1 Overview ................................................................................................123 123 3.1.2 State3. Level1.2 Registry S tUserate Assistance Level R& Resourcesegistry User Assistance & Resources ..............................125 125 3.1.3 SLR/NLR3.1. 3Interfaces SLR/NLR Interfaces ...............................................................................126 126 3.1.4 Program3.1. Updates4 Pandrog SLRram Functionality Updat es and SLR Functionality ...............................................128 128 3.2 Eligible3.2 ProfessionalsEligible Professionals ......................................................................................130 130 3.2.1 Eligible3.2. Professional1 E lTypesigible Professional Types ....................................................................131 131 3.2.2 Eligibility3.2. Formulas2 E forlig Professionalsibility Formulas for Professionals .....................................................132