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Health IT Policy Reports

The Maryland Health Care Commission’s (MHCC) Center for Health Information Technology and Innovative Care Delivery (Center) publishes various documents related to advancing the adoption and use of health information technology (health IT).  Below is a list of publications organized by topics (i.e. Health Information Exchange, Electronic Health Records, Health Information Technology Survey Reports, Health Information Technology State Plan, and Other Health Information Technology Reports).

Cybersecurity

Health Care Data Breaches:  2017 Findings (2018)

The MHCC analyzed health care data breaches reported in 2017 to the Department of Health and Human Services Office for Civil Rights.  The report assesses the number of breaches reported and records compromised, and key trends in Maryland and the nation. 

Health Care Data Breaches:  How Maryland Compares (2017)

The MHCC analyzed health care breaches reported to the Department of Health &nd Human Services Office for Civil Rights from 2013 through 2016.  This report presents Maryland's ranking in relation to other states and provides a more detailed evaluation of records compromised and location of breached information. 

Health Care Data Breaches:  A Changing Landscape (2017)

The MHCC analyzed health care breaches reported to the Department of Health & Human Services Office for Civil Rights from 2010 through 2016.  This information brief discusses the increasing prevalence of health care breaches, and includes recommendations on enhancing security processes to prepare for and mitigate the effects of new and evolving cyber threats.

Hospital Cybersecurity:  Evolving Threats Require New Approaches (2016)

The MHCC conducted an assessment of hospital cybersecurity to determine how hospitals are preparing for and managing cyber risks.  This information brief highlights key findings from the assessment.

Electronic Health Records

Dental Electronic Health Record Adoption (2018)

The MHCC conducted an environmental scan to assess electronic health record (EHR) adoption among Maryland dentists.  This information brief provides key findings on the benefits and barriers to EHR adoption, top vendors, and areas of opportunity. 

Electronic Health Records - An Update on Adoption and Incentives Paid by State-Regulated Payors (2018)

The MHCC analyzed payor submitted data on EHR incentive payments made to primary care practices.  Data from the Maryland Board of Physicians was used to assess EHR adoption. This information brief provides details on the total incentives disbursed by payors and the growth in EHR adoption among primary care physicians.

Physician Adoption of Electronic Health Records - An Information Brief (2017)

The MHCC conducted an assessment of EHR adoption among practicing physicians in the State.  The brief highlights growth in EHR adoption since 2011 by specialty, geography and practice ownership type. 

Health Information Exchange

Dental Electronic Data Interchange Review - An Information Brief (2017)

The MHCC regulations require certain payers to submit an EDI progress report annually.  EDI use among payers and providers can generate administrative efficiencies, minimize manual data errors, and reduce costs.  The EDI review summarizes dental EDI activity among private payers and Medicaid.

HIE During a State of Emergency, Policy Guidance (2019)

This policy guidance document aims to assist HIEs considering making protected health information (PHI) accessible to incident responders during a state of emergency.  An HIE should use these guidelines to inform state of emergency HIE access policies. 

Hospital Image Exchange:  Exploring Opportunities for a Statewide Image Repository through the State-Designated Health Information Exchange (2016)

The MHCC conducted an environmental scan (scan) that identified benefits, challenges, and financing opportunities for an image sharing repository managed by the State-Designated health information exchange, CRISP.  The scan assessed hospital interest in expanding a use case where images could be made available through the CRISP Query Portal.

Ensuring the Privacy and Security of Electronic Health Information:  Keeping Pace with an Evolving HIE Landscape (2016)

This report was developed in collaboration with stakeholders and highlights the need to amend the current definition of a health information exchange (HIE). The definition of an HIE in law has not kept pace with the changing HIE landscape, creating gaps in privacy and security of electronic health information.  An increase of HIE services is being offered by health IT vendors.  Only select HIEs are subject to the existing regulations, COMAR 10.25.18:  Health Information Exchanges:  Privacy and Security of Protected Health Information.  Revising the HIE definition ensures that enhanced privacy and security standards apply to all HIEs operating in Maryland, which could increase consumer trust and information integrity.
CRISP Connectivity - Ambulatory Practices (2017)

The MHCC conducted an analysis of ambulatory practices' connectivity to CRISP.  This information brief offers insight on connectivity through various EHR integration levels and assesses progress towards enabling bidirectional exchange of clinical data among ambulatory practices and CRISP in the State.

Electronic Data Interchange (2017)

EDI has been used in health care for more than 30 years to exchange medical, billing and other administrative health information.  State law requires certain payers to annually report on their EDI activities.  This information brief highlights electronic data interchange (EDI) activity among government and private payers.

Health Information Technology Survey Reports

Comprehensive Care Facilities:  Adoption of Health Information Technology (2018)

Summary of the Comprehensive Care Facilities:  Adoption of Health Information Technology (2018)

Comprehensive Care Facilities (CCFs) provide services for residents presenting with disease, disability, or advanced age.  The MHCC collects data on health IT adoption from CCFs through its Annual Long Term Care Survey.  The survey data is used to assess health IT adoption trends, including electronic health records (EHRs), health information exchange (HIE), and telehealth.

Ambulatory Surgical Center Electronic Health Record Adoption (2017)

In the fall of 2016, MHCC assessed Maryland Ambulatory Surgical Centers (ASC) Electronic Health Record (EHR) Adoption.  Included in the assessment is the identification of leading benefits and barriers to EHR diffusion in ASCs.

Health Information Technology:  An Assessment of Maryland Acute Care Hospitals (2018)

Summary of the Health Information Technology:  An Assessment of Maryland Acute Care Hospitals (2018)

The MHCC conducts an annual Hospital Health Information Technology Survey that provides information regarding current trends and the future direction of health IT adoption among all acute care hospitals in Maryland.

Other Health Information Technology Reports 

Controlled Dangerous Substance Permit Distribution - A Physician Assessment (2017)

The number of deaths nationally from opioid drug overdoses more than tripled between 2000 and 2015.  In recent years, Maryland has seen an increase in opioid related deaths of 75 percent from 2007 to 2015.  Opioid abuse mortality rates statewide parallel cancer, strokes, and heart attacks.  The Maryland Health Care Commission assessed the Maryland Department of Health’s, Office of Controlled Substances CDS database to gauge CDS permit distribution among physicians statewide.

ICD-10 Readiness - A Summary of Payors Testing Efforts (2015)

The International Classification of Diseases (ICD) is a standardized coding system for medical conditions, diagnoses, and institutional procedures.  ICD-10 consists of a new set of codes that replaced the previous ICD-9 codes, which contained outdated and/or obsolete terms that were no longer consistent with current medical practice.  The MHCC surveyed the five largest payors in the State inquiring about the status of their ICD-10 preparedness activities, and the findings are included in this brief.   

Independent Nursing Home Health Information Technology Grant Program Assessment (2015)

The MHCC, in collaboration with the State-Designated health information exchange (HIE), the Chesapeake Regional Information System for our Patients (CRISP), implemented an Independent Nursing Home Health Information Technology Grant Program (grant program) between May 2013 and March 2014.  The grant program aimed to facilitate the adoption and use of health information technology (health IT) among independent long term care (LTC) facilities, with a focus on HIE, to support improved transitions of care between hospitals and the LTC facilities.  This report presents the findings of the grant program assessment (assessment).  

Management Service Organizations – A Vision of State Designated Organizations for Physician Practices (2009)

Management Service Organizations (MSOs) have emerged as a way to address the critical challenges of widespread use of EHRs. This report identifies the critical infrastructure requirements for MSOs that seek State Designation. For a presentation summary of the MSO State Designation Program year one accomplishments (May 2010 – May 2011), click here.

Maryland Medical Assistance Program Health Information Technology Planning Advanced Planning Document (2010) 

Describes how the Maryland Medical Assistance Program will develop a high-level management statement of Maryland’s vision, needs, objectives, plans, and estimated costs that will result in a State Medicaid Health IT Plan.

Strategy for Implementing Electronic Advance Directives & MOLST Forms (2012)

Making advance directives and Medical Orders for Life Sustaining Treatment (MOLST) forms legal documents electronically at the time and place of care may help ensure that a patient’s wishes are known and honored. This report identifies recommendations for a framework for storing and exchanging advance directives and MOLST forms as follows:  create a patient managed registry for advance directives, where patients can make their own health documents available to treating providers via the statewide HIE through use of a personal health record system connected to the HIE; and develop a registry for electronic MOLST forms that is also accessible via the statewide HIE.

Telehealth

Advancing Population Heath and Primary Care Transformation via Telehealth:  A Compilation of 2015 & 2016 Telehealth Grant Final Reports (2018)

The MHCC awarded telehealth grants to five organizations in December 2015 and June 2016 to assess the use of telehealth to support population health and primary care practice transformation.  The five awardees were Associated Black Charities; Gerald Family Care, LLC; Union Hospital Cecil County; MedPeds, LLC; and Gilchrist Greater Living.  Telehealth services were provided to patients in a variety of settings, including primary care practices, patient homes, and community centers.  This report provides information on the project implementation, data collection, outcomes, challenges, solutions, lessons learned, and sustainability plans for the grantees’ telehealth projects. Lessons learned include:  1) successful telehealth requires practices to assess the need for telehealth, identify an appropriate modality, and ensure sufficient patient and provider willingness to engage in telehealth; 2) telehealth is generally an effective care delivery method where a multi-disciplinary team can deliver comprehensive patient care; and 3) telehealth reduced barriers to care for patients typically considered reluctant to adopt/accept telehealth services (e.g., the elderly and those with behavioral health conditions).

Adoption of Telehealth - Office-Based Physicians (2018)

In the fall of 2017, MHCC conducted an environmental scan of office-based physicians to assess telehealth diffusion.  This information brief highlights key findings from the assessment, including current trends, leading barriers, and adoption by specialty and geography.

Remote Patient Monitoring Telehealth Grants: Brief and Final Reports (2017)

The MHCC awarded three telehealth grants to demonstrate the impact of telehealth using remote patient monitoring devices to support chronic care management of high risk children, adults, and elderly patients.  This document includes a brief by MHCC and project reports by grantees:  Crisfield Clinic in Somerset County, Union Hospital of Cecil County, and Lorien Health Systems in Baltimore and Harford Counties.  The brief outlines lessons learned from these projects and key telehealth implementation considerations to be used by those interested in implementing similar remote patient monitoring projects.  The individual reports include a description of technology infrastructure, implementation and assessment approach, project limitations and challenges, and plans for sustainability of these projects. 

Long Term Care and Hospital Telehealth Project Grants: Brief and Final Reports (2016)

The MHCC awarded three telehealth grants to implement telehealth to improve transitions of care between hospitals and nursing homes. This document includes a brief by MHCC and project reports by grantees regarding the outcome of the projects implemented over 12 months beginning in October 2014. The brief highlights lessons learned from these projects and key telehealth implementation considerations to be used by those interested in implementing similar telehealth projects. The Long Term Care and Hospital Telehealth Project Grant reports include a description of technology infrastructure, implementation and assessment approach, project limitations and challenges, and plans for sustainability of these projects.

Telehealth Assessment Readiness Tool (2019)

The Telehealth Readiness Assessment Tool (tool) is designed to assist small practices with assessing their readiness for implementing or scaling a telehealth project.  The tool consists of a self-evaluation questionnaire, scoring methodology, supporting guidance, and additional resources.  Tool content is evidence-based and serves as an educational resource to support small practices in their decision to offer teleheatlh services.  The MHCC encourages lead practitioners or practice managers to complete the tool in collaboration with other practice stakeholders to increase readiness and identify areas for improvement. 


Last Updated: 3/20/2019