The California Health eQuality (CHeQ) 2013 Rural HIE Incentive Program
The CHeQ Rural HIE Incentive Program is designed to help further stimulate adoption of Health Information Exchange (HIE) in rural and often underserved areas of California. HIE creates a HIPAA-compliant, secure method to share health-related information across organizations, often among disparate EHR, lab, and other systems, allowing 24/7 access to a patient’s records from multiple sources. Use of HIE helps improve patient care coordination, reduces the need for expensive, redundant testing, and enables secure exchange of information over sometimes major rural distances.
CHeQ is taking advantage of the emergence of a new model for HIE—the HIE service provider—to promote a more cost-effective means of establishing health information exchange in rural areas by subsidizing the implementation costs of HIE technology services for rural providers, clinics, and hospitals. Through a competitive process, CHeQ has selected five Rural HIE Service Providers to offer a suite of high-priority, standards-based HIE services including secure messaging, results delivery using traditional HL7 messaging, and a repository and portal model for accessing longitudinal patient records. The selected portfolio allows rural health care providers choices in order to adopt the services that best meet their needs.
On July 11th, CHeQ hosted an informational webinar about the program and the Rural HIE Service Providers. Please see the slide deck below for more information:
Who is eligible for the Rural HIE Incentive Program?
Health care providers, clinics, and hospitals in counties and Medical Study Service Areas (MSSAs) described as Frontier or Rural by OSHPD are eligible to take advantage of the Rural HIE Incentive Program.
Check the detailed OSHPD maps at these links to evaluate eligibility for specific geographic areas:
A link to more specific county-level information and maps can be found at:
In addition, CHeQ has designated the following eleven counties’ entire geographies as qualifying areas. While there are urban MSSAs within these counties, given their predominantly rural character and underserved populations, we are identifying them as qualifying areas. The counties are:
Though rural health care providers, clinics, and hospitals are considered end users, subsidies will be provided directly to the Rural HIE Service Providers who pass the saving on to providers.
How much does the Rural HIE Incentive Program subsidize?
The Rural HIE Incentive Program subsidizes 65% of the cost for connectivity work billed by the Rural HIE Service Providers, who in turn give that discount to the end users with whom they are contracted. The end users—rural health care providers, clinics, and hospitals—are responsible for the remaining 35% of implementation costs.
CHeQ will subsidize the Rural HIE Service Providers upon verification of contractual agreement with rural providers, clinics, and/or hospitals.
What is subsidized under the Rural HIE Incentive Program?
CHeQ will subsidize the implementation of HIE services that enable exchange between qualifying health care providers, either directly or through a Health Information Organization (HIO). Relevant connectivity implementations include:
Ongoing maintenance fees are not covered by the Program. If a community chooses to initiate its own HIO with separate facilities involving capital projects to build the new entity, those capital costs are not covered. Connectivity to independent labs, rural pharmacies, and ancillary services are not included.
What HIE services are offered through the HIE Service Providers?
The HIE services offered through the Rural HIE Service Providers fall into two general categories, though each have sub-categories as well. The general categories are directed exchange, including Direct, and longitudinal patient records. A needs assessment conducted during interviews with the Rural HIE Service Providers will guide the choice and implementation of HIE services.
Directed Exchange Services
Directed exchange services move data between Electronic Health Records (EHRs) and other electronic systems using HL7, Direct, and/or other methods. Services include:
- Orders – labs, radiology, etc.;
- Results delivery – structured lab results, radiology results, encounter notes, discharge summaries, etc.;
- Public health reporting – immunizations, reportable conditions, etc.;
- Transitions of care – exchanging patient care summaries, as well as referrals between unaffiliated providers (including hospitals) using Direct, or the development of interfaces to EHRs, or similar industry approaches;
Longitudinal Patient Record Services
- Integrating data on patients across various sources that can be queried by participating providers.
- At minimum, query systems should enable exchange of the types of information listed above for directed exchange, plus patient demographics (such as enabled by ADT messages) to enable patient matching, through interfaces to participants’ EHR systems and (optionally) a user portal.
Designated HIE Service Providers for the Rural HIE Incentive Program
The five Rural HIE Service Providers selected to deliver the HIE services are divided into two categories: two offering directed exchange and three offering both longitudinal patient record and directed exchange services. Please contact the Rural HIE Service Providers directly to arrange detailed discussions of both needs and capabilities. Again, CHeQ will subsidize the HIE Service Providers once they contract with rural health care providers, clinics, and/or hospitals, and the HIE Service Providers will then discount their prices so that rural providers are only responsible for 35% of the remaining costs.
Directed Exchange Services
Directed Exchange and Longitudinal Patient Record Services
Bill Beighe 831-465-7874
For more information regarding the CHeQ Rural HIE Incentive Program, please contact Elsa Schafer, Rural HIE Incentive Program Manager (firstname.lastname@example.org ), or Rayna Caplan, HIE Acceleration Program Director (email@example.com ).