Florida Rep. Holly Benson

Would you please describe your state’s strategy for using health information technology (HIT) to improve the efficiency and quality of health care?

Our biggest HIT initiative is Florida Compare Care (http://www.floridacomparecare.gov/). This website allows consumers to compare all sorts of things, including cost of care, physician licensing information, hospital quality and health plans.

Florida has also taken the lead on Regional Health Information Organizations, or RHIOs. We have used some funds to support the creation of these RHIOs, and have had a lot of early successes in terms of developing databases and tracking patients.

As a compliment [to the RHIOs], we’re planning on launching the Florida Health Information Network. The purpose of this network is to figure what information we have available in state databases and improving the coordination of this information. We’re also working with the private sector to [help us] use existing data better to drive improvements in quality.

In addition, we have given our top 3,000 Medicaid [prescription drug] prescribers PDAs. The devices contain our Medicaid drug formulary, drug interactions and they allow physicians to e-prescribe. So far the program is going very well. I suspect in the next few years you will see a real push in Florida, as well as many other states, to use e-prescribing.

(In 2006, Rep. Benson co-sponsored legislation (HB7073) which, among other things, authorizes the Agency for Health Care Administration to develop an electronic health information network.)

What are the biggest difficulties that you’ve encountered so far, and how are you working to overcome them?

You always want more money than there is available, so limited resources is the first difficulty. Second, because every system has been investing in separate technology the challenge becomes achieving interoperability. You need data systems to talk to each other so that you can make better use of all the data that you’ve captured.

Some experts say that states will be able to restrain rising health-care costs by using HIT to reduce the number of medical errors that occur. Are you tracking medical errors, and if so, how?

If you look at all the old Institute of Medicine reports about patient safety issues, it’s obvious that if you improve health information technology you can reduce errors. This is particularly important with respect to pharmacy issues. It’s been well demonstrated that if you can track people’s prescription drug usage, you can reduce exponentially the number of patient safety issues.

We’re currently reporting patient safety indicators at the hospital level—this information is available on the http://www.floridacomparecare.com/ website. In addition, we’re collecting data on “present-at-admission” status, or whether a patient’s diagnosed illness was present when he/she was admitted to the hospital. This data will help determine if there are patient safety issues arise once patients are admitted and enable hospital to address problems when they arise.

A couple of years ago, we established the Florida Patient Safety Corporation, which is a public-private partnership. The corporation is charged with looking at other patient safety measures, though they haven’t released any recommendations yet. We do lots of public-private partnerships in the state because there are an entity that give us a little more flexibility.

Are there any dangers in relying on HIT?

Any time you rely on technology you want to make sure people’s private information is kept private. There continue to be too many reports about data being leaked. [Personal information] is too valuable to let get into the wrong hands so before you put too much out there in the public domain you have to ensure that all the safety measures, firewalls, etcetera are in place.

You always have worries about system failures but beyond that, I think most patient will view HIT as tremendous value, particularly the high consumers of health care.

What have you learned so far from Medicaid reform in Florida, and what lessons do you have for other states seeking reform?

We have found that choice really is important to our Medicaid recipients. One of the key things for other states looking to reform their programs is having good counseling in place.

Another thing, we worked very hard to establish is a competitive market place. Under reform, we finding we have many more health plans serving Medicaid beneficiaries in Broward and Duval County than we ever had prior to Medicaid reform. When you have major undertaking like this, the outreach to the community, the beneficiaries and the providers is crucial. You have to make sure the process is transparent—and transparency is an ongoing obligation.

Finally, I think it’s also important to always look to outside resources and consultants throughout the process for help. They often have different resources than are available within state government. We found that utilizing more formal project management techniques is really essential. There are just certain things you need to get from the private sector about how to run a business that you wouldn’t traditionally tap into.