Membership: (§381.90, F.S.)
The council shall be composed of the following members or their senior
Secretary of the Department of Health (DOH)
Director of the Agency for Healthcare Administration (AHCA)
Attorney General (AG)
Secretary of the Department of Business and Professional Regulation (DBPR)
Secretary of the Department of Children and Families (DCF)
Secretary of the Department of Corrections (DC)
Commissioner of Education (DOE)
Secretary of the Department of Elder Affairs (DOEA)
State Treasurer/Insurance Commissioner (DOI)
Secretary of the Department of Juvenile Justice (DJJ)
Executive Director of the Correctional Medical Authority (CMA)
Two Representatives of County Health Departments (CHD)
A Representative of Florida schools of public health chosen by the Board
of Regents (BOR)
A Representative of the Florida Association of Counties (FAC)
A Representative of the Florida Healthy Kids Corporation
Council Members in Attendance:
David Taylor, representing the Department of Health
Carolyn Turner, representing the Agency for Health Care Administration
William Kearns, representing University of South Florida, College of Public Health
Rich Robleto, representing the Department of Insurance
Glenn Palmiere, representing Department of Children and Families
Rod Westall, representing the Department of Corrections
Charles Faircloth, representing the Attorney General’s Office
George Hinchliffe, representing the Department of Juvenile Justice
Dr. John Heilman, representing Pinellas County Health Department
Lisa Gill, representing the Florida Healthy Kids Corporation
Council Members Absent:
Maureen Olson, representing the Department of Elder Affairs
Lee Cornman, representing the Department of Business and Professional Regulation
Gay Williams, representing Florida Association of Counties
Donald Bennett, representing the Correctional Medical Authority
Vacancy, representing the Commissioner of Education
Vacancy, representing the County Health Departments
Others in Attendance:
Susan Phillips, Statewide Research (DOH)
Stephanie Daugherty, Bureau of EMS (DOH)
Ben Harris, Department of Children and Families (DCF)
Lori Schultz, DCF
Allen Pearman (DOH)
Linda Brady (DOH)
I. Call to Order and Welcome: David Taylor, Chief Information Officer, Department of Health, called the Florida Health Information Systems Council meeting to order at 1:00 p.m. and welcomed all participants.
II. Roll Call: A formal roll call was conducted by Allen Pearman, and attendees identified themselves and the organization they represented. A quorum was established. Attendance is reflected above.
A formal roll call was conducted and attendees identified themselves and
the organization they represented. Attendance is reflected above. An
absence of a quorum was noted.
III. Approval of Minutes: The minutes of the Florida Health Information Systems Council meeting held September 24, 2002, were reviewed and approved.
IV. FHISC Strategic Plan Update and Revisions (Due June 2, 2003)
Allen Pearman noted that statutes require that the council submit a strategic plan to the State Technology Office (STO) on June 1 of each year. There will be no major changes to the Strategic Plan instruction requirements per conversation with STO. However nothing has been received formally regarding strategic plan instructions. Our intent, unless significant issues arise, would be to act on the proposed revisions that have been provided and forward them to STO. STO will then review, comment, and return the document to the council for further revisions.
Allen Pearman then reviewed the specific changes and modifications made to the draft strategic plan document which included the following:
1. Modified membership to reflect legislative action conforming Florida Statutes to amendment of Article IV, Section 4 of State Constitution, in which functions of former positions of Comptroller and Treasurer were combined into Office of Chief Financial Officer.
2. Modified start date to annually identify and prioritize data needs for Florida entities collecting or maintaining health-related data.
3. Added discussion of AHCA Emergency Room Patient Data Collection.
4. Modified strategic objective to reflect the extension of HIPAA transaction standards deadline to October 16, 2003.
5. Modified strategic objective to reflect need for on-going monitoring of state
agency compliance with HIPAA privacy requirements.
6. Modified discussion of HIPAA security regulations to reflect publication of final regulations with corresponding effective date.
7. Minor editorial changes were made to update text and to clarify meaning (including certain references to Florida KidCare, Title XIX).
8. Added reference to State Technology Office HIPAA Web site and appointment of statewide HIPAA coordinator.
9. Statutory references updated to reflect current statutes.
Ben Harris then questioned whether or not the ultimate goal is to create a single information system. The response from Allen Pearman was that the Executive Summary in the Strategic Plan identifies the two charges made to the council. The basic thrust of the council was to try to ensure capabilities for data sharing between state agencies and to try to avoid duplication of data collection efforts. The intent was not to come to a single data system but to promote compatibility between systems. The history of the council is such that one of the initiating factors had to do with Medicaid fraud. Several years ago, in an attempt to share information, it was found that this was not possible because of variations in systems. The legislative charge to the council was not to specifically create a monolithic health-related data system. It is not mandated but not prohibited either. Modifications to the Strategic Plan could be addressed in the future regarding this issue.
Ben Harris commented that the Department of Children and Families (Glenn Palmiere, specifically) has been working on a system that would fit with this mission. DCF is finding it a challenge to get agencies to state who owns the data and how it will be shared. Allen Pearman stated that this is consistent with the council charge. This is why there is a reference of AHCA joining with representation from the Department of Health to try to address issues with respect to collection of the emergency department patient data.
Glenn Palmiere inquired as to how the department related to SB 1276. Allen Pearman stated that this bill is referenced on page 26 of the Strategic Plan. This relates to the involvement of multiple agencies in promoting a shared system.
Allen Pearman stated that this issue could be an agenda item for future meetings. The council is required to meet quarterly (statutorily), but council could meet more frequently.
Glenn Palmiere inquired as to the reason that there have been no meetings of the council since September 2002. Allen Pearman responded by saying that the Strategic Plan was completed in September. Then there were a number of issues within the Department of Health in terms of turnover of staff that delayed scheduling of council meetings.
Ben Harris continued by saying that he will be meeting with AHCA, DOH, and DCF to point out that Medicaid eligibility data, vital statistics, and FLORIDA system data could produce profitable data sharing for all of these agencies.
David Taylor pointed out that it sounded like a possibility for a
sub-committee to work on an implementation portion of the Strategic Plan.
Charles Faircloth from the Office of the Attorney General commented that his office should be involved in this as all of this was started by fraud and abuse problems. He concurs that this information would be a good surveillance tool. His office uses Food Stamp information or Medicaid data for tracing clients. He stated that the AG’s office could assist as far as issues concerning data ownership.
Ben Harris stated that hopefully the AG’s office could produce more of a global agreement regarding data sharing. It was suggested that the AG could have an agreement in place that would require signatures of those in a global agreement.
There was then a motion and second to approve the changes as detailed in the Strategic Plan draft document. Without objection the motion was approved and staff directed to forward strategic plan as required by statute.
V. AHCA Emergency Department Patient Data Collection Proposal
Carolyn Turner (AHCA)
The proposed emergency department patient data rules were published in April 11, 2003, FAW (Vol. 29, No. 15, pages 1477-1487). See http://faw.dos.state.fl.us/fawframes.html. Note that the proposed rules are not final and are subject to change.
Carolyn Turner announced that Kathy Holster now heads the Data Collection Unit of AHCA. Ms. Turner pointed out that language that she suggested has been incorporated on page nine (9). Basically, the unit collects hospitalization data and ambulatory surgery data. This project would expand this data collection activity to include emergency department patient data. This consists of obtaining data on each emergency visit to a hospital. Most of this information is drawn from billing systems.
AHCA has worked closely with DOH to ensure that needs are met. The first Rules Development Workshop met on May 7. The emergency patient data collection section is being amended to the rules for ambulatory data rules section. Having this in the Strategic Plan increases awareness. The target date to begin collecting data is January 2005.
David Taylor commented that we are in the final stages of preparing the request for the bioterrorism grant for next year. If this money broadly fits within the area of public health preparedness or disaster recovery, it could be available. Funds cannot be used for recurring items.
Allen Pearman stated that one of the issues raised with the data collection effort is showing the different needs such as timing of submissions. This would aid epidemiology in regard to baseline data and trend data. It does not address real time monitoring in areas such as changes in health status or the types of patients showing up at emergency departments. It would provide a basis, even by specific facility, of indicating patterns of admissions.
Carolyn Turner thinks that the Internet transmission will speed up the turnaround time that is about six months.
There was a discussion as to whether we are trying to leverage our position to assist manufacturers to develop medical equipment in order to produce standardized interfaces that might provide more accurate data transcription into our systems. David Taylor responded that it is not a current goal but could be at a later time.
William Kearns commented that the data interchange format among a number of the systems has been specified to be .xml. He wondered if there are manufacturers who have devices that might be able to transmit direct data output from emergency rooms in .xml format. The goals would be to use the format at the outset.
Charles Faircloth asked for a clarification regarding comments about billing. Carolyn Turner responded that the hospitals are responsible for reporting. Their data source will be their billing information.
Other comments followed. It was stated that most hospitals use their computer systems just to do their billing. The electronic medical records systems have yet to be developed and adopted by all hospitals. Most electronic data that is available from a hospital is going to be what is produced to submit their bills. The easier way to get information from health care providers is to take the data elements that are available on their billing records. A few additional elements are requested.
VI. Other Business: David Taylor stated that we now have an opportunity to have a sub-group at the implementation level for discussion of the data-sharing issue, quality assurance, and the confidentiality issues. Ben Harris responded by saying that he would like to participate in a sub-committee. Charles Faircloth also expressed interest in becoming a part of this sub-committee. David Taylor suggested that the issue be placed on the agenda for the next FHISC meeting and move up the meeting date. [Allen Pearman noted that due to notice requirements it will probably be
mid-June before another meeting can be scheduled.]
Allen Pearman commented to Carolyn Turner that it sounded like Medicaid representation is needed. She requested additional information on the project so that she could identify an appropriate person for this forum.
Allen Pearman also mentioned that we have a vacancy on the council for a representative from the Department of Education. David Taylor welcomed anyone who is an interested party to participate in our meetings even if they are not members of the council. Allen Pearman followed by commenting that meetings are advertised prior to the meeting date in the Florida Administrative Weekly, and meeting information is emailed or mailed to members prior to the meetings.
VII. Adjournment: A motion was made and seconded to adjourn. Without objection, the meeting was adjourned.