Louisiana Looks Toward Healthcare Redesign

Information technology will be a centerpiece of an ambitious plan to rebuild the crippled healthcare infrastructure in Louisiana to a higher standard than what existed before Hurricane Katrina, according to a top state health official. "We're trying to build a better mousetrap," says Roxanne Townsend, M.D., Medicaid medical director at the Louisiana Department of Health and Hospitals.

The plan is to migrate from a hospital-based system that focused on treating acute illnesses to a geographically dispersed, ambulatory system based on primary and preventive care, relying somewhat on personal responsibility, according to Townsend. State officials want to build incentives for IT into the recovery plan.

A lot of the work will fall on the Louisiana Healthcare Redesign Collaborative, a statutorily created body charged with creating an evidence-based, quality-driven healthcare system in the state. On Monday, Gov. Kathleen Babineaux Blanco and various state and local officials will join U.S. Department of Health and Human Services (HHS) Secretary Mike Leavitt to sign the collaborative's charter at a meeting of the Southern Governors Association in New Orleans. A draft version of the charter envisions a healthcare system in Louisiana that could serve as a model for the rest of the country.

The first order of business for the collaborative is to pursue a Medicaid waiver and Medicare demonstration project for the four parishes that make up the New Orleans metro area.

According to Townsend, the demonstration project will focus on primary and preventive care for Medicare and Medicaid recipients, and, significantly the state's many uninsured residents. Blue Cross and Blue Shield of Louisiana also is participating, so the program potentially encompasses 70 percent of Louisiana's population.

Specifically, Townsend says, the collaborative is pushing physicians who are restoring their practices to move to electronic health records and connect to a statewide health information network, since so many paper records were lost in the August 2005 hurricane and the subsequent flooding in and around New Orleans. "We want them to come back electronically and for them to send data via the Louisiana Health Information Exchange," Townsend says.

Construction of the electronic exchange is part of a $3.7 million federal contract to build an interoperable regional health information organization (RHIO) prototype. In the weeks following Katrina, HHS carved out a special award for Louisiana, outside of the regular bidding process for National Health Information Network (NHIN) contracts that took place last year.

Louisiana's specific use case is to determine what clinicians would need to know if a patient ended up in a hospital emergency department and develop a way to deliver such information. While other NHIN contracts run for three years, Louisiana must have its work done by Sept. 30.

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