# Presentation: 028002

## Health Passport presented toAHRQ Informatics Teleconference

- July 26, 2001

- J. Terry Williams, MPH
- e-mail twilli@state.wy.us
- Telephone 307-777-6008

## Key Findings of the Demonstration by Urban Institute

- 1. Providers liked the concept, clients were positive about the card.
- 2. Privacy/Security was not a problem for clients.
- 3. Clients felt empowered in using the card and managing their child’s health data.

## Who Is Benefiting?

- Mothers and Children
- True access is the engagement of parents so they are a partner in the delivery of health care for their children.
- Terry Williams, Health Passport Manager, WGA
- Health Care Providers
- In most communities, providers function in almost total isolation-- they have little opportunity to share ideas, learn new skills or provide support and guidance to one another.
*Starting Points, Meeting the Needs of Our Youngest Children*, the Carnegie Foundation

**Notes:**
Retailers are benefiting too as payment for WIC food benefits are handled entirely electronically rather than using the old paper voucher system.

## Health Passport Demonstration

**Western regional pilot**
**Pilot sites:  Cheyenne, WY; Reno, NV; Bismarck, ND**
**Launch:  Bismarck & Cheyenne -- June 1999   **
**	****	****	****Reno -- June 2000**
**20,000 moms and kids**
**17 local partner organizations**
**Retail Stores:  WY & NV**
**Private medical providers**

**Notes:**

Programs:
WIC
Immunization
Maternal and Child Health
Optimal Pregnancy Outcome Program
Medicaid
EPSDT
Head Start

##  The Challenge:

-  Use of Technology
- Focus on the End Result, not the Process
- Empowerment, not government control
- Gaining acceptance
- Make HPP transparent to users, providers
- Protect personal privacy

**Notes:**

A.  Results are for the following goals (next slide)

B.  As an enabler in participation, government must empower the citizen for  economic and social reasons so they can make better lives for themselves.

## Phase I Card

** ****One card per family member**
** ****Multi-application hybrid architecture **
**   ****(mag stripe for backward integration)**
** ****8 k microprocessor**
** ****Internet back-up from host using data**
**  ****encryption via network**

**Notes:**
HPPCARD-

Hybrid card - to function not only as interactive storage 	base (chip), but also compatible with mag-		stripe Medicaid service authorization and 		first step in claims processing. 
	Cost approx $3.80 per card

Internet Back-up - Data stored in HOST during pilot to 	repopulate card if lost/stolen.

Open systems - Making it as open as possible; working 	with Navy and GSA to achieve fully open 		architecture points of	possible partnership for 	phase #2.

## Legacy Integration

- HPP
- Card

- Immunizations

- HPP-
- Turnkey

- Head
- Start

- WIC

**The HPP Card captures data from each legacy system**
** ****and has the ability to send new information to the legacy system**

- Medicaid

- MCH

**Notes:**
Legacy systems are existing, separate ‘smokestack’ programs where there is little or no sharing of data.
  HPP card, through application program interfaces allows read/write with legacy systems.
  WIC - Women, Infants, and Children
  Med. - Medicaid
  HS - Head Start
  HPP Turnkey - Application to support stand-alone data 	systems such as private medical services
  MCH - Maternal and Child Health
  Imm. - Immunization
  Each card protected by client selecting own PIN number 		(personal identification number).
  Each providers’ read/write authorization based on ‘need to 		know’; physician, nurse, secretary, authorization 		provided through provider card; takes client and 		provider cards present to read/write.

## On the Card:  Programs with Status

**Programs with Detailed  Information:**
**WIC & EBT**
**Nutrition Program**
**Immunization**
**Medicaid EPSDT**
**HeadStart**
**Maternal and Child Health**
**Public Health Nursing**
**Private Providers **
**Cheyenne Children’s Clinic**
**Med-Center One: Family Doctor’s Clinic**

**Programs with Status Only:**
**Food Stamps, commodity food program**
**Oral Health (Dental)**
**Children’s Special Health Services**
**Well Baby Clinic**
**Housing or Fuel Assistance**
**AFDC/Power/TANF**
**Food Pantry**
**School Lunch & Breakfast**
**Family Planning (Reproductive Health)**
**Tracking System (Children)**
**SSI**
**Extension, EFNEP, FNP**
**Presumptive Eligibility for Pregnant Women**
**Others**

**Notes:**
EBT - Electronic Benefits Transfer

EPSDT - Early and periodic screening, diagnosis and treatment

## On the Card:  Medical Results

**Height and weight.**
**Hemoglobin/Hematocrit test results.**
**Immunizations**
**Pregnancy Status and Due Date**
**Gravia**
**Parity**
**CDC Breast Feeding Information**

**Client Exam Data:  Coded Results, Source Code, Date Stamp**
**Heart**
**Blood Pressure**
**Lungs**
**Abdomen**
**Teeth**
**Hearing**
**Vision**
**Extremities**
**Nose**
**Throat**

- Medical results and
- date last updated:

**Notes:**
Could add client providers as acceptance grows
Pediatrician
OB-Gyn
Family Doctor
Dentist
Hospital
School
Optometrist

## Project Sponsors

- HHS: PHS, MCH, & Head Start
- Medicaid
- State Immunization Program
- USDA - Food & Nutrition
- National Library of Medicine
- GSA -  Technical evaluation
- Several large pharmaceutical companies
- Blue Cross/Blue Shield North Dakota

**Notes:**
  As Lead Governor of HPP, I invite you to take a closer look 	at WGA, and in particular my own State of 		Wyoming, where we have pioneered Smartcard 	use since 1992.

  Together, let’s identify the markets and roles where we 	can forge a win-win partnership that would 		bring efficiencies to government and benefits to 	the private sector.

  Come and ‘kick our tires’ and see what we are made of.

  There is still time to climb aboard Health Passport.  We will have an independent evaluation available for review next summer.

We are considering how best to share the technology and the HPP system with other states and agencies.