The Massachusetts Health & Hospital Association (MHA), on behalf of our member hospitals, health systems, physician organizations, and allied healthcare providers, appreciates this opportunity to offer comments in strong support of HB2469/SB1214, “An Act to Enhance Access to Prescription Information and Overdose Reporting for Care Coordination.”

This legislation will ensure that entities such as the MHA Pre-Manage Emergency Department (ED) initiative can access Massachusetts Prescription Awareness Tool (MassPAT) data for healthcare diagnosis, treatment and coordination purposes. Through this voluntary Pre-Manage ED initiative, an online collaborative care management tool is being implemented within every hospital Emergency Department (ED), integrating existing clinical workflows from every hospital in the state and pushing high-value, actionable insights to providers the moment a high-risk patient presents in an ED. Pre-Manage ED takes an Admit-Transfer-Discharge (ADT) feed of all ED and inpatient encounters over a secure Virtual Private Network (VPN) from each hospital in the state. It pools this information within a secure data repository from which it can construct a complete longitudinal patient history and run real-time risk analytics when a patient presents at a given point of care. There are approximately 20 hospitals currently live on the system and we anticipate approximately 20 more going live by end of year 2017.

Pre-Manage ED may also pull in additional information such as existing advanced care planning documents, participation in a plan care management program, and MassPAT-filled prescription history information to augment the patient history to aid in risk identification and community care planning. HB2469/SB1214 ensures that provider entities and their vendors that provide Health Information Exchange Platforms or care management tools (such MHA’s Pre-Manage ED initiative) are able to access, integrate and maintain a patient’s MassPAT data within the electronic health records of a healthcare provider to support the diagnosis, treatment and care coordination for patients with a comprehensive medical history displayed in real-time -- wherever a patient presents for care.

MHA views the Pre-Manage ED initiative as an important tool to help combat the opioid epidemic affecting every community Hospitals have already used this system to successfully identify and enroll patients with high ED and inpatient utilization rates into case management programs to reduce readmissions. We are currently working to integrate our state’s substance use disorder evaluations and voluntary non-opiate directives into the system to further assist ED physicians in making better and more informed clinical treatment decisions for substance use disorder patients. However, in order to give providers a full, real-time clinical picture of the patient presenting in the ED, MassPAT data needs to be seamlessly integrated into the Pre-Manage ED platform. The language included in HB2469/SB1214 will accomplish this goal.

While Pre-Manage ED involves a small degree of information exchange, it is not a Health Information Exchange (HIE), and it is not intended to compete with state’s HIway infrastructure. Instead it can complement those systems by improving access and coordination of high-cost, high-needs patients. By giving clinicians visibility into prior hospital visits and, in its next phase, community-based clinical visit and prescription history in real-time, Pre-Manage ED enables them to deliver higher quality and better coordinated care. Pre-Manage ED delivers critical information to providers proactively in an easily digestible format so they don’t have to waste time searching for it. This allows clinical staff to spend more time treating or caring for the patient, and limits the time and resources currently required to populate a patient’s treatment history.

This legislation also includes a provision that would maintain essential state and regional reporting on fatal and non-fatal opioid overdoses. Since the filing of this bill, similar language has already been enacted as outside section 48 of Chapter 47 of the Acts of 2017 (the FY18 budget) – creating a new section 237 of Chapter 111 of the General Laws.

Thank you for the opportunity to offer testimony on these important issues. If you have any questions or require further information, please contact MHA’s Vice President of Government Advocacy, Michael Sroczynski, at (781) 262-6055 or msroczynski@mhalink.org.