Georgiahealthinfo.gov was designed to help Georgia citizens make better healthcare decisions by providing them with more information to consider when selecting healthcare providers and services. Choosing the providers and services that best meet their medical, financial, and access to care needs, will improve the value of healthcare delivery for consumers. Increased information regarding healthcare choices is expected to promote competition among providers to offer the best possible care.
The goal of the georgiahealthinfo.gov project was to design, develop, implement and manage an internet accessible Web site that provides healthcare consumers the following types of information: (1) access to health and self-care information, (2) healthcare provider comparison information, and (3) consumer planning information for episodes of care.
1.	Health Education: 
Health education and self-care information regarding prevention, wellness, and common chronic disease states shall be available directly on the Web site content and/or via links to nationally recognized medical resources. 
             	2.  Healthcare Provider Comparison Information: 
Comparison information will be provided on select healthcare services and about healthcare providers with respect to quality, cost and accessibility of care. Healthcare providers include, but not limited to hospitals, nursing homes, pharmacies, and ambulatory surgical centers.
               	3.   Episodes of Care Information: 
The information describing an episodes of care would include a set of services commonly listed or offered together to ensure comprehensive care, such as a treatment plan that includes multiple services prescribed by the treating physician. The episode of care information would include, but is not limited to quality, cost, service availability information, outpatient services, inpatient care, professional fees, pharmacy costs, rehab services and home health services and durable medical equipment  and where applicable projections  regarding long term care. Episodes of Care information provide the consumer descriptive information about common surgical and outpatient procedures including benefits and possible risks.   This information should be made available either directly on the Web site and/or via links to nationally established medical Web sites.
The project approach was a multi-phased development approach that allowed DCH to continue to provide additional data sets and functionality over timed phases. The site was launched in December 2008 and will continue to expand in phases over the coming years.
.
Georgiahealthinfo.gov is an important part of a larger strategy of healthcare transformation. Longer-term goals of improvements in the delivery of care including reduced medical errors and more informed treatment by healthcare providers through health information exchange are part of the vision.  The Web site is helping DCH reach its broader goal to be more responsive to citizens and healthcare providers through the use of a new, more advanced generation of technology that facilitates finding healthcare information to support important life decisions.

In this project the DCH project team worked with IBM to design, build, and deploy a healthcare transparency Web site for the State of Georgia that is comprised of the following three sub-systems:
Health Transparency Website Content Management System (CMS)
Health Data Warehouse
Search for Care Web Application

These sub-systems and their respective high level scope definitions are listed below;
.
Health Transparency Website Content Management System
Integrate up to 2,200 MayoClinic.com Health Information Content Objects
Browse and keyword search Health Information content from MayoClinic.com
Up to 16 Health Transparency Website support pages with workflow
Up to 6 CMS Presentation Theme Templates
Up to 6 Web Content Types
Up to 6 CMS Authoring Forms
Up to 2  4hour CMS Authoring Workshops to support up to 15 DCH CMS Authors
Up to 5 CMS User Roles
Health Data Warehouse
Up to 10 Subject Areas
Up to 600 attributes
Up to 14 Discrete Data Sets 
Search for Care Web Application
Summary Profile Display, Compare Quality and/or Cost Data for health care providers
Up to 5 comparison data elements
Geographic Mapping Functions 
Profile Update Notification Email
Driving Directions

The project utilized the latest interactive web technologies to deliver an engaging and highly usable interface to a large set of educational content and an easy-to-use search interface to healthcare cost, quality and other data sets. IBM's DB2 database engine was used to create and manage the Health Data Warehouse component. IBM utilized advanced open source frameworks for delivering the service on the web, including Drupal for web content management and Ruby on Rails for the search and comparison application for healthcare providers. IBM also utilized pre-existing application assets to enable a rapid project timeline along with advanced web technologies such as AJAX, CSS and JavaScript. The technology enabled the DCH and IBM team to focus more time on achieving the business value of the service, including data analysis of the multiple sources of healthcare data, and less time on performing lengthy code development and testing cycles before the service was ready for production launch.

Yes

Yes

Georgiahealthinfo.gov provides healthcare consumers with detailed information on health care providers and services in the state.  The site enables citizens to research where to get the best medical and prescription services they can afford closest to them, and find out more about topics of interest.  Georgiahealthinfo.gov provides answers to the 7 commonly asked questions about health care: how, what, who, which, when, where and why: 

	How can I improve my or my families health, prevent illness and manage their conditions? 
	What is a particular condition or illness, what caused it and what can be done to prevent or treat it?
	Which health professionals and facilities provide services related to my needs and where are they located?
	Who provides the services that I need based on quality, cost and availability in my community? 
	When preparing for episodes of care, what additional services will I need to arrange for example home care, rehab therapy, medical equipment, etc.?
	Why is health information technology like electronic health records and e-Prescribing important and why is information privacy and security critical?

Benefits to State of Georgias healthcare consumers include increased visibility and transparency of healthcare costs and quality of care, increased visibility and transparency of prescription drug costs, better educated healthcare consumers in all demographics including Medicaid and Medicare populations, improved access to healthcare services in the consumers geography, and increased competition among Georgias healthcare providers.

The site content enables citizens to research where to get the best medical and prescription services in their communities. Georgiahealthinfo.gov provides:
	Information on diseases and conditions articles
	A way to search for pharmacies, hospitals and outpatient centers near citizens homes
	Health plan comparisons, so people can choose the right plan for themselves and their families
	Frequently asked questions about medical conditions
	Tips on healthy living for fitness, nutrition, aging and stress 
	Tools for health and wellness with videos, slide shows, a calorie calculator and a stress assessment, plus many more
	An online users guide to help consumers make the most out of the site
	Frequently asked questions
	A way that consumers can give the DCH feedback about the site that is staffed by a person dedicated to answering inquiries


The project team is working on the second release of the Web site which promises to provide even more valuable information for Georgias health consumers.  DCH leadership has commended the project team for its customer-friendly approach to the design and development of the Web site, as well as its foresight in developing easy-to-use information.  Georgiahealthinfo.gov is an excellent resource that will empower the states healthcare consumers to make wise health care decisions for many years to come.

The Web sites design, look and feel, and navigation were all consumer-conceived and tested.  From the very start, DCH focused on providing Georgia consumers with health care information in the way they wanted it.  In 2006, DCH conducted a series of community-based consumer forums in locations throughout Georgia to ensure consumer input into the design, content, and scope of the Web site.  DCH also worked with consumer advocate groups, such as Georgia Watch, to insure that the Web site design and development continued to meet consumer expectations and needs. Consumers wanted a user friendly, easy to navigate interactive Web site.

DCH has developed a formal evaluation plan to assess the site to insure that it continues to meet the needs of the health care consumer. The team has already conducted an onsite usability survey with Medicaid members and has launched a survey on the Web site for consumers to complete while using the Web site. The team also conducts daily reviews of the feedback that is sent through the Feedback and Contact Us sections of the Web site. 

Since the launch in December, the Web site and has garnered favorable feedback and several testimonials about the site.  We received one from a young mother whose 9 year son had appendicitis and was admitted to the hospital.  Her other children wanted to know about the condition and so the family gathered around the computer in the hospital waiting room and visited georgiahealthinfo.gov.  The family was able to review the treatment options, symptoms and other details about the surgery.  She was able to find pictures of the appendix to show the other children.  She reported that the web site was very easy to use and contained useful information.  She was also able to compare the quality score for the hospital and get an idea of how long her son would have to stay in the hospital.  She commented that having this information so readily available helped to ease her worries during this difficult time.

Other comments and feedback obtained about the Web site:
 Very well done.
The site looks great.
Impressive site.
The site looks WONDERFUL with very cool designs. I love the person that you can click on and find out more information about different parts of the body. Lots of useful information. Great job, Georgia team!
I love the web site!
This is a great site. Better than WebMD. I can use it to find out information for my son. I was able to locate his doctor immediately on the Web site.
This is a very helpful site.
The Web site is easy to navigate, fast, and fun!
I was able to find more information in 15 minutes of using georgiahealthinfo.gov than I had searching on the internet for hours on other Web sites.
There is lots of useful information for me and my child on this site. 
Excellent source for additional health information.

Citizens of Georgia who are in need of medical care are now able to help themselves make smarter healthcare decisions using GeorgiaHealthInfo.gov in ways they could not before the Web site launched in December 2008. Healthcare consumers can now, in one place, compare hospitals based on quality of care, relative costs, distance from their home, accreditations, length of stay for procedures, and other criteria using the innovative search and compare application.

Georgiahealthinfo.gov demonstrates the overall benefits of interoperable data exchange to healthcare consumers and providers. The goal of this project was to develop a transparency health information Web site that enables access to cost, quality, and service information across the continuum of care by including provider specific profile information, location, type of service, cost, consumer satisfaction and risk adjusted quality of care information on the Web site.  Accomplishing the goals of the Web site required interoperable data collection and exchange between various units within DCH and externally with data partners. 

The data is housed in a health data warehouse (HDW). The HDW is an operational database that stores the profile, cost, and quality data used by the Web site. Additionally, the technical solution uses nationally recognized standards for the technical architecture, security, and back-up systems. The technical solution is scalable and flexible enough to support the continuous evolution of georgiahealthinfo.gov.

Data Partners include;
1.	Georgia Department of Human Resources-Office of Regulatory Services (ORS)
2.	DCHs Office of Health Planning (DHP)
3.	Georgia Hospital Association (GHA) 
4.	Georgia Association of Health Plans (GAHP)-including 7 major commercial health plan providers
5.	Thomson Reuters (TR) through DCHs Decision Support Systems Office for Medicaid Claims Data
6.	Care Management Organizations
7.	Health Information Security and Privacy Collaborative 
8.	State Health Benefit Plan
9.	MayoClinic.com
10.	Centers for Medicare and Medicaid Services (CMS)
11.	Composite State Board of Medical Examiners
12.	Georgia Association of Primary Health Care 
13.	Georgia Department of Human Resources- Division of Aging Services
14.	Georgia Department of Human Resources- Division of Public Health
15.	National Association of Home Care
16.	Office of the State Long-Term Care Ombudsman
17.	State Bar of Georgia 
18.	U.S. Department of Health and Human Services

Identified partners and provider groups participated in the planning, building, testing, and implementation of the technical solution for data collection and exchange. 

All together, the data from the various sources comprise over 800,000 rows of data located in the health data warehouse used to support the features and functions of georgiahealthinfo.gov. 

Georgiahealthinfo.gov is the first Web site in the state of Georgia to accomplish the advanced levels of interoperable data collection, exchange, and display. Georgias healthcare consumers are able to research diseases and conditions, search for providers, compare quality, services, and costs of procedures and medications, compare quality rankings for health plans, and research the topic of privacy and security of health information in one Web site. 

The Web site establishes a very strong brand presence that is consumer-focused and engaging to drive a high usage level of the educational and searching components of the site. The Web site is designed to be very usable, leveraging commonly understood services such as Google Maps, interactive Flash components to help the consumer navigate to the healthcare education content most relevant to their needs.

Obstacle: Detailed Data Analysis Required 
Georgiahealthinfo.gov promotes data-driven decision-making for healthcare consumers, healthcare providers, state agencies, and other stakeholders. The centralization and integration of data from the various sources needed to create georgiahealthinfo.gov required the project team to obtain critical information quickly and accurately.  The data required detailed analysis and cross-matching before publication on the Web site.  Timeliness of receipt of acceptable sample and production data files was an issue and impacted the project schedule.   Data analysis and finalization progressed slowly. 
Resolution: To overcome the data analysis challenges, additional project staff was assigned to the project to assist with the data analysis and data finalization tasks.  The project team created a data dashboard report which was used to track progress as the data specifications, sample files and final production files were completed. 

Obstacle:  Compressed Project Schedule
The Web site project was included on the list of the states most visible projects with an extremely aggressive timeline.  As such it was included on the Governors list of critical projects.  The project team had just six months to deliver a prototype and full launch of the Web site.  In order to meet the project requirements, the team employed an Agile Project Management Methodology.  This included streamlined delivery management processes and, concurrent build, design and testing cycles.  This was the first time that the Agile methodology was ever used for a critical project in the State of Georgia.

As a result of the Agile methodology the members of georgiahealthinfo.gov project team became over-allocated and the project schedule would have been jeopardized if any member of the team was unable to complete their assigned tasks.  

Resolution: The Project team developed a project resource matrix which identified resource requirements needed through out the project.  The team was then able to leverage resources from other DCH departments to assist with the Web site. DCH executives also authorized the hiring of additional staff to work exclusively on the georgiahealthinfo.gov project. The project structure was amended to provide the necessary skill sets to effectively support the project and the Agile methodology. 
The project was delivered on schedule and within budget.  As a result of the successful of the Agile methodology on this project, the State of Georgia is planning to use this methodology for future projects.

Funding challenges to create georgiahealthinfo.gov included the need to cover the total costs of the project including staffing, implementation costs, and systems operations costs. The original, State allocated funds were not enough to cover the total costs of the project. It was necessary for DCH to seek additional funding to support the project. 

In June 2007, DCH applied for and was awarded a $3,929,855 Medicaid Transformation Grant from the Centers for Medicare and Medicaid (CMS) to assist with the implementation of georgiahealthinfo.gov. DCH was able to effectively demonstrate the impact georgiahealthinfo.gov would have on Medicaid beneficiaries and Georgias Medicaid program.  

Exceeded

Georgiahealthinfo.gov is changing the way Georgias citizens interact with their health care providers. Healthcare consumers have more access to information about providers than ever before, and are able to anticipate the costs and quality of the services they receive before actually receiving them. This promotes choice and independence.    Georgiahealthinfo.gov is a vehicle for increased visibility of costs, quality of care, and prescription drug pricing, and services to promote competition and improve the value of health care delivery.

The Web site is a model for other states who have already initiated the process of making health care information transparent. These states currently allow access to this information in distinct silos based on provider type. For instance, their consumers must access one URL for pharmacy information and another one for nursing home information. Georgiahealthinfo.gov provides access to information about numerous providers from a single URL. Furthermore, states will be able to follow our model for gathering consumer information to find out what information is important to them prior to developing the site. Other states have performed this process differently, by creating the site first, and then seeking consumer input. Georgiahealthinfo.gov also set the bar for states that have yet to develop a health information transparency website. DCH has already received inquires from other states about using georgiahealthinfo as a model as they embark on developing their own sites. 

The Web site has already established a global, worldwide presence by reaching consumers from other countries including Canada, Japan, Brazil, Germany, Taiwan, South Africa, China, India, the Netherlands, the United Kingdom, France, Mexico, and Sweden.  

The service has experienced a 1000% growth rate of users from the production launch date in December, generating over 1.4M hits in only its 3rd month in production.