health information exchangeconnected communities. connected healthcare

Health Information ExchangeConnected Communities. Connected Healthcare

San Luis Valley Health Information Technology Symposium, November 4, 2011 1

Phyllis AlbrittonExecutive Director

CORHIO

Nancye LahueTechnical DirectorBEACON Program

Today’s Session Roadmap

• About CORHIO & Colorado’s Vision for HIE • What is HIE? • Current HIE Activity in Colorado• Technical Infrastructure• Other HIT Initiatives at CORHIO

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

Patient Engagement

New Realities in Health Care

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

New Payment Models

New Care Delivery Models

Technology & Interoperability

Improved Quality of

Care & Value!

Care Coordination and Transitions: Reality Meets Opportunity

Hospital Readmission• 19.6% of Medicare patients were readmitted within 30 days of discharge• 1 in 5 older adults with complex chronic health conditions is readmitted within 30 days of hospital discharge• 34% were readmitted within 90 days of discharge• $17.4 billion cost to Medicare for unplanned hospital readmissions in 2004

Chronic Conditions• 75% of health care expenditures are for chronic illnesses• 16 physicians – providers an individual with chronic illness may see in a year

Medication Management• 66% of medication errors occur during transitions: admission, transfer or discharge

Source: National Transitions of Care Coalition: Improving Transitions of Care , Sept. 2010

The Consumer Perspective

About Their Providers• 88% want doctors to use EMRs. • 92% want doctors to exchange patient info with other doctors.

About ThemselvesFew adults have electronic access to records or doctors:Record access (14%). Schedule appointments (22%). Email doctors (21%). Refill prescriptions (34%).

• 73% would use a secure online healthcare communication solution.• 50% would consider switching doctors for the ability to communicate and complete

health care tasks online.

© 2011 Colorado Regional Health Information Organization (CORHIO) All Rights Reserved CORHIO Proprietary - Not For Redistribution

Sources: "A Call for Change: The Commonwealth Fund 2011 Survey of Public Views of The U.S. Health System." Intuit Health’s second annual Health Care Check-Up Survey.

About CORHIO

Who We Are

• A nonprofit, public-private partnership

• The state-designated entity for health information exchange (HIE) in Colorado

Vision

• Shared health information for all individuals in every Colorado community promoting the right care, at the right time andthe right place.

Goals for 2015•Health information exchange deployed in every community•85% of all providers are meaningful users of EHRs and health

information technology

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HIE Progress in Colorado

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

Northern Colorado

Steamboat(QHN)

Pueblo

CO Springs

Aspen(QHN)

Montrose(QHN)

Boulder

NW Denver

S. Metro Denver

San Luis Valley

Summit

Grand County

Durango(QHN)

Gunnison(QHN)

Delta(QHN)

Grand Junction(QHN) Live on CORHIO

Implementing CORHIO

QHN

Investigating HIE

LTPAC Challenge Grant Community

AuroraCentral Denver

Salida

Future

Convening

Participant Agreement

Connected to HIE (Live)

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Participating Providershttp://www.corhio.org/participating-providers.aspx

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

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Vision for HIE

• No Wrong Door for Patients

• Providers have access to a patient’s complete health history to provide high quality, cost effective treatment during the visit

• Providers have access to the information needed to evolve with health reform (e.g., ACOs)

• Patients are active participants in their healthcare

• Communities and policy makers have accesses to aggregated, de-identified health data to improve community and public health

04/09/2023 © 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

04/09/202310

What is HIE?

Health information exchange (HIE) is the ability to electronically exchange patient health information including:

…when it’s needed for patient care.

(all data shared safely & securely, meeting or exceeding HIPAA standards)

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

– Lab results

– Pathology results

– Radiology reports

– Transcribed notes

– Referrals & Consults

– Secure Messaging/Email

– ADTs

– Orders

– Patient care summaries, meds, allergies, Dx (CCD)

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“The typical primary care physician has 229 other physicians working in 117 practices with which care must be coordinated.”

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

Source: Annals of Medicine 2011

Is this your reality?

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41.9% to 70% of Medicare patients admitted to the hospital received services from an average of 10 or more physicians during their stay

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

Perhaps, this is Your Reality?

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How Does HIE Work?

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

The Clinician Perspective

Paper & phone based with some limited electronic connections

One electronic connection to the HIE to access/share patient information across the state

Public Health Initiatives

• CORHIO Support Services• Newborn Metabolic Screening Orders and

Results Delivery• Electronic Laboratory Reporting• Immunizations

© 2010 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

04/09/202315

Additional CORHIO HIT Initiatives

• CO-REC

• Mental & Behavioral Health Policy Workgroup

• Long Term Care

• Medicaid State HIT Plan– Meaningful Use/Medicaid EHR Incentive Program– SDAC

• CIVHC All Payer Claims Database

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

04/09/202316

A Roadmap for HIE in Colorado

Results Delivery(2011)

Referrals(2011/2012)

CCDs & Orders(2012)

Public Health (CDPHE) & QHN Integrations(2011/2012)

Support Data Analytics

Health Plan Participation / Funding

Support SDAC/RCCO Data for Analytics

Patient Tools(2012/2013)

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

Stakeholder Engagement

04/09/202317

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

“Providers in communities will become communities of providers”

- Dr. David Ehrenberger, CMO Avista Adventist Hospital

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Thank you!

Phyllis AlbrittonExecutive Director

palbritton@corhio.org 720-285-3200

© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights ReservedCORHIO Proprietary - Not For Redistribution

Governance and Stakeholder Trust

November 4, 2011 INHS Business CONFIDENTIAL

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Nancye LahueTechnical DirectorBEACON Program

San Luis Valley Health Information Technology Symposium, November 4, 2011 19

• Founded in 1994• 501(c)(3) Non-profit• Healthcare and Healthcare IT Focus• 1,100 employees across 4 business lines• 2010 Gross Revenue of $167 million• Nationally recognized leader in healthcare collaboration

• INHS is governed by our board made up of sponsoring hospitals and community physicians. – Customers govern their projects and IT direction independently.

November 4, 2011 INHS Business CONFIDENTIAL

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INHS Introduction

21November 4, 2011 INHS Business CONFIDENTIAL

Current Beacon Area

• 300+ IT Professionals• 750+ Physician EMR systems hosted• 38 Hospital HIT systems operated & hosted• Nationally recognized programs (Beacon

Community, VLER, SSA, CDC, 21 of 100 Most Wired Hospitals, 5 HIMSS Level 6 Hospitals)

November 4, 2011 INHS Business CONFIDENTIAL

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Information Resource Management (IRM)

• Owner / Operator of Healthcare Systems• 100% focused on Hospital HIT and Physician

EMR• 100+ healthcare entities already committed to

Beacon • Host and support (24 x 7 x 365)

November 4, 2011 INHS Business CONFIDENTIAL

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Key Differentiators

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Environment:

Collaboration based on community relationships and individual leaders

Technology:

Shared information systems with standardized data

Environment:

New business relationships with decision-making occurring outside the community

Technology:

Disparate information systems relying on health information exchange to conduct business

Environment:

Population-based approach to care delivery in a competitive health system

Technology:

Disparate information systems interacting with shared information hub that supports common metrics and care coordination

Shared Technology

Shared Technology Information Hub

Other Hubs

Journey Through the HIE

Health Information Exchange

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Primary Care Provider

EMR

Specialty CareEMR

HospitalInformation

System

Long Term Care EMR

PharmacyInformation

System

Primary Care Provider

EMR/Disease Management Application

Other HIEsPhase 1

Phase 2

Care Coordination Tools

Electronic Health Record

Quality Measures

data

data

data

data

data

data

data

BCIN HUB

• Level the playing field– Technology agnostic– Speed of delivery– Focused set of options– Incentive Alignment– Funding Strategy– ADDS VALUE

November 4, 2011 INHS Business CONFIDENTIAL

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Guiding Principals

• Warehousing Data demands trust – Secure Transfer of Data– Secure Storage of Data– Secure Access of Data

• Communication –– Strategic Planning– Collaboration– Advisory Committee

• Sustainability –– Adding value – Flexibility for different customers while maintaining standardization

November 4, 2011 INHS Business CONFIDENTIAL

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Importance of Trust

28November 4, 2011 INHS Business CONFIDENTIAL

Questions??

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Inland Northwest Health Services (INHS)Contact: Nancye Lahue

lahuen@inhs.org(509) 868-8462

November 4, 2011 INHS Business CONFIDENTIAL

Thank you