behavioral health information network of arizona hit policy committee privacy and security tiger...

Behavioral Health Information Network of Arizona

HIT Policy Committee Privacy and Security Tiger Team

April 16, 2014

BHINAZ Private and Confidential

Who is Behavioral Health Information Network of Arizona (BHINAZ)?

Community Stakeholder Owned Official formed as a Limited Liability

Company (LLC) in Arizona – June 2013 Arizona statewide initiative – Behavioral

Health Providers, Public Agencies, Health Information Network of Arizona, and consumers


“To develop a statewide behavioral health information network that will improve quality, safety, create efficiencies, reduce health disparities, engage patients and families, improve public health and protect patient information.”

Mission


The Vision

PCP/Specialist

Payor

Laboratory

Pharmacy

Hospital/Health Systems

Patient

HINAZ

Rehab/Detox

Counseling Services

Crisis Services

Laboratory


Key Drivers

Health Care Reform / Patient Affordable Care Act (ACA)

Heath Information Technology for Economic & Clinical Health (HITECH) Act

Meaningful Use of Certified Electronic Health Records (EHR)

Integration between physical and behavioral health Health / Medical Home Models Outcome and Performance Based Contracting Arizona – Maricopa County Behavioral Health MCO

Contract


Public Availability and efficient

distribution of a large volume of patient data

Efficient exchange of standards-based data (CCD, IHE, etc.)

Gateway to the National Health Information Network

Arizona’s HINAZ

Public Versus Private HIEPrivate

* Coordination of care among the providers in a community – workflow improvement

* Connecting systems and users with different technical capabilities and workflow needs

* Access to the community patient chart

* Business intelligence service to optimize pay-for-performance and quality improvement

* Support for emerging integrated delivery networks


Complicated Federal Laws around Privacy - 42 CFR Part 2

We have a unique opportunity here in Arizona Maintains integrity of Behavioral Health system

in Arizona Provides a platform for emerging business

opportunities Allows behavioral health providers to

collectively own new technology

Why a Separate BH HIE Initiative?

HIE Benefits*

Improve patient safety by reducing medication and medical errors

increase efficiency by eliminating unnecessary paperwork and handling

provide caregivers with clinical decision support tools for more effective care and treatment

eliminate redundant or unnecessary testing

improve public health reporting and monitoring

engage healthcare consumers regarding their own personal health information

improve healthcare quality and outcomes

reduce health related costs

*Healthcare Information and Management Systems Society (HIMSS). “Evaluating a Potential HIE Opportunity ”,

HIMSS Guide to Participating in HIE. 2009 November.

Reduced staff time spent on handling lab

and radiology results

Reduced staff time spent on

clerical administration

and filing

Decreased dollars spent on redundant tests

Decreased cost of care for

chronic care patients

Reduced medication

errors

HIE Cost Savings*

*eHealthInitiative. “A Report Based on the Results of the eHealth Initiative’s 2009Sixth Annual Survey of Health Information Exchange”, Migrating Toward Meaningful Use:

The State of Health Information Exchange. 2009 July.


Behavioral Health Providers Public and Private External HIE’s Patients and Consumers Advocacy Groups Public Agencies Primary Care Laboratory Companies (LabCorp, Sonora Quest, etc.) SureScripts/RxHub Specialists Hospital Systems

The BHINAZ Network


Clinical Data Repository (On demand CCD/CCDA/CCR/HL7)

XCA/XCPD Gateway Services Master Patient Index Granular Consent Management Provider & Resource Directory Data Analytics & Reporting Orders & Medication

Reconciliation

BHINAZ HIE Solution

Secure, Web-Based Portal Access Support for Single Sign-on Security, Auditing & Network

Management Support Core Integrated

Healthcare Enterprise (IHE) Profiles

Individual Referral Management between disparate EHRs

Population Management Direct Exchange


Structured Data Elements Demographics, Labs,

Medications, Allergies, & Diagnosis

Clinical Documents Psychiatric Evaluations,

Assessments, Crisis & Safety Plans, Discharge/Transitions Plans, Individual Service/Recovery Plans, Progress Notes

Exchange & Clinical Information


Current Technology

BHINAZ HIE

NextGen HIE

(BASE)

Mirth Solutions(Expanded Solutions)

Topaz Information Solutions(NextGen

EHR)

ClearData (Hosting)


Enrollment and Care Team Assignment Integrated Care Plan Centralized Referral Management Patient Engagement & Communication Population Management Reporting and Data Analytics

Goals Around Care Integration- Care Coordination Platform


Consent Management


• Patient must OPT OUT• Otherwise, they are

Opted IN by defaultOpt Out

• Patient must OPT IN• Otherwise, they are

Opted OUT by defaultOpt In

Opt In vs. Opt Out

©BHINAZ Private and Confidential. Content may not be reused without permission.


The state of Arizona is an “Opt-Out” state. BHINAZ operates under an “Opt-in” model

requiring the client to specifically agree to share their protected data from one provider to another.

The BHINAZ model ensures that data protected under 42 CFR part 2 is not re-disclosed without proper consent.

All BHINAZ data is treated as Part 2 data.

Privacy & Consent


Consent is captured electronically at the point of care

Opt-in consent is valid for 365 days, then a new consent is collected

Patients can revoke at any time The consent is “all or nothing” per

agency/entity. We are not doing data segmentation at this time

BHINAZ Consent Facts


We require the additional consent of minors aged 12-17. Minors can revoke without parents.

Opt-in status reverts to “no consent on file” at the age of 18 or age 12. A new consent is required.

Break-the-Glass is allowed regardless of consent status for valid emergency situations.

BHINAZ Consent Facts


In Network

Participant visits Agency A They sign a consent to allow their Agency A

data to be shared/viewed by ALL BHINAZ organizations

Agency A Data now flows to all other BHINAZ organizations.

Agency A

SMI Clinic

Crisis Center

Detox Center

* Participant visits Detox Center

* They choose NOT to share their detox data

* No detox data can be viewed by any other agency on the network

Opt Out

Opt-In



Viewing Out of Network data

BHINAZ receives a feed of data from out-of-network HIE

Participant receives services at BHINAZ Agency A

A patient match is made with the out-of-network data feed

CCD documents and/or Alerts are routed directly to EHR

BHINAZ Agency A

Outside Network

BHINAZ

BHINAZ ID

Match

Stage 1

Starting

•Recognition of the need for health information exchange among multiple stakeholders in Arizona Behavioral Health Community.

Stage 2

Organizing

•Getting organized; defining shared vision, goals and objectives; identifying funding sources, setting up legal and governance structures.

Stage 3

Planning

•Transferring vision, goal and objectives to tactics and business plan; defining your needs and requirements; securing funding

Stage 4

Piloting

•Well Under way with implementation – technical, financial and legal.

Stage 5

Operating

•Fully operational health information organization; transmitting data that is being used by behavioral health stakeholder

Stage 6

Sustaining

•Fully operational health information organization; transmitting data that is being used by behavioral health stakeholder and have sustainable business model.

Stage 7

Innovating

•Sustainable and fully operational health information organization. Demonstration of expansion of organization to provide value-add services such as advanced analytics, quality reporting, clinical decision support, and closed-loop referral management.

HIE Development

BHINAZ

42% of HIE participants surveyed by eHealth Initiatives in 2013 have reached Stage 5 or Higher


Partnership with Health Information Network of Arizona (HINAz)

Partnership with Mercy Maricopa Integrated Care (MMIC)

Partnerships


Participating Agencies sign a Qualified Service Organization Agreement (QSOA)

Pay one-time connection fee Pay monthly subscription fee BHINAZ will work with organization IT for

technical connection and customization BHINAZ provides workflow analysis and

training

Getting Connected


Questions


ContactLaura Young, Executive Director

[email protected]

602-567-8356
