SHIN-NY Statewide Patient Record Lookup

WebinarJune 2015

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Agenda

• Webinar Objectives• SHIN-NY Overview• The SHIN-NY Today • SHIN-NY Capabilities: How it is Evolving• Statewide Patient Record Lookup: Timing and

Availability• Q&A

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Webinar Objectives

• Increase awareness of Statewide Health Information Network of New York (SHIN-NY) capabilities to healthcare providers

• Inform healthcare providers on ways to access and share patient records through the SHIN-NY

• Discuss new SHIN-NY capabilities for healthcare providers in 2015

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SHIN-NY Overview

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The SHIN-NY in a Nutshell

• A secure network for sharing electronic clinical records in New York State since 2008• With patient consent, electronic health records can be accessed and exchanged securely

between healthcare providers• Patients decide which providers can access or see their records• Having access to clinical records through this network helps providers better manage patient

care• In sum, the SHIN-NY can help reduce healthcare costs, improve healthcare coordination,

and increase the quality of care for patients in New York State

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Easy/Instant exchange of clinical records

AllergiesDrug interactions

Co-morbiditiesVital statistics and demographics

Recent lab testsRadiology reports

Better collaborationReduced hospital re-admissionsAvoidance of drug interactions

Reduction of duplicate tests

How Can Data Exchange Improve Patient Care ?

Accessible Clinical Records Access to Medical Histories Improved Patient Safety and Care

The SHIN-NY TodayHow Does it Work?

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Management of the SHIN-NY

• State and Federally funded• New York State Department of Health oversees operations,

policy, and direction by ensuring:Secure technical infrastructureSet of regulations to govern the networkPolicies which allow flow of information while safeguarding all patients’

information and right to privacy• Key healthcare providers give input through a statewide

collaboration process• Comprised of 9 regional hubs (RHIOs) certified by the

Department of Health

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SHIN-NY StructureA “Network of Networks”

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RHIOs:Community Networks That Form the SHIN-NY

• Non-profit, Regional Health Information Exchanges• Originally established by local healthcare stakeholder

communities to serve their health IT needs • Key Services:

Aggregate electronic health records from participating healthcare providers

Provide access to network via EHRs and/or portalsAllow providers to search for and access electronic health information

from other providersMakes available patient contributed data to patient’s other providersDeliver notifications (alerts) and secure message exchange (DIRECT)Each RHIO may have additional custom services such as analytics

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RHIOClinicians

Types of Providers Connecting to a RHIO Today

KEY= Transmission of

Clinical Patient Information

Home Care AgencyCommunity Hospital

Medical Center

Reference Laboratory

Nursing Home

Primary Doctor’s Office

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Evolution of the SHIN-NY

2006 2007 2008 2009 2010 2011 2012 2013

HITECH Signed

MU Stage 1 Released

MU Stage 2 Released

2014

NYeC Established

SHIN-NY Standardized Basic Services Across RHIOs Defined

And In Place

NY

US

SHIN-NY Launched

2015

Statewide Patient Record Look-Up

Available

RHIOs establish community HIEs

Each RHIO offers its own suite of services:Alerts, clinical queries, secure messaging, etc.

RHIOs Certified by DOH

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Services Offered by All RHIOs Today

Services Definition

Patient Record Lookup

Search for existing patient records within the local RHIO

Secure Messaging Send (push) peer-to-peer messages between two trusted providers

Notifications (Alerts)

Allow users to establish subscriptions to pre-defined events (currently related to admission and discharge) and receive notifications when those events occur

Lab Results Delivery

Deliver diagnostic results and reports back to ordering providers and others designated to receive results

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Examples of Patient Data Available Through RHIOs

Medications

Encounters

Demographics

Lab Reports

Diagnoses

Immunizations

Dental records

Admissions/Discharges

Histories

Allergies

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Support Services RHIOs Provide to Participants

• Legal and information sharing agreements• Ongoing monitoring and audits• Marketing and recruitment• Support adoption and usage• Participant/authorized user training• User support (help desk and online service support)• Governance

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Nine RHIO Organizations Across New York State

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SHIN-NY Participation by Healthcare Provider Type

*

Patient Consent by % of Population

Increasing Value of the SHIN-NY

More Patients Consent

More Providers Connect

More Providers Contribute Records

Increased Use/Sharing of Records

Improved Care/Lower

CostsVALUE

Importance of the SHIN-NY TodayBetter Care• Immunization reporting• ER admissions, discharges, transfer reports available in

the SHIN-NY result in:• 30% fewer admissions from the emergency department• 57% reduction in patient readmissions within 30 days

after hospital discharge• Standards for exchanging information within “Health

Homes”

Greater Efficiency• Less duplicate/unnecessary tests, procedures and

paperwork• 27% fewer repeat images within 90 days of first imaging

procedure• $52MM in potential annual cost savings across NY State

• Value-based payments and collaborative models

• Meeting DSRIP metrics

• PPS requirements for standardized data sharing

Why The SHIN-NY is anEssential Tool for Providers

SHIN-NY CapabilitiesHow the SHIN-NY is Evolving

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The Next Step….

Interoperability:RHIO participants will have access to all

SHIN-NY electronic records

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SHIN-NY Will Interconnect All RHIOs

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• Participants will continue to:Send/receive direct messagesDeliver diagnostic results/reportsReceive Notifications and Alerts on a specific patientProvide data for public health reportingAccess immunization data and reporting Track patient consent to access records Rely on identity management and security

• …AND once all RHIOs are interconnected, providers can : Look up a patient’s medical records, hospital admissions and

discharges, lab results, and radiology reports from across the state

What Does this Mean for Providers?

What Will Be Different?

Patient Record Lookup function will now be

Statewide26

Statewide Patient Record Lookup

• How does Statewide Patient Record Lookup work?o Same service used to search for patient records within a RHIOo Acts like a secure search engine

• Will the user experience be different?o sPRL makes data from across the state available to all RHIOso However, a provider’s experience may differ depending on the

participant’s RHIO, EHR, or portal Some may see no change in their clinical viewer, but will see more more

documents available Some may need to click some additional tabs Some clinical viewers may look a little different

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Example of a Patient Search

•Potential reasons a patient’s record would not show up:Patient received treatment from provider that is not a RHIO participant The patient did not give consent to the treating provider The patient demographic data may vary too much across RHIOs to

establish a match The system may have “timed out,” meaning it was taking a very long

time to find the records•Contact your local RHIO if you have a problem with using the SHIN-NY query (e.g. records do not appear that you are expecting to see)

Why Might Some Patient Records Not Show Up in a Search?

What Does sPRL Mean for Providers?

• Up-to-date clinical records available from anywhere in state regardless of which RHIO you participate in

• One connection gives broader access• Same service available across the state

Records from other regions may be formatted differently• No cost for SHIN-NY basic services or participating in a RHIO

RHIO may offer supplemental or custom services for a feeMay be a one-time cost to connect if custom interfaces required for

EHR Limited funding available for Medicaid Eligible Providers needing

interface connections

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When Will Statewide Patient Record Lookup be Available?

• Onboarding of RHIOs to the statewide hub begins July 7th

through end September• RHIOs come on board in groups of three

Onboarding process approximately one month per group Time to make sure all connections working effectivelyRecords accessible at the conclusion of each group’s onboarding

• As each RHIO group comes onboard, their data become available to users in other RHIOs

• All RHIOs capable of statewide patient record look-up by early October

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Schedule for Onboarding

• Group 1: Records available week of 8/4o HealthlinkNYo HealtheConnectionso Hixny

• Group 2: Records available week of 8/25o Bronx RHIOo Healthixo Interboro RHIO

• Group 3: Records available week of 9/15o Rochester RHIOo HEALTHeLINKo e-Health Network of Long Island

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Questions and Answers

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