orange county partnership regional health information organization helping providers attain...
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Orange County Partnership Regional Health Information Organization
Helping Providers Attain Meaningful Use Stage II
December 5th , 2012
December 5th , 2012
Paul Budilo, Executive Director
Joel Chantraprabhavej, Project Manager
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Your Community HIE Partner
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Orange County Health Care Agency
Hospital Association of Southern California
Inglish HealthcareConsultants, LLC
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Your Community HIE Partner
• Community collaboration of health care providers whose mission is to facilitate health information exchange in Orange County
• Formed in 2006 • Launched Emergency Room data sharing initiative in 2009• In 2011 recipient of California Health & Human Services
(CHHS) HIE Expansion Grant to meet the unique needs of Orange County
• In 2012 recipient of California Health & Human Services (CHHS) HIE Infrastructure Grant to increase participation and functionality of the HIE
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Governance Structure
• Executive Committee– Elected by the Board / Leadership Group
• Board of Directors– Governing body– Voting authority – No less than 7 members and no more than 15 members– Representative of constituents
• Membership– Interested constituents– No voting authority
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Governance Structure
• Executive Committee– Chair – Bill Farry– Vice Chair – Russ Inglish– Secretary/Treasurer – Nova Stewart– Privacy Officer – Eileen Moscaritolo– Immediate Past Chair – Nova Stewart– Member at Large – David Souleles– Staff – Paul Budilo, Executive Director
• Board of Directors– Hospital – Jim Murry (UCI); Bill Russell (St Joseph’s Health System)– Hospital Association of Southern California – Julie Puentes– Clinician – Bill Farry (Monarch HealthCare); Scott Joslyn (Memorial Foundation)– Orange County Health Care Agency – David Souleles– Orange County Medical Association – Dr. Abhay Parikh, MD– Community – Russ Inglish (Inglish Consulting); Eileen Moscaritolo (COREC); Vacant (1)– Health Plan – Future– Consumer/Patient – Future– Ancillary - FutureDecember 5th , 2012
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Pharmacy
Radiology
HospitalLaboratory
Patient - PHR
Payers
Providers
Orange County Partnership Regional Health Information Exchange
Personal Health Record
www.ocprhio.org
(Other HIEs)
Health Information Exchange
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Overall Objective – insure that hospitals and physician groups who see a significant number of the patients in the county, are able to participate in improved coordination of care through HIE.
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OC Unites
Health Information Exchange
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OC Unites HIE Summary
• Recognize that large providers of the County have already invested in their own HIE technology
— Leverage community investment— Collaborate vs. compete— Identify value to this constituents (i.e., immediate value, future
positioning - meaningful use phase II / phase III)
• Offer classic HIE services— For those who have not yet made the investment into IT HIE
infrastructure— Log onto the OCPRHIO Portal, search for patient; print out Continuity
of Care Document (CCD)December 5th , 2012
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OC Unites HIE Summary
Phase 1 Participants:
• Integrated HealthCare Holdings, Inc. (IHHI) – Chapman Medical Center– Coastal Communities Hospital– Western Medical Center Anaheim– Western Medical Center – Santa Ana
• Monarch Healthcare• St. Josephs Health Systems
– St Joseph’s Hospital– St Jude Hospital– Mission Hospital
• UCI Medical Center• Mirth Corporation
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OC Unites HIE Summary
Phase 2 Participants: • CalOptima Regional Extension Center (COREC)• Community Clinics• LabCorp• Memorial Healthcare• Quest Diagnostic Labs
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OC Unites
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Classic HIE
IHE Connectivity
Health Event Notification
(HENs)
Public Health Event Notification
Phase 1
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Classic HIE
• Provide ability to entities to access and exchange clinical data• Data aggregation of key data sources at participant level• Access through web portal and/or traditional interfaces• Value: Enables fundamental data sharing by individual
participation at the community level
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Classic HIE
IHE ConnectivityHealth Event
Notification (HENs)
Public Health Event
Notification
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IHE Connectivity
• Leverage connectivity standards to exchange clinical data Integrating Healthcare Enterprise (IHE) protocols
• Creation and exchange of a “community” Continuity of Care Document (CCD) transaction
• POS – Clinical Delivery location accessibility to data• Value: Meaningful Use compliance; repeatable platform for
community with like systems• Leverages entity investment in disparate technology
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Classic HIE
IHE ConnectivityHealth Event
Notification (HENs)
Public Health Event
Notification
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Health Event Notification
• Leverage connectivity standards to exchange clinical data based on health events
• Expand accessibility beyond point of care to those managing care
• Proactive data notification based on care event(s)• Value: Innovative technologies; broad value to participants
within the health care delivery system
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Classic HIE
IHE ConnectivityHealth Event
Notification (HENs)
Public Health Event
Notification
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Public Health Event Notification
• Use business rules to generate message to public health of selected notifiable events.
• Leverage HIE enabled data to support automated notifications• Value: Improve patient safety, preventative health services
and public health surveillance
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Classic HIE
IHE ConnectivityHealth Event
Notification (HENs)
Public Health Event
Notification
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Phase 1 Status
• Go-Live: 4th Quarter of 2012• Includes:
– approximately 30% of the hospitals in Orange County– 10% of patient population in Orange County– 30% of physicians
• Use business rules to generate message to public health of selected notifiable events. – Initially targeting immunization
• Leverage HIE enabled data to support automated notifications• Value: Improve patient safety, preventative health services and
public health surveillanceDecember 5th , 2012
Classic HIE
IHE Connectivity
Health Event Notification
(HENs)
Public Health Event Notification
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OC Unites
December 5th , 2012
CORECMemorial
Health Systems
Quest DiagnosticsLabCorp
Phase 2
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Phase 2 Goals
• Broaden Participation– Onboard additional entities similar to Phase 1 participants
• Medical Groups & IPAs• Hospitals
• Increase Functionality– Interfaces to additional EMR Systems– Imaging report– Structured lab Results– Prescription data– Immunization Registry
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CORECMemorial
Health Systems
Quest DiagnosticsLabCorp
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Broaden Participation
• Memorial Health Systems– Orange Coast & Saddleback Hospitals– Memorial Medical Group– Greater Newport Physicians
• Community Clinics– Altamed– UCI (clinics)
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CORECMemorial
Health Systems
Quest DiagnosticsLabCorp
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Increase Functionality
• COREC– Top (5)+ EMRs
• Allscripts• MedAZ• NextGen• Office Ally• Sage• eCW
– Stakeholders– Common marketing events
• Lab Data– Quest Diagnostics & LabCorp
• Results only; Lab ordering Q2-2013
• Imaging Data – RadNet– Images and report links
• Prescription Data - Surescripts
December 5th , 2012
CORECMemorial
Health Systems
Quest DiagnosticsLabCorp
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Orange County Statistics
• 3,055,745 patients (pop.)• 9,240 doctors• 59 Primary Care Center Location• 590 Pharmacies• 32 Hospitals• 74 Long Term Care Facilities• 110 Home Health Agencies and Clinics• Numerous Laboratories• 39 Specialty Care Clinics (Dialysis, Surgery, Infusion, Endoscopy, etc.)• Numerous Radiology Centers• Numerous Physical Therapy CentersDecember 5th , 2012
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OCUnites Facilitates Data exchange
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OC Unites HIE Benefits• Provides interoperability between otherwise unaffiliated systems• Providers require only one connection to obtain data from
multiple providers • Improves patient care by obtaining close-to real time information
from other providers during the diagnosis and treatment process• Improves quality of care by obtain patient information faster and
by eliminating testing duplication • Reduces overall cost of patient care
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Meaningful Use Stage II• On Sep 24th, 2012 CMS published final rules for the Stage II MU criteria• EHR Driven (17) Core Measures
1. Medication Orders1. Use Computerized provider order entry for Meds/labs/rads
2. ePrescribing3. Record Demographics4. Record Vital Signs5. Record Smoking Status6. Clinical Decision Support7. Patient Electronic Access8. Clinical Summaries9. Protected Electronic Health Information10. Clinical Lab Test Results11. Patient List12. Patient Reminder/Preventive Care13. Patient Specific Education Resources14. Medication Reconciliation15. Summary of Care16. Immunization Registry17. Secure Electronic Messaging to communicate w/Patients (new requirement)December 5th , 2012
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Meaningful Use Stage II• EHR Driven (6) Menu Measures (select only 3 of 6)
1. Capability to submit electronic syndromic surveillance data to public health agencies (new requirement)
2. Record electronic notes in patient records (new requirement)
3. Imaging results consisting of the image itself and any explanation or other accompanying information (new requirement)
4. Record patient family health history as structured data (new requirement)
5. Capability to identify and report cancer cases to a public health central cancer registry, except where prohibited (new requirement)
6. Capability to identify and report specific cases to a specialized registry (other than a cancer registry) (new requirement)
• Physicians must meet 2-years of reporting criteria on MU-Stage I before advancing to Stage II
• Meaningful Use Stage II Reporting Period Begins on Jan 1st, 2014
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Meaningful Use Stage II• Core objectives are Interoperability and Health Information
Exchange– Exchange Continuity of Care (CCD)
• Uniformly formatted common dataset required• Provide CCD for > 50% of transitions of care and referrals with 10% sent
electronically and at least one sent to a recipient with a different EHR Vendor or successfully testing with CMS’s test HER.
– Lab Results• LabCorp• Quest Diagnostics
– Quality Reporting• Demographic Reporting
– Immunization• California Immunization (CAIR) Registry
– Public Health Notice
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Meaningful Use Stage II• What is a CCD?
– Comprehensive view of a patient’s clinical information including medical history and Conditions• Typical Uses – patient transfers, referrals and ED visits
– Standard dataset used to seamlessly move clinical information from one health organization to another• Advance Directives• Alerts• Encouunters• Family History• Functional Status• Immunizations• Lab Results• Medical Equipment• Medications• Payers• Plan of Care• Problems List• Procedures• Purpose• Results• Social History• Vital Signs
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How do I participate?
• OCPRHIO is beginning to work with – Allscripts/MedAZ/NextGen/OfficeAlly/Sage– Affordable Monthly costs
• Startup Costs to connect to OCUnites– Currently paid by the above 5 EHR systems via COREC partnering agreement
• HIE connectivity for solo partners– $500 budgeted per provider/facility via service partner assistance
– Next Steps• Go to the www.OCPRHIO.org website• Email [email protected]
• Signup to participate
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Questions
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Thank you for your time and interest in…..