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Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th , 2012 December 5th , 2012 1 Paul Budilo, Executive Director Joel Chantraprabhavej, Project Manager

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Page 1: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

Page 2: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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Your Community HIE Partner

December 5th , 2012

Orange County Health Care Agency

Hospital Association of Southern California

Inglish HealthcareConsultants, LLC

Page 3: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Page 4: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Page 5: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

Page 6: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

6December 5th , 2012

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

Page 7: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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.

December 5th , 2012

OC Unites

Health Information Exchange

Page 8: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

Page 9: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Page 10: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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OC Unites HIE Summary

Phase 2 Participants: • CalOptima Regional Extension Center (COREC)• Community Clinics• LabCorp• Memorial Healthcare• Quest Diagnostic Labs

December 5th , 2012

Page 11: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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OC Unites

December 5th , 2012

Classic HIE

IHE Connectivity

Health Event Notification

(HENs)

Public Health Event Notification

Phase 1

Page 12: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Classic HIE

IHE ConnectivityHealth Event

Notification (HENs)

Public Health Event

Notification

Page 13: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Classic HIE

IHE ConnectivityHealth Event

Notification (HENs)

Public Health Event

Notification

Page 14: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Classic HIE

IHE ConnectivityHealth Event

Notification (HENs)

Public Health Event

Notification

Page 15: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Classic HIE

IHE ConnectivityHealth Event

Notification (HENs)

Public Health Event

Notification

Page 16: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

Page 17: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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OC Unites

December 5th , 2012

CORECMemorial

Health Systems

Quest DiagnosticsLabCorp

Phase 2

Page 18: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

CORECMemorial

Health Systems

Quest DiagnosticsLabCorp

Page 19: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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Broaden Participation

• Memorial Health Systems– Orange Coast & Saddleback Hospitals– Memorial Medical Group– Greater Newport Physicians

• Community Clinics– Altamed– UCI (clinics)

December 5th , 2012

CORECMemorial

Health Systems

Quest DiagnosticsLabCorp

Page 20: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

Page 21: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

Page 22: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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OCUnites Facilitates Data exchange

Page 23: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Page 24: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

Page 25: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Page 26: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Page 27: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Page 28: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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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

December 5th , 2012

Page 29: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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Questions

Page 30: Orange County Partnership Regional Health Information Organization Helping Providers Attain Meaningful Use Stage II December 5 th, 2012 1 Paul Budilo,

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Thank you for your time and interest in…..