Albuquerque Forum: New Mexicos Health Information Exchange Thomas - - PowerPoint PPT Presentation

Albuquerque Forum: New Mexico’s Health Information Exchange

Thomas D. East, Ph.D., CEO

NMHA 69th Annual Meeting 9/25/14 11:20-12:20

New Mexico HIE

Hospital

Clinician Office

Diagnostic Tests & Imaging Emergency Department

Gathers and associates records with the right patient

Hospital

Clinician Office

HL7

Integrated Clinical Record

• Clinical Portal with results Viewer
• Clinical Data Repository
• Enterprise Master Patient Index
• Direct Exchange
• eHealth Exchange
• Clinical Alerts/Notifications
• Public Health Reporting
• Syndromic Surveillance
• Privacy and Consent Management /Auditing

What the NMHIC HIE offers

Core HIE data

• Demographics
• Allergies
• Medications
• Immunizations
• Insurance
• Procedures
• Problem List
• Encounters (Visits) & Diagnoses

Note: Data available varies by organization

• Lab Data
• Radiology Data
• Clinical Notes

NMHIC – HIE Status

• Core HIE will be live by 9/30/14

– History Backload from Jan. 2013 forward

• >140M Messages Loaded- Remainder due by 9/17
• Over 1 Million patients loaded- All of Centennial Care
• Seven data providers/organizations (27 feeds)

– Clinical Portal will have Core Functionality

• Direct secure messaging will be live before 12/2014
• eHealth Exchange gateway will be live First Quarter 2015 or

earlier

2426 52% 2204 48%

NM Hospital Beds Providing Data

Data Providers Not Providing Data

NMHIC - Outreach Update

14 Signed Agreements

• Hospitals

– LifePoint Hospital- Memorial Medical Center – LifePoint Hospital- Los Alamos Medical Center – Gila Regional Medical Center – Nor Lea General Hospital – San Juan Regional Medical Center – Sierra Vista Hospital – Holy Cross Hospital- Taos – Union County Hospital

• Provider Practices

– ABQ Health Partners – NM Heart Institute – NM Orthopedics Association – NM Primary Care Association – Taos Clinic for Children and Youth

• Diagnostic

– X Ray Associates of NM

757 16%

3873 84%

NM Hospital Beds Signed to Use NMHIC

Signed Not Signed

>1250 Providers

Looking at the Patient’s Chart

Complete Medical History at a Glance

Notifications

• Accommodating Meaningful Use requirements to qualify for reimbursements

and avoid significant penalties.

• Medication reconciliation, including the ability to automate this function that

is now performed by one or more pharmacists.

• Electronic submission of all reportable conditions and vital statistics.
• Enhanced workflow processes and reduced courier costs.
• Strengthened relations with physicians resulting in increased referrals and

laboratory revenues while improving clinical decision-making and patient care with more timely information.

• Reduced administrative burden for collecting, managing and distributing

medical records.

• Prevention of unnecessary 30-day readmissions.
• Easier admission process.
• Increased efficiency and decision-making by providing more complete

patient information at the point of care.

Hospital HIE Benefits

The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781

Hospital HIE Benefits… continued

• Enabling hospitals to take a team approach with other providers outside of

their systems to provide coordination of care.

• Enabling more streamlined physician referral processes and care transition.
• Enhanced relationships between patients and families by improving

communications and the sharing of data.

• Enabling relationships between hospitals and other healthcare providers to

improve the quality and efficiency of healthcare and improve patient safety through use of data analytics and development of standards of care.

• Prevention of unnecessary re-hospitalizations by providing discharge plans to

care settings across the spectrum of healthcare delivery that will enable effective follow-up treatment plans.

• Reduced adverse drug events resulting from drug interactions and allergies by

providing improved access to a more complete medication and allergy history.

• Providing more complete patient data from a multitude of settings and

emergency departments.

The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781

Hospital HIE Benefits… continued

The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781

• Utilization of complete health information at the point of care from a variety
• f facilities such as lab orders, imaging, and prescriptions.
• Providing Master Patient Index (MPI) functionality to enable health systems

to transmit information electronically from clinics to hospitals.

• Serving as a cross-check for data integrity to the individual facilities.
• Acting as the universal portal for any entity seeking electronic access and

sharing of ePHI.

• Addressing ongoing maintenance, support, and security concerns of portal

functionalities.

• Enabling the identification of fraudulent practices by providers and

consumers.

• Reduced administrative burden for collecting, managing, and

distributing medical records.

• Reduction in chart pulls, leading to a more efficient workflow.
• Aggregation of healthcare data at the point of care, improving

the efficiency and quality of care delivery, increasing patient safety by reducing the opportunity for medical errors, and helping to eliminate waste related to unnecessary or duplicative tests.

• Easier pre-authorization.
• Ability to access patient data outside the clinical setting.
• Faster access to lab results and radiology reports.
• Streamlined access to patient histories and discharge

summaries.

Physician HIE Benefits

The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781

• Community-wide and statewide connectivity.
• Automated physician referral and consult processes.
• Reduced administrative and overhead costs.
• HIPAA-compliant data-sharing with other healthcare providers.
• Local connectivity for rural providers, enabling delivery of data from

referring hospitals to meet rural physicians’ immediate needs.

• Business and clinical information exchange between HIOs and key

trading partners like health plans, referral networks and public agencies in a less costly, complex or risky way.

• Qualification for Meaningful Use incentive payments, which require

electronic exchange of health information.

• Relationships with ACOs, which involve sharing data to better

coordinate patient care and improve outcomes.

Physician HIE Benefits… continued

The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781

Estimated Annual HIE Benefit for NM

The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 Gartner Study done for Arkansas extrapolated for New Mexico- Appendix D http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781

Value that is Financial and Measurable Prevent Unnecessary 30-day Readmissions $7,810,205 Reduce avoidable Adverse Drug Events (ADEs) –Inpatient $2,073,297 Avoid Duplicative Testing and Imaging $13,619,776 Avoid Duplicative Consults $1,169,140 Reduce Length and Complexity of Stays $2,450,260 Reduced burden for collecting, managing and distributing medical records (providers) $3,141,360 Reduced burden for collecting, managing and distributing medical records (hospitals) $4,751,635 Total $35,015,673 Value that has Multiple Dependencies or is Difficult to Measure Reduction of inpatient costs by allowing stays in less expensive settings $2,771,787 Increase in patient load per provider $6,096,675 Increase in Patient Empowerment (Inpatient) $1,427,891 Increase in Patient Empowerment (Emergency Department) $749,943 Total $11,046,296

Overall Total $46,061,969

Estimated Annual HIE Benefit for NM Healthcare Providers

The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 Gartner Study done for Arkansas extrapolated for New Mexico- Appendix D http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781

Hospitals $6,448,676 (14%) Healthcare $4,145,577 (9%) Professionals

NM HIE Can assist with: Stage 2 Eligible Hospital and Critical Access Hospital (CAH) Meaningful Use Core and Menu Objectives

(11) The eligible hospital or CAH who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication

reconciliation.

(12) The eligible hospital or CAH who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary

care record for each transition of care or referral. (Direct, SOAP or eHealth Exchange)

(14) Capability to submit electronic reportable laboratory results to public health

agencies, where except where prohibited, and in accordance with applicable law and

practice. (15) Capability to submit electronic syndromic surveillance data to public health

agencies, except where prohibited, and in accordance with applicable law and practice.

NM HIE Can assist with: Stage 2 Eligible Hospital and Critical Access Hospital (CAH) Meaningful Use Core and Menu Objectives

.

Potential EHR Meaningful Use Penalties for Albuquerque Hospitals 2015 $1,119,400 2016 $2,238,900 2017 $3,358,200

HIE

Hospitals Providers

How to contact us

Email: info@nmhic.org

Call: (505) 938-9909 Visit: http://www.lcfresearch.org/nmhic-hie