Topics To Be Covered HealthInfoNet Overview and Exchange Updates - - PDF document

HealthInfoNet: A Data Platform for Health Reform in a Changing Medical Landscape

Maine Medical Association 22nd Annual Practice Education Seminar July 24, 2013

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Topics To Be Covered

• HealthInfoNet Overview and Exchange Updates
• HealthInfoNet Value-Added Activities
• Introduction to the HealthInfoNet Data

Warehouse

• HealthInfoNet Data Use and Release Policy
• State Innovation Model Grant

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What is HealthInfoNet?

• HealthInfoNet operates Maine’s statewide

health information exchange (HIE), a secure, standardized electronic system where providers can share important patient health information.

• The use of this system:

– Saves time and reduces paperwork. – Facilitates more informed treatment decision-making. – Leads to improved care coordination, higher quality of care, and better health outcomes.

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HealthInfoNet History

• 2004 - Maine Health Access Foundation, Maine CDC, Maine Quality

Forum and Maine Health Information Center study need and support for an exchange in Maine.

• 2005 - Stakeholders begin planning and development.
• 2006 - HealthInfoNet incorporated with Devore Culver, formally Chief

Information Officer of Eastern Maine Healthcare, as Executive Director.

• 2008 - Demonstration phase begins.

– Participants included MaineHealth, Central Maine Healthcare, Eastern Maine Healthcare, Maine General Health, Martin’s Point Health Care, Franklin Memorial Hospital and the Maine CDC.

• 2010 - Demonstration phase ends and statewide roll-out begins.

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How Does the HIE Work?

• HealthInfoNet’s system combines information from

separate health care sites to create a single electronic patient health record

• Patient health information is automatically uploaded

from a provider’s electronic medical record system

• The information is standardized and aggregated

across care sites

• Clinicians can seamlessly access their patient’s

information in HealthInfoNet from within their EMR

• HealthInfoNet automates reporting of certain illnesses

and conditions like Lyme disease or food poisoning, to public health experts at the Maine CDC

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HIE Connections

Hospitals, FQHCs, Ambulatory

• 34 of 38 hospitals connected
• All Maine Hospitals under

Contract to HIN

• 15 FQHCs
• 376 Ambulatory sites

including physician practices behavioral health and long term care

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Data Categories Managed in HIN Today

• Patient Identifier and Demographics, including insurer
• Encounter History
• Laboratory and Microbiology Results
• Radiology Reports
• Adverse Reactions/Allergies
• Prescription Medication History
• Diagnosis/Conditions/Problems (primary and secondary)
• Immunizations
• Vital Signs
• Dictated/Transcribed Documents
• Continuity of Care Documents (CCD)

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What do providers say about using HealthInfoNet?

• It’s more efficient. Automated sharing of information,

less paperwork, reduced time to access clinical information at the point of care, fewer repeat tests and procedures.

• Results in more Informed treatment decisions. A more

complete and up-to-date patient medical record, including information from all a patient's participating health care providers.

• Leads to healthier patients. Fewer medical errors,

improved patient safety, improved continuity of care, and better patient outcomes.

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HealthInfoNet’s HIE Operating Statistics As of June 30, 2013

• 1,235,022 individuals have a HealthInfoNet record

(86% of Maine’s resident population)

• 13,594 individuals have opted out (1%)
• 1,527 Maine clinicians and support staff have active

HealthInfoNet user accounts

• 3,109,365 inbound messages are received by

HealthInfoNet each week

• The HealthInfoNet Central Data Repository (CDR) is

1.454 TB in size and is growing at 3 GB a day

% of Patient “Cross Over” Between Corporately Unaligned Provider Organizations As of 04/31/2013

Current Totals Through June 30th, 2013 CurrentSite PercentageCrossover Bridgton Hospital 53.45% Calais Regional Hospital 60.43% Cary Medical Center 69.66% Central Maine Medical Center 62.06% Down East Community Hospital 61.83% Eastern Maine Health Systems (EMHS) 62.48% Engel Place 100.00% Franklin Memorial Hospital 56.32% Health Access Network 75.96% Henrietta D. Goodall Hospital 50.86% Houlton Regional Hospital 54.73% Katahdin Valley Health Center 0.00% Laurel Court 100.00% Maine Coast Memorial Hospital 60.93% Maine General Health 52.42% Maine Medical Center 69.74% MaineHealth 79.23% Martin's Point Health Care 56.03% Max Health Maine 74.07% Mayo Regional Hospital 76.07% Mercy Hospital 77.82% Miles Memorial Hospital 66.00% Millinocket Regional Hospital 79.11% Mount Desert Island Hospital 62.88% Parkview Adventist Medical Center 71.72% Penobscot Community Health Center 85.94% Penobscot Valley Hospital 91.19% Redington-Fairview General Hospital 80.67% Ross Manor 89.51% Rumford Hospital 70.31% Sebasticook Family Doctors 88.28% SJH - Ambulatory Care, Inc 98.61% Southern Maine Medical Center 59.80% St Marys Regional Medical Center 79.21%

• St. Andrews Hospital

66.59%

• St. Joseph Hospital

92.12% Stephens Memorial Hospital 74.30% Stillwater Health Care 83.50% Sylvia Ross Manor 91.66% Wilson Stream Family Practice 91.80% Average Crossover 71.93%

Core Exchange Services

• Interface Development, Management and

Support

• Data Mapping and Standardization
• Patient Centered Portal Access and Data

Download Functionality

• Real Time Event Notification

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HealthInfoNet Value Added Services

• Notifications
• Meaningful Use Stage 1 & 2 Connection to Public

Health for Laboratory Reporting, Syndromic Surveillance, Immunization Reporting

• ACO/Value-Based Purchasing Data Source
• Vendor Neutral Architecture Image Repository
• Enterprise Master Patient Index Management
• Interoperable Secure Messaging
• Data Warehouse and Reporting Tools

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Notifications

• Real Time e-Mail Notifications Based of Key

Registration and Clinical Results Events

• Current Notifications for:
• Admission to Hospital
• Discharge from Hospital
• Admission to Emergency Department
• Discharge from Emergency Department
• Notifications in Development:
• Lab Result Received
• Radiology Result Received
• Discharge from Skilled Nursing Facility (SNF)

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Meaningful Use Stage 1 & 2

• Standardized, Structured Electronic Lab Result

Reporting to Maine CDC for Positive Values Associated with Mandated Disease Reporting

• Adult Immunization Reporting to Maine’s

IMMPACT II Immunization Registry

• Syndromic Surveillance Reporting to Maine CDC

(under development)

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ACO/Value-Based Purchasing Data Supplier

• Data Source for NNEACC (ADT & Lab) for

MaineHealth & Bangor Beacon LLC ACO Patients

• Monthly ACO EMPI File for Bangor Beacon LLC

Vendor Neutral Architecture Image Repository

• Statewide Repository for Managing Digital Archive

Images (Radiology, Cardiology, etc.)

• Reduced Total Cost of Operation for Image

Management Through Statewide “Group Purchase” Strategy

• Enhanced Access to Relevant Prior Examinations

to Support Reduced Testing Redundancy

• Increased Leverage with PACs Vendor
• Strengthened Business Recovery Position

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Vendor Neutral Architecture Image Repository

• Solution Agnostic as to Type of Image

and DICOM Standard

• Fixed Pricing On A Per-Study Basis
• Free Total Cost of Ownership Analysis to

Support Evaluation of Annual Cost Reduction Opportunity

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Enterprise Master Patient Index Management

• Supports Resolution of Patient Identity

Across An Enterprise Where Different Medical Record Numbers Are Used to Manage the Same Patient

• Delivers and Maintains a Unique, Single

Enterprise Patient Identification Number for Better Coordination of Care Management, Billing, Data Integration

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Interoperable Secure Messaging

• Connects Hospital and Physician Practices to The

National Health Information Network (NwHIN) to Support Secure, Trust-Based, “Push” Exchange of Clinical Information

• Provides Access to Registries of “Authenticated”

NwHIN User e-Mail/Secure Messaging Addresses

• Supports Secure Exchange of Clinical Information

Across State Lines

• Low Annual Fee of $144 per User Account

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Data Warehouse and Reporting Tools

• Service Now Under Development (available in Fall
• f 2013)
• Leverage Transactional Data Flowing Into the

Exchange to Support Quality and Population Health Analysis as well as State, Federal, and Health Plan Reporting

• Near Real Time Data Set to Support Market Share

Analysis, Patient Origin Studies, etc.

• Foundation for Community-Wide Health Reform

Reporting

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Process for Data Use and Release Policy Development

• Based Upon Participant Agreement Provisions
• Incorporation of relevant HIPAA and MHDO

Data Access & Use Rules

• Review by legal counsel, HIN staff, &

consultants

• Adopted By HIN Board of Directors – 3/20/13
• Patient Communication Plan – Consumer

Advisory Committee

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Data Request Categories

• 1. Participant request for clinical data for

treatment and/or operations purposes

• 2. Participant request for meeting reporting

requirements

• 3. Request by Participant for providing clinical

data to patients via PHR

• 4. Request for utilization data authorized as public
• 5. Request by a non-Participant for provider

specific data not considered public

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State Innovation Model Testing Grant

• Centers for Medicare and Medicaid Innovation

(CMMI) Grant awarded to the State of Maine and includes as partners, HIN, Quality Counts and the Maine Health Management Coalition

• Goal of the Grant from CMMI is to assure that

health care services for 80% of the Maine population are paid through an alternative payment model (not fee-for-service)

• The grant total is just over $33 million
• Grant activities scheduled to begin July 1, 2013

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HIN SIM Activities

• Provide automated notifications to MaineCare care management staff as well

as participating provider care managers when MaineCare patients are admitted to Emergency Departments and Inpatient Settings (Approval by HIN data use committee received 3/13)

• Continuing HIN’s Behavioral Health HIT efforts:

– Paying for HIE subscription fees for participating behavioral health providers – Supporting HINs technical needs in managing the opt-in model – Providing EHR adoption incentives to BH Providers to support their purchase and implementation of EHRs and connect to HealthInfoNet

• Developing and deploying the "blue button" approach to allowing patients

who access their medical records through provider-base personal health portals, to access their HealthInfoNet data

• Measuring clinical quality of care delivered for MaineCare patients and

reporting those quality measures to provider and MaineCare (pending approval by the HealthInfoNet Data Use Oversight Committee and validation by participating organizations)

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Summary of HIN Activities to Support the Changing Delivery System

• All Maine Hospitals Connected in 2013
• Connect 1,000+ Primary Care Providers to HIN
• Continue connection with FQHCs, BH agencies and

specialists

• Focus efforts on connecting and meeting the needs of

Home Health and Long-term care

• Finalize Pilot of Statewide Image Repository and Go-live
• Deliver patient access to HIE data through provider

patient portals through SIM

• Deliver Reporting and Analytic Framework/Tools to

Support Providers, Organizations, and Systems

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Questions/Comments?

Shaun Alfreds, COO, 207-541-9250 ex 205 salfreds@hinfonet.org

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