Delaware Health Information Network Town Hall Wednesday, December 11, :00 a.m. 11:00 a.m.

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1 Delaware Health Information Network Town Hall Wednesday, December 11, :00 a.m. 11:00 a.m. Conference Room 107 Wolf Creek Boulevard Suite 2 Dover, DE Meeting Minutes Purpose To keep our public informed. Agenda What we are doing What we will be doing What should we be doing (public feedback) I. CURRENT Activities Update DHIN has certified results delivery interfaces for two additional EHRs; Sequel Med and Waiting Room Solutions, which brings us to 17 different EHRs. This represents 70% percent of all DHIN EHR users. Mercy Diagnostics has gone into production; even though we encountered a small hitch with Med Labs Diagnostics, they are scheduled to go into production early next week. DHIN is happy to announce that we have implemented the Cerner Community Health View at Nanticoke Hospital. A single sign on between the Cerner EHR and the DHIN portal will allow someone who is in their EHR to automatically be able to sign in to view the data inside Cerner. It gives the user the ability to do look ups in ProAccess without having to exit their work flow. This will also be available for other users of Cerner. DHIN is very excited to share that Nanticoke is the first facility to go into production to enable Image Viewing from within the DHIN environment. Once a radiology report comes thru DHIN, there will be a link embedded in the report that the end user can click on and it will take them to the actual image and be able to share with patients. DHIN is now in business discussions with several other imaging centers for implementation. Nanticoke has been in production for almost a month and it is exciting to see the images already available for viewing. We expect utilization to increase once providers are aware it is available. 1

2 Event Notification System Event Notification System has already been implemented and is in full production for two Medicaid MCO s. They are receiving daily notifications of their patients that have been seen and/or discharged from the emergency department. We have been working with the MCOs to ensure they are getting what they need content wise and if it is making a difference. We have discovered that two hospitals are not sending us ADTs on emergency department discharges, only on inpatient discharges. In order to add value for whole state and for other participants, DHIN has gone back to the hospitals and requested they send ADTs from emergency department discharges. DHIN is working with Aetna and Highmark, the health care plans for the state employee benefits. Aetna has completed the preliminary technical preparation and we need to confirm where the reports should be sent on a daily basis. Highmark is currently holding back on the on boarding documents that are required. DHIN is happy to report that there has been some conversation with CIGNA which currently has some presence in Delaware. CIGNA is already participating in Maryland with the Event Notification System. One of the conditions of the Marketplace is that the health plans must agree to participate in DHIN as a data exchange service. At the October Health Care Commission meeting, there was only a small number of Delawareans that have signed up through Marketplace. DHIN also would like to offer this service to practices so they can receive timely notification of when one of their patients has been seen in the hospital or emergency department. DHIN expects to go live within the week with our first beta practice. Anyone using certified EHRs would be able to produce a roster of their patients with the correct fields needed to support the Event Notification System. Public Health St. Francis, Beebe and Bayhealth are all in full production for both technical and content point of view for Electronic Lab Reporting; messages are going through DHIN and being received by the epidemiologist. Public Health has reviewed data from CCHS for content and have found a few issues; CCHS is going back to review the data. In the meantime, Public Health is working with Nanticoke on content. DHIN continues to work with Public Health to on-board the Public Health Lab as a data sender into DHIN and plan on moving into production in late January. In parallel with the technical work on that implementation, Public Health has given us a list of the practices that most frequently order from the Public Health Lab and we are making sure they are all enrolled in DHIN. Several of these are school based clinics, some of which have already been enrolled. 2

3 DHIN has also had open discussions of doing e orders to the Public Health Lab. A planning document needs to be completed and forwarded to Medicity to see if we can get the features in the planner, Medicity will then get back to us on pricing estimate. Newborn Screening The state s software vendor, Neometrics, which is a division of Natus Medical Incorporated, is working with DHIN and DHIN s vendor, Medicity, to ensure that messages for Newborn Screening are in the proper format. Once Medicity approves the messages, they will have all the pre-requisites required and can schedule a technical kickoff of the project. DHIN anticipates the kickoff for Newborn Screening to be in the near future. Immunizations DHIN has not received the updated November numbers from Public Health regarding immunizations. DHIN continues working with Public Health on immunizations and currently have two hospitals in production, CCHS and Nemours; and testing with BayHealth and Nanticoke. Nanticoke is currently sending messages. As for practices, there are four EHR vendors currently in production which includes one pharmacy and we are working with an additional thirteen different EHR vendors and pharmacies in testing. Currently two hospitals are in production, two hospitals in test, four EHR vendors in production and thirteen EHR vendors and pharmacies in test. Transcribed Reports DHIN continues to work with Nanticoke on Transcribed Reports. Due to resource constraints on their end, there has been a delay in production and we are now looking at a January time frame for production. CCDs There has been progress with the CCD exchange project with Delaware Health Net, with a few issues pertaining to formatting. We have received the ADTs and CCDs, Jody Wilson has been working closely with Delaware Health Net, Allscripts and Medicity and we believe to have found a potential solution for the formatting problems. Out of State DHIN is also in the process of connecting with CRISP; Maryland s HIE in exchanging ADTs with each other and with residents of both states. Currently, the hold- up is getting permission from the hospitals to use the data. DHIN requires permission from the data senders along with Data Use Agreements. II. CURRENT Activities Update 3

4 DHINs Cooperative Agreement Grant with ONC has almost ended. We have received $4.7 million over the past four years and have spent all but $125,000 and we have until the end of January to spend down the remainder of the money. DHIN is looking at several options for additional funding. DMMA and DHIN are working together on a proposal to develop capabilities for reporting Clinical Quality Measures. DMMA has submitted the proposal to CMS and they have reached back with comments and also asking for additional information regarding the budget. The state has put in an application for a CMMI Grant and has listed DHIN as one of their partners. The proposal for this grant, which is based around Consumer Engagement, has been submitted and we are now waiting for results which are expected in February. DHIN has also partnered with the state and is winding down the design on the SIMs Grant. The final deliverable on this grant is scheduled for submission by the end of this month and we expect a funding announcement for the testing grant by late January. At that time, we will be writing the grant proposal for testing the plan. If approved, this will be a substantial development and will include expanding the patient portal to accommodate bi-directional information exchange between practices and payers and would also include additional work in consumer engagement activities. DHIN is also working with the Delaware Health Science Alliance regarding a plan for DHIN data to be available in support of clinical research. DHIN also has a legal firm working with us on the legal ramifications. There is rich value to access aggregated data in support of population level analytics including clinical research; however, we must move carefully and properly to ensure patient rights are protected. III. Public Comments: C: (Joann Hasse): The Medicaid MCO s on the Event Notification System, some hospitals are not fully doing this as originally thought. Having sat through many sessions when the state was doing the primary funding for development of DHIN and more recently the Joint Finance Committee Special Session for Medicaid, it is hugely important from a state budgetary standpoint to show the value to the Medicaid system for ENS; this can really make a difference in willingness of the state government funders. Legislature does not understand how much of a difference, especially since state employees and retirees are a huge part of patient population in Delaware; it is so important to continue to adequately fund DHIN. C: DHIN is working on metrics to actually measure in quantitative terms, the value and savings that DHIN is providing to the state. The state is a special customer and we are focusing our energy on what value we are providing. DHIN is working with DMMA to find out the data we each have and if that data be combined to get a solid measurement of the value to Medicaid and Public Health., Delaware is number three in the nation in volume of data exchange between the State HIE and public health agencies. The state agency with the highest level of DHIN 4

5 utilization is the epidemiologists. The epidemiologists can log into DHINs patient portal for all their patient charts. Q: Who are the deciders when it comes to changes in Data Use Agreements? A: Documents must be signed by someone empowered to act on the institutions behalf. Normally, documents will go through the privacy officers of each institution and it is explained to the privacy officers that we are protecting the data and we are fully complying with the HIPAA laws. The next Town Hall is scheduled for January 8 10:00 a.m. 5