HIE Services & Pricing

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1 Services Available at No Cost Health Information Exchange Services & Pricing Package

2 Services Available at No Cost Services Available at No Cost HealthlinkNY Web Portal The HealthlinkNY Web Portal is available for use by clinical providers, administrative staff, and public health employees in the community. Access to the HealthlinkNY Portal includes the following features: Patient Record Lookup (Community Level): Quickly and securely access your patients consolidated HIE records online through the HealthlinkNY Web Portal in a read-only, printable format. Patient records include data from providers in the HealthlinkNY region who utilize an EMR/EHR with an interfaced connection to the HIE and include test results and associated reports. HealthlinkNY Community PACS Viewer: With authorized access to the HealthlinkNY Portal, users automatically get single sign-on access to the HealthlinkNY Community PACS Viewer, which allows users to load and view patient radiology images without any additional downloads or login information. Online Consent Management: The HealthlinkNY Web Portal has a built-in consent management tool that allows authorized users to record patient HIE consent choices into the portal. This allows immediate updates to patient consent values, which control all access to patient records throughout the HIE. Secure Messaging: A secure messaging service is incorporated into the HealthlinkNY Web Portal, allowing users to securely communicate with other HealthlinkNY Web Portal users, send clinical document attachments, and include protected health information when necessary. Notifications and Alerts: A HealthlinkNY Web Portal account allows users the option to set up customized alerts on their patients to notify them when specific events occur, such as an ER or hospital admission in the HealthlinkNY region. Tickler messages for these notifications can be routed to an outside personal address to inform the user they have a notification awaiting them in the portal. Identification Management & Security: HealthlinkNY provides secure identification authentication prior to granting providers and other individuals access to the HealthlinkNY Web Portal in order to ensure appropriate access to patient records. In addition, HealthlinkNY adheres to federal and state regulations and performs regular access audits to further safeguard patient privacy. Statewide Patient Record Lookup (Coming Soon): The ability to search for a patient s HIE records statewide is anticipated to be available as a feature of the HealthlinkNY Web Portal in May of This feature, powered by the SHIN-NY, will allow HealthlinkNY Web Portal users access to their patients records from any provider in New York State contributing data to a QE.

3 Services Available for a Fee Services Available for a Fee Interface Connections HealthlinkNY offers the ability to establish both one-way and two-way connections by building interfaces between a provider s electronic medical record (EMR or EHR) system and the HIE. Bi-directional exchanges allow patient data to flow in two directions: Patient records can be sent from the provider s EMR/EHR to HealthlinkNY and become an integrated part of the patient s comprehensive HIE record; Patient HIE records can be queried and returned directly into the provider s EMR/EHR- either upon request or through an automated process. Various customization options regarding triggers and alerts exist when configuring these types of connections. Interfaced Connection Options Average Cost* C-CDA: Add-on Connection via Hub Model $2,700 C-CDA: New Connection (Non-Hub Model) 1 $32,500 Standard Hospital Connection (Multi-feed Package) 1 $29,400 1 Connection prices include an ADT w/consent feed. *For additional important details regarding the availability and costs associated with all services, please reference the package sections titled Interface Connection Descriptions, Interface Connection Details, and Interface Connection Pricing Details. For definitions of terms and acronyms, please reference the Glossary of Terms section. DIRECT-Enabled Secure Messaging Services DIRECT-Enabled secure messaging offers the user a specialized type of secure account through the DIRECT protocol. Designed to be HIPAA compliant while still allowing quick and easy transmission of patient data between providers, the DIRECT protocol utilizes a network of Health Information Service Providers (HISPs) to allow a user to send and receive secure messages with any other individual using a DIRECT-enabled inbox. HealthlinkNY offers two DIRECT-enable secure messaging services: HealthlinkNY DIRECT Messaging Options DIRECT Secure Messaging via Web Access: Through a separate online web-access portal, users can login to their secure DIRECT-enabled inbox to exchange messages containing protected health information with other individuals using any DIRECT-enabled messaging service. DIRECT Secure Messaging via EMR/EHR: Through a DIRECT HISP connection provided by HealthlinkNY, the user is able to exchange secure messages with any other individual using a DIRECT-enabled inbox from within their own EMR/EHR system- no need for any separate logins! One-Time Set-Up Fee Recurring Annual Fee $0 $200 $5,000 $500

4 Interface Connection Descriptions Interface Connection Descriptions: CCD / C-CDA: New Connection (Non-Hub Model) A new CCD or C-CDA connection between a participant s EMR/EHR system and the HealthlinkNY requires the following interfaces to be established: PIX CCD / C-CDA Consent feed (as applicable): o XACML o ADT w/consent This type of connection serves only one single participant s EMR/EHR connection and does not apply to a participant using an EMR/EHR with a Hub Model (see below). CCD / C-CDA: Add-on Connection via Hub Model CCD and C-CDA connections established through the Hub Model Add-on process utilize the same interface types associated with a typical C-CDA connection (see above). In this model, these interfaces have already been established between the EMR/EHR vendor hub and the HIE, enabling simplified connection process for any participants using an EMR/EHR vendor with an established Hub Model connection to the HealthlinkNY HIE. Please reference the list of currently supported vendor Hubs in the Interface Connection Details section of this package. Standard Hospital Connection (Multi-feed Package) The Standard Hospital Connection involves a package of multiple interfaces to individually deposit patient data into the HIE from various sending systems, as opposed to utilizing a single C-CDA interface to exchange data. The interfaces included in this package include: ADT w/consent ORU MDM

5 Interface Connection Details General Interface Connection Details and Requirements: All types of interfaced connections require a commitment and collaboration between the HealthlinkNY team, the participant, and their EMR/EHR vendor. A HealthlinkNY Participation Agreement, Business Associate Agreement, and Services Work Order must be executed prior to the start of any interface work. HealthlinkNY requires that all interfaced connections where the source system supports sending electronic consent values via an ADT w/consent or XACML feed will implement these feeds as part of their connection with HealthlinkNY in order to maintain appropriate patient consent management system-wide. HealthlinkNY requires that all interface connections with inpatient facilities implement an ADT feed to support HealthlinkNY community alert and notification functions. Average timeframes for establishing interface connections with the HealthlinkNY HIE range from 3 to 12 weeks, with conforming interfaces typically completing closer to the 3 week timeframe. Project Management hours are included in the prices indicated in this package as follows: o CCD and C-CDA exchanges involving interfaces determined to be conforming will include up to 40 hours of Project Management services from HealthlinkNY. o Standard Hospital connections involving interfaces determined to be conforming will include up to 40 hours of Project Management services from HealthlinkNY. o Individual interfaces and Add-On Connections for Hub Models will include up to 20 hours of Project Management services from HealthlinkNY. The costs associated with establishing these complex electronic connections will vary. Prices shown in the HIE Services and Pricing package are average one-time costs for conforming feeds and exclude any additional charges the participating organization may owe to their EMR/EHR vendor. A technical discovery meeting will be required to obtain confirmed pricing. Non-conforming feeds will incur extra costs associated to customization efforts and added Project Management services. Additional Project Management services beyond the included hours will be billed at a rate of $200 per hour. Where a substantial variation from services and pricing agreed to in the Work Order is foreseen, both parties must agree in writing to the additional work via a Change Order. Add-on connections are only available for Hub Model connections currently established with the HealthlinkNY HIE. Our list of currently connected EMR/EHR vendors with Hub Models include: o MEDENT o ecw Opportunities for cost-sharing may exist when establishing a Bi-Directional connection between HealthlinkNY and a new EMR/EHR vendor hub. When multiple facilities already utilize the same EMR/EHR vendor and are willing to collaborate to establish a new hub model connection, the cost burden associated with establishing this connection with the HealthlinkNY HIE can be reduced for all involved participants through cost-sharing. PACS imaging can be added for additional fees. A Standard Hospital Bi-Directional Connection (Classic v2 Package) is required for this add-on. Please refer to the PACS Imaging Connection Details sheet for more information.

6 Interface Connection Pricing Details Interface Connections Implementation Pricing Details: HL7 v.2 Implementations Average Cost* Classic v2 Package includes: ADT with Consent ORU MDM $29,400 ADT with Consent $8,000 ADT without Consent $5,800 HL7 v3 Implementations Average Cost* CCD Bi-Directional includes: PIX ADT o Consent through ADT or XACML 1 $32,500 C-CDA Bi-Directional includes: PIX ADT o Consent through ADT or XACML 1 $32,500 Add-on to Existing Hub $2,700 1 Connection prices include the additional fee associated with an ADT w/consent feed. * The costs associated with establishing these complex electronic connections will vary. Prices shown in the HealthlinkNY HIE Services & Pricing package are average one-time costs for conforming feeds and exclude any additional charges the participating organization may owe to their EMR/EHR vendor. Non-conforming feeds will incur extra costs associated to customization efforts and added Project Management services. A technical discovery meeting will be required to obtain confirmed pricing. Please reference the Interface Connection Details and Interface Connection Descriptions pages of the HealthlinkNY HIE Services & Pricing package for more information.

7 PACS Imaging Connection Details PACS Imaging Connection Details: Individual Facility PACS Imaging Connections Setup Cost* Annual Cost Extra Large Facility Over 300k imaging studies per year $30,800 $36,960 Large Facility Between 100k and 300k imaging studies per year $22,000 $26,400 Medium Facility Less than 100k imaging studies per year $14,300 $17,160 Small Software-only Connection Less than 24k imaging studies per year $5,000 $9,900 All implementations include 30 day pre-caching of images. One-time setup costs include configuration, installation, and integration of all required hardware and software. A Standard Hospital Interface Connection (Classic v2 Package) is a prerequisite for adding a PACS connection. * The costs associated with establishing these complex electronic connections will vary. Prices shown in the HealthlinkNY HIE Services & Pricing package are average one-time costs for conforming feeds and exclude any additional charges the participating organization may owe to their EMR/EHR vendor. Non-conforming feeds will incur extra costs associated to customization efforts and added Project Management services. A technical discovery meeting will be required to obtain confirmed pricing. Please reference the Interface Connection Details and Interface Connection Descriptions pages of the HealthlinkNY HIE Services & Pricing package for more information.

8 Glossary of Terms QE SHIN-NY CCD C-CDA ADT w/consent ORU MDM PACS A Qualified Health IT Entity, or QE for short, is determined by the New York State Department of Health (NYS-DOH) to have met strict guidelines through a certification process which designates the QE eligible to participate in the SHIN-NY. HealthlinkNY currently maintains certified QE status. The Statewide Health Information Network of New York (SHIN-NY) is a private and secure information network connecting the regional QEs in New York State to allow for statewide patient data exchange. The SHIN-NY is governed by the NYS-DOH and the New York ehealth Collaborative (NYeC). CCD stands for Continuity of Care Document. The CCD is a core data set of administrative, demographic, and clinical information covering one or more healthcare encounters for a patient. C-CDA stands for Consolidated Clinical Document Architecture. Clinical Document Architecture (CDA) is a certified standard regarding the coding, structure, and semantics of electronically exchanged clinical documents. A Consolidated CDA (C- CDA) is the new ONC standard for the electronic transfer of Care Summary to meet CMS Meaningful Use Stage 2 requirements and expands the data elements and healthcare information previously captured and exchanged via the CCD. The ADT feed is a single data feed that electronically transmits Admission, Transfer, and Discharge information for patients admitted to a facility. The ADT w/consent feed indicates that an HIE consent value, collected and electronically stored in the facility s EHR/EMR system, is also included in this feed to automatically update patient consent values in the HealthlinkNY HIE. The Observation Result (ORU) feed is a single data feed that provides clinical observations (results) for patients, i.e. laboratory results. The Medical Document Management (MDM) feed transmits new or updated clinical documents and/or the documents status. Picture Archival and Communication Systems (PACS) is technology that allows for short and long term storage, retrieval, management, distribution, and presentation of medical image studies.

9 Glossary of Terms (Continued) Hub Model Conforming feeds Technical Discovery Meeting A Hub Model refers to a structure of HIE connection where an EMR/EHR vendor has established a centralized hub that individual clients (i.e. physician practices or healthcare organizations) connect to for EMR/EHR services and this vendor hub has an established interface connection with the HIE. This single interface connection between the vendor hub and the HIE can potentially allow patient data to flow bidirectionally from any of the clients connected to the vendor hub if the client elects to do so. In a Hub Model, the technical work and costs associated with connecting a vendor hub client with the HIE are substantially reduced as opposed to those of individually establishing interface connections between each client and the HIE. A conforming feed (aka interface) is one that adheres to industry standards for data exchange and does not require customization work in order to be accepted and processed in the HealthlinkNY HIE. Conforming interfaces ultimately have shorter golive timeframes and cost less overall to implement. A collaborative meeting that must occur between appropriate staff at the potential participant organization, resources from their EMR/EHR vendor company, and HealthlinkNY technical team members to determine the interoperability, pricing, and timelines associated with connecting the organization with the HIE. Various factors discussed in this meeting may influence the pricing and timelines for connection.

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