An Overview of THINC s Health Information Exchange Initiatives

Transcription

1 An Overview of THINC s Health Information Exchange Initiatives Susan Stuard, Executive Director June 22, 2011

2 THINC Goals THINC s Goals: 1. HIT Adoption both implementation of EHRs and standing up a health information exchange 2. Quality and Care Coordination first foray into this area with P4P-Medical Home project 3. Evaluation assess whether HIT and care coordination interventions demonstrate improvements in quality or utilization

3 Geography Hudson Valley Westchester, Putnam, Dutchess, Rockland, Orange, Ulster and Sullivan THINC is one of 9 organizations of its type in NYS (RHIOs) we all cover discreet geographic areas THINC, however, focuses EHR adoption and care coordination as well as health information exchange

4 THINC Participants Participants (in all projects) 78 physician practices (representing 750+ MDs) 19 hospitals 3 community health centers 6 health plans 1 employer 7 local health departments 8 commercial labs

5 Physicians Consumers Hospitals Public Health Health Centers THINC 501(c)(3) Payers Employers THINC s Constituents Board of Directors 1. Physicians 2. Hospitals 3. Health Center 4. Public Health 5. Consumer 6. Business Board of Directors Committees Program Office Operating Committees 1. Privacy & Consumer 2. Security & Technology 3. Quality & Clinical 4. Public Health 5. Finance

6 THINC Governance THINC has a fiduciary, not-for-profit model with representation for constituent groups on its Board and Committees Committees shape all of THINC s work; please participate THINC is not a membership organization and does not charge membership fees Service model - fees arise only when a participating organization elects a service EHR implementation and maintenance, HIE interfaces, data aggregation for medical home project Mandate from Board: focus on health information technology adoption, but only because it is a critical building block for quality and care coordination

7 What building blocks need to be in place to improve quality and reduce costs?

8 I. EHRs: Key Building Block Slow EHR adoption was primary driver for THINC s founding in 2005 and our first project We started active implementation of EHRs in 2007 well before Meaningful Use Vision for care coordination and health information exchange cannot be fully achieved until physicians implement EHRs in their practices

9 I. EHR Adoption and Meaningful Use 750 EHR implementations complete HEAL 1 grant to support EHR adoption goal is 1,000 eclinical Works implementations Use local vendor MedAllies and require them to provide enhanced implementation services THINC is local extension agent for the NYeC REC in the Hudson Valley Supports sign-up of all primary care providers no matter the EHR vendor

10 Current: II. Care Coordination and Medical Home In collaboration with Taconic IPA, worked with 305 primary care physicians in 12 practices and 3 FQHCs All 305 primary care providers received NCQA recognition for medical home at highest level (Level 3) Six commercial health plans participating in project Paid ~$1.5million of incentives to physicians achieving medical home recognition from NCQA Populating claims data base that we will use to watch changes in quality measures and utilization of services over the course of five years Are pursuing work on enhanced care managed within the PCMH practices

11 III. HIE: Leverage EHRs and Achieve Care Coordination Health information exchange should create efficiencies to allow a community to better coordinate care and support quality Not just faxes or scanned data but exchange of structured data that can be used for decision support and quality improvement and support achievement of meaningful use Standardize transactions and enable connections to key outside data sources (Medicaid, public health, quality reporting, laboratories)

12 THINC s HIE: 5 Functionalities 1. Build an Health Information Exchange that complies with NYS DOH s required SHIN-NY architecture 2. Implement a Viewer that allows providers, with patient consent, to view a patient summary upon request. Uses the Continuity of Care Document (CCD) to transmit patient information and support continuity of care 3. Integrate Laboratory Ordering and Results Review within physician practice EHR 4. Public Health Use Case. Support automated public health reporting for hospitals and some ambulatory physicians via the HIE. 5. Quality Reporting Use Case. Develop a quality reporting service that will connect with multiple EHR systems to collect, analyze, aggregate, and generate quality metrics reports

13 THINC s HIE and Meaningful Use Viewer Allow physicians and hospitals to meet objective for capability to exchange key clinical information among providers of care and patient-authorized entities electronically MU Stage 1, Core Set Objective Public Health Allow physicians and hospitals to meet objective for capability to provide electronic syndromic surveillance data to public health agencies. Immunization capability will be added by NYS DOH and NYeC in fall 2011 MU Stage 1, Menu Set Objective

14 III. Health Information Exchange Current: Laboratory ordering and results delivery: live and integrated into the eclinicalworks EHR. Strong volume and excellent physician feedback First thing that had made the administrative aspects of my practice easier in the last decade Public health reporting 7 hospitals and first ambulatory sites are live Hudson Valley has first live providers in New York State viewer is in production 8 hospitals in process of going live during summer; several large ambulatory providers as well Will build data volume and then launch community viewer capability at end of 2011

15 Participating in the HIE If you are interested in participating in the HIE and integrating your EHR vendor, please contact us Vendors we have integrated or are in pipeline: Next Gen, Epic, eclinicalworks, Meditech, Cerner, Siemens, Greenway, McKesson Costs are an issue if your vendor is not in pipeline but we are working with NYeC and other local providers on means to lower costs to add additional vendors so reach out to us Susan S. Stuard, Executive Director, THINC, Inc. Phone: x.3018

16 What is Direct: Direct 101 Spearheaded by ONC for HIT of HHS; a Public-Private Partnership Launched March 2010 Vision: Simple, secure, scalable, standards-based send of health information over the Internet More than 200 participants from over 50 different organizations EHR and PHR vendors, medical organizations, systems integrators, IDNs, federal organizations, state and regional health information organizations, organizations that provide health information exchange capabilities, and health information technology consultants Focuses on the technical standards and services necessary to securely flow content from a sender to a receiver Satisfies some Stage 1 Meaningful Use requirements 16

17 Why Direct Meaningful Use-compliant Direct use cases tied to MU priority areas, including patient care summaries Standardized Direct provides a standardized transport mechanism for patient care summaries Simple Simplicity helps adoption among low volume practices and small, independent providers Scalable Direct can be utilized beyond 2011 in meeting future stages of meaningful use requirements and other business goals

18 Health Information Exchange and Direct HIE and Direct should be viewed as complimentary resources At direction of Office of the National Coordinator for Health IT at the U.S. Department of Health and Human Services, the New York ehealth Collaborative will be supporting both Direct and HIE for New York State Also appears that Direct will be required as part of Stage 2 Meaningful Use

19 Traits of HIE and Direct Taconic Health Information Network and Health Information Exchange Patient Transition Unanticipated Anticipated Direct Availability Available to Many Providers Sent to One Provider Consent Required Not Required in NYS Send vs. Query Provider Must Query for Info Provider Must Send to Other Provider Network Sponsor Structured Data Typical Uses Population and Patient Health Relies on a -Based Organization to Sponsor Some HIEs have ability to import CCD into EHR as Structured Data Patient Summary Look-up, Public Health, Quality Reporting, etc. Supports Population Health and Some Care Transition Activities Relies on EHR Vendors to Connect Up to Direct Network Patient Summary Can Be Accepted into EHR as Structured Data (for Hudson Valley) Referral, Consult, Discharge Summary, etc. Supports Care Transitions Activities

20 Additive to Create More Capabilities within a HIE for Population Health Direct for Care Transitions Ability to address many quality and care needs within a community

21 MedAllies Direct Pilot in Hudson Valley A. John Blair, MD CEO, MedAllies

22 MedAllies Direct Pilot Objectives Overview: Enhance patient care and safety across transition of care settings by real time transfer of pertinent clinical information across disparate EHRs in a fashion that is consistent with existing clinical workflows Clinician adoption Secure, fast, inexpensive and interoperable Support small practices, large integrated delivery systems, and everything in between Support advanced primary care and accountable care models

23 HISP MedAllies Hudson Valley New York State Participants Healthcare Organizations Hospitals: Albany Medical Center, Health Quest Systems Primary Care: Albany Medical Center, Care Physicians, Health Quest Systems, Institute for Family Health, Scarsdale Medical Group, Specialists: Albany Medical Center, Asthma and Allergy Associates of Westchester EHR Vendors Hospital: Siemens, Cerner Primary Care: Allscripts, Epic, NextGen, eclinicalworks Specialists: Allscripts, Greenway

24 User Stories: Hospital Discharge Hospital Discharge to PCP

25 User Stories: Closed Loop Consultation Closed Loop Referral (PCP to Specialist & Back)

26 Direct Video