9/8/ About Health Information. Agenda. Exchange and NC HIE

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1 North Carolina Health Information Exchange (NC HIE) Current Landscape and Initiatives September 17, 2014 Agenda I. About Health Information Exchange and NC HIE II. NC HIE Updates III. IV. Participating with NC HIE QA About Health Information Exchange and NC HIE 1

2 What is Health Information Exchange (HIE)? A secure electronic network that uses state-of-the-art technology to ensure that medical professionals can access their patients most up-to-date health information and provide the best possible health care. Allows health information to be shared across multiple systems and entities. Helps doctors, hospitals and other health care providers share medical information for patient care quickly and securely through an electronic network. Information is shared in a more protected way than paperbased files, faxes and mail (HIPAA compliant). What is NC HIE? North Carolina s state-designated entity to facilitate health information exchange across all provider types statewide. The most robust and advanced type of HIE in the industry, enabling both a single virtual statewide patient record and point-to-point secure electronic exchange of patient data Originally intended for treatment and healthcare operations purposes, including public health activities. Legislatively mandated to connect approximately 140 Medicaid-serving NC hospitals, and grant-funded to connect 1,500 Medicaid physician practices. As of May 2014, contains data on 461,370 patients with ~2M data transactions and 1,579 provider users. One Connection, Many Data Sources One connection to NC HIE means access to: Provider electronic health record systems State systems Pharmacies Labs Behavioral health organizations Long-term care entities Disease registries Other sources of patient data 2

3 NC HIE Updates Current Footprint Currently, more than 800 sites are participants of NC HIE. We build connected communities that include clinics, local health departments and long-term care and behavioral health providers. A complete list can be accessed on our website: Legend: Hospitals Physician Practice Primary Care Physician Practice Specialist Long-Term Care Current Hospital Participation Ashe Memorial Hospital Blowing Rock Rehabilitation & Davant Extended Care Center Cannon Memorial Hospital CaroMont Medical Center Cherokee Indian Hospital Hugh Chatham Hospital Davie Medical Center Granville Medical Center Halifax Regional Medical Center Harnett Health Betsy Johnson Hospital Harnett Health Central Harnett Hospital High Point Regional Medical Center Johnston Medical Center Lenoir Memorial Hospital Lexington Medical Center Maria Parham Medical Center Morehead Memorial Hospital Nash General Hospital Northern Hospital of Surry County Onslow Memorial Hospital Our Community Hospital Person Memorial Hospital Randolph Hospital Rex Hospital UNC Caldwell UNC Chatham UNC Hospitals UNC Pardee UNC Wakebrook Wake Forest Baptist Medical Center Watauga Medical Center Wayne Memorial Hospital Wilson Medical Center 3

4 Jul-13 Sep-13 Nov-13 Jan-14 Mar-14 May-14 Jul-14 Sep-14 Nov-14 Jan-15 Mar-15 May-15 Jul-15 9/8/2014 Ambulatory Progress and Goals Currently, more than 800 ambulatory sites are participants of NC HIE including practices, clinics, health departments and long-term care and behavioral health clinics Ambulatory Note: Increase of approximately 200 provider sites since March 2014 NC HIE Integration Progress July 2014 August 2014 September 2014 Live on DSM: UNC Hospital Rex Hospital UNC Chatham Hospital Granville Medical Center CaroMont Medical Center Randolph Hospital UNC Pardee UNC Caldwell Morehead Memorial Hospital Wayne Memorial Hospital Halifax Regional Medical Center Harnett Health Betsy Johnson Hospital Harnett Health Central Harnett Hospital Live on ORU (Radiology): Lenoir Memorial Hospital Halifax Regional Medical Center (December 2012) Morehead Memorial Hospital (June 2014) Live on ADT: Halifax Regional Medical Center (December 2012) Live on ADT: Morehead Memorial Hospital Live on ADT and CCD Inbound: Hugh Chatham Hospital Ashe Memorial Hospital Live on CCD Exchange/ ITI Transactions: Halifax Regional Medical Center Granville Medical Center Lenoir Memorial Hospital Morehead Memorial Hospital Direct Secure Messaging: Typically a 6 week process but integrated 10 hospitals in 4 weeks Participant focus on meeting Meaningful Use TOC Obstacles with vendor setup/configuration Collaboration with NC DHHS Data use agreement signed on May 12, NC HIE and DHHS have agreed upon leveraging ADT and CCD interfaces to achieve data reporting requirements. State budget included $2mil state and expected $2mil federal match Will impact hospital fees to connect to NC HIE Pricing proposal is being developed with the State 4

5 Recent News Initiatives Chronic disease registries endorsed by America Academy of Family Physicians Working with first Physician Quality Reporting System (PQRS) customer New electronic medical record (EMR) vendor partnerships: athenahealth Patagonia Health CureMD Netsmart Services: Enabling Meaningful Use Immunization Registry Reporting Objective/Measure Submission of electronic data to an immunization registry Core or Menu Stage 1 Menu for EPs and EHs Core or Menu Stage 2 Core for EPs and EHs Electronic Lab Reporting (ELR) Submission of electronic reportable laboratory results to the State public health agency Menu for EHs Core for EHs Electronic Clinical Quality Measures (CQMs) Transitions of Care Electronic Clinical Quality Measures (CQMs) reporting (NC HIE enables for Medicaid Eligible Professionals) Provide a summary care record for at least 50% of transitions or referrals, 10% of which must be electronic. - Required for EPs and EHs - Core for EPs and EHs Specialized Registry Reporting Identify and report specific disease cases to a specialized registry (other than a cancer registry) - Menu for EPs Cancer Registry Reporting Identify and report cancer cases to a public health cancer registry - Menu for EPs EPs- Eligible Professionals EHs- Eligible Hospitals Services: Population Health Analytics Functionality: Incorporation of multi-sourced information, both clinical and claims data, into comprehensive view of evidence-based population health dashboards/utilities to facilitate systematic approaches to improve care. Development of chronic disease registries Diabetes Asthma Heart Failure Hypertension Reporting of Clinical Quality Measures Certified in all 64 CQMs Basic data set allows for population of ~28 5

6 Services: PharmaceHome Complete Medication Management Patient Problem Problem Resolution/ Problem/Provider Problem Hospital Transitional Care Manager (TCM) CCNC Network Network Pharmacist (PharmD) Is Patient Enrolled? Prescription Fill History? Adherence? Home Primary Care Manager (PCM) Patient Medication Taking *Behavior *Active List *Challenges CCNC Network Network Pharmacist (PharmD) Which Prescribers? Which Problems? Clinic CCNC Physician (PCP) Medical Chart Active? Medication List? Discharge Medication List? Plan for Resolution Other Care Team Members Administrative Claims Data NC HIE Provider/Extender Derived Data Participating with NC HIE Subsidy Program Eligibility Must be a: Note: Eligibility ends in one year CCNC Carolina Access II Practice or Medicaid MU 1 Practice or Medicaid AIU Practice and contributing data: Full patient panel participation in HIE (Paid) Medicaid patient panel participation in HIE, full panel for meeting Meaningful Use (Paid) 6

7 Connectivity Method 1: Vendor Collaboration Established Agreements Covisint AllScripts eclinical Works Aprima CompuGroup Patagonia Netsmart CureMD Ongoing Conversations: Ambulatory Greenway NextGen SuiteMed Athena Care 360 Hospital Meditech Epic Cerner CPSI Other Pioneer Rx Relay Correct Care Subsidy Program Cost Coverage HIE Costs Integration Development of interfaces SSO/Visual integration Training Account setup for users Data load (historical and ongoing) Maintenance Ongoing subscription fee** Vendor Costs Integration Development of interfaces* SSO/Visual integration Maintenance Possible interface maintenance charge Covered by subsidy Not covered by subsidy May be covered by subsidy *varies based on whether NC HIE has a contract or fixed pricing from vendor **for eligible practices, this is $150/clinical user per year Connectivity Method 2: Covisint Third-party data aggregator service that establishes a unidirectional feed of information from the EHR to NC HIE Allows practices to meet measures for Meaningful Use Stages 1 and 2 (NCIR, CCR, CQMs, Disease Registries, TOC) Users will access NC HIE through the Provider Portal online and be able to download or (via Direct) information contained within the network Costs for Subsidy Eligible Practice Costs for Subsidy Ineligible Practice Integration = $0 Integration = $6,000 Maintenance = $600/year $175/physician/year Maintenance = $600/year $175/physician/year 7

8 QA Questions? Contact: Jayson Caracciolo, Director, Stakeholder Services /