Illustrations of Community HIEs and Interoperability

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Illustrations of Community HIEs and Interoperability The Search for Real Chuck Tryon Co-Chair ONC Beacon-EHR Vendor Affinity Group

Topics Beacon Projects Beacon Benefits Case for Interoperability Realities of Interoperability Recommendations Session Learning Objectives How MyHealth became a Beacon leader exchanging CCDs Patient and provider benefits realized from MyHealth Access Network. Beacon Learning Guides

Beacon Projects Initiated by Office of the National Coordinator (HHS) 3 year effort launched in 2011 Utilize HITECH to support Triple Aims of Improving care quality Better patient outcomes Lower healthcare costs $250 million to 17 communities Included Tulsa (GTHAN/MyHealth) Link to: Beacon Community Program

Tulsa s Story Integrating over 100 diverse sources Over 2500 active users Complex architecture that includes Both structured (coded) and unstructured (text) data Mirth-based Clinical Data Repository (CDR) Provider portal that summarizes patient information Comprehensive analytics environment for quality reporting Decision support tools

The Learning Guides and the Beacon-EHR Vendor Affinity Group are already delivering significant value.

Benefits: Beacon Learning Guides Proven strategies and actionable information that can be adapted by hospitals, health systems, individual practices and health-focused community organizations. Improving Hospital Transitions and Care Coordination Using Automated Admission Discharge and Transfer Alerts Strengthening Care Management With Health Information Technology Capturing High Quality Electronic Health Records Data to Support Performance Improvement Enabling Health Information Exchange to Support Community Goals Driving Clinical Transformation in a Practice Setting with Health Information Technology Building Technology Capabilities to Aggregate Clinical Data and Enable Population Health Measurement Link to: Beacon Learning Guides

Benefits: Affinity Group I Formed in December 2011 Included 17 Beacons and 7 EHR vendors (more) Targeted inconsistent adoption of HITSP standards for CCD Established the C83/66 as a common CCD definition Demonstrated adoption in December 2012

Benefits: Affinity Group I (cont.) Beacon # of Practice Locations # of Providers # of Patients Impacted Bangor 2 23 16,096 Cincinnati 3 8 4,200 Colorado 1 6 4,500 Crescent City 8 81 81,036 Inland Northwest 19 139 3,590 Keystone 14 43 76,000 Rhode Island 9 54 64,888 Southeast Michigan 9 22 2,824 Southeast Minnesota 29 231 184,300 Tulsa 121 1,330 1,126,200 Utah 2 13 36,000 Western New York 1 5 1,402 Grand Total (Live + Planned) 218 1,955 1,601,036

Benefits: Affinity Group II Reconvened in April 2013 Included subset of Beacons and EHR Vendors Focused on MU2 requirements as they pertain to HIEs Transitions of Care View online/download/transmit Secure communications Delivered recommendations and training December 2013

Case for Interoperability Advanced HIEs (like MyHealth) depend on granular clinical data that must be delivered accurately and consistently Community-wide point-of-care patient data Consolidated picture of patient history Duplicate tests avoided Improved medication management Unnecessary procedures prevented Informed effective care transitions

Case for Interoperability (cont.) Custom alerts and quality reports Community-wide analytics Objective quality reporting for payment reform Position for MU3 requirements Health Information Exchanges offer the only vehicle to deliver these proven benefits.

Realities of Interoperability Limited EHR adherence to standards MU1 HITSP standards for C32/C83 CCD ignored! MU2 Consolidated CDA alarming!! HL7 feeds non-standard Uncontrolled, inconsistent EHR integration fees Minimal ONC standards enforcement Certification too easy Limited penalties for failure to comply Slow adoption by HIE vendors

Realities of Interoperability (cont.) Confusion about MU requirements Limited contribution to patient outcomes Fail to address true healthcare issues Capturing data out of context Ignore the value of HIEs Don t capitalize on Beacon HIE investment This combination has made collecting accurate clinical information complex and time-consuming.

Recommendations Emphasize role of HIEs Primary focus for future MU requirements, not an afterthought Require data delivery Provide incentives for community adoption of HIEs Establish HIE funding source for sustainability Utilize real world collaboration efforts to test new MU requirements BEFORE they become final Audit EHR and HIE vendors to certify compliance with MU requirements

Questions??? Contact Information: Chuck Tryon chucktryon@tryonassoc.com 918.625.8258