HealthInfoNet s Clinical Portal Supports PCMH Goals

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HealthInfoNet s Clinical Portal Supports PCMH Goals Sharon Bearor, RN, BSN, Clinical Program Coordinator Katie Sendze, MBA, Program Director Trudy Iams, RN, Lead Nurse/Care Coordinator, Franklin Health Internal Medicine Maine Quality Counts Learning Collaborative Augusta, Maine June 20, 2014 1

Agenda Today Introductions HealthInfoNet Overview Clinical Portal Demonstration Katie, 5 min Katie, 5 min Sharon, 20 min Benefits of Utilizing the Clinical Portal Trudy, 15 min Questions & Answers All, 15 min 2 2

Panel Speakers HealthInfonet: Katie Sendze, Program Director ksendze@hinfonet.org Sharon Bearor, RN, BSN, Clinical Program Coordinator sbearor@hinfonet.org Franklin Health Internal Medicine; PCMH Practice: Trudy Iams, RN, Lead Nurse/Care Coordinator tiams@fchn.org 3 3

What is HealthInfoNet (HIN)? HealthInfoNet operates Maine s only statewide Health Information Exchange (HIE) network which is voluntarily participated in by health care providers across the state The HIE feeds HIN s Clinical Portal. The Clinical Portal is a electronic health record system where participating providers share patient health record information The Clinical Portal is used by a wide variety of healthcare providers across the state to coordinate care. 4

What is HealthInfoNet continued Maine-based: The Board of Directors are active and prominent in the Maine medical community and represent a variety of organizations and interests Independent: HealthInfoNet is independent and is not owned by insurance companies, health care organizations, associations, employers or government Non-profit: HealthInfoNet is a private nonprofit organization. It is funded by many sources including charitable foundations, Maine health care providers, and state and federal government Multi-stakeholder: Involves Consumers, Providers, Payers, Business and Government 5

How Does the HIE Work? 6 HealthInfoNet s system combines information from separate health care sites to create a single electronic patient health record Patient health information is automatically uploaded from a provider s electronic medical record system The information is standardized and aggregated across care sites; uses a master person index to create one statewide patient record Clinicians can seamlessly access their patient s information in HealthInfoNet from within their EHR or a web link HealthInfoNet automates reporting of certain illnesses and conditions like Lyme disease or food poisoning, to public health experts at the Maine CDC

HIE Connections Hospitals, FQHCs, Ambulatory Current live map available at www.hinfonet.org 34 of 37 hospitals (all under contract to connect in 2014) 34 FQHC sites 386 ambulatory sites including physician practices, behavioral health, and long term care facilities 7

HealthInfoNet s HIE Operating Statistics as of April 31, 2014 1,326,691 lives in the HealthInfoNet database 1,174,795 Maine residents have clinical data in the exchange (88% of Maine s resident population) 15,450 individuals have opted out (1.2%) 2,049 Maine clinicians and support staff are active users of the exchange 60% of active users accessed the exchange in April, 2014 8 8

HealthInfoNet s HIE Operating Statistics as of April 31, 2014 13,169,716 inbound messages are received by HealthInfoNet each month 157,820 patient clinical messages sent monthly in support of ACO organizations in Maine 61,088 data transmissions sent monthly to Maine CDC in support of Electronic Lab Reporting, Syndromic Surveillance and Immunization Reporting (Meaningful Use Measures) 21,164 patient lookups performed each month 9,800 Continuity of Care Documents (CCD) sent monthly for discrete data integration into EHR applications Over 8,000 real time email notifications sent each month The HealthInfoNet Central Data Repository (CDR) is 2.34 TB in size and is growing at 4 GB a day 9 9

Data Categories Accepted by HIN Today Patient Identifier and Demographics, including insurer Encounter History Laboratory and Microbiology Results Radiology Reports Adverse Reactions/Allergies Prescription Medication History Diagnosis/Conditions/Problems (primary and secondary) Immunizations Vital Signs Dictated/Transcribed Documents Continuity of Care Documents (CCD) Mental Health and HIV Information (New and In Process) 10 10

Security Processes Uses a Virtual Private Network (VPN) and protected by a dedicated Firewall. Data is encrypted at all times (in motion and at rest) and stored separately from clinical data. All users are given unique passwords and can only access the system from their organization s EHR. Provider activity logs are audited daily by HealthInfoNet staff and access reports can be generated at any time. Users must confirm they have a relationship with the patient and a need to see their information. This is recorded in the system. 11

Clinical Portal Demonstration Accessing the portal Key functionality Notifications Best practice tips 12 12

Benefits of Utilization HealthInfoNet s Clinical Portal Franklin Health Internal Medicine (PCMH practice) begin accessing the Clinical Portal about six months ago 13

How is the Clinical Portal used? New patient s MA s use the portal as part of chart prep and are able to build a new patient chart, even if we don t receive records from previous PCP Medication reconciliation Lab results- lab results go back to 2009 Imaging- when was that last mammogram? Op notes- when was the last colonoscopy? Documents- Consults, H&P s, discharges 14

Care Coordination I receive an email when a patient has had activity in the HIE such as: When patients are admitted, discharged or have a ER visit. This is particularly helpful when a patient moves out of our network (Maine Med, CMMC etc.) I am able to access reports and scan them into patient s chart to be available for their f/u visit with their PCP I can reconcile medications over the phone using updated info in the portal 15

Cost Reduction Reduces chance of duplication: For lab or imaging orders Easy to identify high utilizers: One of my first emails prompted me to check an ER visit out of area, the patient had been to the ER 63 times in the last year! Time saver: No more calls to hospital medical records to get copies of CT scans, x-ray s, etc performed at another facility. I can access them in less than a minute and print them off. 16

Detective Work Access the PMP (prescription monitoring program) through HIN to check narcotic activity Great tool to gather info for case studies Easy to identify patient s medication compliance by reviewing available pharmacy fills Can see providers that patient has seen across the state 17

Success Stories Patient with 63 ER visits referred to CCT Identified a patient who had 27 chest x-rays in 1 year from various facilities Identified a patient who was using two PCP s and a psychiatry office: One billed as MaineCare, two as self-pay Using several pharmacies, was getting Ambien, Vicodin, oxycodone and Lunesta 18 This program has been immensely helpful in the short time we have been using it; staff & providers happy to have INFO!

Questions/Comments? HealthInfonet: Katie Sendze, MBA, Program Director ksendze@hinfonet.org Sharon Bearor, RN, BSN, Clinical Program Coordinator sbearor@hinfonet.org Franklin Health Internal Medicine; PCMH Practice: Trudy Iams, RN, Lead Nurse/Care Coordinator tiams@fchn.org We want to hear your feedback and stories! 19 19