ACO to MU Healthcare IT

ACO to MU Healthcare IT

Healthcare IT: Talking about a Revolution!!! Russ Branzell CIO/Vice President, Information Services CEO/Poudre Valley Medical Group Poudre Valley Health System FACHE, FCHIME, FHIMSS, CHCIO

Current Healthcare IT

Change in National Healthcare Spending Source: Hussey, et al NEJM 361: 2109-2111 Nov. 26 2009

American College of Healthcare Executives Top Issues Confronting Hospitals: 2010 Issue 2010 2009 2008 2007 Financial challenges 77% 76% 77% 70% Healthcare reform implementation 1 53% 53% Governmental mandates 32% 30% 26% 22% Patient safety and quality 2 31% 32% 43% 33% Physician-hospital relations 30% 25% 32% 35% Care for the uninsured 28% 37% 41% 38% Patient satisfaction 16% 15% 22% 17% Personnel shortages 11% 13% 30% 30% Technology 10% 7% 9% Capacity 6% 7% 16% 11% Governance 3% 2% Issues about not-for-profit status 2% 1% 2% Disaster preparedness 3 < 1% 1% 1%

The Healthcare CIO: From Crawling to Walking Upright to Carrying the Organization An Advisor role Tech Manager IT Operations A Supportive role Application Purveyor Vendor Manager Project Manager Asset Manager Problem Manager Skill Manager Process Navigator An Enabler role + + Knowledge Purveyor Technology Interpreter Process Visionary Process Consultant Financial Analyst Change Agent Educator Lobbyist A Driver role CIO 1.0 CIO 1.5 CIO 2.0 Source: Gartner CIO 2.0 Conference Service Broker Project Advisor Venture Capitalist Customer Service Innovator Economist Risk Manager Political Visionary

CIO Competencies and Skills Skills Technical Financial Managerial Leadership Relationship IT Mgr. CIO 1.0 CIO 1.5 CIO 2.0 80% 20% 20% 30% 25% 15% 15% 15% 45% 25% 10% 35% Standards, Delegation, Technical Operations, Cost Drivers, IT Processes Resource Maximization, Financial Reporting, Project Management, Vendor Management Strategic Thinking, Communication, Negotiation Collaboration, Change Leadership, Education, Influencing/Selling Business 15% 55% Business Processes, Political Environment, Industry, Economics, Globalism Source: Gartner CIO 2.0 Conference

Evolutionary versus Revolutionary Change CIO s Dilemma

Time for a revolution Disruptive innovation is a term used in business and technology literature to describe innovations that improve a product or service in ways that the market does not expect, typically by lowering price or designing for a different set of consumers.

Current Technology is Failure Current investments massively under utilized and leveraged Current purchases solve current problems Commodity Distracters Examples PACS VOIP email

From Accountable Care to Meaningful Use Why HIE is the Linchpin Chad Jones AVP Corporate Systems, Epic Project Executive Ochsner Health System New Orleans, LA

Agenda Ochsner Health System Overview Background Plan Leverage HIE concepts for internal data sharing Initiate MPI to connect disparate IP and OP EMRs HIE Aggregation platform Orion Health Connect Private Practice Physicians and provide Portal Next Steps: Extend technology to integrate with Epic

Ochsner Health System Overview Largest integrated, multi specialty, academic healthcare system in the Gulf Coast 8 hospitals across Greater New Orleans and Baton Rouge Regions Nearly 40 health centers throughout South Louisiana with 1.3M patient visits annually ~850 employed physicians in over 95 medical specialties and subspecialties Largest private employer in Louisiana with over 12,000 employees #1 fitness chain with 20,000 members, state of the art wellness facility

Ochsner Health System Quality Recognition Healthgrades Distinguished Hospital for Clinical Excellence Thomson Reuters Top 100 Hospitals, Top 50 CV Hospitals Thomson Reuters Top 15 Large Teaching Hospitals SDI Top 100 Integrated Systems US News & World Report Best 50 Hospitals 7 Specialties Top 11 Transplant program in the U.S.

Ochsner History and Recent Growth

2009 Strategic Plan OCW Practice Mgmt. Signature Billing Amb EMR EMPI Master Patient Index Initiate Systems Clinical Data Repository / Clinical Decision Support OMC/WB INVISION INVISION Pat Mgmt INVISION Pat Mgmt INVISION Pat Mgmt Pat Mgmt INVISION INVISION ADT INVISION ADT INVISION ADT ADT INVISION INVISION Patient INVISION INVISION Acct. Patient Acct. Quality Reporting K Patient Acct. Hospital BR Patient Acct. CPSI ADT CPSI Billing St. Anne LAB RAD PACS RX SURG CARD ED Dept Sys B Departmental Systems PBAR ADT PBAR Billing OMC NS Health Information Exchange (HIE) Private Practice Physicians ACO Clinical Integration Network Data Management Data Warehouse ECHO Eclipsys Bed Control Kronos Lawson Analytics Security / Disaster Recovery / Business Continuity

Current State CIN ACO Epic EMR or Portal C32 CCD

Next Steps Lessons Learned Now Deploying Epic, leveraging HITSP C32 Document exchange for legacy data access with CareEverywhere HIE is not one size fits all, we started with EMPI and view only portal Prioritize what data to exchange Beware mapping and standards issues i.e. SNOMED LOINC, external labs etc. Data Exchange is no longer optional, must be core competency of IS for strategic advantage

AHA Leadership Summit From Accountable Care to Meaningful Use, Why Health Information Exchange Is the Linchpin Doug Dietzman, Executive Director July 2011

Michigan Health Connect Mission: To advance the delivery and coordination of health care across Michigan through collaboratively leveraging information technology and clinical data exchange. Current Anchor Members Ascension Health Beaumont Hospitals Lakeland Health System McLaren Health Care Metro Health Northern Michigan Regional Health System Spectrum Health Trinity Health MHC Represents 46 hospital facilities Over 80% of counties in the lower peninsula 10,457 licensed beds 1.47 million annual ED visits Over 13,000 combined active medical staff 22

MHC Model & Characteristics Privately funded & sustainable no state or federal grants to-date True community RHIO collaboration amongst competitors Focused on incremental, value-add services (bottom up) rather than a governance driven, big bang approach (top down) 23

MHC Model & Characteristics Incremental, subscription-based pay-asyou-grow business model Solutions are no-cost to physician offices Members retain control over their data and can participate at their own pace with the solutions that make the most sense for their organization 24

MHC Guiding Principles There is no need, or requirement, for MHC to do it all solve real problems / gaps Complement and collaborate with, don t duplicate, existing services and solutions Keep providers and other users in their native systems if at all possible Can be done focus rather can t be done Become Indispensable and Invisible 25

Today s Solution Components Solutions connecting hospital members and over 600 provider offices across the state. MHC Results - 830,000+/mo MHC Lab Orders - 13,400+/mo MHC Scheduled Orders - 900+/mo MHC Referrals - 75 locations, 59 specialties MHC Community Viewer (MPI/RLS) - Sept 11 26

Why Collaborate? RHIOs aside electronic, community HIE is an Enterprise imperative and non-negotiable the question is how best to meet it Connectivity quickly becoming a commodity Economies of scale: technology platform, vendor interfaces, and process expertise Proactive vs Reactive position it is happening, who wants to drive? 27

Why Collaborate? Quality programs (e.g., readmissions) require collaborative data sharing across organizations Risk-based funding models require aggregated, normalized data from external sources Your employed / affiliate EMR providers need electronic data from your competitors It does not require giving away your jewels It s part of your organization s Mission 28

Challenges Being satisfied with general fairness vs absolute fairness Building new stakeholder business models Communicating need for collaboration across all areas within member organizations Balancing enterprise needs/timing with community needs/timing 29

Future? HIE is a personal story for each person Solve problems Eliminate the binder 30

Colorado Initiatives

Questions????