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Healthcare Today: A Disconnected System

Partnering to Improve Patient Health Outcomes Polly Mullins-Bentley, RN, RHIT, CPHQ Acting Executive Director Governor’s Office of Electronic Health Information State Health I.T. Coordinator. Healthcare Today: A Disconnected System. Islands of data Poor coordination Fragmented processes

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Healthcare Today: A Disconnected System

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  1. Partnering to Improve Patient Health OutcomesPolly Mullins-Bentley, RN, RHIT, CPHQActing Executive DirectorGovernor’s Office of Electronic Health InformationState Health I.T. Coordinator

  2. Healthcare Today: A Disconnected System • Islands of data • Poor coordination • Fragmented processes • Limited connectivity • Patients and clinicians often left without tools and data required

  3. NQS Framework 3

  4. 1. Making Care Safer 2. Ensuring Person- and Family-Centered Care  3. Promoting Effective Communication and Coordination of Care  4. Promoting the Most Effective Prevention and Treatment of the Leading Causes of Mortality, Starting With Cardiovascular Disease 5. Working With Communities to Promote Wide Use of Best Practices to Enable Healthy Living 6. Making Quality Care More Affordable National Quality Initiative: Aims, Priorities and Goals for Improving Quality

  5. eHealth in Kentucky • eHealth Milestones • March/2005 • Legislation (Senate Bill 2) to create a secure interoperable statewide electronic health network • 2007 -2008 • Medicaid Transformation Funding - $4.9 million • Built the technical infrastructure for the KHIE • 2009 • ARRA/HITECH Funding - $9.75 million • 2010 • Kentucky Health Information Exchange LIVE

  6. Kentucky Health Information Exchange: Governance Structure • Polly Mullins-Bentley, ActingExecutive Director, • CHFS, Governor’s Office of Electronic Health Information (GOEHI)

  7. Governor’s Office of Electronic Health InformationStrategic Priority Goals • Promote and increase the adoption and use of health information technology • Assist with and facilitate state-wide meaningful use initiatives (with other HITECH programs) • Provide governance and oversight to the Kentucky Health Information Exchange • Provide HIE Connectivity to as many providers as possible as quickly as possible • Build critical mass • Demonstrate value • Assist providers in meeting meaningful use • 2012 Key Goals • Immunization Testing for Stage One MU • Work with pharmacies to increase electronic prescribing in KY • Implement lab results exchange with delivery • Facilitate exchange of key clinical information to improve transitions of care • Implement Direct Secure Clinical Messaging 7

  8. Data Sharing! • Community/Master Patient Index • Populated by ADT’s/patient demographics • Record Locator Service • Locates all the patient encounters • Consolidates patient information for presentation to the provider • Access • KHIE Community Portal/Virtual Health Record • Provider EHR Portal/Dashboard How the Exchange ‘Works’

  9. KHIE Community Portal (Virtual Health Record)

  10. Implementation Success • 226 Participation Agreements Signed • Represents 500+ provider organizations • Active implementations • 82 LIVE Connections • Data is being exchanged between providers today • Labs, Rads, Transcribed Reports • Clinical Summaries (CCD’s) • Immunizations routed to the KY IR • Policies written, approved and in effect

  11. Participation Agreements Hospitals/Physicians by County 226 Signed PA’s Updated 08/10/12 Campbell Boone Congressional District 4 Congressional District 6 Hospital Physician Lab Combination Kenton Gallatin Bracken Pendleton Carroll Grant Mason Trimble Congressional District 3 Owen Greenup Robertson Lewis Henry Harrison Oldham Fleming Nicholas Carter Franklin Boyd Congressional District 2 Scott Shelby Rowan Bourbon Jefferson Bath Elliott Woodford Lawrence Montgomery Spencer Fayette Bullitt Anderson Menifee Clark Hancock Jessamine Meade Morgan Powell Johnson Mercer Henderson Martin Nelson Breckinridge Washington Wolfe Estill Union Daviess Madison Magoffin Hardin Garrard Boyle Lee Larue Marion Floyd Breathitt Webster McLean Pike Lincoln Ohio Jackson Owsley Grayson Rockcastle Crittenden Taylor Knott Hart Casey Perry Hopkins Edmonson Green Butler Livingston Muhlenberg Clay Caldwell Pulaski Leslie Laurel Letcher Adair Ballard McCracken Metcalfe Russell Lyon Warren Barren Carlisle Marshall Christian Knox Logan Todd Cumberland Harlan Trigg Wayne Whitley Graves Simpson Allen Hickman Clinton McCreary Monroe Bell Calloway Congressional District 5 Fulton • Other Participation Agreements: • Kentucky Immunization Registry • Kentucky Cancer Registry • Kentucky State Laboratory • Cumberland Medical Lab • Labcorp Congressional District 1

  12. KHIE Hospital Participation Agreements Hospitals by County 64 Signed PA’s representing 90 Hospitals (22 are CAH) Updated 08/13/2012 Campbell Boone Congressional District 4 Congressional District 6 Hospital Kenton Gallatin Critical Assess Hospital Bracken Pendleton Carroll Grant Mason Trimble Congressional District 3 Owen Robertson Lewis Greenup Henry Harrison Oldham Fleming Nicholas Carter Franklin Boyd Congressional District 2 Scott Shelby Rowan Bourbon Jefferson Bath Elliott Woodford Lawrence Montgomery Spencer Fayette Bullitt Anderson Menifee Clark Hancock Jessamine Meade Morgan Powell Johnson Mercer Henderson Martin Nelson Breckinridge Washington Wolfe Estill Union Daviess Madison Magoffin Hardin Garrard Boyle Lee Larue McLean Marion Floyd Breathitt Webster Pike Lincoln Ohio Jackson Owsley Grayson Rockcastle Crittenden Taylor Knott Hart Casey Perry Hopkins Edmonson Green Butler Livingston Muhlenberg Clay Caldwell Pulaski Leslie Laurel Letcher Adair Ballard McCracken Metcalfe Russell Lyon Warren Barren Carlisle Marshall Christian Knox Logan Todd Cumberland Harlan Trigg Wayne Whitley Graves Simpson Allen Hickman Clinton McCreary Monroe Bell Calloway Congressional District 5 Fulton Congressional District 1

  13. FQHC Participation Agreements FQHC by County 11 Signed PA’s representing 51 Sites Campbell FQHC Boone Congressional District 4 Congressional District 6 Kenton FQHC Sites live on KHIE Gallatin Bracken Pendleton Carroll Grant Mason Trimble Congressional District 3 Owen Robertson Lewis Greenup Henry Harrison Oldham Fleming Nicholas Carter Franklin Boyd Congressional District 2 Scott Shelby Rowan Bourbon Jefferson Bath Elliott Woodford Lawrence Montgomery Spencer Fayette Bullitt Anderson Menifee Clark Hancock Jessamine Meade Morgan Powell Johnson Mercer Henderson Martin Nelson Breckinridge Washington Wolfe Estill Union Daviess Madison Magoffin Hardin Garrard Boyle Lee Larue McLean Marion Floyd Breathitt Webster Pike Lincoln Ohio Jackson Owsley Grayson Rockcastle Crittenden Taylor Hopkins Knott Hart Casey Perry Edmonson Green Butler Livingston Muhlenberg Clay Caldwell Pulaski Leslie Laurel Letcher Adair Ballard McCracken Metcalfe Russell Lyon Warren Barren Carlisle Marshall Christian Knox Logan Todd Cumberland Harlan Trigg Wayne Whitley Graves Simpson Allen Hickman Clinton McCreary Monroe Bell Calloway Congressional District 5 Fulton Congressional District 1

  14. Rural Health Clinics Participation Agreements RHC by County 42 Signed PA’s representing 80 Sites Updated 08/13/2012 Campbell RHC Boone Congressional District 4 Congressional District 6 Kenton Gallatin Bracken Pendleton Carroll Grant Mason Trimble Congressional District 3 Owen Robertson Lewis Greenup Henry Harrison Oldham Fleming Nicholas Carter Franklin Boyd Congressional District 2 Scott Shelby Rowan Bourbon Jefferson Bath Elliott Woodford Lawrence Montgomery Spencer Fayette Bullitt Anderson Menifee Clark Hancock Jessamine Meade Morgan Powell Johnson Mercer Henderson Martin Nelson Breckinridge Washington Wolfe Estill Union Daviess Madison Magoffin Hardin Garrard Boyle Lee Larue McLean Marion Floyd Breathitt Webster Pike Lincoln Ohio Jackson Owsley Grayson Rockcastle Crittenden Taylor Hopkins Knott Hart Casey Perry Edmonson Green Butler Livingston Muhlenberg Clay Caldwell Pulaski Leslie Laurel Letcher Adair Ballard McCracken Metcalfe Russell Lyon Warren Barren Carlisle Marshall Christian Knox Logan Todd Cumberland Harlan Trigg Wayne Whitley Graves Simpson Allen Hickman Clinton McCreary Monroe Bell Calloway Congressional District 5 Fulton Congressional District 1

  15. LIVE Connections Boone Congressional District 4 Congressional District 6 Hospital Physician/Clinic Lab Combination Kenton Campbell Gallatin Bracken Pendleton Carroll Grant Mason Trimble Congressional District 3 Owen Greenup Robertson Lewis Henry Harrison Oldham Fleming Nicholas Carter Franklin Boyd Congressional District 2 Scott Shelby Rowan Bourbon Jefferson Bath Elliott Woodford Lawrence Montgomery Spencer Fayette Bullitt Anderson Menifee Clark Jessamine Meade Morgan Hancock Powell Johnson Mercer Henderson Martin Nelson Breckinridge Washington Wolfe Estill Union Daviess Madison Magoffin Hardin Boyle Garrard Lee Larue Marion Floyd Breathitt Webster McLean Pike Lincoln Ohio Jackson Owsley Grayson Rockcastle Crittenden Taylor Knott Hart Casey Perry Hopkins Edmonson Green Butler Muhlenberg Clay Livingston Caldwell Pulaski Leslie Laurel Letcher Adair Ballard McCracken Metcalfe Russell Lyon Warren Barren Carlisle Marshall Christian Knox Logan Cumberland Todd Harlan Trigg Wayne Whitley Graves Simpson Allen Hickman Clinton McCreary Monroe Bell Calloway Congressional District 5 Fulton • Others: • Kentucky Immunization Registry • State Lab (Microbiology) (Franklin) • Grundy, VA Congressional District 1

  16. Outreach Coordinator Regions Campbell Boone Kenton Region 1 – Laura Shonk Region 2 – Teresa Poff Region 3 – Ann O’Hara Region 4 – Dawn Gasser Region 5 – Pat Robinson Gallatin Bracken Pendleton Carroll Grant Mason Trimble Owen Greenup Robertson Lewis Henry Harrison Oldham Fleming Nicholas Carter Franklin Boyd Scott Shelby Rowan Bourbon Jefferson Bath Elliott Woodford Lawrence Spencer Fayette Bullitt Montgomery Anderson Menifee Clark Hancock Meade Jessamine Morgan Powell Johnson Mercer Henderson Martin Nelson Breckinridge Washington Wolfe Estill Union Daviess Madison Magoffin Hardin Garrard Boyle Lee Larue Marion Floyd Breathitt Webster McLean Pike Lincoln Ohio Jackson Owsley Grayson Rockcastle Crittenden Taylor Knott Hart Casey Livingston Perry Hopkins Edmonson Green Butler Muhlenberg Clay Caldwell Pulaski Leslie Laurel Letcher Adair Ballard McCracken Metcalfe Russell Lyon Warren Barren Carlisle Marshall Christian Knox Logan Todd Cumberland Harlan Trigg Wayne Whitley Graves Simpson Allen Hickman Clinton McCreary Monroe Bell Calloway Fulton

  17. GOEHI’s Plan/Scope of Work • Assist the existing Pennyroyal Behavioral Health recipient with KHIE connectivity • Provide connectivity for other CMHCs • Enhance the capability of the KHIE and the current CCD • Develop a 42 CFR 2 compliant consent • Develop consent training protocols • Inform both healthcare providers and consumers about this process

  18. Hospitals Imaging Center What’s Possible? With a Connected Community Tightly Aligned Physicians Owned Practices/ Clinics Better Care Affordable Care Health People/Healthy Community Reference Lab Community Pharmacy Non-affiliated Practices Patients Loosely Affiliated Physicians

  19. More information on the KHIE can be found on the Governor’s Office of Electronic Health Information website at http://khie.ky.gov Polly.Mullins-Bentley@ky.gov

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