“From Interaction to Integration to Transformation: Healthcare’s Journey & Information’s Role”

1. “From Interactionto Integration to Transformation: Healthcare’s Journey & Information’s Role” Mike Mote Vice President Product & Service Strategy

2. HealthBridge Background

3. HealthBridge • One of the nation’s oldest, largest, most advanced and successful health information exchanges • In operation since 1997 • 501c3 Not for Profit • One of only a handful of HIE/RHIOs nationwide with a sustainable business model • (Pre ARRA) 97% of revenue from fees; <3% grants • 5-12% annual return for last eight years

4. HealthBridge • Delivers more than 3.5 million clinical messages PER MONTH; more than 35 million messages for 2010 • Total of 50+ hospitals, 7500 physicians • Connectivity with 40+ HIS/LIS; 27 different ambulatory vendors, 60+ versions • Provide technology infrastructure for four other HIEs – Dayton HIN, CCHIE, HealthLINC, NEKY RHIO • Cincinnati Network • 26 local hospitals in Kentucky, Ohio and Indiana • 5500+ physicians • 17 local health departments • Large commercial, hospital, & physician office labs • Diagnostic centers

5. HealthBridge

6. HealthBridge HIE Value Progression • Meaningful Use, Medical Home and Payment Reform

7. HealthBridge – HIE Services • EHR Integration/Interfaces • Electronic Results Delivery – • Labs, Radiology, ADT, etc. • Electronic Order Entry • E-Prescribing • HIE Portal & User Management • HIE Technology Support – Master Patient Index, Provider Directory and Record Locator Service • Summary Record Exchange • Nationwide Health Information Network Direct and CONNECT Gateway & Connectivity • Public Health Reporting & Syndromic Surveillance • Billing and Eligibility Verification • HIE Consulting, Outsourced Technology & Implementation

8. HealthBridge – Future Plans • REC - Expanded Meaningful Use Assistance for Stages 2-3 • Beacon - Enhanced Suite of Quality Improvement, Care Transformation and Accountable Care Services and Tools (Data Warehouse, Data Analytics, Summary Patient Records, etc.) • Patient Engagement- Connectivity to Personal Health Records, Mobile Technologies and Consumer Technologies (Beacon, IN Challenge Grant) • HIE Expansion– • Connect to new providers and stakeholders for improving continuity of care (home health, long-term care, payers, etc.) • Connect with State HIEs and Provider Networks (IN, KY, OH) • Use Nationwide Health Information Network (NwHIN) Direct and CONNECT platforms • Spread of Advanced Technologies to Other Communities • Community Credentialing

9. “From Interactionto Integration to Transformation: Healthcare’s Journey & Information’s Role” Creating a Community Data Repository

10. Healthcare’s Journey • Whether or not you believe that REFORM is coming here are some thoughts to ponder: • The US healthcare system is broke; the current rate of growth can not be sustained; 1/6th of the US economy is based upon healthcare • New York Times article claims “By 2020 the American health insurance industry will be extinct.” • Accountable care is coming; Value based payments are coming; Volume based payments will continue to decline • Missing data today results in missed opportunities to: • Prevent complications • Ensure better outcomes • Reduce unnecessary costs • Reduce patient’s safety risks • Improve transitions in care

11. The “Journey” Business Realities Penalties Incentives

12. Care Delivery’s Journey

13. Quality Metrics’ Journey

14. Payment Reform’s Journey

15. Data Analytics’ Journey

16. Information’s Journey

17. Information’s Role

18. Information’s Role – Domain Requirements Encounters People & Organizations Referrals & Authorizations Lab Orders & Results Appointments Patient Revenues (Charges, Grants ..) Medications & Prescription Information Provider Expenses (Payroll, Supplies, Infrastructure, …) Immunizations Payer Products Radiology & Transcribed Reports Staff Member Enrollment Master Data (ICD, CPT, DRG, HCPCS, CCS, CRG …), Geography Medical & Rx Claims Facility Medical Conditions (Allergies, Family-social-medical history) Revenue, Billing, & Payment Data Clinical Observations & Vital Signs Utilization Provider Payer Legend:

19. Creating a Community Data Repository & Establishing a Community Data Trustee

20. HealthBridge’s Data Infrastructure • New Suite of Health Care Innovation & Quality Improvement Tools and Services funded through Beacon Program: • Disease Registry • Clinical & Claims Data Warehouse • Data Analytics and Business Intelligence • Alerts & Notifications • Transitions in Care Assistance • Quality Reporting Support • Process Improvement and Workflow Redesign Support

21. HealthBridge’s Solution Components • Enterprise Master Patient Index (eMPI) • IBM’s Initiate™ • Clinical & Claims Data Repository & Clinical Analytics • PluralSoft’s CareQuotient™ • Semantic Data Normalization • Clinical Architecture’s Symedical™ • Claims Data Grouping Engines • OPTUMInsight’s Symmetry™ • Patient Registry • WellCentive’s Registry™

22. Why? • Today this enables • Identification of gaps in care • Point-of-Care Decision Support • Patient engagement • Longitudinal Patient Record • ED, Admission, & Discharge Alerts & Notices • Information exchange at the point of Transitions in Care • Intra-practice comparative performance analytics • Interoperability between organizations (“Rosetta Stone”)

23. Why? • Tomorrow this will enable: • Population-based performance measurement • Risk adjusted comparative performance analytics • Risk adjusted comparative cost analytics • Predictive modeling & performance forecasting • Service demand forecasting • Payment incentive modeling • Revenue versus cost modeling • ACO business and operational modeling • Best practice identification & modeling

24. Q & A