Connecting Healthcare Stakeholders Through HIT and Health Information Exchange

1. Connecting Healthcare Stakeholders Through HIT and Health Information Exchange The Inland Northwest Health Services Story Thomas Fritz, CEO

2. Inland Northwest Health Services INHS is a not-for-profit 501(c)3 corporation created in 1994, owned by the hospitals in Spokane and serving residents of WA, ID, MT, OR and Canada. We facilitate clinical care by: • Improving clinical outcomes through information access and integrated clinical systems for physicians, hospitals, clinics and other health providers • Acting as the “trusted party” and secure custodian for the regional clinical data repository and a community-wide electronic medical record and serving as a neutral party for all hospital-based collaboration • Leveraging collaborative assets to control costs and provide high levels of expertise using shared resources

3. Scope of System • 32 hospitals, with over 3,000 beds, participating in the integrated information system • More than 400 Physician practices are able to view hospital, laboratory and imaging data via a private network. • More than 700 physicians accessing patient records and 225 wirelessly in hospitals via personal digital assistants • 67 hospitals, clinics and public health agencies connected to the region’s telemedicine network • 180 member technical staff serving over 18,000 end users

4. Community RHIO Governance • Inland Northwest Community Health Information Project (INCHIP) • Advisory and decision-making body on community-wide health information standards and processes • Voluntary coalition, with members meeting regularly to discuss and make recommendations and decisions • Governed by Board of Directors with physician, non-physician, and community representatives • Obtain agreement on key issues, I.e. data exchange processes and standards

5. 500,000 Local Area Population Largest Healthcare Service Availability Between Seattle and Minneapolis 9,000,000 Regional Population

7. INHS Regional Network 3 to 5 Years

8. Physician EMR Views per Month EMR Views per Month Office Staff = 36,000 Physicians = 49,000

9. Accomplishments • We have improved clinical outcomes through information access and integrated clinical systems for physicians, hospitals, clinics and other health providers • We have become the “trusted party” and secure custodian for a regional clinical data repository. • We have leveraged collaborative assets to control costs and provide high levels of expertise using shared resources

10. Accomplishments • We established a regional Master Patient Index standard that has allowed us to gather and distribute patient data to the caregivers in our region • Weestablished standard data sets, allowing comparison of clinical data and enhancing the longitudinal patient record • We created a regional integrated information system that connects hospitals, clinics and physician offices, providing a community Electronic Medical Record

11. Accomplishments • Weconnected Physicians throughout the region, directly in their offices and wirelessly within our hospitals, providing relevant clinical data when and where they need it • We enhanced care in rural areas by connecting residents and clinicians to specialists through an extensive regional telemedicine network • We increased patient safety by utilizing advanced systems

12. Obstacles and Challenges • Limited funds from rural hospitals slows their adoption of key clinical systems • Each new hospital brings new challenges – wanting everything for nothing • Minimal physician office automation has slowed the longitudinal electronic medical record • Poor IT investment decisions – hospitals and physicians are buying IT without knowing enough

13. What we have learned • Creating a sustainable business model: • Leverage assets • Provide an efficient cost plus model • Create standardization • Assure value-added services • Assure quality of services • Get lowest cost from vendors • If you do these things, customers will stay and the business will be sustainable

14. What we have learned • Drivers are what affect joint ventures • Are the drivers financial? Probably should look at standardization of information systems • Are the drivers clinical (data exchange)? Can focus on data standards for information sharing • Identify the real business needs of the participants and their communities

15. What we have learned • How do you create sharing among competitors? • Let competitors run on the same network • Governance needs to be neutral, not favoring any competitor • Neutral governance organization can promote agreements on common issues (MPI, network standards, etc)

16. What we have learned • Community governance organizations take work • Members continuously jockey for position • Members have to be willing to set aside self-interest • Everyone has to keep working at it • Organization must have structure. expectations for conduct, and ground rules for communication and problem-solving

17. Thank You Tom Fritz fritzt@inhs.org Fred Galusha galushf@inhs.org Jac Davies daviesjc@inhs.org www.inhs.org