Metropolitan Chicago Consortium Health Information Exchange Greater Chicago Chapter of HIMSS

1. April 15, 2010

2. MCHC Mission The Metropolitan Chicago Healthcare Council (MCHC) is a membership and service organization dedicated to helping members care for their communities through access to health care and improved delivery of services.  Vision High quality, accessible healthcare for all communities.

3. Agenda Health Information Exchange Overview Metropolitan Chicago Consortium Health Information Exchange (MCC-HIE) What�s Next

4. A Critical Time for Health Information Exchange (HIE) In Illinois � On February 4, 2009, Governor Pat Quinn signed Public Act 95-1030 into law, appropriating $3 million to the Department of Healthcare and Family Services to establish a program for health information exchange planning. Across the Country � The American Reinvestment and Recovery Act (ARRA), signed into law on February 17th, dedicates more than $20 billion nationwide in federal funding to implement electronic health records and health data exchange by 2014.

5. Goals of Illinois HIE Improve healthcare quality and outcomes Reduce medical errors and redundant services Improve patient safety Enhance coordination of patient care among providers Engage patients and their families by providing meaningful health care information at the point of care Reduce health disparities; increase disease surveillance Control the cost of health care

6. 16 Medical Trading Areas (MTAs)

7. HIE Planning Grant Domains

8. State � Current Status Awarded 18.9 M Grant from ONC for State-wide HIE Must submit Strategic and Operating Plans before implementation dollars released ($1M to-date) Legislation on Private � Public Partnership Passed House unanimously; broad support Senate hearings began 4-13; second reading today! Evaluation on what pieces make most sense from state-wide perspective; Regionalization discussions Established Office of Health Information Technology to coordinate and leverage stimulus dollars

9. Health Information Technology for Economic and Clinical Health Act of 2009

10. HIE relationship to EMR

11.  2011 Meaningful Use Criteria: HIE �related  HIE requirements will rise significantly in 2013 

13. The Challenge

14. MCC-HIE : Focus of Success

15. Established an Advisory Board Broad stakeholder engagement Active participation, decision making and valued input Engaged in open discussion and thought that has lead to creative ideas Stayed on schedule and on budget Created a Strategic Business Plan and a HIE Model Agreed to initial Use Cases and a conceptual Architectural Model Created an Impact Analysis and initial Financial Model Agreed to a Communication and Marketing Plan framework

16. Utilize Best Demonstrated Practices: Heed Lessons Learned from Other RHIOs/HIEs A community emphasis requires a new organizational framework focused on the individual/patient and requiring the participation of all providers of care for that individual. Identity: who is Dr. X? Who is Patient Y? Authority: can Dr. X see my records? Standards: Can systems talk to one another? Certification: Do EHR systems use the best available standards? Quality: am I getting the care I need? Legal: am I protected�HIPAA�Consent?

17. MCC-HIE Entity

18. Initial Functionality Driving Benefits Top 5 Considerations Diagnostic results delivery CCR/CCD Exchange Medication/Allergy History ED Linking/Clinical Summary Registry State Reporting (Immunizations) HIE Foundation (Core) Services Patient Identity Management Patient Consent Management Record Locator Service Provider Directory

19. Federated, Centralized, Hybrid Alternatives Eliminated the concept of �Building� an HIE from scratch Eliminated �Pure� Federated (aka decentralized) and Centralized models; Decision is focused on a Hybrid approach Core Functions need to be centralized Use Case Discussion exemplifies model Services Approach/Vendor-Hosted System Architecture:

20. Hospital/Health System/Providers Benefit Opportunities* Measurable Economic Benefits: Achieving Meaningful Use Incentives and Penalty Avoidance Operational Efficiencies (clinical data exchange) Reduction in Uncompensated Care (offset by lost revenue from care avoidance) Shared Infrastructure (interface cost savings) Other Potential Benefits: Caregiver productivity Consumer/patient satisfaction Reduction in medical errors/improved quality Reduced malpractice costs and settlements *Findings from IHIE, HealthBridge and WHIE

21. SSI Case Example (SSA and MedVirigina*)Medical Determination for Disability Benefits Value to Persons with Disabilities Access to Healthcare Coverage Avoidance of Financial Burden Improved Health Outcomes Value to Care Providers Administrative Cost Savings Uncompensated Care Cost Recovery Patient Satisfaction

22. C�s

23. Physician/Clinic Benefits* Improved quality Reduced medical errors Meaningful use incentives Operating efficiencies and staff productivity; including quality of life for physicians Improved continuity of care Patient convenience *Findings from the eHealth Institute 2009 study

24. Payer/Employer Benefit Opportunities Economic: Reduction in unnecessary and duplicative tests and procedures Shared infrastructure cost savings Others (not easily quantified): Patient/member satisfaction Improved quality of care Platform for quality and performance measurement and reporting Improved health maintenance and associated cost reduction

25. Consumer Benefits Improved quality of care Increased patient safety Convenience, less hassle Cost savings Increased empowerment and control over information Privacy and security Peace of mind

26. Shared Value Model

27. Financial Principles Self Sustainability - Revenues Aligned with Cost & Value Sustainability via Operational Improvements Pricing Based on Value and Utilization Pricing to Promote Utilization and Adoption Requirement for Funding Prior to Breakeven

28. MCC-HIE Financial Model Overview

29. Marketing Communications Objectives Build positive brand awareness of HIE among key stakeholders. Establish HIE as the leading resource (in the targeted MTAs) for healthcare stakeholder organizations to achieve their business and clinical goals that are supported by health information exchange. Establish consumer awareness and trust in the HIE as vehicle for improving healthcare quality, efficiency, convenience, safety and customer satisfaction. Create momentum to accelerate stakeholder sign-ups to utilize and fund the HIE. Position the HIE as an important component in a state-wide, and eventually national, Health Information Exchange capability.

30. Communication Needs � What is it?� �What�s in it for me?� �I see need and value� �I want to participate�

31. Key Stakeholder Groups

32. HIE Program Management � Key Communication Categories Public Awareness Brand/Image Management Promotion and Acceptance Information and Education Media Management Crisis Management Partner relationship management Direct Client Communication Ambassador/Influencer Communication Project management updates Benefit Realization/Value Promotion Crisis Management Event Communication

33. Key Stakeholder Messages Categories

34. Tactical Communications � 30 to 90 days Raise awareness, establish credibility, and generate interest in working together Meetings with payers (State, Private Insurers, Self-Insured) Collaboration with employer outreach Continued outreach to health care providers Inform, align efforts, plan, and secure commitment HIE Focus Group Working Sessions (CFOs, CMO/CMIOs, CIOs�) Individual meetings with interested parties (1:1); Letter of Intent Collaboration with State of Illinois HIE /REC Grantees for Physician outreach Outreach to promote awareness and receive feedback �Preemptive communication� to avoid duplicative efforts Newsletter updates/Webinar briefings/Social networking Initiate Market Campaign and Development Begin branding Plan public awareness effort

35. Phase II - Overview Continue to refine the Business Plan and Delivery Model on an iterative basis Continue to harmonize with other MTA's and State of Illinois In addition to the Advisory Board, create two workgroups that will be able to assist in developing requirements Technical / Security Use Cases / Clinical Working with those healthcare providers that have expressed an interest in moving first, to develop the framework for the required mapping and technical services Update the Use Cases and build requirements that map to what is expected from the meaningful use final rules Have a check point that assesses the financial readiness to contract with a vendor(s) and moving toward initial implementation Utilize a hybrid process of continued drill down and iterations with vendors as the pool gets narrowed

36. What�s Next Ongoing Senior Executive Discussions across the Metro Chicago Area Broadening Stakeholder Involvement CMOs, CFOs, Payers, Employers Development and continued refinement of sustainability model Aggressive Timeline to meet Meaningful Use expectations -2011/2013 Get up with one or two use cases fast; has most impact Touches most people/entities Anticipating Regionalization with regards to the state�s HIE model Stakeholders to identify functional and technical requirements; RFI

37. Ten Things You should know about HIE Information should follow the patient, and artificial obstacles -- technical, bureaucratic, or business related -- should not be a barrier to the seamless exchange of information. Secure information exchange needs to occur across institutional and business boundaries so that the appropriate information is available to improve coordination, efficiency, and quality of care.�(ONC) It�s about health outcomes, not technology! Quality, Safety, Efficiency, Coordination of Care and Population Health. ARRA Stimulus funds: HIE, Meaningful Use, Regional Extension Centers and Workforce Development are highly interdependent! It�s not if, but when, organizations need to participate in HIE. Cannot meet meaningful use criteria for 2015, without it!

38. Ten Things about HIE (continued) Stakeholders expand beyond traditional healthcare providers; they include payers (government, private and self-insured), employers, consumers, and the broadest reaches of public health There is value and ROI in exchanging information; it varies depending stakeholders and use cases (services). Given any use case of exchanging information, within an organization, it�s all about workflow! Getting ready to participate will involve current EMR *use, interoperability standards, privacy and security, and end-user engagement. * Recognize need to provide access to those without EMR �Critical mass of health care organizations participating is key for consumers/patients and their families to manage their health and information with their providers.

39. MCHC HIE Department:www.mchc.org Mary Anne Kelly, Vice President, makelly@mchc.com Terri Jacobsen, Director, tjacobse@mchc.com Jose Lopez, Program Manager, jlopez@mchc.com Mari Franks, Program Manager, mfranks@mchc.com