6/5/2014

1. National HIT and HIE Trends And the Impact on the Physician Community NEOHC November 6, 2010 Camilla Hull Brown 6/5/2014 1

2. Consulting Background • Representative SFT Engagements • Health Team Works (Colorado Clinical Guidelines Collaborative) • Pennsylvania eHealth Collaborative • North Texas Health Information Exchange (Dallas – Fort Worth) • West Virginia Health Information Network • Michigan Health Information Network • Capital Area Health Alliance (Lansing, Michigan) • Michiana Health Information Network (South Bend, Indiana) • Colorado Regional Health Information Organization • Colorado Telehealth Network • healthLINC (Bloomington, Indiana) • Collaborating Communities Health Information Exchange (Springfield, Ohio) 2

3. Agenda The Way We Were vs. The Forces of Change National priorities State HIE Program Regional Extension Centers Beacon Grants Cam’s Assessment 3

4. A Compelling Vision: Patient Centric Care(Right data available at the “Point of Care”) 4

5. June 2009: Interview Findings(Non-Physicians and Physicians) • Range of responses: • “HIE makes sense for the community. Let’s do it.” • I have a big interest in this. This is important for the community to exchange data.” • “This is new to me: I want to learn more.” • Region is inefficient in care; need ability to look at data and measure outcomes. • This will dramatically improve patient care. • We need to improve continuity of care.

6. June 2009: Interview Findings(Non-Physicians and Physicians) • What you want the HIE to do • Help physicians become electronic • Send clinical messages across institutions • Results delivery and other communication between hospitals and physicians • Interfaces; Quality outcomes • Many comments on collaboration, impact on physicians • I would like to see hospital CEOs and physicians work together • Can we get all the hospitals and all the physicians? • Will this make physician work life better? • How can small practices afford this? • This is great, but who pays?

7. The Forces of Change Feb. 2009 HITECH Act with massive funding Federal funding of rural broadband, telehealth March 2010 Healthcare Reform Legislation Technology innovation (Health 2.0) Meaningful Use as a driver with incentives to change More innovation, more changes, more collaboration…more, more, more, and faster 7

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10. How We Get to Meaningful Use Health Information Exchange and Adoption • State HIE grants • Regional extension centers • Beacon communities • Public health infrastructure • Medicare and Medicaid incentives • Workforce development & expansion • Provider and consumer demand Context • Standards, certification, privacy and security, transparency, innovation, evaluation, etc. 10

12. State-level HIEs 56 awards – From $4.9M for Wyoming to $38.8M for California In the region • OHIP – numerous HIEs and IDNs • Michigan – MiHIN is connecting 7 community HIEs, IDNs, and state-wide HIE (medical society) • Indiana – IHIT will connect 5 community/regional HIEs • West Virginia – WHIN, statewide • Pennsylvania – PHIX, statewide • Kentucky – KHIE, 7 health system pilots 12

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15. Growth of Regional HIEs in Midwest Two of the largest HIEs in the country cross state lines • Indiana Health Information Exchange – 70 hospitals and 19,000 physicians in two states (Indiana and Northern Illinois) • HealthBridge – 40 hospitals, 5500 physicians in 3 states (Ohio, Indiana, and Kentucky); plus 20 hospital Dayton region will soon join In Ohio • HealthBridge, Wright State HealthLINK, Appalachian HIE, Kaiser Permanente, OCHIN, Inc. Patient Information Network, RH Positive, and Universata, Inc. • 40% of hospitals in Ohio are sharing info within orgs. 15

16. Greater Participation in HIEs 16

18. RECs Have a Very Big Task • Many physicians have a long way to go to become electronic • MU is not easy to do • Physicians may feel that incentives may not be worth the journey 18

19. Good News about MU Goals HARD TO DO, BUT… Stage 1 MU regulations are much easier to accomplish than first proposed • Only 5 of 15 core objectives. Examples: • Basic data collection functions • Enter clinical orders, in particular, eRX • Provide patients with electronic info • 5 of 10 advanced functions. Examples: • Lab tests entered in EHR • Drug formulary checks • Medication reconciliation • Provide summary of care record for referrals • Submit surveillance data to public health 19

20. Good News about MU Goals HARD TO DO, BUT… Many HIEs can meet mean MU goals Many simple, low cost EHRs meet MU goals RECs are here to help Incentive payments help a lot • $44,000 through Medicare; $63,750 Medicaid Northeast OHIO is collaborative, experienced, already organized 20

22. Beacon – Insight into the Future • Areas of interest • Care coordination along continuum, reduce re-admissions, reduce ED visits, patient self-help, disparities, Patient-centered Medical Home, immunizations, preventive services • Conditions • Diabetes, asthma, smoking cessation, hypertension, heart disease, obesity, pneumonia • Tools • HIE, PHR, telehealth, cell phone, health record bank, registries, alerts & reminders, patient portals • Regional Grants • IHIE (Indiana) • Cincinnati/HB • Metro Detroit • Geisinger (PA) 22

23. Cincinnati Beacon Collaboration Will work with Cincinnati’s Children’s Hospital and physician practices • 1) Provide optimal care for patients with asthma and diabetes, 2) reduce preventable visits to emergency rooms and re-hospitalizations, and 3) improve information flow and care coordination as patients move from one care setting to another. HealthBridge will provide connectivity • 1) For hospitals to alert care teams when a patient has been released from hospital, 2) for a PCP to send summary medical info to a specialist, 3) for patients to have improved access to their own health information, and 4) for researchers to determine which intervention has the most impact. 23

24. Momentum of Patient-centered Medical Home Modeled in several of the Beacon Grants • Personal physician • Team practice • Coordination across providers, family, and community-based services • Health IT and analytic tools • Greater access to physician and staff through the day • Financial incentives – for cost savings & quality improvements Aligns with Health Reform and Accountable Care Organization pilots 24

25. Cam’s Assessment The vision is the right vision But, very aggressive Back and forth between excitement and fear Examples of physicians adopting MU successfully across a community exist NEO HealthConnect is well positioned to help the physician community move together – if you want to do it 25

26. The End 26