Meridian Physician Summit Building and Connecting the Medical Neighborhood June 7, 2014

1. Meridian Physician SummitBuilding and Connecting the Medical Neighborhood June 7, 2014

2. Topics

3. Jersey Health Connect (JHC) • Non profit NJ Health Information Organization (HIO) established in 2010 • Largest HIO in the state • 4th Largest transactional volume in the Nation • Powered by technology from RelayHealth • Provides access to both physicians and patients • Meridian signed as a member - Feb 2014

4. A Shared Vision for New Jersey… Electronic access to aggregated health information available whenever and wherever it is needed at the point of care. • Improve care coordination, access, outcomes and efficiencies through the use of technologies facilitating to real-time clinical exchange • Comply with national standards related to privacy and security considerations • Allow organizations to maintain individual technology strategies • Provide consumers a consolidated view of their health information to encourage active and informed participation

5. Jersey Health Connect (JHC) 30 Of The State’s Leading Healthcare Providers

6. Hospitals Contributing Data 2012 2013 2014 Overlook Morristown Newton Hamilton Clara Maass Saint Barnabas Medical Center New Brunswick Rahway

7. Jersey Health Connect By The Numbers 766 Connected Practices 1,778 Connected Physicians 20,221 Patient Queries 139,597 Connected Patients 2.6M Results & Messages (serves 6 million patients in 10 counties)

8. 4th Largest Directed TransactionsIn The Country

9. Benefits to JHC Membership • Collaborative model to improve patient care • Opportunity for patient engagement with Personal Health Record • Ability to share and retrieve patient care data across healthcare systems and electronic records platforms

10. What are JHC members contributing? • Patient demographics/Visit History • Lab results • Radiology results • Transcribed documents • CCD/CCDAs

11. What is a CCD? CCD stands for Continuity of Care Document • Contains a summary of the patient’s health status from an episode of care. May include • Allergies • Problems • Medications • Results • Procedures • Vital Signs • Past Medical Hx, Family Hx, Social Hx • Advance Directives • Insurance • Structured format

12. www.jerseyhealthconnect.org

13. Jersey Health Connect (JHC) • Meridian Affiliation Network Connection • Phase 1

14. Acute Facilities & Emergency Depts Post Acute Facilities JSUMC BCH SOMC RMC OMC Home Health LTC Jersey Health Connect ….. powered by RelayHealth Implementation Underway – Phase 1Meridian Affiliation Network Physician Practices eClinicalWorks Allscripts Pro GE Centricity Greenway Practice Fusion Vitera

15. Meridian Affiliation Network Phase 1 Connections Timeline Joined JHC Planning & Vendor Alignment Acute Care Patient (PHR) Ambulatory EMRs & Home Health Provider Portal Long Term Care JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

16. Jersey Health Connect ……………Powered by RelayHealth

17. RelayHealth Clinical Platform Footprint 267 health systems & partners participating 3M+ patients enrolled online 48M+ patient records managed 720k patient messages sent/month 30M+ clinical transactions sent/month 85+ HIEs nationwide powered by RelayHealth 48k+ providers accessing data 125+ healthcare IT vendors integrated DOD 100+ MTFs 10K+ physicians 800K enrolled patients JHC 30 hospitals 1800 physicians 140K enrolled patients

18. Key Capabilities of RelayHealth • Secure Messaging • Provider to provider • Provider to patient • ED Notification • Results Delivery to EMR • Exchange data between EMRs • Provider Portal • Embedded Personal Health Record (PHR)

19. Relayhealth Demonstration

20. Questions & Answers

21. Meridian Physician SummitIntegrating Clinical InformationJune 7, 2014

22. Meridian / Physician EMR Connectivity Update • Connectivity progress over the last 6 months • Hard at work on Cardiology Results

23. Meridian’s Integrated Health Care Delivery System Meridian’s Connected Continuum

24. Meridian’s Continuum Challenge Today data does not always flow between the systems that support our continuum of care • Each service uses a system from a different IT vendor • Inpatient data does not reside in the same database as Ambulatory data • Limited ability for advanced data analytics • Patient data from across the continuum is not easily available to physicians • Patients have often have identifiers that are unique to each computer system making it difficult to merge patient data across the continuum

25. 4 Integrating Clinical Information 3 Meridian has launched an initiative to evaluate the use of an Enterprise Data Warehouse (eDW) to integrate data from across the continuum of services to support the Clinically Integrated Network and Population Health Management. An enterprise data warehouse (eDW), is a database used for reporting and data analysis. Integrating data from one or more disparate sources creates a central repository of data. 2 1 Our Process Down to two finalists used by leading health systems Conducted numerous system demonstrations and technical reviews Spoke to dozens of vendors, consultants and hospital systems and published our requirements Built a Cross Functional Team

26. Meridian Enterprise Data Warehouse - Future State -Disease Registry -Misc. Analytical Systems -Etc. Physician Access Crimson Care Registries MedSeek CRM Predictive Modeling Contact Management P.H. Analytics (TBD) Analytical Systems CMS & Payer Data Meridian Enterprise Data Warehouse Relay Health HIE ETL, Data Warehousing & DSS ETL Engine -Physician EMR CCD’s -Soarian CCD’s -Ext. Lab -Etc. Siemens Data Warehouse Core Operational Systems Soarian Invision Lawson Centricity Cerner -AllScripts -ECHO -Planning -Palliative Care -Etc. Sigma Care -Siemens Pharmacy -Sunquest Lab -Etc.

27. Enterprise Data Warehouse Benefits • Aggregate, transform and reconcile data from cross the continuum of care • Identify, score and project the risks of individual patients • Disease Registries • Physician scorecards • Physician access to information on their population

28. Population Health Analytics - Registries • Disease Registries • Identify high risk patients • Identify patients with care gaps • Provide consistent measurement of quality • Chronic Disease • Diabetes, Hypertension, Heart Failure, etc • Wellness • Pediatric, Adult, Senior & Maternity • Medications • Generic Dispense Rates • Medication Utilization • Support reporting requirements (ACO, HCQA, CMS, HEDIS, etc)

29. Attributed Population Auto-segmented into defined clinical Registries Specific to attributed Population

30. Specific to attributed Population Real-time view of current performance Support PCMH, value based purchasing & visibility into care gaps

31. Real-time, summary performance score calculated by the system Scorecard reflects clinical, financial, and other performance metrics.

32. Drill-down to patient-centric view and performance against defined measures

33. Connecting with Community Physicians eDW vendors & HIE’s like Relay Health are developing their solutions for exchanging data with each other, but the capabilities are still evolving • We have had extensive conversations with Relay Health and the eDW vendors • Over 40 EMR’s in use by Meridian Physicians eDW In Patient EMR HIE Physician EMR Lab Results

34. Connecting with Community Physicians eDW connectivity with community physicians is predicated on use of EMR’s & EMR CCD connectivity with an HIE • Meridian IT is working to connect physician EMR’s with the current HIE • We have connected 155 Physicians to the HIE for CCD’s • Many physicians do not use an EMR today Physician EMR Your Logo

35. Mobile Apps Looking to roll out a Pilot this summer and enterprise wide deployment if successful HIPAA-Secure Messaging • Receive admit & discharge notifications, critical values, exchange critical patient information including X-rays, EKGs & images with colleagues Easy-Access Member Directory • Locate regional physicians by last or first name or by specialty Care Team Directory • Physician created Care Team Pharmacy Search • Find and map a local pharmacy, search by zip code, city, street name Physician Groups • Search physicians by facility privileges or groups of which they are a member

36. The Connectivity Challenge & The Road Ahead 2016 ICA HIE Jersey Health Connect HIE Mobile Apps with Admission, Discharge and Results Enterprise Data Warehousing and Advanced Analytics 2015 2014 2014 Lab, Radiology & CCD connections 2013 2014 2012 ACO Analytics 2011 Your Logo

37. Thank You