HIE / RHIO Products and Services: Planning Framework

1. HIE / RHIO Products and Services: • Planning Framework

2. HIE / RHIO Products and Services: Planning Framework The purpose of these materials is to assist HIEs and RHIOs with product and service definitions, users, beneficiaries, benefits and alternate service fee approaches The following three pages are product and service matrices that list the recommended product / service segments for each of three categories of products and services that an HIE/RHIO may offer. The first matrix is digital healthcare information exchange services, the second is patient centric healthcare record summaries/aggregations and the third is supplemental systems and services. Pages 5-9 describe the five column headings (target users, beneficiaries, service fee basis, benefits and values), and list examples for each column. These materials have been developed by HNS to assist HIEs with the development of their product offerings, and are based on experience working with local, regional and state HIEs and RHIOs throughout the country. They should be reviewed, internalized and modified as needed to reflect the specifics of your HIE / RHIO. HNS has not filled in the cells with our reflections on the project and a beginning set of recommendations. 1

3. HIE / RHIO Products and Services: Planning Framework Digital Information – Phase I 2

4. HIE / RHIO Products and Services: Planning Framework Patient History – Phase II 3

5. HIE / RHIO Products and Services: Planning Framework Supplemental Products and Services 4

6. HIE / RHIO Planning Framework: Explanation Target Users (A) Target users are those people or entities whose effective use of the system and services to make decisions and take actions will be most important to achieving the desired benefits. Therefore, involving them in the design and testing should be considered, as their early and comprehensive adoption of the system will be essential to its success. • Physicians / Practice Staff • Service Provider Staff • Chronic Care Coordinators • Disease Management Staff • Public Health Program Staff • Patients • Pharmacists (Revise to reflect your HIE/RHIO’s specific circumstances.) 5

7. HIE / RHIO Planning Framework: Explanation Beneficiaries (B) Beneficiaries are those people and/or organizations to which the benefits will accrue from the effective use of the system by the target users. An important part of the planning and implementation is to develop and measure the metrics that will be used to document these results. • Service Providers • Physicians / Physician Practice • Insurers • Employers • Patients • Government Programs • Public Health Programs • Clinical Data Contractors / Program Coordinators • Disease Management • Chronic Care Program • Personal Health Record 9. Community-Wide Safety Net Sponsors (Revise to reflect your HIE/RHIO’s specific circumstances.) 6

8. HIE / RHIO Planning Framework: Explanation Service Fee Basis – Payment Options for Beneficiaries (C) Service Fee Basis is the range of payment options for the beneficiaries who will pay for the products and services. The alternative approaches or methods should be carefully selected to match the costs or benefits. Some of the options will work best when the organization is new with a few sponsors and customers. A transition to more advanced options will fit better when there are many customers and much operational history. • Monthly Subscription • Membership Fee • Transaction Fees • Per Person Per Month Fee • Indexed Per Person Per Month Fee • Per Physician Per Month Fee • Per Physician Practice Staff Per Month Fee • Per Application Per Month Fee • Allocation or Appointment of Expenses (all or part) • Gain Sharing Based on Benefits • Payment Based on Type and Size of Organization (Revise to reflect your HIE/RHIO’s specific circumstances.) 7

9. HIE / RHIO Planning Framework: Explanation Benefits (D) Benefits are the measurable results achieved by using the HIE / RHIO. They should be specific to each RHIO, based on stated goals or objectives. Examples are listed below. • Cost Reductions • Cost Avoidance • Risk or Liability Reduction • Regulatory Requirements • Service Level Improvements a. Reliability b. Customer Satisfaction c. Turnaround Time d. Security e. Work Flow Improvement f. Flexibility in Formatting, Packaging of Information g. Reduction of Duplicate or Missing Reports h. Ability to Audit delivery and other service metrics • Patient Safety (medications, allergies, duplicate testing, diagnosis) • Quality of Patient Care • Health Promotion and Prevention (Revise to reflect your HIE/RHIO’s specific circumstances.) 8

10. HIE RHIO Planning Framework Explanation: Value (E) Value is the perceived advantage between service fees and benefits for each product and service. Value relates to the goals and objectives established for the HIE / RHIO and the reasons for its development. It is frequently described in the HIE / RHIO’s vision, mission statement, high level goals or main strategies. A few examples are listed below. • Community-wide advances in patient care • Community-wide health status improvements • Providing information tools to support improvements in the Capital area health economy and enhance its competitive posture • Improved care and outcomes for Medicaid and underserved populations • Streamlined communication of clinical information among physicians, service providers, and other appropriate organizations • A balanced approach toward the support of medical care and public health information • An organized program to provide personalized medical and health promotion information to the people in our medical trading area. (Revise to reflect your HIE/RHIO’s specific circumstances.) 9

11. Questions and Discussion …. Thank you. Jay C. McCutcheon Health Network Services Jcm8838@aol.com 574-274-0252 10