What Are We Going to Do Now? SMRTNET Secure Medical Records Transfer Network

1. What Are We Going to Do Now?SMRTNETSecure Medical Records Transfer Network

2. Today’s Connectivity World

3. How Many Records Do You Have? • Physicians • Pharmacies • Hospitals • Laboratories • Specialists • Public health • Native American and IHS • Veterans • Clinics

4. SMRTNET brings them together Diagnosed With Arthritis 2-9-05 Prescribed medication for Cholesterol 12-22-05 Diagnosed Asthma 5-27-99 Diagnosed With Arthritis 4-29-06 Foot Surgery Bone Spur removal 1-15-02 Diagnosed with IBS 9-30-02

5. Rural Benefits • Medical history • Meaningful use • Ties medical community together • Improve key quality indicators • Efficiency and friction reduction • Communication with specialists and urban areas • Decrease drug seeking • No EHR required • Makes a small office big • Recruiting

6. What is a Network? • Members only • Share data on common patients for treatment • Various EHRs and data sources • Common governance (policies and rules) • Members • Prices • Policies • Member agreement • Security • Finances • Growth • Products • Personnel

7. Public HIE Utility Company • Non profit operated by members • Incubator network and multiple self-governed networks • Governance • Comprehensive member agreement (3 years and $ 125,000) • Planning Process • Privacy policies (1 year and constant upgrades) • Data and connections ($ 650,000) • Return on Investment • Quality improvement • Proven technology that fits with Oklahoma • Economic stability without grant funds

8. Hospital ED Cost Reductions for OKC

9. Current Data • Over 37 million encounters • Over 11,500 contributing providers • Over 3 million patients • Growing significantly

10. Data set • Demographics • Allergies and reactions • Diagnosis • Procedure code • Provider • Medications • Laboratory results • Immunizations • History and physical (July) • Reports (July) • Discharge summary (July)

11. SMRTNET Meaningful Use Consumer Services Health Outcomes Policy Priorities SMRTNET Hub Services • Improve quality, safety, efficiency and health disparities • Engage patients and families • Improve care coordination • Improve population and public health • Ensure adequate privacy and security protections SMRTNET HIE Personal Health Record Alerts & Reminders Secure Messaging Clinical Hub Scheduling Billing EMR View ePrescribe P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P P CPOE Drug interaction checks Problem lists ePrescribing Maintain medication lists Maintain allergy lists Record demographics Record advance directives* Record vital signs Record smoking status Lab test results Generate patient lists Reporting on measures Patient reminders Decision support rules Progress notes* Eligibility checks Electronic claims Electronic copy of record Electronic access to health information Patient-specific education resources Clinical summaries at each encounter Exchange key clinical information Medication reconciliation Electronically submit data immunization data Electronically submit reportable lab results Electronic syndromic surveillance data Compliance with HIPAA privacy and security rules Compliance with fair data sharing practices P P 2011 Meaningful Use Policy Objectives

12. Security • William Braithwaite, MD, PH.D, author of HIPAA • Regenstrief Institute and Chris Sears • Over 20 Oklahoma attorneys • Over 15 privacy officers • 27 privacy policies • Operational for four years without any incidents

13. Development Network • Hospital Tahlequah City Hospital • University Northeastern State University • Public Health OSDH/Cherokee County • Federal Hastings Medical Center • Tribal Cherokee Nation • Mental Health Bill Willis Community MHC • Community Health Ctr NEO Community Health Centers

14. Networks in Oklahoma

15. SMRTNet Growth

16. Incubator Network • State Wide • First step • Meetings are statewide

17. Northeast Oklahoma • Cherokee Nation (14 counties) • Tahlequah City Hospital • Northeastern Oklahoma University • Northeastern Oklahoma Community Health Center • Baptist Memorial (Miami) • Grove General (Grove) • Mayes County Medical Center (Pryor)

18. SMRTNET-OKC (GOCHC) • Greater Oklahoma City Hospital Council • OU Medical Center • Unity Health Center • Edmond Medical Center • Heart Hospital • INTEGRIS Baptist Medical Center • INTEGRIS Canadian Valley Regional Hospital • INTEGRIS Southwest Medical Center • Mercy Health Center • Midwest Regional Medical Center • Norman Regional Hospital • Norman HealthPlex • St. Anthony’s Hospital • Oklahoma Heart Hospital • Moore Medical Center • Oklahoma City-County Health Dept

19. Rural Hospitals • Baptist Regional (Miami) • Bass Baptist (Enid) • Blackwell Regional (Blackwell) • Clinton Regional (Clinton) • Grove General (Grove) • Marshall Memorial (Madill) • Mayes County Medical (Pryor) • Spencer Behavioral Health (Spencer) • Tahlequah City Hospital (Tahlequah) • Hastings Indian Hospital (Tahlequah)

20. Norman PHO • Very unique group of 300 physicians all using the same electronic record system • NPHO will develop their own network • Integrate to SMRTNET network • Object of AHRQ research contract and Beacon grant • Leverage OKPRN Prevention Science Algorithm’s

21. Associated Centers for Therapy Blue Cross Blue Shield Cherokee Nation Community Care Dept of Veterans Affairs EMSA Family and Children’s Services Hillcrest Medical Center Indian Health Resource Center Merck and Company Muskogee (Creek) Nation OMNI Medical Group OSU Center for Health Services OU School of Community Medicine Planned Parenthood Redbud Physical Therapy Regional Medical Laboratory St Francis Health System Tulsa Fire Department Warren Clinic GTHAN Planning Process

22. Central Oklahoma Family Medical Center Mary Mahoney Community Health Connections Cherokee Nation Health Services East Central Oklahoma Family Health Center Robert Clark Family Health Center Family Health Center of Southern Oklahoma Great Salt Plains Health Center Indian Healthcare Resource Center Stigler Health and Wellness Center Kiamichi Healthcare Resource Center Lawton Community Health Center Morton Comprehensive Health Services Midtown Family Health Center Nowata Family Health Center Arkansas Verdigris Valley Health center Caring Hands Healthcare Center Northeast Oklahoma Community Health Center Oklahoma Community Health Services Pushmataha Family Medical Center Community Health Center Planning

23. Ambulatory Interfaces Underway • eClinicalWorks • Allscripts • Cerner • Greenway • NextGen • Others especially upon request

24. Baptist Community Clinic Baptist Mission Center City Rescue Mission and Dental Clinic Cross and Crown Clinic Community Charity Eye Clinic Crossings Community Clinic Good Samaritan Free Clinic of Edmond Good Shepherd Ministries In Gods’ Care King's Klinic Lighthouse Medical Clinic Little Flower Clinic Manus Juntas Clinic Mid-Del Community Clinic Ministries of Jesus Open Arms Clinic Reaching Our City Medical Center St. Charles Clinic OKC Uninsured Clinics

25. Oklahoma State Department of Health • Immunization registry • All 90 county health departments • Oklahoma City County Health Department • Developing bi-directional interface • Four years • Three attorneys • $ 20,000

26. Native American Services • Cherokee Nation possibly the only truly interoperable tribe in the country • SMRTNET member agreement used as national template for Indian Health Service • Active discussions with other tribes

27. Physician Roll-out • 1,400 physicians with medical privileges at 24 hospitals at no charge • Do not have to have an EHR • 1,500 Oklahoma Medical Association (in planning) • Norman Physician Hospital Organization 300 physicians • All other providers through incubator network and do not need to be in a network

28. Contacts Mark Jones Chief Operating Officer and Principal Investigator markjones@smrtnet.org 918 931 9410