Southeast Michigan Health Information Exchange

1. Southeast Michigan Health Information Exchange Stakeholder Kick Off Meeting – September 27, 2007

2. Agenda • Health Information Exchange Overview • Healthcare in Southeast Michigan • SEMHIE Project and Benefits • Initial Governance Committee • Operating Rules • Participation Agreement and Conflict of Interest Forms • Major Tasks, Deliverables and Milestones • SEMHIE Outcomes

3. The Current State of Health Information • Your health records currently reside in multiple organizations • Your health plan has information about things they’ve paid for • Your primary care physician has information about your health and services he or she has rendered • The specialist you went to last month has information about what they did • The hospital has info about a surgery you had • The lab, the pharmacy… • Health information is currently ‘organization-centric’ • Organized around the needs of individual organizations • Disparate electronic connections • Connections largely limited to administrative needs • Consumers are left out • Uncoordinated, inefficient transactions • Clinical decisions are not fully informed • Stakeholders and consumers frustrated

4. The Future of Health Information with HIEs • Health Information Exchanges (HIEs) seek to make health information more ‘patient-centric’ • HIEs enable sharing of clinical and administrative information between organizations • Streamlined electronic connections • Reduced administrative burden • Consumers are included • Coordinated, efficient transactions • Clinical decisions are more informed • Enhances workflow efficiency • Improves quality of care • Stakeholders and consumers satisfied

5. Consumers Laboratories Hospitals Employers Pharmacies Insurers Physicians State Offices The Future of Health Information with HIEs Clinical Information Collection Information Communication • Clinical Messaging • Medication Reconciliation • Results delivery • Secure document transfer • Shared EMR • Clinical Decision Support • Credentialing • Eligibility checking Hospitals Physicians • Clinical Messaging • Provider Orders • Results delivery HIE Labs • Needs Assessment • Surveillance • Reportable conditions State Offices • Clinical Quality Measurement • Claims Adjudication • Secure document transfer Insurers Then securely communicates that information across organizations Provides the means to gather and connect electronic healthcare information

6. Healthcare in Southeast Michigan • Over 43% of Michigan’s population • Over 2 million covered lives • Over 12 million annual visits • Nearly 650,000 annual discharges • Over 7 million lab tests annually • More than half the State’s physicians • 245,379 health sector employees representing $12.1 billion in wages and salaries

7. SEMHIE Initiation • Kick off of HIE feasibility study by Covisint / 3 autos: February 2006 • Expansion of participants to include other stakeholders: began April 2006 • Transition to Community Based Initiative: • Initiation of discussion: June 2006 • Adoption of mission and vision statement: August 2006 • Initiation of host selection process: September 2006 • Formalization of host organizations for planning phase: November 2006 • Altarum (lead host) • Greater Detroit Area Health Council • Oakland County Medical Society • Wayne County Medical Society

8. SEMHIE Project • The Southeast Michigan Health Information Exchange planning project will advance the implementation of integrated, interoperable health information exchange across the region, supporting the data needs of physicians, health systems / hospitals, patients, employers, health plans and other regional constituents. • SEMHIE will provide a platform for the delivery and sharing of electronic health information in a secure and timely manner to authorized users across organizational boundaries. • SEMHIE stakeholders are dedicated to: • Enhancing patient care quality and safety • Increasing effectiveness/efficiency of healthcare delivery • Reducing healthcare costs

9. SEMHIE Objectives • Establish a sustainable, self-sufficient business model that aligns costs with benefits for the stakeholders • Provide for secure, private and efficient cross-institutional exchange of clinical and administrative healthcare data • Create a secure, ubiquitous, interoperable health information technology infrastructure consistent with state and federal standards / guidelines, where applicable • Link to national and regional efforts through use of a common trust framework, business and operating rules, technical infrastructure, and governance models for federated identity management and interoperability • Develop and maintain an environment of trust among the stakeholders

10. SEMHIE Benefits to Southeast Michigan • Facilitating the exchange of information among stakeholder organizations – and later between those organizations and consumers – will significantly enhance coordination, reduce costs, and improve quality of care… • Resulting in reductions in duplicative tests and procedures, improvements in patient safety, more efficient diagnostic processes, and reductions in the costs of administrative transactions • Improved access to healthcare information results in better quality care, healthier populations and decreased costs… • And better quality of care, healthier populations and decreased costs increase competitiveness of Southeast Michigan

11. Initial Governance Committee Members

12. Operating Rules • The SEMHIE Governance Committee has developed and adopted a set of Operating Rules to serve as a governance framework for the Consortium • SEMHIE Operating Rules were adopted September 17, 2007 • These Operating Rules contain the SEMHIE mission, vision and objectives, as well as operational parameters for the Governance Committee, Participant Committee and work groups

13. Joint Participation Agreement and Conflict of Interest Forms In order to participate in the SEMHIE efforts, organizations must complete a Joint Participation Agreement and must disclose any potential conflicts of interest (COI) that may impact their ability to participate in an impartial manner Definition of Conflict of Interest: A conflict of interest exists when a Participating Member has a clear financial or personal interest in a matter under consideration by the Exchange. A personal interest of a SEMHIE Participating Member includes the intention of the Participating Member, an organization that the member is affiliated with, or member’s employer to market or sell a service or product to the Exchange, even though the Participating Member may not receive any pecuniary remuneration as a result. A financial interest of a SEMHIE Participating Member includes the intention of the Participating Member or member’s employer to receive monetary remuneration, from the Exchange. Governing Members need to declare that they have no conflicts

14. Major Tasks • We have grouped activities into five major tasks for the 15-month planning phase: • Engage stakeholders and formalize planning-phase organizational structure • Determine scope of services and business model • Define requirements, policies and performance metrics • Establish post-planning organizational entity • Evaluate and solicit technical solutions

15. Planning Phase Key Deliverables • The establishment of a formal organization built on trust and supported by established operating rules • Development and implementation of a solvent and sustainable business plan • The creation of a solid strategy for community and stakeholder involvement • The development of a defined scope of services and technical strategy for the HIE, informed by an assessment of technological capabilities, market readiness, and market need • The release of a request for proposal (RFP)

16. Planning Milestones

17. Consumers Laboratories Hospitals Employers Pharmacies Insurers Secure, electronic health information hub Physicians State Offices SEMHIE Outcomes When successfully deployed, the Southeast Michigan Health Information Exchange will enhance patient care quality and safety; increase the effectiveness and efficiency of healthcare delivery; and reduce healthcare costs.