Community Care of North Carolina with NC HIE Overview Presentation for NCNA Council on Nursing Informatics May 16, 2014

1. Community Care of North Carolina with NC HIEOverview Presentation for NCNA Council on Nursing InformaticsMay 16, 2014

2. About NC HIE • Population Health Solutions • Q&A Overview

3. About NC HIE

4. One Connection, Many Data Sources One connection to NC HIE means access to provider electronic health record systems, State systems, pharmacies, labs, behavioral health and long-term care entities, disease registries and other sources of patient data. VA, DOD, SSA, etc.

5. NC HIE’s Growing Network of Partners

6. Current Footprint Currently, more than 700 sites are participants of NC HIE. We build connected communities that include clinics, local health departments and long-term care and behavioral health providers. A complete list can be accessed on our website: http://nchie.org/providers/our-providers/ Legend: Hospitals Physician Practice – Primary Care Physician Practice – Specialist Long-Term Care

7. Current Hospital Participation • Ashe Memorial Hospital • Blowing Rock Rehabilitation & Davant Extended Care Center • Cannon Memorial Hospital • CaroMontMedical Center • Carteret General Hospital • Hugh Chatham Hospital • Davie Medical Center • Granville Medical Center • Halifax Regional Medical Center • High Point Regional Medical Center • Hugh Chatham Memorial Hospital • Johnston Medical Center • Lenoir Memorial Hospital • Lexington Medical Center • Maria Parham Medical Center • Morehead Memorial Hospital • Nash General Hospital • Our Community Hospital • Person Memorial Hospital • Rex Hospital • UNC Caldwell • UNC Chatham • UNC Hospitals • UNC Pardee • UNC Wakebrook • Wake Forest Baptist Medical Center • Watauga Medical Center • Wilson Medical Center

8. Current Ambulatory Participation NC HIE ambulatory participation includes more than 700 sites encompassing a variety of provider types: • Primary Care Practices • Specialist Practices • FQHCs • Free Clinics • Long-Term Care • Home Health

9. EnablingMeaningful Use and State Reporting EPs- Eligible Professionals EHs- Eligible Hospitals

10. Improving Care and Population Health Complete Medication Management Population Health Analytics Incorporation of multi-sourced information, both clinical and claims data, into comprehensive view of evidence-based population health dashboards/utilities to facilitate systematic approaches to improve care. • Development of chronic disease registries: • Diabetes • Asthma • Heart Failure • Hypertension • Reporting of Clinical Quality Measures • Development of aggregated reports, currently exploring: • PQRS* • HEDIS* • UDS* • Ad-hoc to allow user to generate and save frequently used reports* *At an additional cost NC HIE with its partner, Community Care of North Carolina (CCNC), is building value-added applications to enhance patient care. Current projects include: PHARMACeHOME Chronic Disease Registries

11. NC HIE and State Reporting Wake Forest Baptist Health System is piloting the connection to submit immunization data to NCIR. Expected pilot completion is Q2 2014. CaroMont Health is piloting the connection to submit reportable lab results to NC EDSS and NC LEAD. Other hospitals have begun the onboarding process. NC HIE and NC Medicaid are building connectivity to enable electronic clinical quality measure reporting directly to NC Medicaid. Service availability is scheduled for Spring 2014. In 2014, to comply with the NC Health Care Cost Reduction and Transparency Act, hospitals will begin reporting Medicaid demographic and clinical data to NC Health and Human Services via NC HIE.

12. About Population Health Solutions

13. Data Phases 1Q ‘14 2Q ’14 3Q ’14 4Q ‘14 Infrastructure Build Initial Clinical Database Build Administrative / Claims Data Build QRDA & Additional Clinical Data Additional Data Sets • Claims • Enrollment • Scheduling • Social History • Asthma Management Data • Screenings • Meaningful Use Quality Specific Data • Prenatal • Foster Children • Special Population Files • Vital Records • Referrals • Demographics • Diagnosis • Procedures • Labs • Medications • Vitals

14. Population Health Solutions • Clinical Quality Measure Reporting • Chronic Disease Registries • Diabetes • Hypertension • Asthma • Heart Failure • Physician Quality Reporting System • ACO Quality Measures

15. The Process • Data Extraction • Assignment of EMPI • Review and Normalization of Targeted Data Sets • Labs, allergies, race and ethnicity, medications • Load into data repository and HIE (if applicable) • Process through rules engine • Present data in population health solutions

16. Data Normalization • In order for applications to recognize, store and process data elements, data must be in a discrete format with a standard codes • Procedure Codes (CPT) • Diagnosis (ICD 9) • Labs (LOINC) • Medications (RxNorm, Multum or NDC) • Med Allergies (RxNorm) • Vitals (SNOMED) • As we are extracting the data, we are finding the data quality varies by practices and by measure set.

17. Clinical Quality Measures - EP

18. Hypertension Measures

19. Hypertension Registry Goshen #1 Goshen #2 Goshen #3 Goshen #4 Goshen #5 Goshen #6 Goshen #7 Goshen #8 Goshen #9 Goshen #10 Goshen #11 Goshen #12 Goshen #13 Goshen #14

20. Hypertension Registry – Site View Ability to select different measures or dimensions Compare performance across providers Provider #1 Provider #2 Provider #3 Provider #4 Provider #5 Provider #6 Provide #X

21. Hypertension Registry – Patient Level Listing Ability to download patient listing to MS Excel for care management and outreach

22. Diabetes Measures

24. Questions?Contact:Marya Upchurch, VP, Solution Development mupchurch@n3cn.org / 919.882.0328