The Nation’s First Statewide Health Information Exchange

1. The Nation’s First Statewide Health Information Exchange Presentation to the Delaware Health Care Commission May 3, 2007 Robert White DHIN Chair Delaware Physicians Care, Inc. Gina B. Perez DHIN Project Director Advances in Management, Inc.

2. Agenda • What is DHIN? • Why do we need it? • Who participates in DHIN? • What does it do? • How is it funded? • What are the benefits?

3. Vision Develop a network to exchange real-time clinical information among all health care providers (office practices, hospitals, labs and diagnostic facilities, etc.) across the state to improve patient outcomes and patient-provider relationships, while reducing service duplication and the rate of increase in health care spending.

4. DHIN Governance Structure • Statutorily Created in 1997 • Public-Private Board of Directors under the Delaware Health Care Commission • Active Executive Committee • Multi-Stakeholder Project Management Team • Consumer Advisory Committee • Clinical User Group

5. What is DHIN? • Secure network for distributing clinical results and reports from the hospital, lab or radiology center to the treating physician • Data is managed by those who order the test and those who perform the test

6. Timeline *Agency for Healthcare Research and Quality

7. Why do we need it? • Most Doctors receive laboratory results from 5 different labs all sending results in a different format and method • Clinicians who use computerized records system are more likely to adhere to clinical guidelines

8. Why do we need it Clinical information is missing in 13.6% of primary care visits: • Lab results - 6.1% • Radiology results - 3.8% • History & Physicals - 3.7% Missing information is Judged to: • Adversely affect care in 44% of visits • Delay care in 59% of visits • Medications - 3.2% • Dictation - 5.4% (“JAMA”, January 2005)

9. DHIN Phase 1 Priorities

10. Phase 1 Data Senders • Bayhealth Medical Center • Kent • Milford • Beebe Medical Center • Christiana Care Health System • Christiana • Wilmington • LabCorp • Account for: • 85% • Laboratory Testing • & • 81% • Hospital • Admissions • in Delaware

11. Phase 1 Data Receivers • Cardiology Consultants • 16 offices statewide • 30 physicians • EMR • CN-MRI • 2 locations in Kent County • 9 physicians • EMR • Nephrology Associates • 8 offices statewide • 21 physicians • Electronic Inbox • Dover Family Practice • 1 location in Kent County • 4 physicians • Electronic Inbox • Georgetown Family Medical • 1 locations in Sussex County • 2 physicians • Fax and Electronic Inbox

12. A Day in the Life of One Doctor’s Fax Machine 1 day 1 doctor 115 faxes 10 ads 55 lab results 30 consult reports 19 pharmacy renewals 1 stat abnormal mammogram that needs immediate attention

14. One Standard DHIN Format

16. Security • HIPAA compliant • Secure Virtual Private Network (VPN) • 128-bit secure socket layer (SSL) encryption • Complete auditing and logging • Data management at the source system

17. DHIN Phase 2 Priorities Future Priorities

18. Physician Use of Technology Source: University of Delaware Center for Applied Demography and Survey Research, Primary Care Providers in Delaware 2006

19. Physician Interest – Next Wave 66 Physician Practices • 21 in Kent County • 18 in New Castle County • 23 in Sussex County • 4 statewide Practices • 29 Primary Care Practices • 33 Specialty Practices • 4 Federally Qualified Health Centers

20. Benefits of DHIN • Improved Patient Care • More complete clinical information • Better communication • Reduced “Hassle Factor” • Information available at appointment • Fewer forms to fill out

21. Benefits of DHIN • Reduced Healthcare Costs • Fewer duplicated tests • Better medication management • Increased Efficiencies • Greater productivity • Reduced delivery/mailing costs

22. THANK YOU from For a Decade of Support!