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Community Stakeholder Meeting Sep 19, 2012 Sutter Solano Medical Center

Community Stakeholder Meeting Sep 19, 2012 Sutter Solano Medical Center. Building sustainable HIE for the North Bay region of California. Agenda. Intros of Attendees All 6:30 – 6:50 pm Intros of Board & Alternates 6:50 – 6:55 pm Sutter Health HIE Sundeep Desai, MD 6:51 – 6:55 pm

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Community Stakeholder Meeting Sep 19, 2012 Sutter Solano Medical Center

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  1. Community Stakeholder MeetingSep 19, 2012Sutter Solano Medical Center Building sustainable HIE for the North Bay region of California

  2. Agenda • Intros of Attendees All6:30 – 6:50 pm • Intros of Board & Alternates 6:50 – 6:55 pm • Sutter Health HIE Sundeep Desai, MD 6:51 – 6:55 pm • HealthBridge • Presentation Keith Hepp 7:01 – 7:45 pm • Q&A Keith Hepp 7:46 – 8:00 pm • Update • Activities Lyman Dennis 8:01 – 8:05 pm • Study Teams & WorkplansTeams8:06 – 8:35 pm • Q&A Teams 8:36 – 8:45 pm • Next Meeting LD8:46 – 8:50 pm

  3. Participant Introductions

  4. Board and Alternates

  5. ConnectHealthcare Board Jeremy Mann, MD, Regional CMO for Ambulatory Services David Jomaoas, CEO Suzanne Ness, Reg VP Kathryn Amacher, DO Alice Hughey, Assistant Director Paul Alcala, VP/CIO Robert Moore, MD, CMO Lori Sklar Kathy Ficco, Ex Dir, CommHlth Lyman Dennis, Ex Dir Adventist Health—Northern CA Network Community Medical Centers Hosp Council of N & Cent CA Medical Societies Napa Co. Health & Human Services Agency NorthBay Healthcare Partnership HealthPlan of CA Redwood Com Hlth Network St Joseph Health System ConnectHealthcare

  6. ConnectHealthcare Alternates Gwen Matthews, Sr VP for Operns Kathleen Marshall Rebecca Rozen Maryanne Eckhout, Cynthia Melody Mitch Wippern, DepDir, Operns Justin Graham, MD, CMIO Liz Gibboney, Dep Ex Dir Mary Maddux-Gonzalez, MD Paul Sampedro, HIE PgmDir Carl Thomas, Ex Dir Adventist Health Community Medical Centers Hosp Council of N and Cent CA Medical Societies Napa Co Hlth & Hmn Svc Agency NorthBay Healthcare Partnership HealthPlan of CA Redwood Com Hlth Network St Joseph Health System SCBH, for ConnectHealthcare

  7. Sutter Health HIE

  8. Keith Hepp, HealthBridge

  9. An Overview of the HealthBridgeData Analytics & ITInfrastructureKeith Hepp, CEO September 19, 2012

  10. HealthBridge Background • One of the nation’s largest, most advanced and successful health information exchanges (HIE) • Provides HIE connectivity for Greater Cincinnati tri-state area and five other HIEs – including Greater Dayton • Connection Statistics • Participants: 50 hospitals, 7500 physicians, 800 practices • Delivers 3-6 million clinical messages per month • More than 60 million messages annually • Clinical information for 3+ million unique patients

  11. Network Size & Adoption • Delivers more than 3.5 million clinical messages PER MONTH; more than 35 million messages for 2010 • Total of 50+ hospitals, 7500 physicians • Connectivity with 40+ HIS/LIS; 27 different ambulatory vendors, 60+ versions • Provide technology infrastructure for four other HIEs – Dayton HIN, CCHIE, HealthLINC, NEKY RHIO • Cincinnati Network • 26 local hospitals in Kentucky, Ohio and Indiana • 5500+ physicians • 17 local health departments • Large commercial, hospital, & physician office labs • Diagnostic centers

  12. Strategic Direction Pre ARRA Post ARRA

  13. HIE Value Progression – Meaningful Use, Medical Home and Payment Reform

  14. Clinical “Inbox”

  15. HIE Services • EHR Integration/Interfaces • Electronic Results Delivery – • Labs, Radiology, ADT, etc. • Electronic Order Entry • E-Prescribing • HIE Portal & User Management • HIE Technology Support – Master Patient Index, Provider Directory and Record Locator Service • Summary Record Exchange • Nationwide Health Information Network Direct and CONNECT Gateway & Connectivity • Public Health Reporting & Syndromic Surveillance • Billing and Eligibility Verification • HIE Consulting, Outsourced Technology & Implementation

  16. Innovation & QI Capabilities New Suite of Health Care Innovation & Quality Improvement Tools and Services through Beacon Program: • Disease Registry • Data Warehouse • Data Analytics and Business Intelligence • Alerts & Notifications • Transitions in Care Assistance • Quality Reporting Support • Process Improvement and Workflow Redesign

  17. Shared IT & Data Background • HealthBridge implemented new CPC-ready Shared Community IT Infrastructure over the last two years that can: • Patient and Physician Attribution • Translate and combine data across different IT systems • Risk stratification • Enables consistent community measures • Support quality and population health improvement • Assist plans in understanding which providers are delivering value vs. volume

  18. Infrastructure Components Available Today Custom Analytics & Reports Provider & Payer Data Claims and Clinical data warehouse CPC Required Measures Translation Master Patient & Provider Index Claims Analysis Tools (Optum Symmetry) Optional Applications Impact Pro Patient Claims Analytics & Reports Impact Intelligence Provider Claims Analytics & Reports

  19. Infrastructure Components Match patients across data sets accurately Combines big data sets – both clinical and claims Helps data speak the same language Patient Attribution, Risk Assignment, & Cost Aggregation • Translation Tool • Semantic Data Normalization • Master Patient and Provider Index • Community Master Patient Index • Patient & Provider Identification • Clinical and Claims Repository • Data Warehouse & Clinical Analytics • Covers 16 of the 18 CPC Measures • OPTUMInsight’s Symmetry • Data Analytic Engines • Patient Attribution Methodologies

  20. Translation • Top half of screen is a source catalog of lab test codes & descriptions • Bottom half of screen are candidate LOINC codes for the term highlighted on the top (blue row)

  21. Tracking Patient/Provider Attribution Attribution Method A John Doe, 1/1/12 -12/31/12 Attribution Method B Sue Smith, 1/1/12 -12/31/12 Attribution Method C Adam Doe, 1/1/12 -12/31/12 Attribution Method D Betty White, 1/1/12 -12/31/12 Attribution Method A John Doe, 1/1/13 -12/31/13 Attribution Method B John Doe, 1/1/13 -12/31/13 • Multiple attribution methods could be simultaneously used and tracked in the MPI • The Patient/Provider attribution is also time-bound with beginning and ending effective dates

  22. Medical Neighborhood Tracking

  23. Clinical and Claims RepositoryCPC Measure NQF #59Diabetes Mellitus: Ha1c Poor Control (>9%) Summary

  24. Clinical and Claims RepositoryCPC Measure NQF #59Diabetes Mellitus: Ha1c Poor Control (>9%) Summary

  25. Episodic Risk Score Computation

  26. Questions and Discussion

  27. Update

  28. Activities • Submitted Cal eConnect Planning Grant • Virtual Site Visit • Announcement of awards delayed • LD HIE Best Practices Toolkit for Planning Grantees • Submitted Infrastructure Grant LOI • Board Meeting Sep 14, 18 • Other below

  29. Exchange Functions Source: HIE Best Practices Toolkit for Planning Grantees, Lyman Dennis, Cal eConnect, Sep 2012.

  30. Core Services • Master Patient Index • Record Locator Service • Connectivity to the NwHIN and CONNECT Gateway • Secure Clinical Messaging (includes Direct) • EHR Interfaces • Provider Directory • Consent Management (opt-in, opt-out, no options)

  31. Basic Exchange Services Part 2 • Immunization Reporting • Reportable Laboratory Results • Syndromic Surveillance Data Part 1 • Receipt of Structured Lab Results • ePrescribing • Sharing of Patient Care Summaries (across unaffiliated organizations using different EHRs)

  32. Additional Services • HIE Portal • Lab Ordering • Personal Health Record • Advance Directives

  33. Value-Added Services, Part 1 • Referrals to Specialists • Authorizations • Clinical Data Repository • Transcription Service • EHR Light • Clinical Decision Support / Data Analysis • Meaningful Use Registry • Disease Management • Enterprise Image Viewer

  34. Value-Added Services, Part 2 • Portal to HIE • Medication Reconciliation • EDI Services (X12 administrative transactions) • Eligibility Checking • Provision of Educational Materials Electronically • Quality Improvement Reporting • Credentialing Services

  35. Value-Added Services, Part 3 • Group Purchasing • Workflow Redesign for Providers • Hosted Helpdesk for Providers • Systems Implementation Technical Assistance • Clinical Trials Management

  36. Community Study

  37. Community HIE Study Team • Lyman Dennis, Lead • Justin Graham, MD • David Jomaoas • Jeremy Mann, MD

  38. Community Study Workplan • Service area – write up what has been done • Community statistical data • Provider distribution – have hospital and physician data. Need other health provider data. • Health financing programs – and imminent changes, e.g., Healthy Families to Medi-Cal • IT systems used by larger providers, in some detail • Current & planned HIE

  39. Procurement of HIE Services

  40. Procurement Team • Paul Alcala, Lead • Robert Moore, MD • Paul Sampedro • Lori Sklar

  41. Procurement Workplan, Part 1 • Determine exchange priorities of participating organizations • Services sought • Interface support desired • Assess HIO/vendor options • Full RFI • Collect summary data from selected vendors • Obtain summary data from selected vendors • Draft business plan • Issue RFI to group of HIOs and vendors

  42. Procurement Workplan, Part 2 • Assess offers • Negotiate agreement and execute • Finalize provider rates • Finalize business plan

  43. Document Development

  44. documents Team • Alice Hughey, Lead • Mitch Wippern • Consultant, Cal eConnect

  45. Documents Workplan, Part 1 • Participation Agreement • Likely use Cal eConnect Modular Agreement • Appropriate for California • Developed with input from Alan Briskin, part of the Markle Connecting for Health team that drafted the Markle Model Contract • DURSA • Standard agreement available • Some possible changes due to change of hosting organization

  46. Documents Workplan, Part 2 • Policies and Procedures – draw from • Markle Model Privacy Policies • Rhode Island Quality Institute • Redwood MedNet • Other sources

  47. Not-for-profit filing

  48. Not-for-Profit Filing Team • Lyman Dennis, Lead • Paul Smith, Esq., Hooper, Lundy & Bookman

  49. Provider Contracting

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