Overview 2018

1. Overview 2018 Updated: May 7, 2018

2. Table of Contents • Slides3 – 13: About Healthix • Slides14 – 26: Healthix Services • Slides27 – 32: Healthix Integration Models • Slides 33 - 35:Uses of Healthix Data • Slides: 36 – 39: PatientConsent Slides that need updating monthly with latest stats: 5,9,14,36 (7,12,38,39)

3. About HealthixStatisticsSHIN-NYRole of HealthixSolutionsSources of data & Types of dataTimelineParticipants

4. Largest Public HIE in the Nation More than16,000,000patients Healthix contains data from healthcare organizations throughout New York City and Long Island. Healthix uses sophisticated software to reconcile data of over 71.7 million provider Medical Record Numbers (MRNs) to create composite profiles of over 16 million patients.

5. About Us Healthix is the largest publicHealth Information Exchange (HIE) in the United States • Supplies secure data to improve healthcare quality, efficiency and effectiveness • Provides a range of clinical information in real-time • Facilitates care coordination Healthix Monthly Statistics (Mar. 2018) • 52.8 Million inbound clinical messages • 2.5 Million Real-time clinical alerts • 1.6 Million Patient Summary Documents Shared (CCDs) Hundreds of healthcare organizations at more than 6,100 sites across New York City and Long Island participate in Healthix.

6. SHIN-NY “Network of Networks” The State Health Information Network – New York (SHIN-NY) is comprised of 8 HIEs or Qualified Entities (QEs) When a user queries for patient data, Healthix automatically returns data from both Healthix and the SHIN-NY.

7. Role of Healthix in Exchanging Information eHealth exchange and SHIEC HEALTHIX

8. Providing Solutions, Adding Value Determine Risk and Provide Actionable Data • Real-time Intervention at the Point of Care Opportunity for a Richer Patient Portal • Coordinated Care: Complete View of Patient 1 2 3 4 BETTER OUTCOMES COST EFFICIENCY HIGHER SATIS-FACTION

9. Sources of Data The breadth of data in Healthix is expanding in the number and type of contributors Federally Qualified Health Centers(FQHCs) Hospitals IndependentPhysician Practices of All sizes Long-term Care, NursingFacilities Behavioral Health Facilities Community Based Organizations Home Care EMS Indevelopment Medicaid Claims PPSLeads Medicaid Health Homes IndependentPharmacies HealthPlans NYC CorrectionalHealth Services All Other Public HIEsin New York State Independent Labs & RadiologyCenters VeteransAdministration

10. Types of Data • Demographics (Name, Gender, DOB, Race, Ethnicity, Language) • Allergies • Medications • Medication Allergies • Smoking Status • Immunizations • Encounters • Observations • Vital Signs (Hgt, Wgt, BP, BMI) • Problem Lists • Pharmacy Fill Data In development • Lab Tests, Values / Results • Radiology Reports • Radiology Images • Other Diagnostic Results • Diagnoses • Procedures • Functional / Cognitive Status • EMS Run Sheets • Discharge Instructions / Clinical Summaries • Advanced Directives • eMOLST • Care Plans/Team Members • Medicaid Claims Data • Social Determinants of Health

11. Timeline: Growth & Milestones ALL RHIOS certified as QEs .All receive funding from HCRA to cover increase participation, utilization, provide core services and connect through SHIN-NY 2007 NYCLIX merges with LIPIX to form HEALTHIXand other RHIOS outsource their IT operations to NYeC 6 different RHIOS established in NYC and Long Island NYS DOH AWARDS HEAL NY GRANTS:$28M to 13 organizations in NYC and Long Island HEALTHIX Receives Grant to form RHIO named NYCLIX PATIENT DATA PATIENT DATA HEALTHIXinsources its IT resources HEALTHIXmerges with BHIX 2012 2014 New York State startsSHIN-NY 2013 2016 2005 2015 2006 PATIENT DATA 2008

12. Geographic Coverage Over 600 Healthcare Organizations with more than 6,100 facilitiesAcross New York City and Long Island

13. Healthix ServicesHealthix PortalDelivery of Clinical SummariesClinical Event NotificationDirect MessagingPredictive Analytics

14. Healthix core services MARCH 2018USAGE Patient Record Search: Access to a more comprehensive patient profile StatewideDelivery of Clinical Summaries: Ability to push clinical summaries (CCD, C-CDA) and lab results Clinical Event Notifications (CENs): 24/7 Custom alerts provide real-time updates for patients in careDirect Messaging: Secure HIPAA-compliant messaging Predictive Analytics: Assessing risk and managing patients to optimize care PATIENT RECORDS SEARCHED VIA PORTAL5,628 CLINICAL SUMMARIES DELIVERED 1,617,909CENs SENT TO:ALL CLINICAL PROGRAMS1,913,984CENs SENT TO: PUBLIC HEALTH (NYSDOH) 618,238DIRECT MESSAGES SENT13,366

15. Patient Search • HEALTHIX PORTAL • Search by Demographics • Search by MRN • Patient Summary Screen

16. Patient Search

17. Patient Search by Demographics Name plus 2 other fields then hit search

18. Patient Search by MRN

19. Patient Summary Screen Side Menu Shows Data Available

20. Clinical Event Notifications • Workflow • Current Offerings • Future Offerings

21. Clinical Event Notification Workflow

22. Healthix Clinical Alerts

23. Clinical Alerts With Affirmative Consent Without HealthixConsent Clinical Alerts • Clinical Alerts Essentials • Clinical Alerts Plus Participants receiving the Clinical Alert must provide treatment or care management for the patient. Content data √ √ √ √ √ √ √ √ √ √ √ √ √ √ √ Patient Identity Location/Date Type of Event Chief Complaint Initial Diagnosis Clinical Results/Data Healthix - 42 CFR Part 2 facilities Cross SHIN-NY SHIN-NY data HEALTHIX Sources

25. Predictive Analytics • Population Health Management • Acute Patient Care Management • Market Share & Volume Analysis DEMO/TRAINING: http://healthix.org/analytics/

26. Predictive Risk Scores Population Risk Models Patient History Patient Risk of Event or Outcome Risk Model Development • (predicts future 12 months) • Predicted future cost • Risk of inpatient admission • Risk of emergency department (ED) visit • Risk of acute myocardial infarction (AMI) • Risk of asthma • Risk of cerebrovascular accident (CVA) • Risk of congestive heart failure (CHF) • Risk of COPD • Risk of diabetes • Risk of hypertension • Risk of mortality • Event Based Risk Models • (predicts future 30 days) • Risk of 30 day readmission • Risk of 30 day ED re-visit Multivariate Statistical Modeling – Decision Tree Analysis Machine Learning • 1000s of Patient Features • Age • Gender • Geography • Income • Education • Race • Diagnoses • Procedures • Chronic conditions • Visit and admission history • Outpatient medications • Vital signs • Lab orders and results • Radiology orders • Social characteristics • Behavioral characteristics

27. Healthix Integration MethodsStandard IntegrationSingle Sign OnEHR Integration FlagsHub ModelsHIE to HIE

28. Integration methods Standard IntegrationSingle Sign-OnEHR Integration Flags Hub Model Integrations HIE to HIE

29. EHR Integration Flags

30. Patient data : Green Consent Status: Yes External Data: YesNew Data: : Yes Message on Mouse Over

31. Patient data: Yellow Message on Mouse Over Consent Status: Not GivenExternal Data: YesNew Data: : N/A

32. Patient data: Red Consent Status: N/AExternal Data: NoNew Data: N/A Message on Mouse Over

33. Uses of Healthix Data

34. uses of Healthix data to facilitate care management • Accessing Patient Data in an Emergency Situation • Managing Patients with Serious Medical Conditions using Clinical Event Notifications • Providing Transition of Care Documents for Physicians • Supporting Secure Direct Messaging Between Providers • Providing Alerts for Frequent Users of ED (3+ visits in 30 days) • Facilitating Research using De-identified Data • Connecting PPS Leads and PartnersIN DEVELOPMENT • Delivering Alerts from Health Plans to Providers re: Gaps in Care

35. uses of Healthix data to improve public health • Supporting Persons with HIV/AIDS • Providing Data for Emergency Patient Search (NYCEPS) • Helping in Public Health Outbreaks (e.g. Zika, Legionella) • Improving Health of Uninsured - Action Health NYC

36. Patient Consent

37. patient consent & engagement AS OF MARCH 2018 • Consent to a Single Participant Organization • Healthix Community Consent • One-to-One Exchange • Supporting Patients’ Access to their Health Data 3,808,064HEALTHIX UNIQUEPATIENT CONSENTS GRANTED 21,189PROVIDERS WITH ACCESS TO PATIENT DATA

38. State Policies • Healthix and State Policy governs how providers and patients engage in health information exchange, and how they access patient information • Compliance with policy facilitates data sharing across RHIOs • Obtaining Consent • Consent Audit, User Audit • Password Strength / Failed Attempts • User Roles, Patient Notices • SAMHSA / Sensitive Data Re-disclosures http://healthix.org/who-we-are/healthix-policies/

39. Patient Gives “Provider Consent” Provider data data Provider queries data from all sources 550 Participants ~ 4,400 Facilities Patient Gives Consent HEALTHIX Provider receives CENs of events at all sources Patient

40. One-to-One Exchange Patients in Common Treatment, Care Management Quality Improvement Participant B Participant A data data Healthix Authorizes Healthix to provide its data to Participant B Participant B can query data from Participant A data Other Participants Participant B can receive Clinical Event Notificationsfrom Participant A 550 Participants ~ 4,400 Sites NOTE: (1) One-to-One Exchange can be reciprocal – each Participant can authorize exchange of its data with the other(2) Excludes data and CENs from any 42 CFR Part 2 facilities of Participant A (3) Excludes data of any patient who has explicitly denied consent to Participant B (4) One-to-One Exchange allows Healthix to provide one Participant with data of the other Participant, but not data from all of Healthix.

41. Contact Us If you have questions, would like to see a demonstration or are interested in connecting with Healthix Your Name646.000.0000yourname@healthix.org