Albuquerque Forum: New Mexico’s Health Information Exchange Thomas D. East, Ph.D., CEO NMHA 69th Annual Meeting 9/25/14 11:20-12:20
New Mexico HIE Clinician Hospital Office Integrated Clinical Record Hospital Clinician Gathers and associates Office records with the right patient Diagnostic Tests & Imaging Emergency Department HL7
What the NMHIC HIE offers Clinical Portal with results Viewer • Clinical Data Repository • Enterprise Master Patient Index • Direct Exchange • eHealth Exchange • Clinical Alerts/Notifications • Public Health Reporting • Syndromic Surveillance • Privacy and Consent Management /Auditing •
Core HIE data • Demographics • Lab Data • Allergies • Radiology Data • Medications • Clinical Notes • Immunizations • Insurance • Procedures • Problem List • Encounters (Visits) & Diagnoses Note: Data available varies by organization
NM Hospital Beds Providing Data NMHIC – HIE Status 2204 2426 Data Providers 48% 52% Not Providing • Core HIE will be live by 9/30/14 Data – History Backload from Jan. 2013 forward • >140M Messages Loaded- Remainder due by 9/17 • Over 1 Million patients loaded- All of Centennial Care • Seven data providers/organizations (27 feeds) – Clinical Portal will have Core Functionality • Direct secure messaging will be live before 12/2014 • eHealth Exchange gateway will be live First Quarter 2015 or earlier
NMHIC - Outreach Update 14 Signed Agreements >1250 Providers Hospitals • – LifePoint Hospital- Memorial Medical Center – LifePoint Hospital- Los Alamos Medical Center – Gila Regional Medical Center – Nor Lea General Hospital – San Juan Regional Medical Center – Sierra Vista Hospital NM Hospital Beds Signed to Use NMHIC – Holy Cross Hospital- Taos – Union County Hospital 757 Provider Practices • 16% – ABQ Health Partners Signed – NM Heart Institute 3873 – NM Orthopedics Association Not Signed 84% – NM Primary Care Association – Taos Clinic for Children and Youth Diagnostic • – X Ray Associates of NM
Looking at the Patient’s Chart
Complete Medical History at a Glance
Notifications
Hospital HIE Benefits • Accommodating Meaningful Use requirements to qualify for reimbursements and avoid significant penalties. • Medication reconciliation, including the ability to automate this function that is now performed by one or more pharmacists. • Electronic submission of all reportable conditions and vital statistics. • Enhanced workflow processes and reduced courier costs. • Strengthened relations with physicians resulting in increased referrals and laboratory revenues while improving clinical decision-making and patient care with more timely information. • Reduced administrative burden for collecting, managing and distributing medical records. • Prevention of unnecessary 30-day readmissions. • Easier admission process. • Increased efficiency and decision-making by providing more complete patient information at the point of care. The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781
Hospital HIE Benefits… continued • Enabling hospitals to take a team approach with other providers outside of their systems to provide coordination of care. • Enabling more streamlined physician referral processes and care transition. • Enhanced relationships between patients and families by improving communications and the sharing of data. • Enabling relationships between hospitals and other healthcare providers to improve the quality and efficiency of healthcare and improve patient safety through use of data analytics and development of standards of care. • Prevention of unnecessary re-hospitalizations by providing discharge plans to care settings across the spectrum of healthcare delivery that will enable effective follow-up treatment plans. • Reduced adverse drug events resulting from drug interactions and allergies by providing improved access to a more complete medication and allergy history. • Providing more complete patient data from a multitude of settings and emergency departments. The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781
Hospital HIE Benefits… continued • Utilization of complete health information at the point of care from a variety of facilities such as lab orders, imaging, and prescriptions. • Providing Master Patient Index (MPI) functionality to enable health systems to transmit information electronically from clinics to hospitals. • Serving as a cross-check for data integrity to the individual facilities. • Acting as the universal portal for any entity seeking electronic access and sharing of ePHI. • Addressing ongoing maintenance, support, and security concerns of portal functionalities. • Enabling the identification of fraudulent practices by providers and consumers. The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781
Physician HIE Benefits • Reduced administrative burden for collecting, managing, and distributing medical records. • Reduction in chart pulls, leading to a more efficient workflow. • Aggregation of healthcare data at the point of care, improving the efficiency and quality of care delivery, increasing patient safety by reducing the opportunity for medical errors, and helping to eliminate waste related to unnecessary or duplicative tests. • Easier pre-authorization. • Ability to access patient data outside the clinical setting. • Faster access to lab results and radiology reports. • Streamlined access to patient histories and discharge summaries. The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781
Physician HIE Benefits… continued • Community-wide and statewide connectivity. • Automated physician referral and consult processes. • Reduced administrative and overhead costs. • HIPAA-compliant data-sharing with other healthcare providers. • Local connectivity for rural providers, enabling delivery of data from referring hospitals to meet rural physicians’ immediate needs. • Business and clinical information exchange between HIOs and key trading partners like health plans, referral networks and public agencies in a less costly, complex or risky way. • Qualification for Meaningful Use incentive payments, which require electronic exchange of health information. • Relationships with ACOs, which involve sharing data to better coordinate patient care and improve outcomes. The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 References to support benefits- Appendix E http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781
Estimated Annual HIE Benefit for NM Value that is Financial and Measurable Prevent Unnecessary 30-day Readmissions $7,810,205 Reduce avoidable Adverse Drug Events (ADEs) –Inpatient $2,073,297 Avoid Duplicative Testing and Imaging $13,619,776 Avoid Duplicative Consults $1,169,140 Reduce Length and Complexity of Stays $2,450,260 Reduced burden for collecting, managing and distributing medical records (providers) $3,141,360 Reduced burden for collecting, managing and distributing medical records (hospitals) $4,751,635 Total $35,015,673 Value that has Multiple Dependencies or is Difficult to Measure Reduction of inpatient costs by allowing stays in less expensive settings $2,771,787 Increase in patient load per provider $6,096,675 Increase in Patient Empowerment (Inpatient) $1,427,891 Increase in Patient Empowerment (Emergency Department) $749,943 Total $11,046,296 Overall Total $46,061,969 The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 Gartner Study done for Arkansas extrapolated for New Mexico- Appendix D http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781
Estimated Annual HIE Benefit for NM Healthcare Providers Hospitals $6,448,676 (14%) Healthcare $4,145,577 (9%) Professionals The Business Case for Interoperability and Health Information Exchange HIMSS 8/2014 Gartner Study done for Arkansas extrapolated for New Mexico- Appendix D http://www.himss.org/ResourceLibrary/genResourceDetailPDF.aspx?ItemNumber=32781
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