Kansas Health Information Network (KHIN ) Key Statistics 1.Over 3.7 million unique patients in KHIN 2.Over 25 million patients available for query 3.9800 providers 4.900+ healthcare organizations in production
Fragmented Clinical Data High-cost patients see 10+ providers Unified, Normalized Clinical annually with data spread across care settings Data Ready for Analytics Office Specialist Ambulatory Hospital Post-Acute Visit Referral Center Stay Care
KHIN products/services 2016-2017 Health Information Exchange State level interfaces • Bi-directional in EHR • Immunizations • Web Based Portal • Syndromic surveillance • Secure Clinical Messaging/DIRECT • Reportable diseases • DIRECT Provider Directory • Cancer registry ONC Certified Personal Health Record • Infectious disease registry • Birth Defect registry • View Download & Transmit • Diabetes registry • Patient Education • Secure Messaging Business Intelligence and Analytics • Patient Electronic Access – Dashboards • Certified Immunization Record • High Risk • Patient Generated Data • Quality Metrics • Readmissions • Disease Registries • Population Health 8 • Controlled Substances* – Data Extracts – Alerts
Two Dimensions of Data Quality Syntax Completeness For included data, did it Were the data included support semantic within a section/entry of a interoperability? clinical document?
Distribution of Scores for Largest Facilities 90% 85% Document Completeness 80% 75% 70% 65% Facility E Facility D 60% Facility C Facility B 55% Facility A 50% 78% 80% 82% 84% 86% 88% 90% 92% 94% Document Syntax
Lowest Scoring Facilities From left to right: total score, demographics, allergies, encounters, immunizations, medications, payers, plan of care, problems, procedures, results, social history, vital signs 1 Total C-CDAs S C S C S C S C S C S C S C S C S C S C S C S C S C Facility A 11,037 92 54 60 68 87 68 100 100 100 58 71 36 100 29 100 0 100 41 100 17 94 46 100 17 100 64 Facility B 60,812 91 55 60 68 82 78 100 100 100 58 73 36 100 29 100 0 100 41 100 17 91 48 100 17 100 65 Facility C 48,303 82 55 84 68 57 52 100 12 100 58 66 36 100 29 100 0 80 71 61 100 80 72 92 17 92 41 Facility D 12,148 93 57 60 68 90 63 100 100 100 58 85 36 100 29 100 0 99 80 97 22 95 44 100 17 100 64 Facility E 39,649 87 60 75 71 87 65 92 24 99 69 87 64 87 36 86 56 93 59 79 69 86 69 87 38 86 45 We are receiving 5+ million clinical documents annually. 1 S- Syntax; C- Completeness
KHIN Can Help Physicians Succeed! Percent of Score THREE AREAS OF MIPS MEASUREMENT-2017 – Quality 60% of Total Score – Clinical Practice Improvement 15% of Total Score – Advancing Care Information 25% of Total Score
MIPS Financial Model Consider : MIPS Potential Impact on $250,000 Annual Medicare Reimbursement per physician.
Kansas Health Information Network Products ACI Base Score: Required = 50 Points Protect Patient Health Information, ePrescribing, Send Summary of Care Record, Accept Summary of Care Record & Patient Electronic Access 1. Secure Clinical Messaging/DIRECT 2. HIE Longitudinal Patient View Within EHR Web-based Access 3. ONC Certified Personal Health Record Patient Electronic Access
Kansas Health Information Network Products ACI Performance Score: Up to 90 Points Patient Specific Education, Patient View, Download or Transmit, Patient Secure Messaging, Patient Electronic Access, Send Summary of Care Record, Request Summary of Care Record, Immunization Registry Reporting & Clinical Data Registry Reporting ONC Certified Personal Health Record Secure Clinical Messaging/DIRECT View Download & Transmit HIE Longitudinal Patient View Within EHR Patient Education Web-based Access Secure Messaging Patient Electronic Access Public Health Interfaces • Immunizations • Syndromic Surveillance • Clinical Data Registry
Kansas Health Information Network Products Clinical Practice Improvement = 15% of MIPS score CPI Activity (choose four) How KHIN Supports Participate in HIE Health Information Exchange Enhanced Patient Portal Personal Health Record Provide patient self management materials at Personal Health Record appropriate literacy level and language Regular review of targeted physicians Preventive Care Dashboards Empanel patients for providers Preventive Care Dashboards Proactively manage patient care Preventive Care Dashboards Identify high risk patients High Risk Dashboard Improve health status of communities Population Health Dashboard Measure and improve quality Population Health Dashboard Participate in research De-identified data extracts
KHIN Products Quality = 60% of MIPS score NCQA CERTIFIED QUALITY DASHBOARDS Screening for Osteoporosis Influenza immunization Pneumococcal vaccination Breast Cancer Screening Diabetes A1c >9 Colorectal Cancer Screening Cervical Cancer Screening
NCQA Certified eClinical Quality Measures # CMS ID HEDIS Measure # CMS ID HEDIS Measure Abbreviation Abbreviation Clinical Process/Effectiveness Clinical Process/Effectiveness 1 CMS74 - Primary Caries Prevention Intervention as Offered by Primary Care Providers, 16 CMS159 DRR Depression Remission at Twelve Months including Dentists 2 CMS82 - Maternal Depression Screening 17 CMS160 DMS Depression Utilization of the PHQ-9 Tool 3 CMS2 DSF Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan 18 CMS165 CBP Controlling High Blood Pressure 4 CMS122 CDC Diabetes: Hemoglobin A1c Poor Control 5 CMS123 CDC Diabetes: Foot Exam 6 CMS124 CCS Cervical Cancer Screening Efficient Use of Healthcare Resources 7 CMS125 BCS Breast Cancer Screening 19 CMS146 CWP Appropriate Testing for Children with Pharyngitis 8 CMS126 ASM Use of Appropriate Medications for Asthma 9 CMS127 PNU Pneumonia Vaccination Status for Older Adults 20 CMS154 URI Appropriate Treatment for Children with Upper Respiratory Infection 10 CMS128 AMM Anti-depressant Medication Management 21 CMS166 LBP Use of Imaging Studies for Low Back Pain 11 CMS130 COL Colorectal Cancer Screening Patient Safety 12 CMS131 CDC Diabetes: Eye Exam 22 CMS156 DAE Use of High-Risk Medications in the Elderly 13 CMS134 CDC Diabetes: Urine Protein Screening Population/Public Health 14 CMS136 ADD ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/ Hyperactivity 23 CMS117 CIS Childhood Immunization Status Disorder (ADHD) Medication 24 CMS153 CHL Chlamydia Screening for Women 25 CMS155 WCC Weight Assessment and Counseling for Nutrition and Physical Activity for 15 CMS137 IET Initiation and Engagement of Alcohol and Other Drug Dependence Treatment Children and Adolescents
Identifies patients with 3 or more chronic disease conditions and 5 or more ED visits in the last 12 months across 128 provider groups. MIPS & APM CPIA Requirement: Identify High Risk Patients = 10 points
Identifies patients from one facility that have 7+ chronic diseases and have visited the ED 51+ times in 12 months. MIPS & APM CPIA Requirement: Identify High Risk Patients = 10 points
Provides patient level drill down with name and number of ED visits, at home ED and other EDs. MIPS & APM CPIA Requirements: Routine and Timely Follow Up to ED visits = 10 points
Provides patient level drill down of ED utilization patterns across all EDs. MIPS & APM CPIA Requirements: Routine and Timely Follow Up to ED visits = 10 points
Provides patient level drill down for diagnosis, procedures and insurance provider.
Provides number of chronic diseases by patient age for patients with 5 or more ED visits. MIPS & APM CPIA Requirements: Proactively manage chronic care = 10 points
Provides patient level drill down by chronic disease condition and age. MIPS & APM CPIA Requirements: Proactively manage chronic care = 10 points
Provides real time, preventive care patient level drill down identifying where patients received preventative care, if outside of PCP, for quality reporting. MIPS & APM CPIA Requirements: Measure and Improve Quality at the Practice Level = 10 points
Provides description of the preventative care received. More detailed information is available in the HIE. MIPS & APM CPIA Requirements: Measure and Improve Quality at the Practice Level = 10 points
Provides real time readmission information aggregated across multiple hospitals. MIPS & APM Quality Requirements: All cause hospital readmission.
Provides real time hospital specific information by disease and trend line. MIPS & APM Quality Requirements: All cause hospital readmission.
Provides real time patient specific information regarding readmit facility and readmit diagnosis.
Provides real time heat map of disease prevalence by provider. MIPS & APMs CPIA Requirement: Improve Health Status of Communities = 10 points
Provides patient level drill down of disease prevalence by provider MIPS & APMs CPIA Requirement: Improve Health Status of Communities = 10 points
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