Topics To Be Covered HealthInfoNet Overview and Exchange Updates - PDF document

HealthInfoNet: A Data Platform for Health Reform in a Changing Medical Landscape Maine Medical Association 22nd Annual Practice Education Seminar July 24, 2013 1 Topics To Be Covered • HealthInfoNet Overview and Exchange Updates • HealthInfoNet Value-Added Activities • Introduction to the HealthInfoNet Data Warehouse • HealthInfoNet Data Use and Release Policy • State Innovation Model Grant 2 2

What is HealthInfoNet? • HealthInfoNet operates Maine’s statewide health information exchange (HIE) , a secure, standardized electronic system where providers can share important patient health information. • The use of this system: – Saves time and reduces paperwork. – Facilitates more informed treatment decision-making. – Leads to improved care coordination, higher quality of care, and better health outcomes. 3 HealthInfoNet History • 2004 - Maine Health Access Foundation, Maine CDC, Maine Quality Forum and Maine Health Information Center study need and support for an exchange in Maine. • 2005 - Stakeholders begin planning and development. • 2006 - HealthInfoNet incorporated with Devore Culver, formally Chief Information Officer of Eastern Maine Healthcare, as Executive Director. • 2008 - Demonstration phase begins. – Participants included MaineHealth, Central Maine Healthcare, Eastern Maine Healthcare, Maine General Health, Martin’s Point Health Care, Franklin Memorial Hospital and the Maine CDC. • 2010 - Demonstration phase ends and statewide roll-out begins. 4

How Does the HIE Work? • HealthInfoNet’s system combines information from separate health care sites to create a single electronic patient health record • Patient health information is automatically uploaded from a provider’s electronic medical record system • The information is standardized and aggregated across care sites • Clinicians can seamlessly access their patient’s information in HealthInfoNet from within their EMR • HealthInfoNet automates reporting of certain illnesses and conditions like Lyme disease or food poisoning, to public health experts at the Maine CDC 5 HIE Connections Hospitals, FQHCs, Ambulatory • 34 of 38 hospitals connected • All Maine Hospitals under Contract to HIN • 15 FQHCs • 376 Ambulatory sites including physician practices behavioral health and long term care 6 6

Data Categories Managed in HIN Today • Patient Identifier and Demographics, including insurer • Encounter History • Laboratory and Microbiology Results • Radiology Reports • Adverse Reactions/Allergies • Prescription Medication History • Diagnosis/Conditions/Problems (primary and secondary) • Immunizations • Vital Signs • Dictated/Transcribed Documents • Continuity of Care Documents (CCD) 7 7 What do providers say about using HealthInfoNet? • It’s more efficient. Automated sharing of information, less paperwork, reduced time to access clinical information at the point of care, fewer repeat tests and procedures. • Results in more Informed treatment decisions. A more complete and up-to-date patient medical record, including information from all a patient's participating health care providers. • Leads to healthier patients. Fewer medical errors, improved patient safety, improved continuity of care, and better patient outcomes. 8

HealthInfoNet’s HIE Operating Statistics As of June 30, 2013 • 1,235,022 individuals have a HealthInfoNet record (86% of Maine’s resident population) • 13,594 individuals have opted out (1%) • 1,527 Maine clinicians and support staff have active HealthInfoNet user accounts • 3,109,365 inbound messages are received by HealthInfoNet each week • The HealthInfoNet Central Data Repository (CDR) is 1.454 TB in size and is growing at 3 GB a day Current Totals Through June 30th, 2013 CurrentSite PercentageCrossover % of Patient “Cross Bridgton Hospital 53.45% Calais Regional Hospital 60.43% Cary Medical Center 69.66% Over” Between Central Maine Medical Center 62.06% Down East Community Hospital 61.83% Corporately Eastern Maine Health Systems (EMHS) 62.48% Engel Place 100.00% Franklin Memorial Hospital 56.32% Unaligned Provider Health Access Network 75.96% Henrietta D. Goodall Hospital 50.86% Organizations Houlton Regional Hospital 54.73% Katahdin Valley Health Center 0.00% Laurel Court 100.00% Maine Coast Memorial Hospital 60.93% Maine General Health 52.42% Maine Medical Center 69.74% As of 04/31/2013 MaineHealth 79.23% Martin's Point Health Care 56.03% Max Health Maine 74.07% Mayo Regional Hospital 76.07% Mercy Hospital 77.82% Miles Memorial Hospital 66.00% Millinocket Regional Hospital 79.11% Mount Desert Island Hospital 62.88% Parkview Adventist Medical Center 71.72% Penobscot Community Health Center 85.94% Penobscot Valley Hospital 91.19% Redington-Fairview General Hospital 80.67% Ross Manor 89.51% Rumford Hospital 70.31% Sebasticook Family Doctors 88.28% SJH - Ambulatory Care, Inc 98.61% Southern Maine Medical Center 59.80% St Marys Regional Medical Center 79.21% St. Andrews Hospital 66.59% St. Joseph Hospital 92.12% Stephens Memorial Hospital 74.30% Stillwater Health Care 83.50% Sylvia Ross Manor 91.66% Wilson Stream Family Practice 91.80% Average Crossover 71.93%

Core Exchange Services • Interface Development, Management and Support • Data Mapping and Standardization • Patient Centered Portal Access and Data Download Functionality • Real Time Event Notification 11 HealthInfoNet Value Added Services • Notifications • Meaningful Use Stage 1 & 2 Connection to Public Health for Laboratory Reporting, Syndromic Surveillance, Immunization Reporting • ACO/Value-Based Purchasing Data Source • Vendor Neutral Architecture Image Repository • Enterprise Master Patient Index Management • Interoperable Secure Messaging • Data Warehouse and Reporting Tools 12

Notifications • Real Time e-Mail Notifications Based of Key Registration and Clinical Results Events • Current Notifications for: -Admission to Hospital -Discharge from Hospital -Admission to Emergency Department -Discharge from Emergency Department • Notifications in Development: -Lab Result Received -Radiology Result Received -Discharge from Skilled Nursing Facility (SNF) 13 Meaningful Use Stage 1 & 2 • Standardized, Structured Electronic Lab Result Reporting to Maine CDC for Positive Values Associated with Mandated Disease Reporting • Adult Immunization Reporting to Maine’s IMMPACT II Immunization Registry • Syndromic Surveillance Reporting to Maine CDC (under development) 14

ACO/Value-Based Purchasing Data Supplier • Data Source for NNEACC (ADT & Lab) for MaineHealth & Bangor Beacon LLC ACO Patients • Monthly ACO EMPI File for Bangor Beacon LLC Vendor Neutral Architecture Image Repository • Statewide Repository for Managing Digital Archive Images (Radiology, Cardiology, etc.) • Reduced Total Cost of Operation for Image Management Through Statewide “Group Purchase” Strategy • Enhanced Access to Relevant Prior Examinations to Support Reduced Testing Redundancy • Increased Leverage with PACs Vendor • Strengthened Business Recovery Position 16

Vendor Neutral Architecture Image Repository • Solution Agnostic as to Type of Image and DICOM Standard • Fixed Pricing On A Per-Study Basis • Free Total Cost of Ownership Analysis to Support Evaluation of Annual Cost Reduction Opportunity 17 Enterprise Master Patient Index Management • Supports Resolution of Patient Identity Across An Enterprise Where Different Medical Record Numbers Are Used to Manage the Same Patient • Delivers and Maintains a Unique, Single Enterprise Patient Identification Number for Better Coordination of Care Management, Billing, Data Integration 18

Interoperable Secure Messaging • Connects Hospital and Physician Practices to The National Health Information Network (NwHIN) to Support Secure, Trust-Based, “Push” Exchange of Clinical Information • Provides Access to Registries of “Authenticated” NwHIN User e-Mail/Secure Messaging Addresses • Supports Secure Exchange of Clinical Information Across State Lines • Low Annual Fee of $144 per User Account 19 Data Warehouse and Reporting Tools • Service Now Under Development (available in Fall of 2013) • Leverage Transactional Data Flowing Into the Exchange to Support Quality and Population Health Analysis as well as State, Federal, and Health Plan Reporting • Near Real Time Data Set to Support Market Share Analysis, Patient Origin Studies, etc. • Foundation for Community-Wide Health Reform Reporting 20

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Process for Data Use and Release Policy Development • Based Upon Participant Agreement Provisions • Incorporation of relevant HIPAA and MHDO Data Access & Use Rules • Review by legal counsel, HIN staff, & consultants • Adopted By HIN Board of Directors – 3/20/13 • Patient Communication Plan – Consumer Advisory Committee 23 23 Data Request Categories 1. Participant request for clinical data for treatment and/or operations purposes 2. Participant request for meeting reporting requirements 3. Request by Participant for providing clinical data to patients via PHR 4. Request for utilization data authorized as public 5. Request by a non-Participant for provider specific data not considered public 24 24