Building sustainable HIE for the North Bay region of California
COMMUNITY STAKEHOLDER MEETING SEP 19, 2012 SUTTER SOLANO MEDICAL
CENTER
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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 HealthBridge Presentation Keith Hepp 7:01 7:45 pm
Q&AKeith Hepp 7:46 8:00 pm Update ActivitiesLyman Dennis 8:01
8:05 pm Study Teams & Workplans Teams 8:06 8:35 pm Q&ATeams
8:36 8:45 pm Next Meeting LD 8:46 8:50 pm AGENDA
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PARTICIPANT INTRODUCTIONS
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BOARD AND ALTERNATES
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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, Comm Hlth
Lyman Dennis, Ex Dir Adventist HealthNorthern 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
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CONNECTHEALTHCARE ALTERNATES Gwen Matthews, Sr VP for Operns
Kathleen Marshall Rebecca Rozen Maryanne Eckhout, Cynthia Melody
Mitch Wippern, Dep Dir, Operns Justin Graham, MD, CMIO Liz
Gibboney, Dep Ex Dir Mary Maddux-Gonzalez, MD Paul Sampedro, HIE
Pgm Dir 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
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SUTTER HEALTH HIE
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KEITH HEPP, HEALTHBRIDGE
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HealthBridge is one of the nations largest and most successful
health information exchange organizations. An Overview of the
HealthBridge Data Analytics & IT Infrastructure Keith Hepp, CEO
September 19, 2012 9
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HealthBridge Background One of the nations 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 10
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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 Network Size &
Adoption 11
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Strategic Direction 13 Pre ARRAPost ARRA Value added services
EHR Implementation Basic Messaging Value Added Services HER
Implementation Basic Messaging
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HIE Value Progression Meaningful Use, Medical Home and Payment
Reform Basic HIE Stage 1 MU EHR Adoption (REC Services) Basic
Electronic Messaging (NHIN DIRECT) Community Portal Web-Based
Results Delivery Value: Dramatic reduction in redundant paper,
phone contacts; Greater efficiency Intermediat e HIE Stage 2&3
MU Structured Data Delivery to EHRs Results Delivery (Lab, Rad,
ADT, etc.) Summary Record Exchange (CCD) Value: Necessary to
achieve truly electronic workflows; Dramatic increase in efficiency
Advanced HIE PCMH, ACO & Payment Reform Readiness Data
Warehouse & Analytics Disease Registry Quality Reporting
Support Full Integration Services & Bidirectional Exchange
Value: Dramatic improvements in quality and performance
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Clinical Inbox
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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
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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
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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
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19 Infrastructure Components Impact Intelligence Provider
Claims Analytics & Reports Impact Intelligence Provider Claims
Analytics & Reports Impact Pro Patient Claims Analytics &
Reports Impact Pro Patient Claims Analytics & Reports Provider
& Payer Data Translation Master Patient & Provider Index
Claims Analysis Tools (Optum Symmetry) Claims Analysis Tools (Optum
Symmetry) Claims and Clinical data warehouse CPC Required Measures
Custom Analytics & Reports Available Today Optional
Applications Optional Applications
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Infrastructure Components 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 OPTUMInsights Symmetry Data Analytic Engines
Patient Attribution Methodologies 20 Match patients across data
sets accurately Combines big data sets both clinical and claims
Combines big data sets both clinical and claims Helps data speak
the same language Patient Attribution, Risk Assignment, & Cost
Aggregation
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21 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)
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22 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
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23 Medical Neighborhood Tracking
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Clinical and Claims Repository CPC Measure NQF #59 Diabetes
Mellitus: Ha1c Poor Control (>9%) Summary
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Episodic Risk Score Computation
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27 Questions and Discussion
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UPDATE
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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 ACTIVITIES
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Source: HIE Best Practices Toolkit for Planning Grantees, Lyman
Dennis, Cal eConnect, Sep 2012. EXCHANGE FUNCTIONS
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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) CORE SERVICES
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Part 1 Receipt of Structured Lab Results ePrescribing Sharing
of Patient Care Summaries (across unaffiliated organizations using
different EHRs) Part 2 Immunization Reporting Reportable Laboratory
Results Syndromic Surveillance Data BASIC EXCHANGE SERVICES
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HIE Portal Lab Ordering Personal Health Record Advance
Directives ADDITIONAL SERVICES
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Referrals to Specialists Authorizations Clinical Data
Repository Transcription Service EHR Light Clinical Decision
Support / Data Analysis Meaningful Use Registry Disease Management
Enterprise Image Viewer VALUE-ADDED SERVICES, PART 1
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Portal to HIE Medication Reconciliation EDI Services (X12
administrative transactions) Eligibility Checking Provision of
Educational Materials Electronically Quality Improvement Reporting
Credentialing Services VALUE-ADDED SERVICES, PART 2
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Group Purchasing Workflow Redesign for Providers Hosted
Helpdesk for Providers Systems Implementation Technical Assistance
Clinical Trials Management VALUE-ADDED SERVICES, PART 3
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COMMUNITY STUDY
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COMMUNITY HIE STUDY TEAM Lyman Dennis, Lead Justin Graham, MD
David Jomaoas Jeremy Mann, MD
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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
COMMUNITY STUDY WORKPLAN
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PROCUREMENT OF HIE SERVICES
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PROCUREMENT TEAM Paul Alcala, Lead Robert Moore, MD Paul
Sampedro Lori Sklar
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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 PROCUREMENT WORKPLAN, PART 1
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Assess offers Negotiate agreement and execute Finalize provider
rates Finalize business plan PROCUREMENT WORKPLAN, PART 2
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DOCUMENT DEVELOPMENT
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DOCUMENTS TEAM Alice Hughey, Lead Mitch Wippern Consultant, Cal
eConnect
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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 DOCUMENTS
WORKPLAN, PART 1
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Policies and Procedures draw from Markle Model Privacy Policies
Rhode Island Quality Institute Redwood MedNet Other sources
DOCUMENTS WORKPLAN, PART 2
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NOT-FOR-PROFIT FILING
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Lyman Dennis, Lead Paul Smith, Esq., Hooper, Lundy &
Bookman NOT-FOR-PROFIT FILING TEAM
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PROVIDER CONTRACTING
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PROVIDER CONTRACTING TEAM Suzanne Ness, Lead Lyman Dennis
Robert Moore, MD
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Profile functions desired by each provider Determine first
movers Focus on California Model Modular Participation Agreement,
include DURSA Rates will be determined as agreement is refined
Review policies and procedures with parties PROVIDER CONTRACTING
WORKPLAN
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ADVISORS
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ADVISORS TEAM Kathy Amacher, DO John Buzolich Sundeep Desai, MD
Kathy Ficco Patricia Rehfield, DO
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Review work products Second opinion Consider community
interests beyond current participants ADVISORS
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ANNOUNCEMENT
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http://www.youtube.com/user/redwoodmednet
http://www.youtube.com/user/redwoodmednet PRESENTATIONS & DEMOS
FROM REDWOOD MEDNET CONFERENCE
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FINANCIALS
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NEXT COMMUNITY STAKEHOLDER MEETINGS
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TopicsDateLocation Redwood MedNet, Orion HealthNov 15,
2012Adventist Health, St Helena Mirth Corporation (HIE Solution,
Tools)Jan 17, 2013Partnership HealthPlan of CA, Fairfield Status
UpdateMar 21, 2013NorthBay Healthcare, Fairfield UPCOMING COMMUNITY
STAKEHOLDER MEETINGS
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Lyman Dennis Ldennis@connec tHealthcare.org 707-863-0130
DISCUSSION
