A Community Asset Health Information Exchange with Providers and Health Plans

Transcription

1 A Community Asset Health Information Exchange with Providers and Health Plans October 5, 2017 Avalon #16 2:20PM 3:10PM Jack Hueter, CEO Digital Health Consultants Daniel Wilt, Senior Director, HealthShare Exchange

2 Agenda Overview Providers and Health Plan Community Introduction HealthShare Exchange Health Information Exchange Community Asset for Care Coordination Encounter Notification Service o ENShare o Smart Notifications Care Team Identification High Utilizer Identification Learning Objective Take Away

3 Providers and Health Plan Community Introduction Providers are becoming more At Risk with New Shared Savings Contracts with the Health Plans Including the Post Acute Care of Long Term Care Quality Measurement Continues to Evolve With the Federal Government: MIPS, MACRA, CPC+ HSX White Paper sxservices_valueforproviders_final.pdf Delegation of Care Coordination Activities From the Health Plans to Providers and ACO s Care Coordination Activities Are Only Successful When You Know About What is Happening in the Community As a Whole 3

4 HealthShare Exchange 4

5 Who is HealthShare Exchange? HSX is a non-profit 501(c)(3) health information exchange (HIE) organization serving the greater Philadelphia Region. The corporation was formed in May 2012 and the Board and Governance was formed in January The HSX Mission is to provide secure access to health information that enables preventive and cost effective care; improves the quality of care; and facilitates the transitions of care. The HSX Vision is to build a trusted community of healthcare stakeholders collaborating to deliver better healthcare to patients. 5

6 HSX Membership a unique mix compared to other HIEs Health Systems 40 Hospitals 93%+ Emergency Department (ED) visits in the region Behavioral Health Organizations Eagleville Hospital Elwyn Northwestern Human Services Specialty Hospitals Physicians Care Surgical Hospital Accountable Care Organizations Delaware Valley ACO Philadelphia-Camden Integrated Kidney Care Other Risk-Bearing Entities Tandigm Health Plans AmeriHealth AmeriHealth Caritas AmeriHealth New Jersey AmeriHealth Pennsylvania Health Partners Plans Independence Blue Cross Clinically Integrated Networks Doylestown Healthcare Partnership Independent Ambulatory Practices (includes Federally Qualified Health Centers) 79 Organizations Long-term Care Organizations Abramson Center for Jewish Life Genesis Healthcare 6

7 HSX Membership Southern NJ connectivity makes good sense for patient flow to and from HSX membership 7

8 Care Coordination 8

9 Coordinating The Care Coordination Encounter Notification Service Description Organizations can Subscribe to Panels of Patients and Receive Timely Notifications When Their Patients are Hospitalized or Present to an Emergency Department and then are subsequently discharged. Recently Added the Ability to Subscribe to Long Term Care Admissions and Discharges Encounter Notification New Features ENShare Light Weight Care Management Smart Notification Care Team Identification Population Health Reporting Identification High Utilizers 9

10 ENS Subscriptions as % of Net MPI 7,000,000 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 Net MPI ENS Subscriptions 3,853,0133,946,545 4,052,925 5,776,711 5,035,287 5,192,103 5,024,275 5,124,7605,094,8945,215,303 5,265,022 5,429,537 2,481,0612,487,8162,481,639 2,655,880 2,708,951 2,810,4222,818,6172,834,083 2,923,185 3,106,5333,106,6753,108,339 1,000,000-66% 62% 58% 54% 64.4% 63.0% 61.2% 52.7% 52.2% 55.9% Percentage MPI Covered by 55.0% 55.6% 56.1% 59.0% 57.2% 53.8% 50% 10

11 ENS Patient Subscriptions and Notifications 3,500,000 3,000,000 2,500,000 Patient Subscriptions 3,106,533 3,106,675 3,108,339 2,810,422 2,818,617 2,834,083 2,923,185 2,655,880 2,708,951 2,481,061 2,487,816 2,481,639 2,000,000 1,500,000 1,000, , , , , , ,622 Notifications 177, , , , , , , , ,000 50,000-11

12 Encounter Notification Service Total LTC Notifications Sent to Subscribers

13 ENShare Capabilities 13

14 Emergency Department Admits and Discharges 14

15 ENS Coverage of Emergency Admit Encounters 250, % 30.02% 35.57% 31.80% 33.50% 33.31% 33.71% 32.73% 33.18% 33.86% 35.40% 35.96% 200, , , , , , , , , , , , , , ,156 50,000 50,972 55,699 54,774 56,391 62,936 57,081 63,971 55,858 61,859 64,830 68,915 77,360 - Total Encounters Notifications Sent Percentage Covered 15

16 Clinical Activity History Total Documents Delivered 2,500 2,000 1,891 1,945 1,933 1,500 1,224 1,285 1,267 1,376 1,437 1,227 1,376 1,339 1,309 1,

17 Population Health 17

18 North Philadelphia High Utilizers Zip Codes Greater than 10 ED Visits Greater than 20 ED Visits Total Individual Identified High Utilizers and Targeted Care Coordination Would Reduce the Emergency Department Visits Community Could Come together To Combine With Social Services and Social Determinant Data Sources To Affect Health Outcomes 18

19 Opioid Usage Dashboard Locating in Real Time The Prevalence of an Individual With a Specific Condition to Improve Health Outcomes 19

20 Learning Objectives Take Away 20

21 Track 5 in Room Avalon #19 at 3:25PM HSX Next Presentation on Where We are Headed: New Roles for Health Information Exchange: Evolution from Data Aggregator to Data Provider 21

22 Sharing is Caring HealthShare Exchange of Southeastern Pennsylvania HealthShare Exchange of Southeastern HealthShare Exchange +HsxsepaOrg1 HealthShare Exchange 22

23 Thank You! Jack Hueter CEO Digital Health Consultants Daniel Wilt Senior Director Information Technology HealthShare Exchange 1801 Market Street, Suite 750 Philadelphia, PA