38 Unique Healthcare Organizations. Tioga. Crawford Wayne. Lycoming. Clinton. Union. Snyder. Juniata Perry. Huntingdon. Franklin.
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2 About KeyHIE 38 Unique Healthcare Organizations Erie Warren McKean Potter Tioga Bradford Susquehanna Crawford Wayne Mercer Venango Clarion Forest Jefferson Elk Cameron Clinton Lycoming Sullivan Columbia Wyoming Luzerne Lackawanna Pike Lawrence Butler Clearfield Centre Union Montour Carbon Monroe Beaver Armstrong Indiana Mifflin Snyder Northumberland Schuylkill Northampton Lehigh Allegheny Westmoreland Cambria Blair Huntingdon Juniata Perry Dauphin Lebanon Berks Bucks Washington Montgomery Cumberland Greene Fayette Somerset Bedford Fulton Franklin Adams York Lancaster Chester Delaware Philadelphia 21 Hospitals 172 Physician Practices 28 Home Health locations 70 Long Term Care Facilities 1 Pharmacy and 1 LTACH
3 Health Information Exchange and HIE The Care Community Clinical Workflow Meaningful Use Accountable Care
4 First, the Alternative to HIE 12 provider organizations Connected to 11 other provider organizations 264 bi-directional interfaces - OR - HIE Requests to each data source
5 HIE and Clinical Workflow Care teams (PCMH, ACO, etc.) Physician practice Emergency Department Acute Inpatient Nursing Home Home Health Home EMS HIE
6 The mission-critical HIE services HIE Services Publishing/ Viewing Notifications Direct Messaging EHR Consuming HIE Patient Portal 6
7 Consuming HIE Data into EHR Connected EHRs HIE Clinical Summary Problem list Medication History HIE Allergies Publish Documents Consume Documents Direct Messaging Other Text
8 HIE and Meaningful Use MU1 (2014) Patient Engagement MU2 Patient Engagement MU2 Transitions of Care
9 Patients & Meaningful Use Stage 1 Inform Me Visit summaries Online (72 hours) for 50% & PHR requests Patient-specific education for 10% Stage 2 Engage Me Visit summaries (24 hours) - online, download, print Patient-specific education Online secure messaging Stage 3 Empower Me Offer online selfmanagement tools Patient reported experiences Patient data into EHR and clinic workflow Secure messaging between patients and providers Participation in a HIE or similar effort
10 MU2 Patient Engagement Core objectives for EP/EH/CAH: Provide clinical summaries for patients for each office visit / discharge Patients can view online, download and transmit their health information Use secure electronic messaging to communicate with patients Provide patient-specific education resources Reference: CMS Stage 2 Guides (9/2013)
11 MU2 Patient Engagement PCP Patient: Mary A. 69 y/o Female with CHF and COPD Physicians: Primary care / Care manager Cardiologist / Pulmonologist Frequent ED and occasional inpatient Specialty HIE Connect to all providers: 1. View, Download, Transmit clinical summary documents 2. Secure messaging with physicians 3. Patient educational materials
12 MU2 Patient Engagement FAQ7735 CMS clarification regarding use of a shared portal or PHR Numerator requirements: 1. Patient is seen during the EHR reporting period 2. Patient views online, downloads, or transmits 3. The EP / EH / CAH contributed at least some of the information to the portal Note: The respective provider need not have contributed the particular information that was viewed, downloaded, or transmitted by the patient.
13 MU2 Transitions of Care 1.Provide a summary of care record (50% total) 2.Provide a summary of care record (10% electronically) 3.Exchange summary of care record with another EHR or CMS test system Reference: CMS Stage 2 Guides (9/2013)
14 MU2 Transitions of Care Provide a summary of care record for more than 10% of the total number of transitions and referrals (a) using Certified EHR Technology (b) via exchange facilitated by an organization that is an ehealth Exchange participant (c) in a manner that is consistent with the governance mechanism ONC establishes for the ehealth Exchange Reference: CMS Stage 2 Guides (9/2013)
15 MU2 Transitions of Care Strategy for Transitions of Care measurement: 1. Using Direct Secure Messaging within EHR 2. Using HIE : a. Access via HIE repository i. Successful access required b. HIE delivery i. SOAP+XDR (CEHRT) ii. Via NwHIN/Healtheways participant c. HIE to provide Numerator Reports
16 Coordinating with Long-Term Care Developed with AHIMA, HHS, and S&I Framework HL7 Balloted. Nationally available Web service. HIE Nursing Homes Home Health MDS OASIS Clinical Summary 16 Copyright 2013 Keystone Health Information Exchange
17 HIE and Accountable Care Care Team Hospitals Practices Nursing Homes Home Health Care Managers HIE Services Publishing/ Viewing Notifications Direct Messaging EHR Consuming Patient Portal Analytics ACO Measures Care Gap Identification Care Gap Closure Population Benchmarks Patient Services
18 For additional information, visit
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