A Regional Approach to HIE Yvonne Hughes, CEO Small & Rural Hospital Conference November 12, 2014
Needs Assessment 2
Governance Structure Multi-Disciplinary Board Regional Hospitals (3 seats) Local Regional Extension Center (1 seat) Rural and Urban Physician Representation (7 seats) Community Care of NC (1 seat) Consumer Representative (1 seat) Clinical Policy/ Legal Business Planning Consumer Advocacy 3
1 st HIE to HIE Connection in the state 35,000+ Transactions/day 55 Data Contributors: 1 st bi-directional HIE in state Deployed technology in 24 counties Four million ++ patient lives HIE TO HIE CONNECTION Footprint CCHIE and CareConnect Carolinas 4
CCHIE Footprint Over 2.8 million patient records 249 unaffiliated practices (822 clinicians) 5 unaffiliated hospitals 1,553,227 Results Delivery in last 90 days ( 6% delivered inside EMR) Labs: 947,580 Rad: 133,441 Trans: 472,206 ADT: 1,424,984 5
CCHIE By the Numbers June 2012 June 2014 % Change Total Logins 632 3,336 428% Unique Patients 367 3,232 781% Results Delivered: Labs 127,763 297,334 133% Rad 20,537 42,220 106% Trans 6,314 156,027 2371% Total 154,614 495,581 6
Use Case for HIE: Community Health Record Tool Data Contributors: 32 + Ambulatory Practices Solstas Lab Outpatient Radiologists FQHC s Free Clinics Health Departments 7
Use Case for HIE: Notify ADT Alerting NOTIFY is Admission, Discharge and Transfer (ADT) Alerting to providers that improves Care Transition, Regulatory Compliance and Reimbursement. In the past 90 days CCHIE has delivered over 1.4 million ADT alerts! Value Add: Supports CPT 99495 and 99496 Transitional Care Management Services Notifications can be delivered to the entire care team to ensure timely clinician engagement impacting 30 day re-admission rates and length of stay. IMPROVED CARE Proposed MU3 Requirement Requires hospitals to send electronic notifications of significant healthcare events to a patient s care team within 4 hours 8
Use Case for HIE: Transition of Care Acute to Ambulatory Proven Results: Hospital inpatient floors use the HIE s Referral application to electronically send care documents and schedule follow up appointments (real time) with two primary care clinics and receive electronic confirmation of appointment details. Efficiency Results: 80% reduction in call volume from the hospital to the practices. Workflow Results: Reduction from 25 mins to 6 mins to schedule the referral appointment. HIE to HIE Connection: Timely access to encounter information, documented reduction in duplicate tests, expedited discharge, workflow efficiencies and better patient experiences. 9
Use Case: Meaningful Use Support Coastal Connect has been Direct/HISP (Health Information Service Provider) enabled: Health Information Service Provider https://direct.coastalconnect.org/ First HISP to CCHIE HISP connection deployed October 14 Value Add: Exchange of Behavior Health Information ehealth Exchange Onboarding Timeline for later in 2015 Enables Connection to VA and Dept of Defense 10
Community Health Record Tool: Stories from the Field Duplicate Test Avoidance Clinical staff excited not to have to re-stick a chronically ill child Mammogram confirmed Drug seekers identified prompting clinical staff to query prior to ordering tests Better Patient Experience Physicians spend appointment time delivering care, not searching for records/results Family members do not need to be the carrier of all information Clinical Workflow Efficiencies Physicians querying to confirm patient they transported was treated appropriately prior to transition Hospitalists accessing care documents from other facilities rather than calling Medical Records 11
Lessoned Learned Identify CEO, CIO, CFO and Provider Champions Cohesive Message: Keep the Patient in the Middle! Sustainability = Affordability Provide Value to Members Demands on Resources Competing Priorities EMR Implementations Vendor Market Instability Remain Flexible! Emerging Technology Emerging ACOs 12
2015 Road Map Community Health Record (CHR) Single Sign On Platform: clinicians work from their native environment Impact: clinical data from disparate systems; delivered in real-time to Hospitialists, ED Staff, Care Managers, EMTs (and others across the continuum of care) in multiple settings: duplicate testing is avoided, service utilization is improved and administrative costs are reduced. Additional Data Contributors Enhanced ADT Alerting: delivery on diagnosis or patient list; assist with a readmission project Regional Analytics Publication of the 3 year Academic Review 13
It Takes a Village CPSI Analytics Care Manager IN Network Provider Skilled Nursing Facility Palliative Care/Hospice Community Health Record OUT of Network Provider