Market Trends and Practical Examples

Market Trends and Practical Examples

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Agenda Market Trends in Interoperability Integrating Clinic and Hospital EMRs HL7 FHIR Today s Speakers Brian Fugere, GM, Global Marketing, Value-Based Care Solutions, GE Healthcare Geoffrey Lay, Sr. Product Management Leader, GE Healthcare Tim Fitzgerald, Director of IT, The Oregon Clinic Keith Boone, Interoperability Guru, GE Healthcare

Survey Conducted With ehealth Initiative in Fall 2016 Health Information Exchange (HIE) 18% Payer 8% Healthcare Delivery 74%

Perspectives on Interoperability and Value-Based Care 95% agree that strong interoperability capabilities are a key IT requirement for a successful transition to value-based care 85% agree that current interoperability solutions in the market are not meeting their needs as they transition to value-based care ehealth Initiative Survey Fall 2016

Rate Your Current Interoperability Solutions Ability to Drive Value-Based Care Outcomes 70.0% 60.0% 63.9% 50.0% 40.0% 30.0% 20.0% 10.0% 20.8% 15.3% 0.0% Table stakes we have the basics, interoperability is not driving outcomes Some value add interoperability is driving some benefits ehealth Initiative Survey Fall 2016 Significant value add interoperability is driving significant benefits

Overwhelming Agreement That Strong Interoperability is Key to Successful Transition to Value-Based Care 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 3% 1% 15% 5% 4% 3% 1% 1% 4% 6% 17% 10% 8% 10% 18% 37% 25% 79% Strong interoperability capabilities are a key IT requirement for a successful transition to VBC. 48% Current interoperability solutions in the market are not meeting our needs as we transition to VBC. 25% 31% 1% Since 2008, technology has helped decrease healthcare costs 57% 49% 18% 19% Since 2008, technology has helped increase healthcare quality Agree Completely Agree Somewhat Neither Agree nor Disagree Technology has helped promote team-based care concepts ehealth Initiative Survey Fall 2016

Interoperability Budget Changes Over Next 2-3 Years Decrease significantly, 2.9% Decrease a little, 5.7% Increase significantly, 28.6% No change, 17.1% Increase a little, 40.0% ehealth Initiative Survey Fall 2016

Willingness to Pay 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 10% 10% 43% 48% 47% 42% readily available via an always-on connection readily available AND also easy to locate 28% 55% 49% 38% 16% 13% readily available, easy to locate AND also integrated into clinicians workflow readily available, easy to locate, integrated into clinician's workflow AND also drives significant practice outcomes Significant value add - I would pay premium fee for this capacity Some Value add - I would pay a nominal fee for this capacity Table stakes - Iam not willing to pay for this ehealth Initiative Survey Fall 2016

Comments from Respondents Need for Standardization Integration with EMR Strong Business Case Data Ownership Lack of standardization among vendors. Need for standardized vocabulary and well-defined operational definitions of data fields. Information coming from another provider needs to be integrated in our EMR. There should be a query and retrieve function. There needs to be increased willingness to share patient data among providers. Currently difficult to directly show improved outcomes as a result of investment. Payers still own data, so it is difficult to retrieve. Inability to convert all the data from over 300 systems into one data warehouse in a usable fashion Integration with outside data, integration into workflow Access to data from disparate platforms due to cost, politics, and restrictions on proprietary code Depends on how you define interoperability. ehealth Initiative Survey Fall 2016

Overall Trends Strong agreement that interoperability is needed for value-based care Majority of respondents did not feel interoperability was decreasing healthcare costs in their organizations, and many expect their budgets for IT to increase in the coming years ehealth Initiative Survey Fall 2016

Overall Trends Connectivity across provider organizations is most important to organizations. Exchanging data for regulatory reporting and industry wide data for research purposes is not as important connectivity area for payer, provider and HIE organizations. Majority felt federal policies and regulations are not currently sufficient to help the nation achieve interoperability by 2020, however majority believe more federal incentives are needed. ehealth Initiative Survey Fall 2016

Give Clinicians an Hour Back Each Day: Interoperability with Epic Care Everywhere Geoffrey Lay, Sr. Product Management Leader, Interoperability, GE Healthcare Tim Fitzgerald, Director of IT, The Oregon Clinic

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Give Clinicians an Hour Back Each Day: Interoperability with Epic Care Everywhere Objective Increase clinical efficiency and enhance care quality by improving connectivity between ambulatory practice and referring hospitals. Agenda Challenges associated with care coordination Benefits of clinical integration Anticipated outcomes Next steps

Background/Overview Multi-specialty ambulatory clinic, 230 providers Physician-owned, autonomous Provide specialty care for two large hospital systems who use Epic Care Everywhere Ongoing dialogue with hospital leadership about care coordination/improving communication Ongoing internal dialogue about efficiency, clerical burden, and time spent with patients Dr. Craig Fausel

Challenges Associated With Care Coordination

CHALLENGE: Current Referral Process Costs Providers and Staff Time and Lacks Agility Hospital System Via Fax, phone Ambulatory Practice Create Chart e-referral Schedule Visit(s) Request Records Attach Records Into Chart Review Chart Document Visits Med Asst. Chart Review Visits Occur MD Chart Review Via PDF/Fax Chart Notes Sent Via PDF/Fax Key challenges 1. Staff invest significant time retrieving and attaching data to chart 2. Physicians lose time reviewing attached data that isn t integrated into chart 3. Important data can be overlooked 4. Missing data is not easy to obtain in real time

Benefits of Clinical Integration

INNOVATION: Interface with Hospital System Increases Clinical Efficiency and Enhances Care Quality Hospital System Ambulatory Practice Via CCDA Create Chart e-referral Schedule Visit(s) Request Records Integrate data Into Chart Review Chart Med Asst. Chart Review MD Chart Review Key benefits 1. Referral data integrated into chart Document Visits Visits Occur Via CCDA Chart Notes Sent 2. Physicians spend less time searching for data 3. Administrative staff spend less time. preparing charts Via CCDA 4. Missing clinical data easy to obtain in real time before patient leaves

Anticipated Outcomes

Ambulatory Practices Gain Efficiency The Oregon Clinic expects providers to gain 60 min/day per provider in chart efficiency. Normally changing healthcare is hard, but in this case we think it will be really easy. - Tim Fitzgerald, Director of IT, The Oregon Clinic

Health System Sees Clinical Benefits From the Integration Working in the ED on Saturday night, I was able to access labs recently done at The Oregon Clinic for a patient I was seeing. Having the recent labs for comparison was so helpful in the clinical care of this patient. Access from the Epic side was seamless and looks just like other local (Epic) facilities in Care Everywhere. Thanks so much for your hard work on this important tool that will no doubt help countless patients our organizations care for together. - Dr. Andy Zechnich, CMIO, Providence Health System

The Workflow 2 4

Start a Chart Update and Open the Reconcile Form

Type of document (CCD or Progress Note) Filters and Actions Summary of Results Returned Source of Document Date of Service

Select the Latest CCDA and Reconcile Reconcile this CCDA

Select and Reconcile Medications Review/Compare

Select and Reconcile Medications Select Medication to Import

Select and Reconcile Problems Select Problems to Import

Select and Reconcile Allergies Compare known allergies

Reconciled Medications in Centricity Practice Solution

Reconciled Problems in EMR

Current Status

Current Status at The Oregon Clinic Rolling out to HIM department and each specialty with very positive feedback from clinicians. Expected completion Q/2017. The connectivity has created hope for clinicians. It s clear that there is an urgent, significant need out there. Two additional Health Systems in progress. Any descriptions of future functionality reflect current product direction, are for informational purposes only and do not constitute a commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.

Carequality and GE Healthcare

Carequality and GE Healthcare Building out our cloud based endpoint now Establishing our pilot sites Participation on Carequality production calls Goal: General Availability in Q3 of 2017 Any descriptions of future functionality reflect current product direction, are for informational purposes only and do not constitute a commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.

The Commitment to Interoperability

The GE Commitment Continues Added three development teams globally Trained more than 100 engineers in FHIR Onboarded numerous partners in our API program Demonstrated two FHIR prototypes at Centricity Live Continued our commitment to FHIR development Brought new product to Connectathons in HL7 and IHE Piloted use of IHE profiles with an ambulatory clinic and three hospitals Spinning up our Carequality Implementer program Piloted FHIR development with customers and partners

Looking Forward in 2017 Introducing use of HL7 FHIR APIs in for release in mid 2017: Centricity Practice Solution 12.3 Centricity EMR 9.12 33 FHIR Resources supported for Clinical & Practice Management use. FHIR infrastructure also appearing in our Project Northstar program. Future plans include: Cloud support of FHIR APIs Connecting payers and providers with FHIR APIs More Interoperability to show at Centricity LIVE, Boston, May 17-20, 2017 Any descriptions of future functionality reflect current product direction, are for informational purposes only and do not constitute a commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.

The Magic of FHIR We ve enabled John Halamka s Magic Button using HL7 FHIR Entering pilot stage at Fenway Health and Beth-Israel Deaconess Medical Center Any descriptions of future functionality reflect current product direction, are for informational purposes only and do not constitute a commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.

New Standards? No Problems Alliance of Chicago demonstrating use of Centricity Practice Solution 12.2 with our new API Server our new CDA Generator Built with 10 years of Connectathon experience to produce a new standards based document

Demonstrating Interoperability Across the Spectrum

Summary

GE Healthcare's commitment It s all about the customer and outcomes Enhance Care Quality, Improved Provider Efficiency, Strengthen Financial Performance It s all about standards Carequality, FHIR Five use cases in the Interoperability Showcase Come see us!

Providers Will Not Succeed in the World of Value-Based Care Without Interoperating With Their Environment. Let s Join Together to Help Them!

Thank you for joining us. Questions?