The Nation's First Statewide Health Information Exchange

The Nation’s First Statewide Health

Information Exchange

Presentation to the Delaware Health Care Commission

May 3, 2007

Robert White DHIN Chair

Delaware Physicians Care, Inc.

Gina B. PerezDHIN Project Director

Advances in Management, Inc.

Agenda

• What is DHIN?• Why do we need it?• Who participates in DHIN?• What does it do?• How is it funded?• What are the benefits?

Vision

Develop a network to exchange real-time clinical information among all health care providers (office practices, hospitals, labs and diagnostic facilities, etc.) across the state to improve patient outcomes and

patient-provider relationships, while reducing service duplication and the rate of

increase in health care spending.

DHIN Governance Structure• Statutorily Created in 1997• Public-Private Board of Directors under

the Delaware Health Care Commission• Active Executive Committee• Multi-Stakeholder Project Management

Team• Consumer Advisory Committee• Clinical User Group

What is DHIN?

• Secure network for distributing clinical results and reports from the hospital, lab or radiology center to the treating physician

• Data is managed by those who order the test and those who perform the test

TimelineYear Activity Funding Source

2001 HIE Concept Embraced DHCC Pilot Funds

2004 Project Director Contracted Longwood Foundation & Federal Funding (beginning in Sept. 2005)

2005 Requirements Definition BeganFederal AHRQ* Funding Secured

State Funding thru DHCC & Federal Funding

2006 IT Vendor Selected System Implementation Began

State, Private and Federal Funding

2007 DHIN CIO Hired Federal Funding

System Go-Live State, Private and Federal Funding

*Agency for Healthcare Research and Quality

Why do we need it?

• Most Doctors receive laboratory results from 5 different labs all sending results in a different format and method

• Clinicians who use computerized records system are more likely to adhere to clinical guidelines

Why do we need itClinical information is missing in

13.6% of primary care visits: • Lab results - 6.1%• Radiology results - 3.8%• History & Physicals - 3.7%

Missing information is Judged to:

• Adversely affect care in 44% of visits• Delay care in 59% of visits (“JAMA”, January 2005)

• Medications - 3.2%

• Dictation - 5.4%

DHIN Phase 1 Priorities

2006-2007

• Secure results/reports delivery to ordering physician

–Lab/Pathology Results–Radiology Reports–Admission, Discharge & Transfer Reports–Admission Face Sheets/Demographics

• Security access controls

• Audit processing & reporting

• Electronic Medical Record (EMR) interfaces

• Consumer participation via Consumer Advisory Committee

Phase 1 Data Senders

• Bayhealth Medical Center– Kent – Milford

• Beebe Medical Center• Christiana Care Health

System– Christiana– Wilmington

• LabCorp

Account for:85%

Laboratory Testing

&81%

HospitalAdmissions

in Delaware

Phase 1 Data Receivers

• Cardiology Consultants – 16 offices statewide – 30 physicians– EMR

• CN-MRI – 2 locations in Kent

County – 9 physicians– EMR

• Nephrology Associates – 8 offices statewide– 21 physicians– Electronic Inbox

• Dover Family Practice – 1 location in Kent County– 4 physicians– Electronic Inbox

• Georgetown Family Medical – 1 locations in Sussex County– 2 physicians– Fax and Electronic Inbox

Total:• 28 practice sites• 66 physicians

A Day in the Life of One Doctor’s Fax

Machine

1 day

1 doctor

115 faxes

10 ads

55 lab results

30 consult reports

19 pharmacy renewals

1 stat abnormal mammogram 1 stat abnormal mammogram that needs immediate attentionthat needs immediate attention

One Standard DHIN Format

Security• HIPAA compliant• Secure Virtual Private Network (VPN) • 128-bit secure socket layer (SSL)

encryption• Complete auditing and logging• Data management at

the source system

DHIN Phase 2 Priorities

2007-2008

• MSDHub – Value Added Services• Patient Centric History• Medication history• Public Health reporting• Consumer participation via Patient

Portal • Electronic order entry

2009-2011

• Chronic Disease Management• Outcomes and Incentive Management• Benefit Eligibility and Claims

Processing

Future Priorities

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Source: University of Delaware Center for Applied Demography and Survey Research, Primary Care Providers in Delaware 2006

Physician Use of Technology

Physician Interest – Next Wave

66 Physician Practices • 21 in Kent County• 18 in New Castle County• 23 in Sussex County• 4 statewide Practices• 29 Primary Care Practices• 33 Specialty Practices • 4 Federally Qualified Health Centers

Benefits of DHIN• Improved Patient Care

– More complete clinical information– Better communication

• Reduced “Hassle Factor”– Information available at appointment– Fewer forms to fill out

Benefits of DHIN

• Reduced Healthcare Costs– Fewer duplicated tests– Better medication management

• Increased Efficiencies– Greater productivity– Reduced delivery/mailing costs

THANK YOU from

For a Decade of Support!For a Decade of Support!