How HIEs Are Making the “Patient Information Anywhere” Dream … · member HIEs across 35 states • Provide person-centric health records • Unbiased data trustees focused on

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How HIEs Are Making the “Patient Information Anywhere” Dream a Reality Today

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Housekeeping

• Webinar Moderated by Anthony Guerra, editor-in-chief, healthsystemCIO.com

• Simultaneous TweetChat Hosted by Kate Gamble, Managing Editor & Director of Social Media, healthsystemCIO.com (@khgamble)

• Participate in separate browser or on your phone by using #HSCIOchat

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• Deck @ http://healthsystemcio.com/presentation/hie-webinar.pdf

http://healthsystemcio.com/presentation/hipaa-bcp-webinar.pdf


Agenda

• 12 minutes: Chuck Christian, VP Technology & Engagement, Indiana Health Information Exchange

• 12 minutes: Douglas Dietzman, Executive Director, Great Lakes Health Connect

• 12 minutes: David Kendrick, CEO, MyHealthAccess

• 10 minutes: Audience Q&A

STRATEGIC HEALTH INFORMATION EXCHANGE COLLABORATIVE©2017, SHIEC. All rights reserved, Proprietary & Confidential. Not for further redistribution.

How HIEs Are Making the “Patient Information Anywhere”

Dream a Reality Today

STRATEGIC HEALTH INFORMATION EXCHANGE COLLABORATIVE

This is SHIEC.

5

% of US Population Served


This is SHIEC.

6

% of US Population Served

• 55 member HIEs across 35 states

• Provide person-centric health records

• Unbiased data trustees focused on better health

• Altogether currently serve >195M patients

• Rapid growth from foundation 2 years ago

• 30 Strategic Business & Technology Partners


The PCDH Concept

Every person deserves to have their

complete, longitudinal health record

available whenever and wherever it is

needed for decisions that affect their care,

their health, and their well-being.

7


3 Key Questions

• Where did my patients get care?

– Where do I need to query to get the information?

• When did my patients get care?

– Who is getting it right now that I don’t know about?

• Who is the patient that got care?

– Do my identifiers for the patient match all of the other

organizations’?

8


How PCDH Works

9

PCDH + HIE Interoperability

10


What should I know about HIEs?

All HIEs are not the same.

• Different geographies Different services

• PCDH is the standard platform on which HIEs

can successfully exchange data

11

CREATING CARE-CONNECTED COMMUNITIES

COVERAGE & VOLUME

Michigan’s HIE Company

129 Hospitals = 85% of Acute Beds

4,000+ Connected Participants

8,700,000 Unique Persons

1,000,000,000 Messages p/y


“COLLECTIVE INDIVIDUALISM”

Behavioral Health


FLINT COMMUNITY

• Working for years to integrate healthcare ecosystem across Flint region – Greater Flint Health Coalition

• Water crisis presented another “reason why” connected communities are vital to residents

• GLHC recognized need for advancing data infrastructure to support healthcare & wellness goals of those affected in short and long term

– Longitudinal health record, referral/care coordination, clinical messaging, active health monitoring, intelligent alerts

– Physical health, Behavioral health, Social services, Schools, Local public health

15


PCDH APPLICATION

• Residents increasingly live/moving outside of Flint

• Increased awareness…

– to local clinicians when patients are seen outside the state

– to out-of-state clinicians who might not otherwise know of this background

• Collective individualism applies here as well

©2017, MyHealth Access Network. Contents may not be copied or distributed without permission.

The Journey from Volume to Value:Infrastructure for improving health

and reducing costs

David Kendrick, MD, MPH


Locations 1072


MyHealth Patient Population


Disaster Case


Critical National Infrastructure

HIE’s (with PCDH) can• Pre-disaster

– Organize medical records for all individuals– Resolve identities– Identify most vulnerable patients for prioritized

evacuation/assistance

• Intra-disaster– Provide access to medical records and demographics while

other systems down or inaccessible– Real-time monitoring of resource utilization and needs

• Post-disaster– Ensure medical records available to evacuated/relocated regions– Return records from evacuation sites to home


Value Based Payment Models

• Here to stay . . .

– MACRA passed with strong bipartisan support

• House: 392 FOR to 37 AGAINST

• Senate: 98 FOR to 2 AGAINST

– Demonstration projects showing promise (and savings)

• CPC, CPC+

• ACO’s

– Significant Commercial payer buy-in


Many programs, common deliverables

SIM

CPC+

ACO

APM

MIPS


MIPS Components: Final

Quality Reporting60%

Advancing Care Information

(interoperability)25%

Clinical Practice Improvement

Activities15%

Resource Use0%

2017 MIPS COMPONENTS FINAL


• 68 practices, 265 docs

• OK Payers require MyHealth Participation

• >30 hospitals affiliated

• Four payers (BCBS, CCOK, Medicaid, Medicare)

• >90% of covered lives

• Shared savings Y3-4

Comprehensive Primary Care “Classic”

$100M in Care Management and Practice Transformation fees to PCPs



CPC+ in Oklahoma: 181 Practices

• BCBS• CommunityCare• United• OHCA• CMS


Claims DataClaimed diagnoses, procedures, medications

Patient Out of Pocket

EHR 1

EHR 2

EHR 3

EHR 4

EHR 5

EHR 6

EHR 7

EHR 8

EHR10

EHR 9

Ind

epen

den

t P

har

mac

ies

Pu

blic

Hea

lth

Dep

artm

ent

Sure

Scri

pts

Fed

eral

So

urc

e (

VA

/Do

D/I

HS)

Claims: Medicaid

Claims: Commercial 1

Medicare

Commercial




Patient A

Patient B

Patient C

Patient D


Fragmentation quantified

43% of all patients have records in 2 or more systems

Average PCP must coordinate care with 225 other providers in 117 other organizations

Mai Pham, NEJM


Fragmentation: Pt’s with DM

66.6% of patients with DM have records in 2 or more places


Quality Payment Program

Get your Data to CMSIndividual Group

QCDR (Qualified Clinical Data QCDR (Qualified Clinical Data Registry)Quality Registry) Qualified Registry

Qualified Registry EHREHR Administrative ClaimsClaims CMS Web Interface

(groups of 25 or more)CAHPS for MIPS Survey

AdvancingCareInformation

ImprovementActivities

AttestationQCDRQualified RegistryEHR Vendor


AttestationQCDRQualified RegistryEHR VendorCMS Web Interface(groups of 25 or more)


14







Activities15%

Resource Use0%



Scoring MIPS/CPC+

5.2 4.0 4.6 7.5 3.2 4.8 3.4 3.9

Summary6 MIPS measures: 30

Electronic Submission bonus: 6Additional Measures bonus: 6

Total: 42/60 = 70%







Activities15%

Resource Use0%



9 of 15 Achieving Care Interoperability measures

MEASURE NAME OBJECTIVE NAME

REQUIRED FOR BASE SCORE

PERFORMANCE SCORE WEIGHT

Clinical Data Registry ReportingPublic Health and Clinical Data Registry Reporting

No 0

Clinical Information Reconciliation

Health Information Exchange No Up to 10%

Immunization Registry Reporting

Public Health and Clinical Data Registry Reporting

No 0 or 10%

Provide Patient Access Patient Electronic Access Yes Up to 10%

Public Health Registry Reporting


No 0

Request/Accept Summary of Care

Health Information Exchange Yes Up to 10%

Send a Summary of Care Health Information Exchange Yes Up to 10%

Syndromic Surveillance Reporting


No 0

View, Download and Transmit (VDT)

Coordination of Care Through Patient Engagement

No Up to 10%







Activities15%

Resource Use0%



13 Improvement Activities (2 req)ACTIVITY NAME SUBCATEGORY NAME ACTIVITY WEIGHTING

Leveraging a QCDR for use of standard questionnaires Achieving Health Equity Medium

Leveraging a QCDR to promote use of patient-reported outcome tools

Achieving Health Equity Medium

Leveraging a QCDR to standardize processes for screening Achieving Health Equity Medium

Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive.

Beneficiary Engagement Medium

Participation in a QCDR, that promotes implementation of patient self-action plans.


Participation in a QCDR, that promotes use of patient engagement tools.


Participation in a QCDR, that promotes use of processes and tools that engage patients for adherence to treatment plan.


Use of QCDR data for ongoing practice assessment and improvements

Patient Safety & Practice Assessment

Medium

Use of QCDR data for quality improvement such as comparative analysis reports across patient populations

Population Management Medium

Use of QCDR for feedback reports that incorporate population health

Population Management High

Use of QCDR patient experience data to inform and advance improvements in beneficiary engagement.


Use of QCDR to promote standard practices, tools and processes in practice for improvement in care coordination

Care Coordination Medium

Use of QCDR to support clinical decision making Beneficiary Engagement Medium


MIPS & CPC+ Benchmarks: Advantage QCDR


MIPS & CPC+ Benchmarks: Advantage QCDR

Other initiatives supported

PCDH with real time nationwide alerting enables:

• PDMP Services and medication data to facilitate management of Opioid abuse

• Business continuity support during outages or cyberattacks

• Qualified Clinical Data Registry (QCDR) services to support analytics and MIPS Reporting, Value Based Payment models

• Connect and support behavioral health improvement

• Track and address health related social needs (AHC)

• Enable the generation of new knowledge per 21st

Century Cures ACT

Growth: National Model with

Multiple Regions

Northeast Region

Southeast Region

Western

Central

Heartland

Northwest Region

Regional Gateway Connections

Implications of PCDH

Centralization of all data on each patient in their PCDH enables:

Nationwide ADT alerting (with complete histories)

More accurate care gap analysis (support quality)

More accurate quality measures (support VBPM’s)

National patient identity assurance

Possibility of centralized patient consent management

Patient access to their entire record in one place– for the first time (patient empowerment & engagement)

Costs:

Relatively little– must maintain governance, geographic relationships, and minimal technology


Discussion

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[email protected]

www.MyHealthAccess.net

mailto:[email protected]


http://www.myhealthaccess.net/


Audience Q&A

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• Continuing Education • CHIME CHCIO Credits – Attending our Webinars = 1 CEU• Certificate of attendance: See final slide

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• Thanks to our speakers: • Chuck Christian • Doug Dietzman• David Kendrick

• Thanks to YOU!


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Certificate of Attendance

This bearer of this certificate has attended the healthsystemCIO.com-Produced Web Seminar, entitled, “How HIEs Are Making the “Patient

Information Anywhere” Dream a Reality Today” on 10/3/17

Contacts:

Anthony Guerra, Editor-in-Chief, healthsystemCIO.com

Nancy Wilcox, Director of Sales and Marketing, healthsystemCIO.com

Documents

How HIEs Are Making the “Patient Information Anywhere” Dream … · member HIEs across 35 states • Provide person-centric health records • Unbiased data trustees focused on