Agenda
HIE and HIT Today
RHIO Background and History
Rochester RHIO & DSRIP
• Role as a Qualified State Entity (QE)
• Support of FLPPS Initiatives
Rochester RHIO Services
Looking Ahead
The Future is Bright
Health Information Exchange (HIE) becomes
both the noun and the verb in our dynamic and
evolving landscape.
Why?
• Critical for successful healthcare reform
• Fundamental instrument in enabling interoperability
and meaningful use of Health IT
• Data vs actionable information
HIT Today
Federal Initiatives
– Meaningful Use
– Patient Centered Medical Home (PCMH)
New York State Initiatives
– SHIN-NY: Rochester RHIO becomes community
gateway to sharing patient health information across
NY State
– DSRIP: Medicaid Redesign whose purpose is to
fundamentally restructure the health care delivery
system
– Health Homes: GRHHN & HHUNY
Health IT Today
RHIO Timeline
7
2006-2008 2009-2011 2012-2015
• HEAL 1
• Incorporation
• Stakeholder collaboration
• Policy development
• Technology foundation
• Pilot RHIO services
• Increase in quantity/ types of data avail.
• Full-scale deployment
• Increased physician adoption
• HEAL 5 and 17
• Community health centers
• HIE growth
• EHR adoption & integration
• EHNAC certification as DIRECT HISP
• Accreditation as Qualified Entity of SHIN-NY
• Advanced Interoperability
• Working with Health Systems on Transitions of Care & other Community Initiatives
• Update technology stack
Who We Are• Rochester RHIO expanded from an independent, non-
profit, community health information exchange in 13
counties of NYS’ Finger Lakes region into a Qualified
Entity (QE) of the State Health information Network of NY
(SHIN-NY).
• We provide health information exchange services to
support improved quality and efficiency of healthcare
delivery.
• We provide authorized medical providers electronic
access to:
– Lab reports
– Radiology results
– Radiology images
– Clinical reports
– Discharge Summaries
– Patient Care summaries from
clinical providers in practice
settings (CCD/CCDA)
An up to date full list of data providers is posted on the Rochester RHIO website: http://providerportal.grrhio.org/en/Data%20Providers.aspx
Which hospitals provide data to the RHIO?
9
Allegheny County•Jones Memorial Hospital
Chemung County•Arnot Ogden Health System
•St Joseph Hospital
Genesee•United Memorial Medical Center
Livingston County• Nicholas Noyes Hospital
Monroe County•Rochester General Hospital
•Strong Memorial Hospital
•Highland Hospital
•Unity Hospital
Ontario County•Clifton Springs Hospital/Clinic
•Thompson Health
•Geneva General Hospital
Orleans County•Medina Memorial Hospital
Schuyler County•Schuyler Hospital
Steuben County•St James Mercy Hospital
•Ira Davenport
Yates County•Soldiers&Sailors Hospital
Wayne County• Newark Wayne
Wyoming County• Wyoming County Community Hospital
NEXT STEPS – data from practices and community based organizations!
- Patients must provide written consent to allow viewing of their Explore
data using the approved NYS DOH form
- Patients can revoke consent at any time and it is durable until they
change or revoke it
- Patients can request an audit of who has accessed information
- Minor Consent Process
Patient Survey Results & Engagement in Rochester
- Currently 97% of our patients provide consent to their providers when
asked
- Over 3 million consent forms have been signed in our service area
- Approximately 1 million unique patients
**NEW**
- RHIO wide denial option
Patient Consent
10
“Break the Glass”
- Emergency access to patient information
without patient consent
• Access to the community RHIO's clinical query portal
to provide comprehensive patient health information
(as appropriate).
• DIRECT 1-to-1 messaging between agency staff and
community, urgent care, or hospital physicians
(accommodates Behavioral Health/Chemical
Dependency data)
• Alerts to provide real-time information to residential
nursing staff in the event of patient hospitalization, ED
visit or ambulance transport, replacing current manual
processes.
11
CBOs (Community Based Organizations) without an EHR can still use RHIO:
• Rochester RHIO is a local hub of the SHIN-NY
• Responsible for secure, vital access to
patient’s health information statewide
• Community utility, offering core services to
participants at no cost (Dial Tone Services)
Role as a Qualified Entity (QE)
Existing infrastructure to grow from:
• Connected to hospitals in our 13 county service area
• Established connection with over 25 EHRs and counting
• Strong core service offering help support DSRIP and other
State/Federal initiatives
• Data Normalization Efforts
Proven Impact: Prior studies confirm when a patient’s
records from our RHIO were reviewed:
• 30% less likely to be admitted from the ED
• 55% less likely to be re-admitted within 30 days
Supporting DSRIP Initiatives
• We continue to connect with an expanding assembly of
clinical providers in our community, our Health Homes
(GRHHN & HHUNY), ACOs and other care providers to
supply the pipes essential to efficient information
exchange.
• Initiatives like DSRIP open doorways for enhancements to
and expansion of RHIO product offerings.
• As we continue to work closely with FLPPS on connecting
provider & sharing patient information, Rochester RHIO’s
existing infrastructure serves as a foundation for
supporting additional information sharing services in our
region.
Supporting DSRIP Initiatives
SHIN-NY “Dial Tone” Services • Patient Record Look Up Services (Community)
• Patient Record Look Up Services (Statewide)
• Consent Management
• Secure Messaging – Direct
• Notifications (Alerts)
• Identity Management and Security
• Provider and Public Health Clinical Viewer
• Public Health Integration
• Cross RHIO query
• NEW – Imaging services
• NEW – Patient Portal (NYS level)
For additional details, here is a link to the RHIO website: http://grrhio.org/providers/services.aspx
RHIO Explore (Our Clinical Query Portal with Statewide
Query Access)
RHIO Services
RHIO Alerts- Emergency Room and Inpatient
Admit/Discharge Notification, EMS Encounters (patients
with consent)
DIRECT- Nationally accredited HISP with peer to peer
messaging platform
Technical:
• Regional Master Patient Index
• Provider directory
• EMPI & Record locator service
• Query Portal
• Image Exchange services
• Access controls & audit logs
• Extensive interfacing support
Services:
• Adoption Support
• Training
• Audit & Compliance
• Data Normalization
• Community Collaboration
Send ordered/copied tests to connected EHRs
RHIO Services
Forward ordered/copied
tests to other care engines
Receive all clinical data
for consented patients
For additional information on RHIO Services see: http://providerportal.grrhio.org/RHIO%20Services.aspx
22
Using the DIRECTory
Search by practice or provider
Available contact information including DIRECT address
DIRECT: A simple, scalable, standard-based way to transport encrypted
health information over Internet to known, trusted recipients
• Secure, HIPAA compliant messaging service
• Supports transitions of care, referrals, peer-to-peer data exchange
• Easy as email with same ability to attach multiple data types including
documents, photos, Excel files or patient summary documents (CCD)
• Can use RHIO Direct web-portal OR integrate within EHR
• Can help support Meaningful Use
WHAT IS A HISP? HISP = Health Information Service Provider
• For a message to flow, HISP A must have a trust relationship with HISP B as well
as the other way around.
What is DIRECT?
23
Using Direct
24
• Medical Doctor
• Care Manager
• Health Home
• Patient Registration
• Message
• Patient Summary
• CCD
• Referral
• Care Summary (can
include BH information)
• ROI (Release of
Information)
• Medical Doctor
• Care Manager
• Patient Registration
• Coder/ Biller
Sender Direct Recipient
What Do Alerts Look Like?
*Note: Currently the Rochester RHIO receives ADT messages automatically from 18+ hospitals in 13
county region. For more detailed on participating providers: http://www.grrhio.org/patients/doctors.aspx
25
Community Initiatives
26
• Clinical Document Normalization• Patient Care Networks• Provider Directory• Public Health Analytics• Public Health Access/Services• FQHC project to enable CCD exchange• Customized interfacing and data connectivity to practices• Eldercare data - Senior Care Summary• Perinatal Data - Care Summary• Health Home Connectivity – Care Plans• EMS Prehospital Care Documents• Emergency Department focus and support
• Rolling out new Query Portal - Explore
–User Migration
• ALL users migrated to Explore by 12/4/15!!
– Training Options & Requirements
–Statewide Query
• Bi-Directional Information Exchange
• DIRECT & Alerts
For additional information on RHIO Services see:
http://providerportal.grrhio.org/RHIO%20Services.aspx
Rochester RHIO News & Updates
RHIO & FLPPS Team continue to work
collaboratively
RHIO Connection Opportunities: Today,
tomorrow, and the next day
1.) Paperwork: Data Sharing Agreement
2.) Meet with Deployment Representative to
discuss unique practice workflow and needs
3.) Coordinate with FLPPS
4.) Work with FLPPS to deploy required
interoperability solutions
What’s Next?
Paving the Way to the Future
RHIO
Regional Health
Information Organization
Healtheway (NHIN)
National Health
Information Network
SHIN-NY
Statewide Health
Information Network
New York
RHIO Deployment Team
Rochester RHIO Deployment Team
Customer Support Center
Tel: 585.410.6800
Toll Free: 877.865.RHIO (7446)
Fax: 585.410.6801
General Email Inquiries: [email protected]
Thank You
Questions & Answers
Gloria HitchcockDirector, Care Improvement Initiatives
Phone: (585) 481-2967email: [email protected]