Health Information Exchange: “The Future’s not what it used to be” - Yogi Berra on the state of HIE

1. Health Information Exchange:“The Future’s not what it used to be” - Yogi Berra on the state of HIE Michael Matthews

2. “The future’s not what it used to be.” In 2004, did you anticipate….? • Physician EHR adoption • Employed physicians • Focus on quality and outcomes • ACOs • ICD-10 • MU • ACA • PHRs • Free-standing EDs

3. Overview • Current and projected availability of health information via HIE. • Practical approaches to integration HIE into clinical workflows and clinical decision-making. • Future possibilities

4. HIE: Where we are….

6. eHealth Exchange Participants • Alabama One Health Record • Centers for Medicare and Medicaid Services (CMS) • Childrens’ Hospital of Dallas • Community Health Information Collaborative (CHIC) • Conemaugh Health System • Department of Defense (DOD) • Department of Veterans Affairs • Dignity Health • Douglas County Individual Practice Association (DCIPA) • Eastern Tennessee Health Information Network (etHIN) • EHR Doctors • Hawaii Pacific Health • Geisinger Health • HealthBridge • HealtheConnections RHIO Central New York • HEALTHeLINK (Western New York) • Idaho Health Data Exchange • Indiana Health Information Exchange (IHIE) • Inland Northwest Health Services (INHS) • Kaiser Permanente Lancaster General Health Marshfield Clinic Medical University of South Carolina (MUSC) MedVirginia MultiCare Health System National Renal Administrators Association (NRAA) New Mexico Health Information Collaborative (NMHIC) North Carolina Healthcare Information and Communications Alliance, Inc. (NCHICA) OCHIN Quality Health Network San Diego Beacon Social Security Administration (SSA) South Carolina Health Information Exchange (SCHIEx) South East Michigan Health Information Exchange (SEMHIE) Strategic Health Intelligence University of California, Davis Utah Health Information Network (UHIN) Walgreens Wright State University

7. eHealth Exchange Growth • Participation reaching critical mass • 40+ Participants • More than 45 in application / testing phase • Hundreds of hospitals, thousands of physician practices, reaching nearly 100 million patients • Dozens of others planning to onboard • National-level coverage increasing; reaching tipping point of adoption • Collaboration extending breadth and depth of connectivity • Care Connectivity Consortium – Kaiser Permanente, Mayo Clinic, Geisinger, Group Health Cooperative, Intermountain Healthcare • Coordination with state-level efforts • Meaningful Use (Stage 2) is one factor driving adoption among vendors and providers

9. COV Agency Node

11. HIE: What we believe…. • Many respondents agree that having patient information at or before the point of care will improve care coordination (96%), provide a more complete (95%) and accurate patient medical history (94%), improve test/procedure coordination (94%) and identify discrepancies in patient information (94%). • Respondents are slightly less likely to agree that having medical information at or before the point of care will improve the quality of care (88%), streamline patient communication (88%), allow for more timely health maintenance screening (87%) and allow for easier public health reporting (84%). • Respondents are least likely to agree that having medical information at or before the point of care will reduce health care costs (59%), create additional work tasks (54%), decrease face time with patients (43%) and generate information that is not valuable(40%). • There seems to be a gap in awareness of electronic health information exchange participation: 77% of provider respondents say they exchange health information electronically and only 26% of consumer respondents say their provider has asked them to participate in electronic health information exchange. • Providers are more likely to agree than consumers that electronic health information exchange will improve care coordination, provide a more accurate medical history and that patient information will be used responsibly.

12. “Workflow is the enemy…. status quo is the competition.”

15. Workflow Solution Weekly ADT Schedules Patient Correlations

16. ADT Clinical Alerts http://www.hibeacon.org/images/BeaconNation/Beacon_Nation_Learning_Guide_ADT_Feeds_Final.pdf

17. Encounter Alerts Hospital Info System Master Patient Index Encounter Registry Notifications ADT Messages

18. HIE Generations

20. From this…..

21. ….to this.

22. Data Integration and Analytics ACO Claims Virtual db EMR Data Extraction Data Integration 13,000 Attributed Lives Care Coordination Analytics

23. “It’s not that complicated.” • Will the world be different in 10 years? • If yes, should I do nothing or do something? • If do something, should I start now or wait 10 years? • If I start now, should I turn my world upside down over night or implement low-risk, high-yield, scenario independent strategies?

24. “The future’s not what it used to be.” From 2006…. From 2014 • Physician EHR adoption • Employed physicians • Focus on quality and outcomes • ACOs • ICD-10 • MU • BYOD • ACA • PHRs • Free-standing EDs • Personalized medicine • Genomics • BYOD • Manpower • Socio-cultural • Political • ? • ? • ? • ?