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NewYork-Presbyterian System SelectHealth – an HIV Special Needs Plan (SNP)

NewYork-Presbyterian System SelectHealth – an HIV Special Needs Plan (SNP). The Challenge.... 1400 people living with HIV and receiving care from a multitude of different providers, institutions, and agencies

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NewYork-Presbyterian System SelectHealth – an HIV Special Needs Plan (SNP)

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  1. NewYork-Presbyterian SystemSelectHealth – an HIV Special Needs Plan (SNP) • The Challenge.... • 1400 people living with HIV and receiving care from a multitude of different providers, institutions, and agencies • unstable housing, complex co-morbidities (mental health, chemical dependency, HCV) result in care and services routinely being provided in a critical ‘information vacuum’ • HUGE opportunity to do better, to reduce errors, to effect improved care coordination! • The Solution (?)…. “My Health Profile” • Adopt an evolving standard for Health Information Exchange, the Continuity of Care Record (CCR), for all individuals • Provide easy access for patients, their designees, and their providers • Utilize Health Information Exchange network(s) as the ‘backbone’ of the overall program

  2. NewYork-Presbyterian SystemSelectHealth HRSA Special Projects of National Significance Information Technology Networks of Care Initiative (2007-2011) My Health Profile: a Member Continuity of Care Document (CCD)* • Core Elements of CCD • CCD Identifying Information • Patient’s Health Status • Diagnoses • Medications • Laboratory results • Procedures/Imaging • Allergies/adverse reactions • Social history/Family history • Advanced Directives/Life Documents • Care Documentation • Practitioners *Offers patients and providers access to key elements of their clinical, psychosocial, and administrative record over a secure, web-based portal. For more information email pgg2@columbia.edu or call 212-305-3272 PI - Peter G. Gordon, MD & Co-PI - Eli Camhi, MSSWRon Hesse, Project CoordinatorSuzanne Bakken, RN, DNSc, Evaluator

  3. My Health Profile project Success Stories#1. Patient Empowerment! • Over 120 patient users have logged in >500 times • Each has received an Internet 101, My Health Profile training session, unique passwords, and emergency access cards • Adoption of service (technology) has been rapid • Structured feedback has been overwhelmingly positive • Security and privacy concerns have been addressed

  4. My Health Profile project Success Stories #2. Improved Coordination of Care Community Based Case Management Pharmacies Social Service Agency Laboratories Patient ‘Centered’ Care Primary Care Site Hospitals

  5. Patient Centric Patient Centric Patient Centric Patient Centric The SHIN-NY Public Health Other NYS DOH Databases CDC Medicaid Biosurveillance Immunization and Child Health Multiple RHIOs* NYS DOH UPHN SHIN-NY** NYC Health Dept. Local Health Depts. Diagnostic Centers Home Health Care and Telemedicine Patients’ Personal Health Records SHIN-NY** Pharmacies and PBMs Managed Care Physicians Offices and Clinics Hospitals, Nursing Homes, IDNs, etc *RHIOs = Policy **SHIN-NY = Technology

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