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Community Meeting 101 October 16, 2012 Houston

Community Meeting 101 October 16, 2012 Houston. Healthcare in Houston. Healthcare is the largest industry in the US. Houston is home to the the largest medical complex in the world. Workers are well-educated, with income that is higher than average.

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Community Meeting 101 October 16, 2012 Houston

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  1. Community Meeting 101October 16, 2012Houston

  2. Healthcare in Houston • Healthcare is the largest industry in the US. • Houston is home to the the largest medical complex in the world. • Workers are well-educated, with income that is higher than average. • People from around the world seek care from area facilities. • Healthcare helps drive the IT, biotechnology, and education clusters. • Continues to be a crucial component of the area economy. • 60% of all new commercial construction in Houston is Healthcare.

  3. Obama Administration Directive • All U.S. medical records to be computerized within five years; standards created • cut waste, eliminate red tape and reduce the need to repeat expensive medical tests • 2d largest Spending item in 2009 Stimulus Package; $40 Billion • National Health Information Network

  4. 501c3 non-profit corporation governed by a board appointed by Governor to serve as a catalyst for the development of a seamless electronic health information infrastructureFunding – No state funds were ever appropriated to the THSA Texas Health Services Authority

  5. Current State of Healthcare Connectivity • Problems: • Mix of paper and electronic • No standardization • Unmanageable • Incomplete • Expensive

  6. ? Independent physicians Kelsey Gateway Silos of Information Memorial Hermann (Arms Race) HCHD MD Anderson Methodist Baylor HCA St. Lukes Texas Children's

  7. iHealth Trust Vision  • Trusted third party, non governmental, non stakeholder, neutral community information infrastructure provider • High quality, cost-effective health care for all Houstonians • Interoperable health information to support effective decision making and risk management at all levels • Patient care • Population health • Administration • Performance monitoring and evaluation • Policy development

  8. iHealth Trust Vision • iHealth Trust is not controlled by any single entity or segment of the healthcare marketplace • iHealth Trust is a cooperative relationship of entities from across the healthcare provider and insurance spectrum. • iHealth Trust will act as a legal fiduciary of the consumer’s personal healthcare information and will act in the best interests of the community

  9. iHealth Trust Vision • Potential Benefits: • Portable lifetime health record • Improved healthcare delivery

  10. “Data Liquidity”Making it easy for the data to move around and do some good for us all • Nobody can make good decisions without good data • Industry uses data 'lock-in' as a tactic to keep their customers captive.

  11. This is NOT a technology problem, it is a sociology problem. • Consumer is effectively “barefoot, pregnant and in the kitchen”; • information is power • who represents consumer? • Conflicting institutional missions; self interest • Perception of lack of trust • Data rights and permissions issues • Financing, “why should I pay?” • Vendors have silver bullet • I’m from the Government……

  12. Community Infrastructure; Utility 1863, President Lincoln designated 4ft 8.5inches as the gauge of the transcontinental railroad. 1865, the “golden age” of railroads began.

  13. Community Infrastructure; Utility

  14. Step 1:Set up account; authorize deposits and withdrawals; get ID card to facilitate registration process & ID How does the iHealth Trust work? Step 2:Deposit. With your permission, caregivers deposit copies of your medical information into your electronic lockbox Step 3:Verify & Update your PHR. You verify your information through the Internet or with your physician. You can also add updates or comments. Step 4: Withdrawals. With your permission, doctors withdraw a copy of your information from your lockbox to take better care of you and your family.

  15. 3 iHealth Trust Windows Clearinghouse or Repository

  16. Consider the Boston University Framingham Heart Study… • 5209 people 1948 (1st generation) Every 2 years: Detailed Medical History, Physical, Labs • 5124 offspring 1971 (2nd generation) Every 2 years: Detailed Medical History, Physical, Labs • 3500 offspring 2002 (3rd generation) Every 2 years: Detailed Medical History, Physical, Labs

  17. Consider Houston… What will the value be for appropriate access to large-sample, electronically collected, clinical information in the future? Imagine the shear volume of patient medical information within the facilities of the Texas Medical Center.

  18. Dr. Ernest Bertner,January 30, 1949 - Houston “As a time saver, a pneumatic tube system will be included that will connect all institutions in the center.” Why? This was for the purpose of distributing histories of patients and other information that might be needed, as well as a means of communication between departments in the teaching institutions.

  19. Challenges to this initiative. • Conflicting institutional missions; self interest • Perception of lack of trust • Data rights and permissions issues • Houston iHealth Trust financing • Legal issues

  20. Reasons to do this……. • Better Healthcare for community & system to manage uninsured • Supports accountability – measuring results • Decreases duplication of services • Attacks fragmentation – coordinating care • Provides aggregate data for community health measurement • Helps patients learn self-management strategies. • Serves to position Houston as national health leader • Creates Economic Cluster for HIT & Research • Provides bridge for genetic research • Leverage HIT arms race happening now • Going to happen anyway…….

  21. What we know…… • Huge amounts of digital data exist, already formatted electronically, but scattered across many proprietary systems • Huge amounts of digital data is coming • Software and the Internet will make this possible • An integration “big bang” -- getting everybody all of a sudden onto one, single, structured and standard format—can’t and won’t happen. • The doctors MUST participate • Collaboration in Community will be required

  22. What have we done? • Business Structure: IRS approved 501 c3 • Award by THSA: B&O Plan approved • iHealth Physicians, LLC: Operating Entity • Sustainable business model - revenue • Valuable technology offerings • Plan not contingent on Stimulus funding • Nimble and market driven

  23. Path to Sustainability

  24. Where do we start?ID the users. • Identify all providers once • Centralized identity credentials • Centralized clinical credential information • Texas sets National Standard • Identify consumers f/k/a patients • Providers issue branded credentials • Get rid of registration clipboard • Put patient at center of system

  25. The journey begins….. Manfred Sternberg 713-622-4300 manfred@iHealthtrust.org

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