Brenda Ikerd Director, Health IT October 18, 2011

1. Brenda Ikerd Director, Health IT October 18, 2011

2. Who is Louisiana Health Care Quality Forum? • Private, not-for-profit organization formed in 2007 • Volunteer board • 200+ volunteer stakeholders • Providers, payers, purchasers, consumers

3. Mission of the Quality Forum To lead evidence-based, collaborative initiatives to improve the health of Louisiana residents.

4. Philosophy and Structure of the Quality Forum • “Neutral Convener” • Trusted mechanism through which stakeholders collaboratively participate in design, development & implementation of solutions to HC quality & cost challenges • Establish direction through consensus • Role of a “learning system” for stakeholders • Not regulatory, no punitive functions • Encourage, promote, educate and inform - all voluntary • Evidenced-based approach with stakeholder expertise • Support pilot programs & demonstration projects to test ideas • Objective & transparent

5. Initiatives of the Forum • Quality Measurement • Collect and use data to guide improvements in health care quality • Clinical Quality Improvement • Support clinicians in pursuit of meaningful, specific and quantifiable improvements in health care • Patient-Centered Medical Home • Promote use of patient-centered primary care as foundation of coordinated, quality-driven health care • Outreach and Education • Promote better health & health care utilization in communities • Health Information Technology • Enable use of interoperable health IT to improve quality of health care

6. Today’s focus… LaHIE

7. Health Information Exchange…will soon be a reality in Louisiana

8. Louisiana Health Information Exchange “LaHIE” Vision Establish a framework to exchange patient health information for the purpose of improving quality. Mission Be the neutral entity for facilitating authorized sharing of information among all stakeholders to improve the health of Louisiana’s citizens.

9. Coordination of Care Personal Health Patient Independent Laboratory Physicians Hospital Alternative Health Independent Radiology Pharmacy

10. Without LaHIE

11. With LaHIE

12. Data Liberation Quality Reporting Rapid Response Case Mgmt. PHR integration Ambulatory Inpatient ED Researcher Public Health Care Quality Analysis Advanced Analytics Emergency Mgmt. Continutiy of Care Public Health Office Analyst Clinician Case Manager Hospital Network B Hospital Network A Hospital Network C Family Practice Specialist Practice ADT ADT ADT Lab Lab Lab Regional Lab Regional Pharmacy Pharmacy Pharmacy Pharmacy Dental Practice Mental Health Facility EMR EMR EMR

13. Scenario Demographics Allergies Encounters Labs Meds Procedures Demographics Allergies Encounters Labs Meds Procedures

14. Guiding Principles - General

15. Core Services and Use Cases

16. Phase 1 Plan(July – December 2011) Phase I Use Cases • Real time access to patient information through an ED visit registry. • An ED summary view will display ED encounters with ability to expand to full patient summary view with relevant privacy access configured for specific ED users. • Registry will include patient demographics, encounters, allergies, laboratory results, radiology reports and transcribed documents. • Providers can subscribe to be notified when their patients present in an ED. • Enabling providers to meet the public health requirements for Stage 1 MU. This specifically includes facilitation of immunization submissions to LINKS via LaHIE. • Enabling providers to send electronic referrals to other providers via LaHIE.

17. Phase 1 Plan(July – December 2011) Phase One Functionality • MPI • Provider Registry • User Identity Management and Authentication • Audit Trail • Consent Management Phase One Features • Clinical Portal – Clinical Summary View • Public Health – Immunizations, Electronic Lab Reporting and Syndromic Surveillance • Referrals, Secure Messaging and Notifications • CCD/CCR Repository • Exchange of Data

18. Phase 2 Plan(January – June 2012) Expected Phase 2 Use Cases are: • Ability for IDNs and other HIE’s to connect as one system rather than enabling connections with each of their facilities. • Enabling efficient access to LaHIE via single sign on capability from EHRs. • Enhancing provider knowledge of patients by expanding the data presented via LaHIE to include meds, problems, procedures, and claims • Offering a consolidated point of entry to multiple DHH services, including • Public Health (Bi-directional Immunizations, Syndromic Surveillance, Reportable Diseases) • Eligibility verification (eMEVS) • Vital statistics (LEERS) • Emergency preparedness (EMSTAT, At Risk Registry) • Registries • CCN quality reporting • Birth outcomes registry

19. Phase 2 Plan(January – June 2012) Expected Phase 2 Features: • HIE to HIE transaction exchange • Single Sign On (SSO) • Direct Secure Messaging • Additional data flowing through HIE (meds, problems, procedures, claims) • Facilitation of DHH Services • Case management • EHR Lite • Patient Access to LaHIE • Connectivity with Pharmacies

20. Phase 3 Plan(July – December 2012) Phase 3 use cases will be further refined during prior phases to ensure timely, relevant releases. Expected Phase 3Features: • Case management/analytics • Medication Reconciliation • Quality reporting capabilities • Interstate exchange capabilities • Home health, nursing homes, long term care

21. Consent Overview • Language added to existing consent form allowing patients to choose whether to have their data exchanged via LaHIE • Data will be prepopulated in LaHIE for patient matching and locating, but cannot be accessed until the patient has given consent • Patient consent will be flagged in the system to notify providers that it has been obtained • Robust auditing to determine inappropriate use of LaHIE

22. Financial Overview • Cost shared by all who use or benefit from LaHIE • Tiered hospital pricing model based on NPR • Affiliated physicians included in hospital license • 5 year contract, with a capped annual license fee • As volume increases to share the costs, annual license fee may decrease and be returned to hospitals in the form of reimbursements • First year licensure waived for early adopters • Sign up by June 30, 2012 and go-live by December 31, 2012

23. Participation Benefits Better Informed! Improved Outcomes! MU certified EMR lite available for providers with no current system Decrease adverse events when allergy and problems are known to all providers Reduce re-admissions by tracking progress of patient post IP encounter Reduce med errors Decrease test duplication • Providers “know” patients’ movement in the system • Patient and provider communication • Decrease emergency room primary care by referring to medical home • Improve care quality • Integration with current information system

24. Questions www.lhcqf.org Brenda Ikerdbikerd@lhcqf.org