Transcript Charissa Fotinos, Deputy Chief Medical Officer

New HIE Capabilities Enable
Breakthroughs In Connected And
Coordinated Care Delivery.
January 8, 2015
Charissa Fotinos
April 8, 2015
As it is Today: Patients Data Spans Many Siloes
An
individual’s
healthcare
story cannot
be
told in
pieces
Health Information Needs Hierarchy
Patients
Consumers Of Health Care Services
Access to quality care based on
complete, clinically relevant
record describing care & needs.
Clinicians
Decisions at the Point of Care
Access to clinically relevant and timely
information to support decision-making.
Care Teams
Coordination
Within Enterprises
Access to clinically relevant, evidence-based
information supplied by the entire care team.
Community
Coordination
Across
Enterprises
Access to complete and timely patient-level data across
delivery system regardless of entity delivering care.
Purchaser
Value
Access to real time clinical outcomes and quality data that
can be used to drive value-based payment and performance
Meeting Emerging Needs - CDR
New organizational
arrangements (ACOs)
require capabilities
outside traditional
enterprise health IT
resources
More orgs going at
risk for performance,
need info/analytics to
help manage that risk
Needs include
repository, analytics,
reporting and care
management tools
Sponsor
Clinical Data
Repository
(CDR)
Platform
Data needs go
beyond current
claims and ADT,
include clinical
summaries, care
plans, assessments
Health IT Ecosystem: Vision for the Future
Developed by Office of the National Coordinator
We Asked and The
Community Responded
HCA/King County RFI
34 Respondents
Participation from
nearly every major
payer and delivery
system in Washington
“Future care coordination must
enable sharing data regardless of
geographic boundaries and specific
EHR systems.”
“Closing the gaps in care
coordination & reducing
duplication of services are critical to
coordinating care, improving health
and reducing costs.”
“To enhance the efficiency of care,
we need to work on better EHR
integration with external
providers.”
We Asked and The
Community Responded
“Regional or organizational HIE’s
are still silos that do not practice
full interoperability across
organizational or EHR settings.”
“This (HIE) is an evolutionary
process and while significant
strides have been made, we must
continue to improve and add
new capabilities every year.”
“This is a critical opportunity for
state leadership.”
HCA to be first customer of New
Clinical Data Repository Service
• OneHealthPort is launching a new Clinical Data
Repository service.
• Service will enable health care organizations to bring
clinical data together in a shared repository for care
planning and treatment.
• HCA will be first customer - sponsoring Medicaid
enrollees to address data sharing challenges.
• Opportunity: Leverage increased availability of more
granular, clinical information direct from a patient’s
electronic chart currently held within a providers’
electronic health record system.
Clinical Data Information Flow
• Standard sets of high value clinical data will flow
from provider EHR systems to the Clinical Data
Repository through OneHealthPort.
• Data will be integrated from multiple sources using
patient matching technology.
• Access to integrated clinical information for
treatment and operations will be available to
authorized providers through their EHR or through a
web based portal.
A Standard for Sharing Care Summaries is
Continuity of Care Document (CCD)
•Functional Status
•Family history
•Social history
•Medications
•Problem list
•Plan of Care
•Lab & imaging results
•
•
•
•
•
Vital Signs
Procedures
Immunizations
Encounters
Medical Equipment
& Environmental
Modifications
Comparison of CCD data elements to claims data
elements at – healthIT.wa.gov
Clinical Data Repository (CDR) Status
• HCA is finalizing contract arrangements to set up this
service for Apple Health enrollees.
• HCA intends to load Apple Health enrollee
demographic data and two years historical claims
data – starting with those enrolled in managed care.
• “First Mover” health care systems will feed clinical
data which can be exchanged for the purpose of
treatment, operations and payment to CDR as early
as fall 2015.
• HCA and OneHealthPort will be hosting informational
events as implementation details become available.
11
Leverage and Align State Data
Administrative And Clinical Data (Medical And Behavioral Health)
Clinical Data
Repository
Clinical Outcomes;
Data for HEDIS Measures;
Longitudinal Health Record;
Population Management
A
N
A
L
Y
T
I
C
S
All Payer Claims
Database
Pricing Transparency;
Data For HEDIS Measures;
Resource Use Measurement;
Practice Variation
Integrated Real Time
Medical and Behavioral
Health Data
Aggregated Post Payment
Cost Data
Source: Clinical EHR
Systems
Source: Payer Claims
Systems
Questions
Team email: [email protected]
and put HIE in the subject line
Website: HealthIT.wa.gov