Transcript www.nyaprs.org

NYAPRS 7th Annual Executive Seminar on
Systems Transformation
Improving Health and Healthcare with IT:
An Update on the Healthcare Information Xchange of
New York (HIXNY)
April 28, 2011
Scott Momrow, MPH
Vice President, Marketing & Adoption
Healthcare Information Xchange of NY
[email protected]
518.357.3689 x14
Jayson White
HIE Adoption Specialist
Healthcare Information Xchange of NY
[email protected]
518.357.3689 x19
www.hixny.org
518.357.3689
Agenda
HIXNY Update
• Why HIE?
• The value of a connected community
• HIXNY’s service offerings
• Existing uses of the HIE
Brief
Demonstration
• Primer on patient consent
• Overview of HealthyView HIXNY’s window to
the HIE
2
Collaborative Care Measures Across
7 Cohorts
Measure
A
B
C
D
E
F
G
Rank
of G
Percent for whom specialist did not have information
about medical history
19
16
32
16
12
14
22
6
When PCPs refer a patient to specialists, they always
or often receive a report back with all relevant health
information
96
85
78
92
93
83
75
7
Percent of PCPs who report the amount of time they
spend coordinating care for patients is a major
problem
17
33
29
20
18
20
30
6
Time was often or sometimes wasted because
medical care was poorly organized
26
29
31
21
23
18
36
7
Percent of PCPs that receive the information needed
to manage a patient’s care from the hospital in 2
weeks or less from when their patients were
discharged
89
63
81
87
96
75
82
4
With the same doctor ≥ 5 years
61
66
80
79
62
73
53
7
Regular doctor always knows important information
about patient’s medical history
69
67
78
71
69
63
62
7
3
Driver of Meaningful Use of HIT
Measure
(overall ranking on all report measures)
Aus Can Ger Neth NZ
(3) (6) (4) (1) (5)
UK
(2)
US
(7)
Rank of
US
Percent for whom specialist did not have
information about medical history
19
16
32
16
12
14
22
6
When PCPs refer a patient to specialists, they
always or often receive a report back with all
relevant health information
96
85
78
92
93
83
75
7
Percent of PCPs who report the amount of
time they spend coordinating care for patients
is a major problem
17
33
29
20
18
20
30
6
Time was often or sometimes wasted because
medical care was poorly organized
26
29
31
21
23
18
36
7
Percent of PCPs that receive the information
needed to manage a patient’s care from the
hospital in 2 weeks or less from when their
patients were discharged
89
63
81
87
96
75
82
4
With the same doctor ≥ 5 years
61
66
80
79
62
73
53
7
Regular doctor always knows important
information about patient’s medical history
69
67
78
71
69
63
62
7
Source: Mirror, Mirror on the Wall- How the Performance of the U.S. Health Care System Compares Internationally
2010 Update; The Commonwealth Fund
4
The System is Fragmented
and so is the Information
Medical record
Existing
chart
Medical history
Hand-written notes,
transcribed notes
Hard copy reports (fax, mail)
Images
Letters
Copies of copies, faxes
Faxes of copies, faxes
Hand-written notes,
transcribed notes
Physical exam
Patient visit
Laboratory & other tests
Consultants & colleagues
Phone
Fax
Mail
Computer
Hand-written notes
Hard copy reports
(fax, mail)
Electronic reports
Hard copy images
Electronic images
5
Health Information Exchange Enables
Patient-Centered Delivery Systems
Clinician EHR
Clinician
Viewer
Health Information Exchange
Hospital
Labs
Hospitals
Quality
Reporting
National
Labs
Hospital
Imaging
Am-surg
Rehab
Centers
Imaging
Centers
HIE
Nursing
Homes
Rx
History
NYS
Medicaid
Home
Health
Ortho
PCPs
Cardio
Continuity of
Care Document
(CCD)
Other
RHIOs
Hospital
System
Shared with
various
settings via
different
services
Care
Management
Secure
Messaging
Public Health
Reporting
Patient Portal
6
HIXNY Membership
(many more now participating as subscribers)
Physician Class
Hospital Class
Payer Class
CapitalCare Medical Group
Adirondack Medical Center
CDPHP
Community Care Physicians
Albany Medical Center
HealthNow/BSNENY
Hometown Health Centers
Alice Hyde Medical Center
MVP HealthCare
Hudson Headwaters Health Network
Bassett Healthcare
NY Health Plan Association
Prime Care Physicians
Community Providers, Inc.
(CVPH/Elizabethtown)
Whitney M. Young, Jr. Health Services
Columbia Memorial Hospital
Consumer Class
Medical Society of the County of Albany
Ellis Medicine
Schuyler Center for Analysis &
Advocacy
Rensselaer County Medical Society
Inter-Lakes Health
Iroquois Healthcare Association
Government/Education
Northeast Health
SUNY School of Public Health
Nathan Littauer Hospital
Saratoga Hospital
County of Albany
Albany College of Pharmacy & Health
Sciences
Seton Health
St. Mary’s Hospital, Amsterdam
Employer
St. Peter’s Hospital
Center for Economic Growth
7
HIXNY Service Area
Participating Practices
(including Standalone e-Rx users)
REC Practices
CHITA Practices
Member Hospitals
Other Hospitals
8
Data Types and Contributors –
Hospitals
Q1
In Production
Immediate (Q1/ Q2)
HEAL X Planned
HEAL V Planned
TBD
Data Contribution
Demographics Allergies Medications Procedures Immunizations Diagnoses
Notes/
Dept Rpts
Discharge Image Rpt Lab Results
Albany Medical Center
Q2
Q2/Q3
Q3
Q3
Q2
Q2
Q2
Q2
Q2
Northeast (Samaritan, Alb. Memorial)
02/2009
02/2009
02/2009
Q2
Q2
11/2010
11/2010
11/2010
10/2010
Seton Health (St Mary's Troy)
02/2009
02/2009
02/2009
02/2009
Q2
01/2011
01/2011
12/2010
St Peter's Albany
02/2011
02/2011
Q2
Q2
Q2
Ellis Medicine (Ellis, Ellis HC, Bellevue)
06/2009
St. Mary's Hospital at Amsterdam
03/2009
Saratoga Hospital
Q2
Q2
09/2010
06/2009
03/2009
03/2009
03/2009
03/2009
03/2009
03/2009
03/2009
Columbia Memorial Hospital
12/2010
12/2010
Q2
12/2010
Bassett Healthcare
TBD
TBD
TBD
TBD
TBD
Nathan Littauer Hospital
TBD
TBD
TBD
TBD
TBD
CVPH Medical Center
12/2010
02/2011
Q3
Q2
Glens Falls Hospital
via ARCHIE
Pending
Pending
Pending
Inter-Lakes Health (Moses-Ludington)
Q2
Q4
Q2
Adirondack Medical
Q4
Q4
Q4
Q4
Q4
TBD
Q4
Q4
Q4
Alice Hyde Hospital
Q4
Q4
Q4
Q4
Q4
TBD
Q4
Q4
Q4
Elizabethtown Community Hospital
Q4
Q4
Q4
Q4
Q4
TBD
Q4
Q4
CDPHP
01/2009
via RxHub
Lab Corp
MVP
01/2009
via RxHub
Lab Corp
HealthNow
01/2009
via RxHub
Lab Corp
Medicaid
Consumers (PHR)
Retail Pharmacy (SureScripts)
Pending
01/2011
03/2011
Q2
Q2
10/2010
02/2011
02/2011
Q2
01/2011
01/2011
12/2010
02/2011
TBD
TBD
TBD
TBD
TBD
TBD
TBD
TBD
TBD
TBD
Q2
03/2011
03/2011
03/2011
Q2
Pending
Pending
Pending
Pending
Pending
Q2
Q2
Test Q1
TBD
TBD
TBD
for eRXers
9
Data Types and Contributors –
Ambulatory Practices
In Production
Immediate (Q1/ Q2)
HEAL X Planned
HEAL V Planned
TBD
Data Contribution
CapitalCare Medical Group
Prime Care Physicians
Community Care Physicians
Hudson Headwaters Health Network
Whitney M Young Jr Health Services
Hometown Health Centers
Albany Medical Center – Faculty Practices
Columbia Memorial – CHITA (7 practices
totaling 16 physicians)
Glens Falls Hospital - Ambulatory Practices
Inter-Lakes Health - Ambulatory Practices
Adirondack Medical - Ambulatory Practices
Alice Hyde - Ambulatory Practices
CVPH Medical Center - Ambulatory Practices
Demographics
06/2009
03/2009
02/2009
Q2
Q2
Q2
Q2
Q2
via ARCHIE
Q4
Q2
Q2/Q3
Q4
Notes/
Image
Allergies Medications Procedures Immunizations Diagnoses Dept Rpts
Rpt
06/2009
06/2009
09/2010
09/2010
09/2010
03/2009
03/2009
Q2
Q2
Q2
Q2
02/2009
02/2009
Unknown
Unknown
Unknown Unknown Unknown
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q2
Q3
Q3
Q2
Q2
Q2
Pending
Q4
Q2
Q2/Q3
Q4
Small Practice EMR Integrations :
Athena (Includes Hudson Headwaters, Dr. Russell Rider)
eCW (Includes 6 Columbia Memorial CHITA practices)
Medent (also Northeast Nephrology/Complete Women’s Care of Clifton
Park/Kathleen Catalano, DO/Main St. Peds/Amsterdam Family)
GE
Greenway (Prime Columbia Greene Medical Associates)
STI
EncounterPro
Allscripts (includes Dr. Kamini Ramani)
NextGen (includes Prime Care)
Criterions
Q2
Pending
Q4
Q2
Q2/Q3
Q4
Projected
Date
Q2
Q2
Pending
Q4
Q2
Q2/Q3
Q4
Q2
Pending
Q4
Q2
Q2/Q3
Q4
Q2
Pending
Q4
Q2
Q2/Q3
Q4
Q2
Pending
Number of Practices:
13
Number of Providers:
97
Q2
12
39
Q2
Q3
Q3
Q3
Q3
TBD
TBD
TBD
12
7
1
5
1
2
0
0
38
26
10
9
5
5
0
0
Pending
Q4
Q2
Q2/Q3
Q4
Lab Results
Q2
Q2
Unknown
Q2
Q2
Q2
Q2
Q2
Pending
Q4
Q2
Q2/Q3
Q4
10
10
Small Practice Model
Small Practice Model
– $250 per practice plus $240 per provider annually for 1 to 20 providers
– Implementation fee of $5,000 - waived if agree to implement in 2011, actively seek
patient consent, and integrate HIE health record into workflow
Includes the entire suite of offerings
“Many HIE’s achieve sustainability by automating the provision of test results rather than offering more
robust data-exchange functionality.”
Source: ARCH INTERN MED/VOL 170 (No. 7), APR 12, 2010
11
Increased Visibility, Increased HIE Use
12
Existing Uses of the HIE
Ambulatory practices
Acute care
• 298 users of eRX
• 374 users of clinical portal
• Staff and clinicians using
for patient history lookup
at point of care (discharge
summary , image report
use)
• Data source for
medication reconciliation
pre-admission testing
• Hospitalist using for
patient history lookup at
point of care
ED access
Metrics
• Data source for
medication reconciliation
by pharmacists
• Designing workflow and
beginning pilot activities
for patient history lookup
by ED staff and clinicians
• 1.6 million patients in the
master patient index
• 7,500 logons per month
• Over 225,000 eprescriptions
• 14,000 patient history
accesses per month
• 11,000 labs delivered per
month
13
PRIMER ON CONSENT
14
NYS Consent Process Details
• Patient consent is not required for a facility to send data to a
RHIO (HIXNY)
– Sensitive data (HIV, Alcohol and Substance Abuse, Mental Health etc.) is
INCLUDED in the data flow
• Consent is needed to view the patients’ clinical data
15
NYS Consent Process Details
• Each patient must sign a consent
form at each facility at which s/he
seeks care, authorizing that facility’s
authorized users to access his/her
information
• A facility is defined as an
organization under single
governance, and is not locationdependent
• Consent for treatment at a facility is
enduring until/unless it is
withdrawn, by the patient
16
Consent Status
• Yes (granted)
– Consent has been granted to
authorized users affiliated with the
organization
• No (denied)
– Authorized users can’t access the
patient’s clinical data even in the
event of an emergency
• Null (neither granted or denied)
– Either the patient has not been
asked or they chose not to grant or
deny consent in the past
– Clinicians can “break the glass”
ONLY in the event of an emergency
17
Demonstration of HealthyView:
A Clinical Portal to Support Providers in a Connected Community
18
Questions?
Scott Momrow, MPH
Vice President, Marketing & Adoption
Healthcare Information Xchange of NY
[email protected]
518.357.3689 x14
Jayson White
HIE Adoption Specialist
Healthcare Information Xchange of NY
[email protected]
518.357.3689 x14
www.hixny.org
19