Transcript Leveraging North Carolina’s health information exchange to

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Leveraging the power of North
Carolina’s health information exchange
to improve patient outcomes
Organization Name
Date
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What is NC HIE?
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NC HIE operates North Carolina’s
statewide health information
exchange, a secure, standardized
electronic system in which providers can
share important patient health
information.
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The use of this system promotes the
access, exchange, and analysis of
health information.
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Enables participating organizations to:
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Save time and reduce paperwork
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Facilitate more informed treatment decisionmaking
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Leads to improved care coordination, higher
quality of care, and better health outcomes
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What is NC HIE?
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NC-based: The Board of Directors are active and prominent in
the North Carolina medical community and represent a variety
of organizations and interests.
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Independent: NC HIE is independent and is not owned by
insurance companies, health care organizations, associations,
employers or government.
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Nonprofit: NC HIE is a private nonprofit organization. It is
funded by many sources including North Carolina health care
organizations and grants.
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Multi-stakeholder: Involves Consumers, Providers, Payers,
Business, and Government.
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How does it work?
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NC HIE’s network combines information from separate health
care sites to create a single virtual patient health record.
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Patient health information is automatically uploaded or
linked from a provider’s electronic medical record system.
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The information is standardized and aggregated across care
sites.
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Clinicians can seamlessly access their patient’s information in
NC HIE from within their EMR.
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Why use NC HIE?
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Healthier patients: Fewer medical errors, improved patient
safety, improved continuity of care, and better patient outcomes
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More efficient: Automated sharing of information, less
paperwork, reduced time to access clinical information at the
point of care, fewer repeat tests and procedures
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Informed treatment decisions: A more complete and up-todate patient medical record, including information from all a
patient's health care providers
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Supports public health: Automates process of reporting
mandatory reportable conditions to the NC Department of
Public Health
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Why do patients care?
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Care is more coordinated
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Less duplicate tests and procedures
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Less paperwork
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Fewer errors and safer care
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Lower out-of-pocket costs
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Important health information is
accessible when care is
administered
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What is in the network?
In the NC HIE Network:
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Patient Identifier and Demographics
Encounter History
Laboratory and Microbiology Results
Radiology Reports and Images
Adverse Reactions/Allergies
Medication History
Diagnosis/Conditions/Problems (primary and secondary)
Immunizations
Dictated/Transcribed Documents
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What is not in the network?
Not in the HIE Network:
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Information created by a substance abuse facility or
psychotherapy notes
Please note that information indicating a sensitive health
condition may be referenced to in certain situations:
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Medications for these conditions are included if paid for by
Medicare/Medicaid or commercial insurance
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Visit notes from a non-mental health provider may include
reference to one of these conditions
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What does it look like?
Every provider can customize the look and feel of their interface. The process for
this is covered during HIE training. Here is an example interface.
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Every provider can customize the look and feel of their interface. The process
for this is covered during HIE training. Here is an example interface.
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Security Processes
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Connection to the HIE network is secured through the use of a
Virtual Private Network (VPN) and is protected by a dedicated
Firewall.
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All access to NC HIE is password protected. Some organizations
may facilitate access through their EHR and under those
circumstances, a new password is not required.
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Data is encrypted at all times (in motion and at rest).
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Provider activity logs are audited by NC HIE and patients may
request a report on the access of their health record.
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Users can only access patient information with whom they have a
relationship. In emergency situations, physicians can access a
record for a new patient.
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Consent Policy
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Consumers are automatically part of NC HIE if their health care
provider is a participant. North Carolina law requires NC HIE
follow an opt-out consent policy allowing patients the choice of
not participating.
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This policy was written with input from stakeholders
representing patients, providers, employers, payers, and
government.
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Consumers may opt-out by mail using the opt-out form or by
phone. In the future, consumers will be able to opt-out online.
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State law requires participating providers give the patient a
state-approved form the first time they visit that provider
location.
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Mandatory Opt-Out Disclosure
Per North Carolina State law,
participating organizations must give
an Opt-Out Form to all patients at point
of initial contact following connection to
NC HIE.
 Opt-Out Forms will be provided to
participants by NC HIE and can be
re-ordered at any time by contacting
NC HIE’s call center
 NC HIE can provide participants with
a sample “Notice of Privacy Policy”
to help explain NC HIE procedures
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Opt-Out
Three opt-out options are available to patients:
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By physician – health records ascribed to the physicians identified by the
patient will not be part of the patient’s health record in the HIE network.
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By organization – health records collected and maintained by the
organizations identified by the patient will not be part of the patient’s
health record in the HIE network.
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Full Opt-Out – no health records will be in the HIE network.
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What if a patient changes their mind?
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Rescind Opt-Out – a patient who has previously opted out can rescind
their decision at any time and participate in the HIE by filling out the opt
out form or calling NC HIE’s call center.
Please Note: Opting out will not prevent caregivers from sharing health
information with authorized entities when necessary for public health or
research purposes that are permitted or required by NC and federal law. In
cases of medical emergency, a caregiver doctor may request to view a
health record to diagnose or treat an emergency medical condition. NC HIE
audits such requests and makes records available to patients.
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How to inform your patients
 Communication Tools:
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Talking points for all staff
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Scripts for registration and patient relations
areas
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Patient hand-outs (Opt-Out and Brochure)
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Detailed FAQs
 Call NC HIE for support and to answer
questions from patients
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Sample Go-Live Experience
(conducted by HealthInfoNet, Maine’s HIE)
 Primary
care multi-site practice sent mailing to their
39,000 patients
 Total
calls to telephone number indicated: 62
 Gender:
 Age:
 43
Male - 26, Female - 33, Anonymous - 3
Generally over 40, with 61% being over age 60
of the 62 chose to opt-out
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Patient Reactions
 Most patients have no questions and choose to
remain in the system
 Some patients have a few questions (answered in
30-90 seconds) and choose to remain in the system
 A few patients have extensive questions and require
extra time or a call to NC HIE
 NC HIE estimates that 1%-5% of patients will opt-out
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Patient Questions and Concerns
 Recurring
 What
questions:
is this and what is the point?
 Is
my information on the Internet?
 Is
my information going to be sold?
 Who
has access to this system?
 General
 Feel
 Do
concerns:
privacy violated
not trust that the system is secure
 Worried
their information will be available to
insurance companies, government or their
employer
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Questions