Transcript 2008_SCI_Summer_Meeting_HIT-Roy

The Nation’s First Statewide
Health Information Exchange
Paula K. Roy
Executive Director
Delaware Health Care Commission
Robert White
DHIN Chair
Delaware Physicians Care, Inc.
Gina B. Perez
DHIN Project Director
Advances in Management, Inc.
DHIN
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What is it?
Why is it needed?
Who participates?
What does it do?
How is it funded?
What are the benefits?
What is DHIN?
• Created statutorily in 1997 as a public
instrumentality of the State of Delaware
– To advance the creation of a statewide health
information and electronic data interchange
network for public and private use.
– To be a public-private partnership for the benefit
of all citizens of Delaware
– To address Delaware's needs for
timely, reliable and relevant health
care information.
DHIN Vision
Develop a network to exchange real-time
clinical information among all health care
providers (office practices, hospitals, labs and
diagnostic facilities, etc.) across the state to
improve patient outcomes and patient-provider
relationships, while reducing service
duplication and the rate of increase in health
care spending.
DHIN Management
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Hospitals
Physicians
Consumers
Business
Insurance
State Government
Executive
Committee
Consumer
Advisory
Committee
Project
Management
Committee Board of
Directors Clinical
HIMS
Advisory
Committee
Group
DHIN Value
• Reliable, secure and available
information
• Support physicians regardless of their
level of technology adoption
• Manage need along the adoption curve
– “low-tech” vs “high-tech” physicians
• Eliminates multiple delivery methods
Why is it needed?
Clinical information is missing in 13.6% of
primary care visits:
• Lab results - 6.1%
• Radiology results - 3.8%
• History & Physicals - 3.7%
• Medications - 3.2%
• Dictation - 5.4%
Missing information is judged to:
• Adversely affect care in 44% of visits
• Delay care in 59% of visits
(“JAMA”, January 2005)
Why is it needed?
• Most Doctors receive laboratory results from 5
different labs all sending results in a different
format and method
• Up to 20% of test are ordered due the original test
results being lost.
• Lack of clinical information results in adverse drug
events, avoidable hospitalizations and death
• Clinicians who use computerized records system
are more compliant with immunization schedules
Current Functionality
• Secure Results Delivery
– Lab and Pathology Results
– Radiology Reports
– Admission Face Sheets
- Secure Inbox
- Auto-Print
- EMR Interface
• Public Health Reporting
– Real-time reporting of data from hospitals to the Division of
Public Health’s DERSS system
(Delaware Electronic Reporting and Surveillance System)
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Security Access Controls
Audit Processing & Reporting
EMR Interfaces
Consumer Participation via Consumer Advisory
Committee
Initial Data Senders
85%
Laboratory
Testing
&
81%
Hospital
Admissions
Over 1.5 Million
Transactions
Processed per
Month
Christiana Care
Health System
Bayhealth Medical
Center
LabCorp (statewide)
Beebe Medical
Center
Additional Data Senders 2008
Christiana Care
Health System
St. Francis
Hospital
LabCorp
Bayhealth Medical
Center
Quest Diagnostics & Doctors
Pathology Services
(statewide)
Nanticoke
Memorial
Hospital
Beebe Medical
Center
DHIN Enrollment
• 54 practices currently live or in the
training process, equates to:
- 100 practice sites
- 284 physicians
- 625 users
• 8 additional practices comprised of 45
physicians are currently in queue for
enrollment and training
DHIN Enrollment
600
Demonstration Phase
Completed
500
400
300
200
100
0
# Practices
# Sites
# users
Future Functionality
2008-2011
• Enhanced Public Health Reporting
- Cancer Registry
- Immunizations Registry
- Birth Defects Registry
- Trauma Registry
- First Responders
- Public Health Alerts
• Patient Portal
• Patient Record Search
• Medication History
• Chronic Disease Management
• Radiology Images
• Clinical Decision Support
• Outcomes and Incentive Management
• Benefit Eligibility and Claims Processing
• Care Coordination – Long Term Care
Patient Portal
• Keep personal health information and print
• Obtain disease-management information
• Fill out registration form for medical
appointment and e-mail or print
• Request report of audit logs
• Future Enhancements
- Review record history in DHIN
- Securely communicate with practitioners
Patient Record Search
• Review results and reports available in
DHIN
• Search capability based on physicianpatient relationship in DHIN
• Others search on “need to know” basis
– New physician-patient relationship
– Emergency care
• History from May 1, 2007
Patient Record Search during
Physician Office Visit
The medical practitioner in his or her office will
have access to all the information needed to
make good clinical judgments at the time and
place of care –lab results, radiology reports,
hospitalizations, and eventually medications
will be at his/her fingertips.
One Standard DHIN Format
Security
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HIPAA compliant
Secure VPN
128-bit SSL encryption
Robust security and access control
model
• Complete auditing and logging
Privacy
“DHIN has better privacy controls than paper”
• Consumer Advisory Committee
• Hospital Privacy Officers
• Patient Portal
• Patient education at the point
of care
Benefits of DHIN
• Saves Time
– Results and Reports Immediately
– All results in one place, in one format
• Improves Care
– Out of range alerts
– Less chance of error
– Continuity of information in event of a disaster
• Reduces Cost
– Reduces Duplication
– Fewer Co-pays from Duplicate Services
• Enhances Privacy
– Secure System
– Ability to request audit
Financing Model: 3 Phases
• Phase I: Strategic Planning (FY05-10)
– AHRQ State and Regional Demonstration
• $4.7 million over 5 years
• Phase II: Capital Funding
– State and Private Matching Funds (FY07-09)
• FY07 = $2.0 million
• FY08 = $3.0 million
• FY09 = $1.5 million
– National Health Information Network (FY08)
• $1.9 million (one year with 2 optional years)
• Phase III: Operations and Maintenance (FY10)
– Fee/Subscription Model
– Those who benefit will pay
What physicians are saying about DHIN
“It’s a great product; it saves a lot of time.”
“I received a critical result as soon as the test result was
ready—it would normally have been days before I got the
information. Because of DHIN, I was able to take immediate
action.”
“We get information faster than we would normally.”
“DHIN listens to us and responds to our needs very quickly”
“We are as pleased as can be. With DHIN, we have taken days
off preparation time for office visits, especially for posthospital office visits.”
“Technical support has been excellent.”
“Set-up is so easy that they couldn’t have made it any easier.”
“Since communication is from provider to provider, DHIN gives
us another way to show we are HIPAA compliant.”
Questions?
Call (302) 672-5190