Transcript Wisconsin Health Information Exchange WHIE Business Plan The

Regional Health Information
Exchange: Getting There
Ed Barthell – Wisconsin Health
Information Exchange
Hugh Zettel, GE Healthcare
Questions
•
•
•
•
•
What are RHIOs?
Why RHIOs?
What are clinical drivers for RHIOs in WI?
What must happen to permit exchange?
What should we be preparing to do?
Medical Trading Areas
US Administration’s Cornerstones
for Care
• Connecting the System: Every medical provider has some system
for health records. Increasingly, those systems are electronic.
Standards need to be identified so all health information systems
can quickly and securely communicate and exchange data.
• Measure and Publish Quality: Every case, every procedure, has
an outcome. Some are better than others. To measure quality, we
must work with doctors and hospitals to define benchmarks for what
constitutes quality care.
• Measure and Publish Price: Price information is useless unless
cost is calculated for identical services. Agreement is needed on
what procedures and services are covered in each “episode of
care.”
• Create Positive Incentives: All parties - providers, patients,
insurance plans, and payers - should participate in arrangements
that reward both those who offer and those who purchase highquality, competitively-price health care.
[http://dhhs.gov/transparency/ ]
WI 5 Year Pathway
• Create eHealth technology platform
– Increase HIT adoption and use
– Foster regional Health Information Exchange
– Establish statewide services
• Value-based healthcare purchasing
• Enhance prevention and disease
management
WI Assets & Readiness
• At least 17 operational projects
exchanging personal health information
electronically, with 11 more planned
• Almost 70% of practice sites have at least
partially electronic records
BUT
• No common data standards
• No common patient index
LEAPING INTO THE FUTURE
THE WISCONSIN HEALTH
INFORMATION EXCHANGE
April 27, 2004
Executive Order 13335
Commitment to the promotion of health information technology to
improve efficiency, reduce medical errors, improve quality of care,
and provide better information for patients and physicians.
Widespread adoption of interoperable electronic health records
(EHRs) within 10 years so that health information will follow patients
throughout their care in a seamless and secure manner.
Establishment of Office of National Coordinator for Health
Information Technology (ONC)
Two Critical Challenges
1. Interoperability and portability
of healthcare information
2. Encouraging electronic health
record adoption
HHS - ONC Contracts
• Standards harmonization – HITSP
– Interoperability specs this fall
• Compliance certification – CCHIT
– EHRs and infrastructure components
• National architecture – NHIN (four)
– Prototypes for interoperability
• Security and privacy – RTI International
– Wisconsin participating
Interoperability showcase - HIMSS07 in New Orleans.
60 organizations demonstrating interoperability in a clinical workflow.
Based on Integrating the Healthcare Enterprise (IHE) implementation guides.
www.himss.org
Meta-Community using existing IHE Profiles
Common
PIX Server
Meta-Community
(1)
(1) Patient Identity
(1)
Source
(3)
XDS Registry
Community A
Patient Identity
Source
(4)
Community B
Cross
Community
Bridge
(4)
XDS Repository
(4)
XDS Registry
(2)
(5)
(6)
Patient Identity
Source
XDS Registry
XDS Repository
(6)
XDS Repository
Document
Consumer
(6)
Community C
eHealth Care Quality and
Patient Safety Board 2007
eHealth Board
Chair: Kevin Hayden
Executive Committee
Chairs of the Board and advisory group
Patient Care
Advisory Group
Chair: Ed Barthell
Consumer Interests
and Privacy
Advisory Group
Chair: Cathy
Hansen
Public Health
Advisory Group
Chair: Bevan Baker
Statewide
Health Information
Exchange
Advisory Group
Chair: Hugh Zettel
Operations
E Health Report to governor
November 2006
Governor submits budget
First Quarter 2007
Legislature approves budget
First half 2007
Wisconsin Health
Information Exchange
AN OPPORTUNITY TO LEAD
High profile
Local problems
Local talent
Technical infrastructure
Willing partners
WHIE Business Plan
The value proposition:
The benefits obtained
from the exchange of
clinical information
across institutional
boundaries exceed the
costs of implementing
the exchange.
PHASE
ONE
Organizational Infrastructure
Legal agreements
Project Priorities - Pilots
PHASE
TWO
Organization Early Operations
Priority Projects
Evaluation and ROI Definition
PHASE
THREE
PHASE
FOUR
Organization Mature Operations
Expand Services and Participants
$ PPM Model with ROI to Payors
Possible Secondary Data Uses
Expanded Decision Support and
Quality Tools
Govt funding,
Grants
Dues
Payor funding or
transaction fees
Potential funding
from secondary
data sales
Actors
Sys
Admin
Systems
Clinical User
Authentication and
Auditing
Result and
Document Delivery
System
Clinician
Patient Record
Location and
Aggregation
Clinical
Results
Source
Systems
Registration
Systems
Registration and
Claims Repository
Public
Health
Payor
Care Mgt
Medication Allergy
Immunization
Repository
Patient User
Authentication and
Auditing
Claims
Systems
PBM,
Pharmacy
Systems
Patient Pre Registration System
Patient
Patient Access to
Medication System
Decision
Support
Systems
WHIE ED Linking Project
HIS
HIS
HIS
HIS
HL7 Registration Message
Claims
data
WHIE ED Linking
System
Azyxxi
Public Health Surveillance
Clinical End Users
Wisconsin Health Information Exchange
SOUTHEAST WISCONSIN EMERGENCY DATA COORDINATION PROJECT
AVAILABLE INFORMATION FOR:
Stanikowski
/
Frank
/ N / 24yo / M / 12-03-81
/ 312 Maple St / Milwaukee
Disclaimer language will be inserted here
DIAGNOSES
LOCATION
CITY
DATE
Diabetes Mellitus
Hypertension
Renal Insufficiency
Mt. Sinai Hospital Emerg Dept
MLK Clinic
Columbia St. Mary’s FP Clinic
Milwaukee
Milwaukee
Milwaukee
5-03-01
6-12-02
4-05-03
MEDICATIONS
SCHEDULE
PRESCRIBED BY
DATE
DATA SOURCE
Glyburide
HCTZ
10 mg po qd
50 mg po qd
Dr. Anderson
Dr. Smith
5-03-01
6-12-02
Patient report
RxHub Pharmacy report
ALLERGIES
REACTION
NOTED BY
DATE
NSAIDs
Hives
Dr. Anderson
5-03-01
PRIMARY PROVIDER ASSIGNED
Dr. Sam Adams
Office Phone 414-290-5555
Pager 414-555-9090
13111 N. Main Stree
Miwaukee
53211
After Hrs 414-444-7777
CASE WORKER ASSIGNED
Ms Carolyn Jones
Office Phone 414-290-5555
Pager 414-555-9090
After Hrs 414-444-7777
SPECIAL NEEDS / COMMENTS
Patient is not able to read English. Care coordinated by aunt – Ms. Jane Parker Phone 414-222-6666
Immunization Information
Clear All
Results Reporting
Print
Authorized Referral Physicians
Exit
Wisconsin Health
Information Exchange
QUESTIONS ??