Expanding Statewide
Collaboration & Connectivity:
A Network Update
Melissa Kotrys, MPH
CEO, Arizona Health-e Connection (AzHeC)
November 2015
1
Agenda
• Current State
– What is The Network?
– Services & Benefits
– Who is The Network?
• Future State
– New Service Opportunities
– Collaborative Activities
• Questions?
2
What is The Network?
3
A Community Collaboration
Community
Providers
Others
Labs
Public
Health
Health
Plans
ACOs
Hospitals
4
What is The Network?
• Network of Networks
⁻ Direct connections
⁻ Hospitals, health plans, community health centers, etc.
⁻ Other provider-based networks
⁻ ACOs, IDNs, clinically integrated networks, etc.
⁻ National health information network (eHealth Exchange)
⁻ VA, SSA, DoD, out-of-state HIEs, & IHS
• The Network currently supports a standard data set:
⁻
⁻
⁻
⁻
⁻
ADT transactions (problem lists, allergies, procedures, insurance, etc.)
Medications
Lab results
Transcribed reports
Radiology reports
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YTD Inbound Transaction Volumes
Transaction Type
ADT
Lab
Radiology
Transcription
SIU – Scheduling
Totals
•
•
•
•
October
Totals
2,873,761
2,344,806
183,741
714,080
0
2015
YTD Monthly
Average
3,309,721
2,502,459
233,111
458,909
17,636
YTD
Totals
33,097,213
25,024,592
2,331,112
4,589,090
176,357
6,116,388
6,521,836
65,218,364
6.2 million patients in the MPI
4.7 million patients with clinical data
6.5 million transactions processed monthly
75+ million transactions projected for 2015
6
YTD Inbound Transaction Volumes
Year-to-Date Inbound Transaction Volumes
as of September 2015
4,213,028
176,357
2,097,269
30,023,849
22,728,805
ADT
Labs
Radiology
Reports
Scheduling
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The Network’s
Data Supplier Status
Data
Supplier
Data
Supplied
Banner Health

All
Benson Hospital

All
Carondelet Health Network

All
Copper Queen Community Hospital

All
Kingman Hospital

All
Little Colorado Medical Center

All
Maricopa Integrated Health System

All except TRN
Mt. Graham Regional Medical Center

All
Wickenburg Hospital

All
Yuma Regional Medical Center

All except TRN
El Rio Health Center

All
Mariposa Health Center

All
Sonora Quest Laboratories

All
Multi-Specialty Interdisciplinary Clinics (CRS) - Phoenix

ADT & SIU
Multi-Specialty Interdisciplinary Clinics (CRS) - Tucson

ADT & SIU
Providers & Labs
Hospitals
Participant
TRN = transcribed reports
ADT = admit/discharge/transfer
SIU = scheduling info update
8
YTD Outbound Transaction Volumes
2015
October
Totals
Transaction Type
CCD Transactions
HL7 Outbound Transactions
Query-Response Transactions
Alerts & Notifications
Portal Access
Totals
YTD
Totals
1,342
66,411
0
78,750
2,536
1,526
94,869
0
186,799
6,803
149,039
289,997
9
YTD Outbound Transaction Volumes
Year-to-Date User-based Transaction Volumes
as of September 2015
6,803
1,526
94,869
186,799
-
CCD
HL7 Outbound
Query-Response
Alerts
Portal Access
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Services & Benefits
11
Network Services
• Bidirectional Information Exchange
• Push/pull or query/response functionality
• Provider Portal/Payer Portal
• Download and single-sign-on EHR integration capabilities
• Alerts & Notifications
• Delivery of ADT Alerts and Clinical Results Notifications in both human and machine
readable formats
• Direct Secure Email
• Secure email for clinical information exchange; DirectTrust certified and HIPAA
compliant
• Public Health Reporting (coming soon!)
• ADHS connections for immunization registry, electronic lab reporting, syndromic
surveillance and disease registries
• eHealth Exchange
• Supports exchange with VA, SSA, DOD, out-of-state HIEs, and IHS later this year
12
Network Services:
A Bundled Approach
Bundled package for all participants includes:
• Interface fees for Bidirectional Exchange (HL7v2, C-CDA)
• Unlimited Provider/Payer Portal access
• Unlimited Direct Secure Email accounts
• Unlimited Alerts & Notifications
• eHealth Exchange connectivity (query/response)
• Public Health Reporting connectivity
13
Network Fee Structure
-- As more organizations participate, fees lower for everyone --- FREE services for community providers --- All payments bundled = no separate interface fees, add-ons, etc. -• After other funding sources incorporated, hospital and health plans split
Network operational costs 50-50
• Hospitals pay based on discharges (per discharge rate)
• Health plans pay based on allocated share (agreed upon by plans)
• Fees for other stakeholder types under consideration
• Keeping rates low based on continued availability of AHCCCS HIE Subsidy
Program funding to subsidize participant rates
• Many Network Participants are required to be an AzHeC member and pay
AzHeC membership dues in addition to Network fees
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Statewide HIE Benefits
• One Connection
• New Patient Information
• Timely Information to Coordinate Care
• Medical Histories from Out-of-State Sources
• Secure Communication
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Who is The Network?
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Current Participation
• Current participants* include 54 entities:
•
14 Health Systems/Hospitals
•
•
(57% of all inpatient discharges)
22 Community Provider Organizations
•
Including FQHCs & rural health clinics
•
12 Health Plans
•
2 Reference Labs
•
2 Counties (corrections, etc.)
•
1 Behavioral Health Provider
•
1 Behavioral Health HIE
*Note: Participants are defined as organizations who have signed a Network Participation Agreement. This information is accurate as
of September 2015. Specific information regarding which participants are supplying and using data is included in presentation.
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Current Participants
Health Systems & Hospitals (14) - ~57% of all statewide inpatient discharges
•
•
•
•
•
•
•
Banner Health
Benson Hospital
Carondelet Health Network
Cobre Valley Regional Medical Ctr*
Copper Queen Community Hospital
Kingman Regional Medical Center
Little Colorado Medical Center
•
•
•
•
•
•
•
Maricopa Integrated Health System
Mount Graham Regional Medical Center
Northern Arizona Healthcare
Summit Healthcare Regional Medical Center
TMC HealthCare
Wickenburg Community Hospital
Yuma Regional Medical Center
*New Participant within 90-days
• Hospitals participating in the Medicaid EHR Incentive Program with AHCCCS
are eligible to receive financial incentives for Network participation.
Note: A Network “Participant” is an organization that has signed a Network Participation Agreement.
These organizations are either already connected to The Network or in the process of connecting.
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Current Participants
FQHCs & Rural Health Centers (11)
•
•
•
•
•
•
•
•
•
•
•
Adelante Healthcare, Inc.
Chiricahua Community Health Center*
Desert Senita Community Health Center
El Rio Community Health Center
Marana Health Center
Mariposa Community Health Center
Mountain Park Health Center
North Country HealthCare*
San Luis Walk-In Clinic
Sun Life Family Health Center*
Sunset Community Health Center
Community Providers (11)
•
Arizona Sun Family Medicine*
•
Children’s Clinics (Tucson)
•
Barnet Dulaney Perkins Eye Center*
•
District Medical Group
•
MD 24 House Call, Inc.
•
Med-Cure Internal Medicine*
•
New Pueblo Medicine*
•
Page Family Practice*
•
Pima Lung & Sleep Center*
•
Valley Anesthesiology & Pain Consultants
•
Virginia G. Piper St. Vincent DePaul Clinics*
*New Participant within 90-days
• FQHCs and RHCs participating in the Medicaid EHR Incentive Program with
AHCCCS are eligible to receive financial incentives for Network participation.
Note: A Network “Participant” is an organization that has signed a Network Participation Agreement.
These organizations are either already connected to The Network or in the process of connecting.
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Current Participants
Health Plans (12)
•
•
•
•
•
•
•
•
•
•
•
•
AZ Health Care Cost Containment
System (AHCCCS)
Bridgeway Health Solutions
Care 1st Health Plan
Cenpatico Integrated Care
Health Choice Arizona
HealthNet
Maricopa Health Plan
Mercy Care Plan
Mercy Maricopa Integrated Care
Phoenix Health Plan
United Healthcare
University of Arizona Health Plans
Other Health Care Organizations (6)
•
•
•
•
•
•
Behavioral Health Information Network
of Arizona (BHINAZ)
ConnectionsAz*
LabCorp
Maricopa County
Pima County (Corrections)
Sonora Quest Laboratories
*New Participant within 90-days
Note: A Network “Participant” is an organization that has signed a Network Participation Agreement.
These organizations are either already connected to The Network or in the process of connecting.
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Connections Coming Soon!
Data flowing by end of 2015 or early 2016:
• Tucson Medical Center
• Northern Arizona Healthcare
• Banner University facilities
Verbal commitments to participate very soon:
• Abrazo Health
• Dignity Health
• Phoenix Children’s Hospital
• Other small and critical access hospitals
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Future Network Activities
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Upcoming Opportunities
•
•
•
•
Expanded Network Participation
The Practice Innovation Institute
Integrated Physical & Behavioral HIE
Expansion of HIE Services
Expanded Network
Participation
• Hospital participation
– 75-80% annual discharges by early 2016
– Close to 100% discharges by end of 2016
• Health plan participation
– Additional commercial plan participation in 2016
• Community Health Centers
– Close to 100% participation by early 2016
• Community Providers & ACOs
– Significant expansion expected in 2016
Expanded Network
Participation
• Working with EHR vendors to support provider
connectivity
–
–
–
–
athenahealth
eClinicalWorks
Greenway
NextGen
• Conducting regional events to connect community
providers to local and regional hospitals
– Kingman
– Northern Arizona
– Yuma
• Other interested stakeholder groups
– West Valley Care Coordination Coalition
– First responders
– Corrections and justice transition activities
$3.6 million
(October 2015 – September 2016)
Arizona
Wins!
Performance
Period
October 2015
to
September 2019
Potential of
$14.6 million
over 4 years
• Target 2,500
providers
• All practices to be
active Network
participants & users
Integrated Physical & Behavioral HIE
• State Innovation Model (SIM) HIT/HIE Plan
• AHCCCS received $2.5 million CMS grant
• AzHeC responsible for HIT portion of SIM Plan
• Final plan due late spring 2016
• Statewide HIE Integration Plan for physical and
behavioral health
• AHCCCS & RBHAs support fully integrated HIE
• Developing a plan for statewide HIE integration
•
•
•
One statewide HIE platform – The Network
One consistent communication strategy
One financial model for physical and behavioral health
• Plan to be complete in January 2016
• Crisis portal for Maricopa County – December 2015
Expansion of HIE Services
Community collaboration for common technology needs
benefits everyone…
• Expanded “Permitted Use” definition
• HIE Subsidy Program expansion – HIE workflow support
coming in 2016!
• Future HIE services (based on community need)
•
•
•
•
•
•
•
Quality improvement reporting (TCPI)
Analytics & population health (TCPI)
Personal health record
Image sharing
Referral management
Secure text messaging
And more…
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Community Collaboration is Key!
Community collaboration for common technology needs
benefits everyone…
• To be most valuable to the community, need ALL hospitals and health plans
participating
• Keeping rates low based on continued availability of AHCCCS HIE Subsidy
Program funding to subsidize participant rates
• As we move forward, need to continue exploring long term sustainability
options for statewide HIE
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Questions?
Arizona Health-e Connection
www.azhec.org
melissa.kotrys@azhec.org
602-688-7200
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