Data Liquidity and PrimeSUITE: Meeting
the new requirements for interoperability
Presented by:
Justin T. Barnes, VP of Industry & Government Affairs
Tone Southerland, R&D Application Engineer
Rob Newman, VP of Interoperability Services
Safe harbor
Safe harbor statement under the Private Securities Litigation Reform Act of 1995:
In addition to historical information, this presentation includes certain forward-looking statements within the meaning of the Private
Securities Litigation Reform Act of 1995. Such statements include both implied and express statements regarding the company’s financial
condition, growth strategy, business development efforts, service offerings, and service delivery models. Such forward-looking statements are
not guarantees of future performance and are subject to risks, uncertainties and other factors that may cause the actual results, performance
or achievements of the company to differ materially from the historical results or from any results expressed or implied by such forwardlooking statements. Risks that could affect the company’s future performance include, but are not limited to, our ability to adapt to evolving
technology and industry standards; our ability to implement our growth strategy; our ability to retain management and other qualified
personnel; failure to prevent disruptions in service or damage to our third-party providers’ data centers; failure to avoid liability for the use of
content we provide; regulation of the healthcare information technology industry; our ability to ensure our solutions meet industry and
government standards; failure to maintain adequate security measures for our customers’ confidential information and personal identifiable
information and their patients’ protected health information; our ability to obtain new provider clients; failure of the HITECH Act and other
incentive programs to be fully implemented or funded by the government; our ability to implement our strategic relationships as currently
intended; failure to establish, protect or enforce our intellectual property; restrictions in our credit facility and future indebtedness.
The company operates in a continually changing business environment and new factors emerge from time to time. Greenway cannot predict
such factors or assess the impact, if any, of such factors on our financial position or results of operations. The company undertakes no
obligation or duty to update or modify these forward-looking statements.
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Today’s speakers
• Justin T. Barnes, VP of Industry and Government
Affairs
• Tone Southerland, R&D Application Engineer
• Rob Newman, VP of Interoperability Services
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© Greenway Medical Technologies, Inc. All rights reserved.
Confidential and proprietary. Not for distribution except to authorized persons.
Today’s objectives
• Overview of the current state of healthcare.
• Utilizing health IT as a foundation for the future of
your organization.
• What interoperability is and why it’s important
• Greenway’s current interoperability services and
strategy
• Use case of successful patient summary exchange
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The current state of healthcare
Justin T. Barnes,
VP of Industry and
Government Affairs
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Confidential and proprietary. Not for distribution except to authorized persons.
State of healthcare
• Healthcare reform/transformation
– 27% Medicare rate cut averted for 2013
• 2013 “doc fix” cost $25B+
• MedPAC recommendations to realign fee-schedule to support primary care
and ACOs, bundled payments, capitated models & shared savings programs
• Bipartisan support now in Congress for permanent SGR fix
• Sequestration
– Went into effect March 1
– Automatic budgetary measure to cut $1.2 trillion over 10 years if
Congress and the Administration do not agree on a plan
• 2% Medicare cuts across the board; EP meaningful use funds reduced by
$240 - $360
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State of ARRA
• EHR Meaningful Use
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Over $27B available with no cap. Protected in Medicare Trust Fund
Stage 1 criteria well within expectations ~ 14 EH/15 EP Core Measures & 5 Menu
Stage 2 criteria well within expectations ~ 16 EH/17 EP Core Measures & 3 Menu
Incentives are front-loaded so begin as soon as you can
As of April, over 394,000+ care providers registered for meaningful use
Over $14.6 billion in incentives paid to eligible providers & hospitals already!
• Over $383 million just to nurses & PAs under Medicaid
– Meaningful Use Stage 2 Overview Chart ~ http://tiny.cc/bnqrjw
• Regional Extension Centers
– Operations underway at various levels of execution
– Find your local REC ~ http://bit.ly/zUb3O9
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Health IT foundation
•
Improve quality, care coordination & patient safety
–
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Patient satisfaction
–
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Revenue cycle management; coordinated & accountable care
navigation
Clinical research
–
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Reduce duplicative paperwork, increase access, education &
accountability
Improve billing & collections
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IOM Report ~ up to 98,000 Americans die each year from medical
errors
Participate with no workflow disruption with provider & patient
revenue
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Interoperability embraced by care models
• Interoperability is data exchange among patients,
providers, HIEs and EHR systems
• Meaningful use Stage 2 emphasizes interoperability
via the View, Download & Transmit (VDT) measure
• ACO, PCMH and other value-based models are
sharing information across settings to establish care
coordination and improve outcomes
• Quality initiatives such as e-prescribing and PQRS
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Who is responsible for interoperability?
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Commonwell Health Alliance; co-founder
• Launched at HIMSS13
• Initial goals of scalable, universal connectivity:
– Advance patient data access across EHR platforms
– Patient record linking
– Standardized consent and authorization
• Private, marketplace initiative in collaboration with standards
organizations:
– Office of the National Coordinator; HealtheWay (eHealth Exchange);
Care Connectivity Consortium (CCC); Integrating the Healthcare
Enterprise (IHE); HL7
• Parallel initiative with Greenway’s Interoperability Services
development and success
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Confidential and proprietary. Not for distribution except to authorized persons.
Defining interoperability
Tone Southerland,
R&D Application Engineer
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Confidential and proprietary. Not for distribution except to authorized persons.
What is interoperability?
• Seamless data transport mechanisms aligned with
readable clinical content to establish scalable
coordinated care
• Greenway supports IHE, HL7 and other standardsbased interoperability
• Standards more broadly adopted so participation is
safe and secure
• Necessary component for success in the future of
healthcare and in meaningful use Stage 2
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Why is interoperability important?
• Enables better workflows and eliminates redundancy
• Improve care coordination and outcomes
• Allows data transfer among systems and stakeholders
such as ACO and other value-based models
• Makes the right data available at the right time to the
right people
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The world of interoperability
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Primary content standards
• HL7v2
– Immunization registries, lab/radiology order/result
transmissions, financial transactions, ADT, and scheduling
• Continuity of Care Document (CCD)
– Primary purpose for transitioning patient data
– Specific document based on HL7 CDA architecture
• Consolidated Clinical Document Architecture (C-CDA)
– Defines nine different types of commonly used documents
such as: Discharge summary, consultation notes, progress
and procedure note
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C-CDA on Meaningful Use Stage 2
Ambulatory Summary
• Plan of care
Clinical Summary
• Clinical notes
• Instructions
• Medications
administered
• Reasons for
referral
• Reason for visit
• Plan of care
• Present illness
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Common C-CDA Templates
• Allergies
• Immunizations
• Meds
• Problems
• Procedures
• Results
• Social history
• Vital signs
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Export Summary
• Functional status
• Plan of care
• Reason for referral
Referral Summary
• Clinical notes
• Functional status
• Plan of care
• Present illness
Primary transport protocols
• Cross Enterprise Document Sharing (XD*)
– Document based exchange to transfer data directly
between systems in a push model or in a centralized
approach using a pull model
• Patient Demographic Query (PDQ) & Patient
Identity Cross Reference (PIX)
– Used to identify patients & visit information to transfer
data from one local domain to another connected system
• Audit Trail and Node Authentication (ATNA)
– Secure node or application, access, audit & network
controls
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Confidential and proprietary. Not for distribution except to authorized persons.
What’s Greenway doing for interoperability?
Rob Newman,
VP of Interoperability Services
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Interoperability services
1,650
Number of sites using
PrimeEXCHANGE
20
670
Vendors connected
with PrimeEXCHANGE
5,700
Different transactions
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Confidential and proprietary. Not for distribution except to authorized persons.
Greenway’s interoperability strategy
Greenway has advanced collaborative relationships with
suppliers of acute-based IT systems for direct interoperability
and provider alignment.
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Confidential and proprietary. Not for distribution except to authorized persons.
Hospital Information System (HIS) partnerships
• Gold Partner, Cerner Interoperability Certification
Program
• Development Agreement and HIE-enabled EHR
connectivity, RelayHealth
• Live patient summary CCD exchange, Epic Systems
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Support from state/regional HIEs
• Practice, hospital and lab data sets
– Colorado Regional Health Information Organization
(CORHIO)
– Health Information Exchange of New York (HIXNY)
– Health Information Network of Arizona (HINAz)
– Indiana Health Information Exchange (IHIE)
– Michigan Health Information Network (MHIN)
– Ohio Health Information Partnership/CliniSync
• Founder of EHR/HIE Interoperability Workgroup
– Coalition of states, health IT companies and HIEs
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Interoperability architecture
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Use of XDS.b for CCD exchange
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Doctors May•Grant, Use Case
• 33 provider, 6 location OB/GYN group practice
• Interoperability with Lancaster General Hospital
• CCD query and retrieve: benefits
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True community-wide care coordination
Increased patient safety & patient satisfaction
Potential reduction in liability
Strengthened referral relationships
Better provider workflow, satisfaction & community
collaboration
– Summary of Care transitions
– Meaningful use Stage 2 preparedness
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Confidential and proprietary. Not for distribution except to authorized persons.
Questions or comments?
www.greenwaymedical.com
info@greenwaymedical.com
866.242.3805
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© Greenway Medical Technologies, Inc. All rights reserved.
Confidential and proprietary. Not for distribution except to authorized persons.