The Next Dimension:
Connecting with Other Providers
through Technology
Presentation to CureMD User Group
Tom Check
President and CEO of Healthix
October 22, 2013
Topics
What is Health Information Exchange?
Directed Exchange
Query-Based Exchange
Benefits and Types of Data
Examples in New York State
What’s Available to You?
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What is Health Information Exchange?
Health Information Exchange is any of several technologies
that allow you to share patient data from your EMR with other
providers (and health plans and patients), and for you to
receive or access data from those sources, electronically.
HIE can support:
• Operational efficiencies
• More fully-informed diagnosis and treatment
• Active collaboration with other providers
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Directed Exchange
• Protocols and standards for a provider to send patient
•
•
•
•
information securely to another provider.
Register with Direct addresses and connect to a HISP.
Use to:
• Refer a patient for a consult or treatment
• Report the results of a consult
• Transfer of Care
Content can be a CCD or C-CDA document.
Standards established and promoted by:
• Office of the National Coordinator for Health IT
• HL-7
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Query-Based Exchange
• Providers can:
• Provide patient data to the exchange
• Access patient data from the exchange
• Via portal or through the EMR
• Subscribe for the exchange to push data to them
• Notify provider if his/her patient registers in an
Emergency Department or is admitted as an Inpatient
• Send and receive Direct messages
• Route orders and receive results
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How does an HIE connect providers?
KEY
HIE
Clinicians
= Transmission
of Clinical
Patient
Information
Examples of Data Available in HIE
• Encounters
• Radiology Reports
• Encounter Summaries
• Lab Test Reports
• Diagnoses
• Discrete Lab Values
• Allergies
• Microbiology Reports
• Next of Kin
• Medications
• Insurance
• Discharge Summaries
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Benefits to Patient Care
• Transitions of Care – Receive and send referral orders,
transfer forms, and plans of care as patients move among
providers, including between acute and post-acute care.
• Be notified immediately when the patient or health plan
member enters an ED or hospital.
• Access the patient’s clinical data to guide diagnosis and
treatment, and to improve care.
• Collaborate with ACOs, Hospitals, and other partners.
• Analytic Reporting to evaluate and improve outcomes.
• In emergency or disaster, public health authority can see
if missing person has registered in a hospital.
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HIE and Meaningful Use
• Support Patient Access to Data
• Perform Medications Reconciliation
• Exchange Summary of Care Record on Transfer
• Submit Data to Public Health Registries
• Maintain current problems, medications, allergies
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Examples of HIE in New York State
• 11 Public Exchanges, regionally-based
• Several Private Exchanges, operated by Integrated Delivery
Networks for their participants
• Exchanges are planning to connect with each other in the
State Health Information Network – New York (SHIN-NY)
• SHIN-NY will eventually connect to HealtheWay, the national
exchange
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HIE Adoption in New York State
80%
70%
60%
50%
40%
30%
20%
10%
0%
Active
Physicians
FQHCs
Data as of June 2013
Hospitals
Home Care Long Term Care Public Health
Agencies
Facilities
Departments
11 RHIOs in New York State
The New York State Health Information
Exchange - Statewide Health Information
Network of New York (SHIN-NY) - will
enable connectivity between RHIOs.
5 RHIOs in NYC and Long Island
Healthix and BHIX have applied to the NYS AG for approval to merge.
Bronx
Manhattan
Suffolk
S.I.
= Hospital
= LTC Facility
Nassau
Brooklyn
Queens
Healthix
BHIX
Merged Healthix
Hospitals
Long Term Care
45
21
6
6
51
27
15
Participants in Healthix, BHIX and Merged
Acute Care Beds
Participants
Type
H
B
M
9
3
12
Integrated Health Systems
7
3
10
Independent Voluntary Hospitals
10
2
12
Long Term Care Providers
4
4
8
Federally Qualified Health Ctrs
13
7
20
Physician Groups / IPA’s
2
3
4
Independent Homecare Agency
4
0
4
Diagnostic Radiology Centers
10
12
20
Behavioral Health / CBOs
0
2
2
Governmental Providers
2
3
4
Health Plans
61
39
96
Total:
Extended Care Beds
Healthix
BHIX
Merged
Healthix
BHIX
Merged
15,101
1,324
16,425
2,528
1,226
3,754
2,257
1,477
3,734
4,783
951
5,734
7,311
2,177
9,488
17,358
2,801
20,159
How Many Patients?
• Challenge: matching patient identities across providers
• The HIE matches patient records from multiple sources
to send you results when you request patient data.
• HIEs are conservative in matching identities: linking
records that are not the same person is worse than not
linking records that are the same person.
• Healthix (pre-merger) holds records of 15.3 M facility
MRNs, which it has linked as 9.3 M individual patients.
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What’s Available to You?
• Directed exchange:
• Get a Direct address and subscribe to a HISP
• Query-Based Exchange:
• What HIEs service your region?
• What data, services and sources do they offer?
• What patient consent is required?
• How can you connect:
• By logging onto the HIE portal?
• By launching a query through your EMR?
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Tom Check
President and CEO, Healthix
(646) 432- 3672
tcheck@healthix.org
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