Connecting Michigan for Health 2013 http://mihin.org/

1. Electronic Health Information
Exchange in Illinois
John Lekich, Project Manager
Illinois Office of
Health Information Technology

2. Illinois at a Glance
• 13 million patients
• > 50,000 physicians
• > 200 hospitals
• Urban and rural
• Statewide Exchange
• 5 Regional Exchanges

3. Goals of the Illinois Health Information
Exchange
• Improve health care quality and outcomes
• Control the cost of health care and enhance value for
patients and payers
• Maximize federal health information technology
funding to Illinois and its health care providers
• Enhance public health and disease surveillance;
reduce disparities

4. Key Drivers of ILHIE Implementation
• State health care transformation agenda
– Medicaid Care Coordination
• State law creating a statewide HIE network
• Federal HITECH Act
– EHR incentives for physicians and hospitals
– HIE infrastructure funding
– Broadband funding
• Affordable Care Act Implementation

5. ILHIE
Authority
Established,
April 2011
ILHIE Direct
Statewide
Go-live,
Dec 2011
ILHIE
Executive
Director
Hired,
Sept 2012
ILHIE
Phase II
Go-live,
July 2013
ILHIE
Operating
as Public-
Private
Entity,
Feb 2014
ILHIE Timeline

6. Infrastructure for Health Care Reform
Better Care,
Health, & Cost
Care Coordination
Information Sharing
ILHIE Network

7. Implementation Phase I: ILHIE DIRECT
• 1,700+ health care professionals statewide
• Approximately 75% are Medicaid providers
• State agencies for programs that require secure
exchange with entities outside State government
• Participating providers include:
– Individual physicians and nurses
– Hospitals
– Long term care facilities
– Community mental health providers
– Dentists

8. ILHIE Direct Participation

9. Implementation Phase II
• Public Health Node Access for electronic reporting to
the Illinois Department of Public Health
• Enterprise Direct – integration of ILHIE Direct into an
EHR system
• Care Summary Exchange – bi-directional, query-
based records exchange
• Approximately 50 health care entities will be on-
boarded for Phase II services by the end of 2013

10. Ongoing Challenges
• EHR adoption rates increasing but still low among
some providers
• Competing priorities for technical staff and resources
• Evolving standards and market options
• Patient consent management

11. California eHealth Stakeholder
Webinar
June 5, 2013
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12. California’s eHealth Vision:
Improve the health and
well-being of all Californians
1212

13. 13

14. 14

15. 15

16. Integrated components for
Appropriate HIE
HIE
Governance
Legal
Technology
OCM
Trust
16

17. Connecting Michigan for Health 2013
17

18. Summary stats for Massachusetts
• 6.5 million citizens
• 4,500 care delivery
organizations
• 39,000 providers
– 27,000 physicians
– + nurse practitioners, physician
assistants, nurse mid-wives,
dentists
• Health IT snapshot
– 70% EHR adoption
– 97% e-prescribing
– 68% labs sending structured
lab results
– $150M+ Medicaid EHR
incentive dollars paid
 Healthcare Reform
 Health IT enabler: HIX &
accountable care
 Legislative action (c. 305, c. 224)
 ‘Opt in’ state
 Physician Licensing Requirement
Starts - January 2015
 All Providers on EHRs and HIE
Connection - January 2017
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19. Adoption
19
The Statewide Health Information Exchange…the Mass HIway
State Designated Entity for Health IT
Region Extension
Center
MEDICAID Incentive
Payment Program
Health Information
Exchange
Operation
Phase 1 Phase 2
2012-2013
• State assumes HISP role
• ‘Directed’ exchange
• Provider ‘push’
2013-2014
• Query-based exchange enabled
• Development of registries
• Patient-directed exchange
Executive Office of
Health & Human Services
………….. …………..
 Design, Development, Implementation - Federal Medicaid/MMIS funds & Federal ARRA HITECH; state
match contribution from the State eHealth Institute Fund
 Operation, Maintenance - Medicaid/MMIS funds, G&A funds & private/commercial subscription fees

20. Catalyzing connections & advancing toward impact
20
HIway Implementation Grants
grantees & their trading partners by location
Discharge summaries from
acute care to SNF and
Home Health
Pre-hospital transport
care coordination for homeless
Care management for
Heart Failure patients
Referrals from
specialty care to
home health
Decision support
through 2-way
exchange of data
Coordination of care for
elderly psychiatric patients
• Grantees (32)
• Trading partners (50)

21. 21
Lessons Learned
 Stick with standards – invent when needed, then keep it
simple
 Plan for sustainability early – funding takes time
 Engage with carrots rather than sticks
 Make it real – identify a use case
 Test network is important
 Clinical champions make things happen
 The impact on clinical workflow cannot be underestimated
 Security and consent matters take time

22. Massachusetts eHealth Institute
617-371-3999
MeHI Community - www.thehitcommunity.org/mehi/
www.mehi.masstech.org
kennedy@masstech.org
Twitter - @seankennedy6
Mass HIway Last Mile Program
1.855.MA-HIWAY (1.855.624.4929) Option 1
MassHIway@maehi.org
mehi.masstech.org/what-we-do/mass-hiway
Connect with MeHI & the HIway
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23. HIE Across Colorado

24. CORHIO’s Progress
43
Number of Office-Based Physicians/Providers
Number of Hospitals (over 90% of beds)
Unique Patients With Clinical Info in the HIE
Go to www.CORHIO.org for the most up-to-date info
1,700+
2,164,000+
115
Number of Long-Term Facilities
12
Number of Behavioral Health Orgs
3
National/Regional Reference Labs

25. Data Being Exchanged
• Laboratory & pathology test results
• Hospital ADT information
• Consult reports
• Transcription notes
• Radiology reports
• Newborn screening results (public health)
• CCDs (non-discrete data)
• Reportable conditions (i.e. electronic lab reporting – public
health)
• Immunization information (CIIS – Public Health)
• Patient referrals w/ attachments (point to point/DIRECT)
• HIE to HIE with Quality Health Network
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26. In Development
• CCD uploads & CCDs w/ discrete data
• High-quality medical image sharing (using Colorado Telehealth
Network VNA)
• IHE XCA interstate exchange
• Orders
• Syndromic surveillance (biosurveillance)
• Cancer registry
• Smoking cessation program
(w/ Denver Public Health & National Jewish)
• Data analytics - support & partnering
• Healtheway/Direct Trust membership
• Patient data sharing
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27. Florida
Health Information Exchange

28. Walt Culbertson
 President, Health Transactions, Inc.
 Host and Producer of Jacksonville Florida’s Medical Update Show Appearing on Comcast Cable
 Technical and Operations Lead, Florida Health Information Exchange
 Founding Chair of the Southern Healthcare Administrative Regional Process (SHARP), a regional collaborative
workgroup alliance of private and public health care organizations and HHS, HRSA and CMS
 Founding Co-Chair of a CMS Sponsored Southern Insurance Commissioner Task Force
 Founding Security and Privacy Co-Chair for the Workgroup for Electronic Data Interchange (WEDi) Strategic
National Implementation Process (SNIP)
 Executive Board of the HIPAA Conformance Certification Organization (HCCO)
 Data Interchange Standards Association (DISA), and DISA XML-EDI
 Healthcare Information Management Systems Society (HIMSS)
Past Roles
 Former Adjunct Professor or eBusiness, Florida State University
 Interim Program Director, Center for the Advancement of Health IT, a Florida Regional Extension Center
 President, ePrescribe America, Inc.
 Founding Executive Director of ePrescribe Florida, a collaboration of Florida’s leading healthplans, provider
and pharmacy organizations, and electronic prescribing vendors
 Founding Chief Technology, Security and Privacy Officer, Webify Solutions (Subsidiary of IBM)
 Founding Chief Technology, Security and Privacy Officer of Availity, LLC
 Vice President of Healthcare for Computer Management Consultants
 Vice President of HIPAA Solutions for the TriZetto Group
 Director in the Healthcare Consulting Practice of PriceWaterhouseCoopers, LLC. 28

29. 1. Direct Secure Messaging
(DSM) is a NHIN Direct
complaint secure e-mail
system that allows
participants to push
encrypted health
information to other
participants and to respond
to requests for information
2. Patient Look-Up (PLU) is a
NHIN CONNECT compliant
service that allows
clinicians to query for and
retrieve patient records
from other participating
nodes on the Florida
statewide network
Both services maintain the same policies and workflows around patient consent and
authorization that exist in paper-based data exchanges today.
Two Florida HIE Services
29

31. DSM Connections
to Other States as
of May 31, 2013
HISP connection complete
Testing in progress
Ongoing discussions
DSM is
connecting over
4,000 Florida
users

32. Disaster Preparedness
Use Care
• Dislocated patient presents in
neighboring state emergency
department
• Rendering provider or facility
sends direct message to patient’s
health plan or Florida care
provider
• Clinical information is returned
via direct message in structured
or unstructured format
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33. Contact
• Website: www.florida-hie.net
• Email: Walt.Culbertson@ahca.myflorida.com
• Phone: Walt Culbertson @ 904-651-1805
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