“�The�Central�Indiana�Beacon�Community�has�a�level�of�collaboration�and�the�ability�to�organize�quality�efforts�in�an�effective�manner�from�its�history�of�building�long�standing�relationships.�We�are�thrilled�to�be�working�with�a�community�that�is�far�ahead�in�the�use�of�health�information�to�bring�positive�change�to�patient�care.”
- Secretary Kathleen Sebelius U.S. Department of Health & Human Services
2010 Annual Report
Message From Board Chairman
The Indiana Health Information
Exchange is helping usher in
this new era of healthcare,
one that supports specific and
measurable improvement goals
to demonstrate the ability of
health information technology
(health IT) to transform local
healthcare systems. The
selection of the IHIE-led collaborative, the $16 million
Central Indiana Beacon Community, validated our secure
health exchange efforts as one of the most advanced
in the nation. It was a highly competitive and rigorous
process, with only 16 other regions in the country selected
to demonstrate improvements in the delivery of care
through health IT.
IHIE was successful in its application in part because of our
already extensive health information exchange network
and existing investments in our signature service, the
Quality Health First® Program.
In 2011, IHIE will look to continue to grow its network,
which today includes 80 hospitals, long-term care and
other healthcare facilities in 22 disparate medical systems
across the state. Over 18,000 physicians participate, not
just from Indiana, but beyond our borders.
With leadership from IHIE’s new Chief Executive Officer,
Harold J. Apple, we are undertaking a comprehensive effort
to further define and guide our organization and evaluate our
services so that we can provide offerings that will continue to
have the strongest impact on patient care in Indiana.
Within this 2010 annual report, you will learn more about
the incredible work the IHIE staff has accomplished. You
will also discover the power of connecting the healthcare
community at a regional, state and national level, so we
can all pull together and contribute to better patient health
and improved safety. Our inspiration continues to revolve
around improving patient outcomes so that all Hoosiers –
and Americans – can lead better lives.
The landscape of healthcare has undergone significant reform since 2009, with federal investments providing a catalyst for change in how healthcare is delivered and reimbursed. As the Health Information Technology for Economic and Clinical Health Act, or HITECH Act, took shape, $2 billion in funding was allocated to lay the groundwork for adoption and use of health information technology to link the access of health information to patient outcomes.
We are the largest
health information
exchange in the U.S.
and we aspire to
be the healthcare IT
model for the nation.
Sincerely,
Vincent C. Caponi, FACHEChief Executive Officer
2
Establishing Trust and Confidence Since 2004
Over the course of the past seven years, IHIE has evolved
from a small, three person operation to over 60 full time
employees. We have a highly skilled workforce of system
analysts and administrators, programmers, and other IT
specialists, a stellar group of application specialists and
customer support personnel, and business, operations,
sales and other support staff.
Along with our technology partner, the Regenstrief Institute,
IHIE is committed to being a partner to communities across
the state to ensure health information is where it needs to
be, when it needs to be there. We take very seriously our
core values of quality, safety and efficiency. In one way or
another, each member of our staff supports our efforts to
address better care coordination by supporting opportunities
for providers to intervene when necessary so that their
patients receive the best possible care.
Raising Our Profile
Indianapolis became one of only five demonstration sites
in the nation for the effort from the U.S. Department of
Veterans Affairs (VA) to securely make veterans’ health
information accessible to physicians at the point of care.
Under the pilot program, Regenstrief and IHIE will work
with the Richard L. Roudebush VA Medical Center in
Indianapolis to exchange medical information using the
Nationwide Health Information Network. The effort is
part of a national program to link VA and non-VA medical
records by the end of 2012. It is estimated that more than
half of veterans and active-duty service members get some
of their care outside of the VA system.
IHIE is in the midst of the five-year Center for Medicare/
Medicaid Services Medicare Health Care Quality
Demonstration Pilot (646). This project examines the impact
of quality reporting and pay-for-performance, and whether
monitoring specific measures will decrease healthcare costs
of Medicare by using several Quality Health First® Program
measures to compare our efforts at reducing Medicare costs
to other communities across the country.
Within Indiana, IHIE expanded its visibility in 2010 by adding
several new events to its marketing roster. IHIE employees
participated in dozens of events in conjunction with the
Indiana Medical Group Management Association, the Indiana
Hospital Association, the Indiana Rural Health Association and
the Indiana Primary Health Care Association, among others.
IHIE continued its leadership efforts with national industry
groups like the Healthcare Information and Management
Systems Society and the eHealth Initiative. We also launched
our first paid advertisement campaign and refined our
marketing strategy, messaging and positioning.
3
The investments by the federal government into Indiana’s
health IT industry extends beyond health information
exchange and into electronic health records (EHRs). The
charge of the Health Information Technology Regional
Extension Centers (RECs) is to offer technical assistance,
guidance and information on best practices to support
and accelerate healthcare providers’ efforts to become
meaningful users of EHRs. By combining the power of
secure health information exchange with EHRs, physicians
and other providers will have a powerful combination
of tools at their disposal to provide the best and most
comprehensive patient care possible. IHIE supports
Indiana’s two RECs: HealthBridge’s Tri-State Regional
Extension Center and Purdue University’s Indiana Health
Information Technology Extension Center.
Under the State Health Information Exchange Cooperative
Agreement Program, Indiana and its current network of
five health information exchange organizations, including
IHIE, are working together to develop statewide health
information exchange capabilities through a new state-
chartered non-profit entity, Indiana Health Information
Technology, Inc. The expected outcomes of this partnership
include an expansion of HIE services to underserved areas,
and demonstrative improvements in the continuity of care
and lowered healthcare costs and improved patient safety.
One of the core founding principles of IHIE was a commitment to collaboration with various stakeholders across the state. This collaboration continued in 2010 through IHIE’s partnership and support for key HITECH Act Program funding recipients. It is only by leveraging funding and expertise of multiple stakeholders will the nation realize the full benefits of a modernized, interconnected and vastly improved system of care delivery.
Leveraging Federal Investments Through Collaboration
Collaboration
By combining the power of secure health information exchange with
EHRs, physicians and other providers will have a powerful combination
of tools at their disposal to provide the best and most comprehensive
patient care possible.
4
The IHIE collaboration is tracking outcomes related to
quality, affordability and population health. It has goals
of measurably improving blood sugar and cholesterol
levels for diabetic patients, reducing hospital admissions
and emergency room visits for patients with conditions
otherwise treatable in an outpatient setting and increasing
screening for cancers of the colon and cervix.
This selection was possible because of the early investments
from IHIE’s stakeholders in our health information
technology infrastructure and services, in particular the
Quality Health First® Program. Hospitals, physician groups,
public health, health insurers, employers, academia, business
and economic development groups, and philanthropic
organizations all have made considerable investments
and other support to make the Central Indiana Beacon
Community a reality. The Beacon Community Program
provides a focus and rallying point to truly bring the Quality
Health First Program to life by providing a mechanism to
transfer real-world feedback and knowledge to help inform
efforts at a national level to transform the healthcare system.
Our application was unique due to the potentially large
number of patients impacted and through the engagement
of the Employers’ Forum of Central Indiana. A key
stakeholder in the formulation and development of the
QHF Program, the Forum has brought additional parties
to the table and helped ensure the program matches the
patient care component with a financial model that has
broad appeal. The Forum continues to work with IHIE
and the Beacon Community to evaluate opportunities to
extend the program, both in scope and geography, and
to identify other potential partners.
A Beacon of Light
Representatives�from�the�Central�Indiana�Beacon�Community�host�HHS�Sec.�Sebelius�and�National�Coordinator�for�Health�Information�Technology�Dr.�David�Blumethal.
LAKE
PORTER LAPORTEST. JOSEPH ELKHART
LAGRANGE STEUBEN
DEKALBNOBLE
KOSCIUSKO
MARSHALLSTARKE
JASPER
NEWTON
PULASKIFULTON
WHITLEY
WABASH
WELLS ADAMS
CASS
MIAMI
WHITE
BENTON
WARREN
CARROLL
TIPPECANOE
MONTGOMERY
FOUNTAIN
PARK
BOONEHAMILTON
HENRYWAYNE
HANCOCKMARIONHENDRICKS
PUTNAM
VIGOCLAY
OWEN
MORGAN JOHNSON
SHELBY
RUSH FAYETTE UNION
FRANKLIN
DECATUR
BROWN
SULLIVAN
KNOX DAVIESS
RIPLEY
OHIO
SWITZERLANDJEFFERSON
SCOTT
LAWRENCE
MARTIN
ORANGE
DUBOISPIKE
GIBSON CRAWFORDFLOYD
HARRISON
PERRYSPENCER
WARRICKPOSEY
VAN
DER
BU
RGH
WASHINGTON
CLARK
JENNINGS
JACKSON
DEARBORN
GREEN
MONROEBARTHOLOMEW
VER
MIL
LIO
N
CLINTON
HOWARD
GRANT
JAY
RANDOLPH
DELAWARE
MADISON
TIPTON
BLACKFORD
ALLEN
HUNTINGTONHUNTINGTON
Kokomo
Fort Wayne
Lafayette
Columbus
Madison
Bedford
Marion
Anderson
Peru
CarmelNew Castle
RichmondPlainfield
Evansville
Greenwood
New Albany
Bloomington
Noblesville
Franklin
South Bend
LaPorte
Crown PointValparaiso
Michigan City
Monticello
Crawfordsville
Indianapolis
Fishers
Muncie
Martinsville
Logansport
Hammond
TerreHaute
Jeffersonville
Our Beacon Community is one
of the largest of the 17 selected
communities, both in terms
of geography and population
base, encompassing 46 counties
and 43% of Indiana patients.
In May 2010, the Central Indiana Beacon Community, a collaboration led by IHIE, received a $16 million investment through the HITECH Act. It represents the single largest chunk of investment from the $50 million in HITECH funding awarded to Indiana entities. It was designed to support communities at the cutting edge of secure health information exchange attain a new level of healthcare quality and efficiency.
5
Services Overview
u Since its launch in 2004, IHIE has delivered a total of over 77 million clinical results.
u Over 18,000 providers in 5,700 practices received results via the DOCS4DOCS Service.
u IHIE delivered 17,267,768 messages in 2010.
Cumulative DOCS4DOCS® Service Messages Delivered
43,776,899
60,331,233
0.0 M
20.0 M
40.0 M
60.0 M
80.0 M
2008 2009 2010
77,599,001
Diabetes can be devastating, both physically
and financially. According to a report by the
UnitedHealth Center for Health Reform &
Modernization, the average annual healthcare
costs in 2009 for a person with known
diabetes totaled about $11,700. The cost
jumps to $20,700 for a person with diabetic
complications. It is estimated that 714,000
Hoosiers have diabetes, and 1.64 million
have pre-diabetes. If programs to prevent and
control diabetes were adopted and scaled
nationally, UnitedHealth’s report said the life
expectancy and health of diabetics would
improve and up to $250 billion could be saved
over 10 years.
IHIE’s core solution, the DOCS4DOCS Service, continued
to expand across the state in 2010. Thirty-four separate
hospitals and other facilities use the service, which serves
as a single source for the electronic delivery of laboratory
results, radiology reports, transcriptions, pathology and
hospital admissions reports, discharge and transfer reports
to help improve patient safety and improve efficiencies.
IHIE’s signature service, the Quality Health First Program,
was designed to help physicians provide the best patient
care possible. For example, the program supports the
management of Indiana’s diabetics to help ensure these
patients receive recommended follow-up care and
screenings to support the management of their disease.
We are seeing nearly four percent more of Indiana
diabetics who receive care by participating physicians
getting the appropriate follow-up care that they need
to help manage their disease. Considering the number
of diabetics in Indiana, this translates into significant
numbers, real dollars being saved from avoidable
complications, plus an improvement in quality of life
of these patients.
The program is the foundation for the Central Indiana
Beacon Community program. At a national level, the
Beacon Program will provide opportunities for learning
and improvement. As a result, the Quality Health First
Program could potentially translate into a model for other
communities outside of Indiana for supporting proactive
and comprehensive diabetic care.
The program helps more than just diabetics. It also
supports patients who need certain cancer screenings, such
as mammograms and colonoscopies, and helps ensure that
the youngest Hoosiers are getting their well-child visits in a
timely manner. It also supports patients with heart disease
and cholesterol conditions.
Our goal is to have every patient covered through this
program, and every primary care physician participating
fully to help support the care provided to their patients.
Special thanks to Medicaid, Medicare, Anthem Blue Cross
Blue Shield, UnitedHealthcare and Unified Group Services
for their participation in the program.
IHIE provides 24x7 customer support and handles over 2,000 customer calls each month.
6
Quality Health First® Program Patients
400 K
600 K
800 K
1,000 K
1,200 K
500 K
700 K
900 K
1,100 K
Dec. 2008Mar. 09
Jun. 09Sep. 09
Dec. 2009Mar. 10
Jun. 10Sep. 10
Dec. 2010
549,419
560,939
556,593
634,460
720,205
865,881
878,999
928,563
1,032,424
Quality Health First® Program Providers
700
800
900
1,000
1,100
1,200
1,300
1,400
1,500
Dec. 2008Mar. 09
Jun. 09Sep. 09
Dec. 2009Mar. 10
Jun. 10Sep. 10
Dec. 2010
761
836855
944981
1,044
1,253
1,315
1,445
St. Francis Medical Group leverages their participation in the QHF Program by supporting a friendly competition among their providers, recognizing each month one practice that has done a particularly outstanding job in the QHF Program.
American Health Network has instituted their Ten4Ten Initiative to help support and raise awareness in the group’s participation in the QHF Program. The goal of AHN’s awareness campaign is to maximize the program benefits for patients and the AHN practices.
From left to right: John Kreimer, Janet Jameson and Dr. Susan Hartman of St. Francis Medical Group display an internal promotional poster.
The program involves payers so that reimbursement to
physicians from payers aligns with improvements in patient
outcomes. In 2009, bonus payments by Anthem topped
$3.5 million. For care provided in 2010, bonus payments to
physicians are expected to meet and exceed that amount,
for a total of over $7 million. The program also helps
providers meet certain Meaningful Use criteria outlined
in the HITECH Act.
“�The�reports�we�receive�help�us�to�find�
patients�who�are�not�getting�regular�
care�for�either�routine�services�or�chronic�
disease�management.�As�a�result,�we�
mail�reminders�or�make�phone�contact�
with�the�patients�based�on�the�reports.”
-Dr.�Louis�Winternheimer��Raphael�Health�Center,�Indianapolis,�IN
u The number of enrolled physicians jumped from 981 in 2009 to 1,445 in 2010.
u 300,000 new patients were included in the program from 2009 to 2010.
u 56 communities throughout Indiana had physicians and patients in the program.
7
Cumulative INPC™ GrowthNew Hospital Members by Year
0
10
20
30
40
50
60
70
80
2004 2005 2006 2007 2008 2009 2010
Cumulative GrowthAnnual Growth
In 2010, IHIE teamed with the Regenstrief Institute to support the expansion of the Indiana Network for Patient Care™ (INPC), a
statewide network of hospitals and other healthcare facilities that provides physicians with a “virtual” patient record to provide a
better overall picture of a patient’s health. This information can be critical to diagnoses, treatment, and referral decisions. Launched in
1995 by the Regenstrief Institute, the INPC remains one of the nation’s best models to demonstrate the power of health information
exchange. Previously funded by grants, in 2010 IHIE introduced a new business model to support the ongoing development and
implementation of the INPC.
With 23 additional hospitals committed to the INPC in 2010, it’s no surprise that the amount of information grew by 48% over 2009.
The INPC is also the foundation for IHIE’s signature service, the Quality Health First® Program, and the Indiana State Department
of Health’s public health surveillance system.
The INPC network includes information from encounters covering over 90% of care provided at hospitals in the Indianapolis
area and is now available at 130 sites in communities across the state, including Columbus, Terre Haute and Vincennes.
Cumulative INPC™ Patient Registration
17,300,000
18,670,415
0.0 M
15.0 M
16.0 M
17.0 M
18.0 M
19.0 M
20.0 M
21.0 M
22.0 M
2008 2009 2010
21,920,141
Cumulative INPC™ Clinical Results
1,076,000,000
2,280,000,000
0.8 B
1.4 B
2.0 B
2.6 B
3.2 B
1.1 B
1.7 B
2.3 B
2.9 B
3.5 B
2008 2009 2010
3,390,000,000
Services Overview, cont.
8
Financials
Consolidated Balance SheetYears Ended December 31, 2010 and December 31, 2009
2010 2009
Assets
Total Current Assets $2,368,277 $3,644,693
Property and equipment, net 1,328,208 277,021
Total�assets $3,696,485 $3,921,714
Liabilities
Total current liabilities $1,605,562 $1,556,462
Total�Liabilities 1,605,562 1,556,462
Unrestricted 1,774,309 1,016,753
Temporarily Restricted 316,614 1,348,499
Total liabilities and net assets $3,696,485 $3,921,714
Consolidated Statement of ActivitiesYears Ended December 31, 2010 and December 31, 2009
2010 2009
Net�operating�revenue $8,162,115 $5,172,026
Operating Expenses
Salaries and employee benefits 4,897,627 3,245,732
Health Information Operations 1,858,835 1,114,879
SG&A 1,723,805 1,615,147
Total�Expenses 8,480,268 5,975,759
Income from Operations (318,153) (803,733)
Investment gains and losses 43,824 86,988
Excess of revenue over expenses (274,329) (716,745)
9
Board Members
Officers:
Vincent�Caponi��ChairmanCEO
St. Vincent Health
Dr.�William�Tierney��Vice ChairmanPresident & CEO
Regenstrief Institute
David�Johnson��Secretary-TreasurerPresident & CEO
BioCrossroads
Board:
Dr.�Craig�BraterDean, Indiana University School of Medicine
Vice President for University Clinical Affairs
Indiana University
Robert�BrodyPresident & CEO
St. Francis Hospital & Health Centers
Dr.�Virginia�CaineCommissioner
Marion County Health Department
Dr.�William�CastAt-large
Dr.�David�CookAt-large
Wayne�DeveydtAt-large
Dr.�John�EllisIndianapolis Medical Society
Daniel�EvansPresident & CEO
Indiana University Health
Matthew�GutweinPresident & CEO
Health & Hospital Corp. of Marion County
Dr.�Gregory�LarkinCommissioner
Indiana State Department of Health
Doug�LeonardPresident
Indiana Hospital Association
Dr.�Ned�LamkinAt-large
Dr.�Teresa�LovinsIndiana State Medical Association
Bryan�MillsPresident
Community Health Network
10
“�As�a�result�of�our�participation�in�the�Quality�Health�First®�Program,�our�practice�
has�established�enhanced�protocols,�especially�in�our�cancer�screenings.�We�now�
have�a�tool�to�complement�the�kind�of�detailed�information�we�need�to�truly�
identify�gaps�in�care.�The�program�is�a�great�way�of�making�sure�our�patients��
get�the�attention�they�need�and�deserve.”
-�Dr.�G.�Alan�Von�Stein�Meridian�Gynecological�Center,�Mooresville,�IN
“�Our�practice�elected�to�participate�in�the�Quality�Health�First®�Program�because�
of�the�standardized�measurement�of�medical�quality�and�outcomes�across�health�
plans.�This�comprehensive�program�gives�us�a�practice-wide�view�of�care�needed�
for�all�of�our�patients,�rather�than�just�a�segment�of�our�patient�population.”
-�Sandy�DeWeese�Southern�Indiana�Pediatrics,�Bloomington,�IN
11
846�N.�Senate�Ave.,�Suite�110Indianapolis,�IN�46202317-644-1750www.ihie.org
