mhin

2017 ANNUAL REPORT

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A NOTE FROM OUR CEODear friends and colleagues,

It is my honor to share our first ever annual report with you. In these busy times, it is important to pause and reflect on the accomplishments and growth of Health Information Exchange that we have achieved together in our community. None of this would be possible without your participation and support over the years. On behalf of the entire MHIN team, we are grateful for the opportunity to serve the healthcare community in such an impactful way. As we are soon approaching a 20 year anniversary, it is amazing to see how far Health Information Exchange has come since our inception and how it has become a routine part of your patient care process. As I collaborate with other HIEs throughout the country, they are amazed with our story and how successful our community has been at achieving data sharing for nearly two decades! We often hear feedback about how it is helpful to providers and clinical staff to quickly access information. But, we are really interested in hearing stories from your practice. How have MHIN solutions made a difference to your patients? Has MHIN expedited a diagnosis or treatment for them? Has it helped save a life? We would love to hear about the impact MHIN solutions have made. These are stories that we will all be able to relate to personally since we are all patients at some point as well. We can put ourselves in the shoes of that patient and be proud of what our healthcare community is accomplishing. I hope you enjoy this report and the glimpse into activities we are engaged in, as well as what is yet to come. We are excited to be growing in new ways and connecting beyond our local community. It is our commitment to stay at the forefront of the health technology industry and continue to empower you with solutions to better serve your patients and ultimately improve health outcomes for our entire community.

KELLY HAHAJCHIEF EXECUTIVE OFFICER

MISSIONMHIN turns data into insights to improve

health for our families, neighbors, and friends by connecting our healthcare community.

CORE VALUESPrivacy and Security | Patient-Centered

Quality | Compassion | Collaboration

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Strengthened MHIN’s security posture through continual enhancements in technology and staff education.

Explored innovation in user access to MHIN data as a supplement to the traditional user account login method.

Launched the MHIN Population Health platform, HealtheIntent, to help providers zero in and narrow gaps in care.

Formed partnership with the Social Security Administration to authorize automated queries of patient information in formal benefits application processes.

Completed technical requirements to exchange data with the Veterans Health Information Exchange through the Department of Veterans Affairs.

Began exchanging bidirectional ADTs regionally with four states in the Midwest to fulfill baseline goals of the national Patient Centered Data Home (PCDH) project.

Joined the HIE trade organization SHIEC (Strategic Health Information Exchange Collaborative) which allows us to benchmark with 55 other HIES across the country.

Fortified MHIN HIE data with official birth and death vital records from the State of Indiana.

Established data sharing relationships with Indiana 2-1-1 and Indiana’s Homeless Management Information System to support the contribution of data related to social determinants of health.

2017 ACCOMPLISHMENTS

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47.2MIL inbound data transactions

15,363charts accessed

everyday

3.7MILtotal patient records

BY THE NUMBERS

53,777health radar alerts

152organizations contributing clinical data

MHIN began in 1998 as a secure central data repository of personal health histories and as a safe and efficient method to share that information with doctors, nurses, rehab facilities, and other caregivers. Access to this information through advanced technology and data sharing models would allow them to quickly provide the necessary and correct treatment for their patients. Today, we’re able to use even more innovative technology to bring information and insights in unprecedented forms to the healthcare community so they can better serve their patients and clients– and improve the health of the entire community.

76.6MILtotal transactions

4,228active users

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WHAT WE CAN OFFER YOUMHIN is one of the oldest and most successful health information exchanges and healthcare information technology organizations in the United States. Since 1998, MHIN has been committed to providing secure, timely delivery of relevant clinical information through a number of technology and communication

solutions that work to streamline secure access to data to improve quality and reduce costs.

HEALTH IT CONSULTING POPULATION HEALTH RESULTS INTEGRATION

DATA ANALYTICS INTERFACE SERVICES DIRECT MESSAGING

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Improving the health of Indiana and Michigan residents benefits everyone living here. That’s been our focus since MHIN began, and has always been at the core of what we do. It’s our mission to provide integrated, confidential, and secure access to patient information through a variety of HIE services. And it’s why we developed our core applications to provide an efficient, timely way for clinicians and institutions to appropriately exchange information and facilitate high-quality, coordinated care.

Today, organizations across the healthcare spectrum – from hospitals, to specialty groups, to medical labs and diagnostic centers – find care solutions by accessing our diverse service platform. Our systems and services help healthcare providers build longitudinal, person-centered health records complete with past history, current medications, and other vital information.

HEALTH INFORMATION EXCHANGEMHIN SOLUTIONS

BETTER ACCESS TO PATIENT INFORMATION MEANS BETTER CARE

We rely on the MHIN team to help us pave the way to great healthcare. Their customer support team responds quickly and always thinks ahead to address concerns before they become problems.

Dr. Matthew Koscielski, Pulmonary & Critical Care Associates

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CREATING A NETWORK OF NETWORKSAccess to critical information like prescriptions, allergies, blood type, and chronic conditions can make the difference between life or death in an emergency situation. When medical records cannot be found quickly, quality emergency care is made more difficult– especially when patients are traveling across state lines or outside of their home community.

Alongside national and regional partners, MHIN led “The Heartland Project” and successfully created a “Network of Networks” to share healthcare information electronically across state lines. With partial funding from the U.S. Department of Human

Services, MHIN worked with six additional Health Information Exchanges to assign every patient to a home Healthcare Information Exchange as the official warehouse of their health data. This concept is called “Patient Centered Data Home.” With a Patient Centered Data Home, linked-HIEs in the Midwest can alert the home HIE when a patient presents for care outside their area and retrieve clinical information from the treatment team.

Having a home base for medical records will make it so a patient who lives in South Bend, spends summers in Michigan, and is having an emergency while on a business trip in Kentucky will have her complete health record from both states available immediately for the treatment team in Kentucky. Likewise, information about the encounter in Tennessee will be shared with MHIN’s Health Information Exchange to be made available to the other providers.

If this pilot project is successful, it could transform the way health records and alerts are shared nationally.

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DAVID NAVARROCHIEF ARCHITECT

How were you involved with the Heartland Project?As the Chief Data Architect for MHIN, it is my job to design the technical requirements around new workflows involving data travelling through MHIN HIE environment. I believe this project is a great fit for our organization because it furthers our mission of connecting healthcare providers and service agencies to provide better care. We are also able to leverage our years of experience in implementing data standards such as HL7 v2, HL7 CDA, and IHE connectivity protocols.

What was the best part about working on this project?By far the best part of the project was the collaboration between different HIEs. It was interesting to hear that most other HIEs are tackling similar issues such as data format conformance, data codification conformance, and patient identity assignment issues.

How do you see PCDH expanding in the future?I think that PCDH is a great first step in sharing data across larger geographic regions. Routing is based upon static list of ZIP codes supplied by the home HIEs. In the future I see routing of alerts occurring at a more granular level. Routing will be determined by the individual Health Care Organizations. Providers will be able to choose specific patient populations to receive alerts for. Querying for clinical data will be less dependent on receiving a patient alert and manually performing a query for clinical data. The process for querying data will be based on matching patients to a centralized MPI service and cross referencing that information with clinical repository endpoints in order to retrieve lifesaving clinical data.

What motivates you to work hard for MHIN’s mission?MHIN has always been fluid organization that’s not afraid to change directions and adopt new technology in order to meet industry trends and client needs. This constant change and adoption of the latest technology creates a great foundation for team synergy. It makes me want to move our team forward to discover the next greatest HIE solution.

Our Chief Architect, David Navarro, reflects on his experience transforming a broad vision of Patient Centered Data Home into a successful national pilot of a Network of Networks across HIEs in five states of the Heartland.

TRANSFORMING VISION INTO REALITY

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POPULATION HEALTH AND DATA ANALYTICS

Today, we know your focus is on keeping the individuals you serve healthy. You are working hard to implement strategies that help you do just that, but sometimes it’s hard to know exactly what to do.

We’re here to help you navigate the road to a healthier community through smarter population health management. By collating and analyzing data from our entire regional network, we provide you

with valuable insights that allow you to sharpen your focus.

Population Health is bigger than any single healthcare provider, greater than any one intervention, and more significant than anything we can do on our own. That’s why MHIN believes in fueling our communities with the best population health management technology we can. It’s more than a solution. For us, it’s our mission.

PROVIDING ACTIONABLE INSIGHTS INTO INDIANA AND MICHIGAN’S OVERALL HEALTH

MHIN SOLUTIONS

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How does MHIN’s services intersect with efforts to improve population health for the entire community?MHIN works to provide the necessary data a wide range of our collaborating organizations need to better understand their attributed populations, even as we look more broadly across the communities that make up the geographic region of Michiana. As healthcare organizations use our services to stratify and manage the most complex and expensive patients to care for, we also work with health departments, state and local agencies, university researchers and community-based organizations to identify and contextualize the impact of social determinants and structural factors on health disparities, equity and outcomes.

What are you looking forward to working on in 2018?A) MHIN will be will be developing a range of new data-informed services to support sectors of the care continuum who have not historically benefited from incentives made available through the traditional Meaningful Use funding model. These will include: Emergency Medical Services (EMS), post-acute care (home care and skilled nursing facilities), behavioral and mental health services and public health (at the state and local levels).

B) Longstanding research at the state and federal level has consistently identified disparities experienced by our racial and ethnic minority, low-income, and other vulnerable communities. In 2018, MHIN will work to increase the amount and diversity of data being collected on the Social Determinants of Health which have a significant impact on health outcomes of residents across the region.

LEADING THE WAY IN POPULATION HEALTH

MHIN works to reduce infant mortality by improving electronic communication in Labor & Delivery clinician workflow. The Community Health Partnerships grant-funded MHIN / Saint Mary’s College research team interviewed and observed provider data-handling workflows at eight prenatal sites and three hospitals serving at-risk pregnant women within Elkhart and St. Joseph Counties. This data is already being used to help in the re-designing of implementations that improve discrete data contribution of important prenatal health indicators that facilitate the quality of care given to at-risk mothers, and reduce premature and low-weight births, as well as fetal and infant death rates in general.

WALDO MIKELS-CARRASCOSENIOR DIRECTOR, REGIONAL POPULATION HEALTH RESEARCH AND POLICY

RESEARCH SPOTLIGHT

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USING DATA FOR ACTION: A STRATEGY FOR THE FUTURE

REGIONAL ANALYTICSBy aggregating, transforming, and reconciling data across the continuum of care, MHIN is applying the power of its data analytics resources and HealtheIntent platform to identify and report on the health ecology of our region’s communities. We are addressing our region’s population health needs using the power of our data-rich Health Information Exchange by improving the secured exchange of data and data products to increase the capacity of partner organizations in Community and Human Service Organizations and in State and Local Agencies.

BIO-SURVEILLANCEBio-Surveillance is the process of gathering, integrating, and communicating essential information that might relate to disease activity and threats to human health. For the public and population health professional, bio-surveillance activities range from standard epidemiological practices to advanced technological systems, utilizing complex algorithms. We are developing secure mechanisms to provide the ability to track population health patterns of disease and act as an early warning system for emergent conditions.

REMOTE MONITORINGBy collaborating with nursing, case management, and care coordination staff, we are working to take corrective action before the patient’s condition begins to degrade. MHIN is developing systems that use remote monitoring technology to predict imminent health events for patients and alert providers in time to prevent poor patient outcomes. The automatic reporting functionality of this technology, paired with our analytics-informed algorithms, ensures the relatively effortless compliance of the patient in data collection and transmission.

REGIONAL HEALTH PRIORITIESMHIN is collaborating with state and regional stakeholders to leverage data and technology to address priority health items across the region: Fetal and Infant Health, Integrated Care and Behavioral Health, and Transitions of Care. These items were identified based on findings from national and state reviews, as well as community health needs assessments from partner tax-exempt hospitals and health departments in the north central part of the state.

POPULATION HEALTH

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Many of the most critical moments in healthcare occur immediately before, during, or after a patient’s transition. While essential to the treatment and recovery process, a patient transition can be overwhelming, clunky, and straining for patients and healthcare providers alike.

By maintaining, coordinating, and transferring patient records for you, MHIN frees up staff to spend time caring for patients. Whether a patient is transitioning to a skilled nursing or rehab facility, to hospice or long-term acute care, or back home, our Care Coordination solutions ensure that the care team is fully engaged and communicating with one another – without creating more work for individual providers.

With our Health Radar system, we also notify physicians when their patients are admitted or discharged from a care facility. This keeps the physician up-to-date on the patient’s status so they can plan to follow up accordingly.

MHIN worked tirelessly to ensure that Health Radar could work at its optimal level, informing us

of urgent hospital encounters in real time.

Claudius Moore, South Bend Clinic

CARE COORDINATIONMHIN SOLUTIONS

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UNIVERSITY OF NOTRE DAME STUDY REVEALS HIE COULD CUT BILLIONS IN HEALTHCARE SPENDINGTwo University of Notre Dame researchers found that investment in electronic Health Information Exchange could save billions of dollars in the Medicare and Medicaid healthcare payer system nationwide. The research, led by IT professors Corey Angst and Idris Adjerid, confirms that regionally-based and longstanding, mature HIEs, like MHIN, are especially effective in reducing costs and saving money. Professor Adjerid explains, “The research…highlights the conditions under which HIEs can have the largest impact. Policymakers and health care entities need to ensure that financial incentives align with the goals of HIEs and give them sufficient time to mature before expecting promised value.” As professors within the Mendoza College of Business, the study focused on determining the impact on financial incentives in HIE investments.

Further demonstrating value, MHIN CEO Kelly Hahaj was cited in a national press release clarifying: “Our services make it possible for providers to have access to patients’ longitudinal clinical records which include data from all our contributors. This allows providers quick, efficient, secure access to information, so they don’t have to repeat tests [and can prevent unnecessary, costly readmissions to hospitals].” Though MHIN is studied as a success story nationally, many regions, including nearby Chicago and Fort Wayne continue to lack robust, inclusive Health Information Exchange across health systems. The study shows, specifically, how well supported HIE could reduce Medicare and Medicaid costs by 1.4% per participant which would net a minimum reduction of over $3 billion dollars annually.

As the nation’s most mature Health Information Exchange, MHIN is in a prime position to return maximum value.

Versions of this story appeared in several news outlets including:

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A MISSIONGROUNDED IN PRIVACY AND SECURITY Even before the advent of HIPAA, MHIN implemented robust policies and procedures related to confidentiality, privacy, and community access standards.

MHIN has many industry-standard security measures in place that support technical and physical safeguards designed to protect the confidentiality and privacy of information. MHIN’s in-house privacy and security team is responsible for oversight of policies and procedures pertaining to privacy and security of healthcare information. Through MHIN’s usage of a secure Class 4 Data Center, we’re able to implement strong security controls, that enable us to constantly monitor information flowing in and out of the HIE, detect potential threats and implement safeguards to protect the system from unauthorized access.

MHIN is committed to continuously enhancing the tools that are utilized to monitor compliance with privacy and security regulations. MHIN uses the FairWarning Patient Privacy Intelligence platform as a foundation for satisfying key provisions of the OCR’s HIPAA Audit protocol. FairWarning is a leading global provider of privacy and security solutions.

MHIN has rigorous policies and procedures for handling healthcare information that is obtained through the MHIN HIE, including:

• Designated Privacy and Security Officers for oversight of policies and procedures pertaining to the privacy of patient information

• Educating participants on MHIN policies and procedures pertaining to privacy and security

• Destruction procedures for paper or hardware containing protected health information

• Routine audits of participants and employees who access data

• Security management plan including quarterly threat and vulnerability assessments

• Annual HIPAA training and continual education on privacy for all MHIN employees and new employees

• Fully accredited as a HIE and Direct Trust Agent

MHIN is one of only seven Health Information Exchanges

in the United States accredited by:

KRISTI SCHMIDTSENIOR DIRECTOR OF

TECHNICAL OPERATIONSAND PRIVACY OFFICER

ED HAYESSENIOR DIRECTOR OF

INFORMATION TECHNOLOGYAND SECURITY OFFICER

privacy and security experts

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2018 AND BEYONDPreparing to lead in new federal projects toward national interoperability. Through the Office of National Coordinator in coordination with the goals set forth in the 21st Century Cures Act, MHIN is positioned to facilitate the establishment of a trusted exchange framework to share health data between health information networks across the country.

Creating focus-driven work groups among our Board of Directors. Highly focused work groups will strengthen the development of relationships and activities related to population health initiatives and research. MHIN will further explore partnership opportunities in health disparity and population health research with local and federal institutions.

Enriching the data in the central repository. MHIN will continue efforts to expose the benefits of integrated electronic data exchange to regional providers. MHIN will engage in a continual process of fortifying privacy and security protocols.

Ramping up efforts to increase local use of population health and analytics tools. MHIN will continue to encourage the use of our HealtheIntent platform and expand the development of data analytics services for our regional partners.

Cynthia AdamsJames AdamsMonique BeckKim BoocherKim BrockieWaldo Mikels-CarrascoMichelle ChurchfieldTony CochraneMichelle FlandersKelly Hahaj, CEOEdward V. Hayes IIJolene HayesHeidi Huff

Chad Towner, ChairmanSaint Joseph Health System

Derrick Forchetti, MDSouth Bend Medical Foundation

Mark Fox, MD Indiana University School of Medicine

Luis Galup, MD St. Joseph County Health Department

Mark Kricheff, MD MHIN, Emergency Medicine

Gary Miller Saint Joseph Health System

Brian Moloney, MD Select Health Network

Claudius Moore The South Bend Clinic

Suhayl Nasr, MD Epworth | Beacon Health System

Dale Patterson, MDBeacon Health System

Shery Roussarie Allied Physicians of Michiana

Joyce Simpson, MD The Medical Foundation

Albert Tomchaney, MD Franciscan Alliance

Mark WarlickBeacon Health System

Patrick LueckeAndy MartinRobin McIntoshDennis McQueenDavid NavarroEvie NickisonBryan SchindlerKristi SchmidtMatthew ShererCathy TomsCaitlin WormSandy Zielinski