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Alaska eHealth Network & Health Information Exchange: Connecting Health Data for all Alaskans Jim Landon, Consultant, AeHN 4/11/2013
Alaska eHealth Network & Health Information Exchange:
Connecting Health Data for all Alaskans
Jim Landon, Consultant, AeHN4/11/2013
Presentation Overview National / State perspectives AeHN overview / services What is health information technology (HIT)? Why is HIT important to me? How is my health information used? How is my health information protected? What is Health Information Exchange (HIE)? What are my options for HIE participation? Projects to date Implementation
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National Perspective
Bipartisan Initiative – Bush/Obama Benefits
Improve health quality, safety and efficiencyEngage patients and their families Improve care coordination Improve population health and reduce
disparitiesEnsure privacy and security protections
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State Perspective
SB 133 Statute – 2009
>$2M annually
Opt–out model (all in)
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Alaska eHealth Network Mission To improve the safety, cost effectiveness, and
quality of healthcare in Alaska through widespread secure, confidential electronic clinical information systems including promotion of electronic health records and facilitation of health information exchange.
Vision A connected Alaska healthcare delivery
system.
Geographic Service Area State of Alaska and Pacific Northwest
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History
6 years in planning and modeling 450 Alaskan providers and consumers
participated 1.5 years implementing $6M in grants and contracts Time investment from many organizations
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Public/Private Convergence
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What is HIT?
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Involves conversion of a paper chart to an electronic medical record. Replaces paper process of the past.
Collects, stores, and facilitates exchange of patient data.
Securely stored and shared only with the same providers and insurers who received paper information.
Health data is encrypted, making the data unreadable except by an authorized health care professional.
Supports “meaningful use”.
Fishing Rod Meaningful Use of Fishing Rod
Meaningful Use – a ‘seasonal’ view
Meaningful Use = Health Care Transformation
Quality reporting
Clinical Decision Support
Improving care coordination
Engaging patients
Meaningful Use Quality
Improvem
ent
Tech
nolog
y
Practice Redesig
n
Exchange
Why is HIT important to me? Provide caregivers information they need to make more
informed care decisions resulting in improved patient safety and reduced medical errors
Better administrative efficiency – reduced paperwork and handling, e.g.. referrals
Provide patients with access to their personal health information
Reduce duplicative tests, unnecessary hospital admissions, and treatment caused errors
Improve public health reporting and monitoring Reduce health related costs
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How is my health information used?
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Health information in the EHR (or paper chart) is protected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. Information can be shared with: doctors, hospitals, and ancillary health providers for
treatment purposes, insurers for billing purposes, and state and federal health reporting agencies as
required by law (e.g., immunization and cancer registries).
Cannot be given to your employer, used for sales or advertising, or any other purposes without signed permission
How is my health information protected?
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AeHN utilizes the highest technology security standards available to protect health information allowing data to be transferred securely and providing an audit of where the data was sent.
Every time the information is accessed an “audit trail” is recorded.
All HIE participants have trust agreements in place defining who can access and change data.
All AeHN participants agree to follow the privacy and security policies that govern data protection and use.
Health Information Exchange
Replaces costly and non-secure processes Ensures timely record access Follows HIPAA guidelines for data exchange
(treatment and payment) Provides audit trails of record access Builds relationships
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Health Information Exchange Software as a Service (SaaS) Model
No capital or replacement costsRapid deploymentLower cost of operation
Orion Health2nd largest HIE vendor in US, global8 SaaS clientsRhapsody Interface Engine
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Health Information Exchange
Multiple modes of secure data transportMaster Patient IndexDirect Secure Messaging (DSM) Interfaces (between EHR and HIE)Data RepositoriesRecord Locator ServiceQuery-Based Clinical Views
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Health Information Exchange
Multiple message types based on EHRContinuity of Care Document (CCD)HL7 Interface StandardPDF, HTML viewable/printable
Multiple data needsLabs, meds, x-raysAllergies, problems, vital signs Immunization registry
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Options for HIE Participation Participation is voluntary and does not impact access to medical
care Opt-in – participation in HIT and data exchange Opt-out – decline participation
medical information will not be available to help participating providers manage care – even in emergency
all health information about patient will be removed from the system except demographics to ensure no additional information is entered.
PDF, HTML viewable/printable Partial Opt-out - health information may only be accessed in an
emergency. ER doctor will be given a decryption key to view your data and indicate why your record is being accessed.
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Projects To Date
Fairbanks HIE pilot – over 2 million messages
Direct (DSM) – 4,000 users, 120,000 messages
Lab pilots – direct pass through results to EHR
State of Alaska / LaTouche Pediatrics
ANTHC/rural sites
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Implementation
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FY13 FY14 FY15 FY16
Hospital 5 9 15 27
DSM Users 4,000 6,000 8,000 10,000
Provider (HIE, DSM) 300 700 1,200 2,000
Payer (covered lives) 90,000 180,000 250,000 300,000
