NC Health Information Exchange:Example of State Health Network

February 21st, 2012

Presenter: Jeff Miller

Overview of Federal Health IT

• Nonprofit organization established as a Statewide Designated Entity

(SDE) in April 2010

• Board of directors: 25 CEOs and health care leaders in the North

Carolina community

• Four workgroups: strategy and policy experts on

– Clinical and technical operations

– Governance

– Finance

– Legal and policy

NC HIE Overview and Governance

NC HIE will provide a set of secure,

scalable information services that

• Promotes the access, exchange

and analysis of health care

information

• Enables participating organizations

to:

– Improve medical decision-making and coordination of care

– Improve health outcomes

– Control health care costs

Setting the Strategic Agenda – NC HIE Mission

Why a NC Health Information Exchange?

Four focus areas for NC HIE initiatives:

NCHIE Solution Components – Detailed View

6

NC HIE Services Overview

• HIE Connectivity Fabric

– Connectivity with participating systems: CCD,

HL7, SSO, Web Services (Rhapsody™).

– Storage of clinical information (CDR).

– EMPI.

– Data normalization.

– Privacy and consent

• Virtual Patient Record Network

– Web-based access to the longitudinal patient

record (Clinical Portal).

– User subscribed notifications

• Data Delivery Services

–Lab results

• Direct Secure Messaging

– Ability to send/receive secure messages with

other Direct providers

– Support for Direct-enabled EMR systems

Timeline

Core Services

• EMPI/provider directory

• Security• Privacy and consent• Clinical messaging• VA Gateway• DIRECT• Web-based clinical

portal• Notifications• Virtual QO services• Hosted EMR

Phase IA

• Medication management

• Immunization registry• Practice analytics• Lab results

Phase IB and Beyond

• Lab ordering • Procedural results• Pharmacy• Consumer portal • Payer gateway • Medical imaging• Population health analytics• Syndromic surveillance• Public health reporting

• Referrals• Senior care• Mobile gateway • Medical device gateway• Clinical decision support• Vital records• Advanced directives• Home health • NwHIN trading partners

Benefits to the Health Ecosystem

North Carolina has an inbound move rate of 55.4%. According to Forbes, Raleigh and Charlotte remain two of the most popular cities for relocation.

There are almost 200,000 deaths a year from preventable medical errors, partly because this information is not readily available to specialists and emergency rooms.

By reducing their dependence on paper records, a practice seeing 3,000 patients annually could save $24,000.

At the highest level of health IT adoption, only 0.001% of prescriptions would require a phone call between a pharmacist and physician.

Across all insurance types, EHR sites were associated with significantly higher achievement of care and outcome standards and greater improvement in diabetes care.

American patients have seen an average of 18.7 different doctors during their lives.

Only 6.3% of physicians use a fully-functional electronic health record system in their practice.

Emergency Departments with connectivity to an HIE have improved productivity by more than 20%

What’s in it for everyone?

Providing NC with better, safer,

more affordable care

• Integration

• Communication

• Insight

• Agility

• Custom

Comparing NC and NL situation

North Carolina

• Government actively supporting HIEs

• Patiënt consent: opt-in needed (forsharing, not collecting)

• Healthcare data also used for analysison population level

• Based on international standards (CCD / HL7)

• Almost 10 million inhabitants, 3,5 timesthe area of NL.

Netherlands

• Government in doubt how to support regional and national HIE

• Patiënt consent: opt-in needed (for bothcollecting and sharing)

• Healthcare data only used on patiënt level

• Based on international standards (CCD / HL7)

• Changing the way of working of a multitude of organizations and

persons, is a tough job.

• Drivers for change are both quantitative and qualitative

– Higher quality of care and lower cost (or more income)

• Even if both are the projected outcome of a network-project, a couple

of objectives must be met to become successful:

– The will to exchange the patients data – and be serious about it

– A compelling business case for the total value chain

– A fair business model promoting the use for each of the participant in the network

– An HIE system that is integrated with the current IS of the caregivers

• Individual healthcare providers have little influence on development roadmap of ISVs

Prerequisites for successful implementation

Questions - Discussion

• Thanks for sharing your thoughts and experiences with us today.

• "I'm Sure it's No Coincidence that

We're Sitting at this table Together.

Some things cannot be Mere Chance;

everybody has got an example of this.

On the other hand I think it's

Nonsense to Say Chance doesn't Exist.

I mean What's the Chance that

Nothing ever happens by chance"

Thank you, Jeff Miller !

Text and design by Nicole van Schouwenburg

for Royal Delft – Koninklijke Porceleyne Fles

Thank you, and have a great time at HIMSS 2012

Jeff Miller

• CEO NC HIE - Health InformationExchange

• jeff.miller@nchie.org

Toon van der Werf

• Consultant Vakgroep Zorg Capgemini Netherlands

• toon.vander.werf@capgemini.com

• +31(0)629 056 330

• Booth #13642-12