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Health Current – Arizona’s Health Information Exchange (HIE) Panel Discussion May 24, 2019
Health Current – Arizona’s Health Information Exchange (HIE)
Panel Discussion
May 24, 2019
CHERYL KNUPP
SVP OF HR & HEALTH SERVICES
602-995-2611
Cheryl Knupp is the Sr. VP of Health Services and Human Resources for the Beatitudes Campus as well as the corporate risk manager. Cheryl is responsible for operations oversight of the Human Resources department on campus along with Health Services which includes our Medicare certified Home Health agency, Beatitudes at Home (non-medical home care), Assisted Living, Outpatient Therapy and Health Care Center.
She received her BS in Business Administration from Arizona State University with a Human Resources emphasis and is looking forward to starting her master’s degree within the next few years.
Cheryl is a Certified Professional in Aging Services Risk Management, holds an Assisted Living Manager’s Certification, is a licensed Nursing Home Administrator in Arizona as well as she is also one of the few NAB (National Association of Long Term Care Administrators Board) Qualified, Health Services Executives (HSE) in Arizona. Cheryl was also recently awarded the Eli Pick Facility Leadership Award at the American College of Health Care Administrators (ACHCA) annual conference in March of 2019. Cheryl’s leadership experience also includes being an Academy alum in both the LeadingAge and Arizona LeadingAge Leadership Academy’s.
Prior to her role at Beatitudes, Cheryl spent almost 10 years in the HR Director and Administrator roles at 2 of Sun Health’s properties. Cheryl gained her HR experience in hospitality, manufacturing and staffing industries prior to entering Senior Living over 15 years ago.
MELISSA KOTRYS
CHIEF EXECUTIVE
OFFICER
602-688-7200
Melissa Kotrys is the Chief Executive Officer for Health Current, the healthinformation exchange that helps partners transform care by bringing togethercommunities and information across Arizona.
Ms. Kotrys currently serves as the Vice Chair of the Maricopa Health CentersGoverning Council and the Secretary of the Board for the national tradeassociation of community and regional HIEs, the Strategic Health InformationExchange Collaborative (SHIEC). Ms. Kotrys also serves on the North AmericaBoard of Directors for the Health Information Management Systems Society(HIMSS), serving a three-year term that began July 1, 2018. Prior to joiningHealth Current, Ms. Kotrys worked as a consultant and health policy analyst atDeloitte Consulting. Ms. Kotrys holds a Master’s in Public Health from TheGeorge Washington University with a concentration in health policy, and aBachelor of Arts from The University of North Carolina at Chapel Hill.
SUMA GADDAM
CBDO BUSINESS DEVELOPMENT
602.688.7214
Suma Gaddam M.S., M.H.S.A., is the Chief Business Development Officer forHealth Current, Arizona’s Health Information Exchange.
Ms. Gaddam has over fourteen years of experience in healthcare from variousverticals including genomic research, healthcare quality benchmarking, payers,providers, academic and community health systems, ACOs, and non-profitsincluding HIEs. Ms. Gaddam has largely been responsible for the strategy andexecution of technology-enabled business transformations at the enterprise-level, paving the path for integrated business models focusing on business-service growth, patient-centered clinical care, care team collaboration andcoordination, enhanced revenue capture, cost containment, collaborations andpartnerships with community-based organizations. Prior to joining HealthCurrent, Ms. Gaddam served as the Senior Vice President and ChiefInformation officer for a large health system in the Northeast.
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AGENDA
• SETTING THE STAGE
SECTION 1
• HEALTH INFORMATION EXCHANGE: HEALTH CURRENT
SECTION 2
• APPLICATIONS FOR POST-ACUTE PROVIDERS
SECTION 3
• STRATEGIC OPPORTUNITIES – IN BOTH PRE & POST-ACUTE
SECTION 4
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OBJECTIVES
• Participants will be able to describe the emerging benefits of Health Current in serving
the changing post-acute health care landscape.
• Participants will be able to align the future vision of Health Current with their
organization’s envisioned future.
• Participants will be able to identify two or more ways in which Health Current could
create greater efficiencies for their organization.
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I. SETTING THE STAGE
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SETTING THE STAGE
• Managing communication - essential for all providers – keeping patient/resident at
center while working together.
• Managing cost - Access to accurate, timely and thorough information critical in
eliminating redundancy, errors and unwanted intervention.
• Managing outcomes – the rules are always changing in an the turbulent health care
landscape.
• Managing expectation – increasing accountabilities with decreasing resources.
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SOLUTION TO MANAGE SPEND STILL ELUSIVE
Covenant Health Network: A not for profit Post-Acute Delivery System, formed in 1997, encompassing
111 senior care facilities in five states, designed to support seamless access to post-acute services, consistently improve quality, reduce cost and highlight the value of a network.
Rehab Therapy Home Health Hospice Pharmacy Technology
Network responsible to identify changing strategic landscape
Develop strategies to manage change Areas include hospital system
consolidation, payor consolidation, market changes, etc.
Measures monitored with early alerts provided
Measures vary with providers and payors so network functions as monitor
Communication and support on CMS changes
Support for higher acuity / specialties
All areas of Quality Metrics Specialties: Wound, IV, etc. Value Based Support: Antibiotic Stewardship
Build relationships with Acute Care Systems as a partner – supporting the acute care system goals
Provide system: process & tools to use assuring a well managed transition process
Provides single point of contact Network handles all credentialing Provides opportunities for value based
purchasing agreements Negotiate favorable rates and clauses Positions network as payor partner
Member organizations: Not for Profit – no common ownership
Consulting and/or management
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II. HEALTH CURRENT – AZ’S HIE
Health Information Exchange in Arizona Today
May 24, 2019
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• Background Information
• Permitted Uses
• Services & Programs
• Operational Statistics
• Opportunities: LTPAC
• Getting Started & the HIE Onboarding Program
Our Discussion Today
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Health Current
Background Information
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Background
Arizona’s Health Information Exchange (HIE), Health Current, is leading the way in providing
access to critical patient health information by post-acute care providers. Health Current has 97% of
Arizona’s hospital admissions, discharges and ED registrations represented by its Participants and
has over the past 18 months conducted a strong campaign to enlist post-acute care providers to
participate in the HIE. Health Current does not currently charge post-acute providers for HIE
services, and through an AHCCCS sponsored HIE Onboarding Program there may be an
administrative offset payment to qualified Medicaid provider organizations when they achieve bi-
directional data exchange with the HIE. These one-time payments of $5,000 are dependent upon
Medicaid funding being available.
The panel will discuss experience to date with the HIE, current and anticipated benefits as well as an
understanding of the impact that health information exchange through Health Current will make
long term for the benefit of those served by improved outcomes and satisfaction, and reduced costs.
This panel will be of interest to all levels of care as well as ancillary providers.
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Background
Who We Are & What We Do
• A public-private partnership that helps to improve health and wellness by advancing
the secure and private sharing of electronic health information.
• Manages and operates Arizona’s Health Information Exchange (HIE).
• Provide secure sharing of patient health information for Arizona’s healthcare
community.
• Arizona’s Data Trustee – the unbiased and neutral community partner.
• Data Manager – ensures Health Current data is usable and valuable.
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Health Information Exchange
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Health Current Today
HIE in Arizona
Health Current
Community Providers
Labs & Imaging Centers
Health Plans
Hospitals & Health
Systems
ACOs, CINs & IDNs
Public Health
Behavioral Health
Providers
Substance Abuse
Treatment Providers
Long Term Care
Post Acute Care
Hospice & Palliative
Care
Emergency Medical Services
(EMS)
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Health Current Today
Arizona’s HIE History
2007 - 2010
2007 - 2010
2010 - 2015
2016 & Beyond
2007 - 2015
Southern Arizona Health Information Exchange (SAHIE)
Arizona Healthe Connection (AzHeC)
Arizona Medical Information Exchange
(AMIE)
Health Information Network of Arizona
(HINAZ)
Health Current
Evolution of Health Information Exchange in Arizona
Merged
Merged
(2017)
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The Patient Rights Process
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Health Current
Permitted Uses
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1. Treatment
2. Care Coordination
3. Case or Care Management
4. Transition of Care Planning
5. Population Health
6. Payment
7. Limited Healthcare Operations
8. With a Valid HIPAA Authorization
9. Health Current Uses
10. Permitted Uses pending Health Current Board approval
Public Health
Medical Examiners
Donor Network
Permitted Uses
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Permitted Uses
1. Healthcare Providers (and Business Associates)
• Relationship with the patient (transitioning, past, present, prospective)
2. Health Plans (and Business Associates)
• Relationship with the patient (transitioning, past, present, prospective)
3. Authorized Recipients
• Any individual the patient elects (e.g. Adult Probation, Life Insurance, etc.)
4. Health Current
• In support of delivering HIE services to participating organizations
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Health Current
Services & Programs
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Services & Programs
Health Current Core HIE Services
• Alerts
• Direct Email
• Portal
• Data Exchange
• Clinical Summary
https://healthcurrent.org/hie/benefits-services/
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Services & Programs
Additional HIE Services & Opportunities
• Alerts – Additional Batch Reporting Functionality
• PDMP/HIE Integration
• Patient Centered Data Home™ (PCDH)
• Part 2 Data Access & Crisis Summary Tab
• Public Health Immunization Reporting – coming soon!
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Services & Programs
Health Current Gateway – Easier Data Submission for LTPAC
• Enables the secure movement of data between the Participant and Health Current
• No interface required
• A simple application is downloaded onto the End User’s computer
• Sends OASIS or MDS Reports to the HIE where they are translated into a machine
consumable format
• Cost to use Health Current Gateway: FREE
Services & Programs
Health Current Gateway
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Services & Programs
Special HIE Programs
• Transforming Clinical Practice Initiative (TCPI)
- Practice Innovation Institute (Pii), in collaboration with Mercy Care & Mercy Maricopa Integrated
Care, supports 2,500 Medicaid providers with practice transformation and VBP
• HIE Onboarding Program
- Assisting Medicaid providers with obtaining HIE services - $5,000 to $20,000 in incentives available
- 313 participant organizations, 178 with portal/alerts, 54 sending data
• Statewide HIE Integration Program (SHIP)
- Integrating physical, behavioral health & substance abuse information
- 65 participant organizations, 58 with portal access/use, 53 receiving alerts, 33 sending data
• Differential Adjusted Payment (DAP) Participation
- 3% Medicaid rate increase for HIE reqs; 104 sites representing 49 participant organizations
• Targeted Investment (TI) Program
- 527 sites representing 123 participant organizations, 113 with portal/alerts, 37 sending data
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Services & Programs
Nationwide HIE Connectivity via Patient Centered Data Home (PCDH)
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Health Current
Operational Statistics
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Operational Statistics
Health Current Participation (as of May 13, 2019)
PARTICIPANTS 608
Accountable Care Organizations 16
Behavioral Health Providers 80
Community Providers 286
EMS Paramedicine Programs 18
Federally Qualified Health Centers 21
Health Plans 17
Hospitals & Health Systems 54
Acute Care Hospitals & Health Systems 35
Behavioral Health Hospitals 7
Rehabilitation Hospitals 9
Long Term & Sub-Acute Hospitals 3
Laboratories & Pharmacies 6
Long Term & Post Acute Care Providers 103
State & Local Government Agencies 7
HIEs (not included in total count) 17
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Operational Statistics
Health Current Operations (as of April 1, 2019)
HIE Operations 2015 4/1/2019
Inpatient Discharges 52% 97%
ED Visits 43% 98%
Patients 6.3 M 10.5M
Patients w/Clinical Data 4.8 M 9.1M
Monthly Transactions Received 6 M 20.4M
Monthly CCDs Received 0 754K
Monthly Alerts Sent 0 9.4M
Monthly Batch Alerts Sent 0 298K
Monthly Real-Time Alerts Sent 0 9.1M
Active Portal Users 8 1,030
Patients Accessed via Portal 210 109K
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Operational Statistics
Health Current Quarterly Growth (as of May 13, 2019)
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Operational Statistics
Health Current Growth – LTPAC Providers (as of May 13, 2019)
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Health Current
Opportunities: Long Term Care – Post-Acute Care
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Opportunities: LTPAC
• If you could have a comprehensive background on the patient before he/she
arrived?
• If you didn’t have to wait for someone to fax a patient’s lab result?
• If you could reduce medical errors?
• If you had all the information you needed at your fingertips to admit someone
to your care?
What would it be worth to your organization…
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Opportunities: LTPAC
• Alerts & notifications
• HIE Portal access to patient information to coordinate care
• Timely access to patient information within your EHRs
• Alerts & medical histories from out-of-state
• Secure communications
• Consolidated health information from multiple sources
The HIE has answers
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Health Current
Getting Started & The HIE Onboarding Program
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Getting Started & The HIE Onboarding Program
No Participation Fees for Community Providers
AHCCCS pays the HIE to onboard Medicaid Hospitals, FQHCs, FQHC-LAs, RHCs,
LT-PAC and community providers.
Current HIE Onboarding Program
• Eligibility – Registered Medicaid Providers treating Medicaid patients
• Requirements – Connect bi-directionally to the HIE
• Subsidy – Administrative offset fee based upon entity type
- Hospitals - $20,000
- FQHCs, FQHC-LA, RHCs - $10,000
- LT-PAC & Practices (25+ providers) - $10,000
- LT-PAC & Practices (1-25 providers) - $5,000
HIE Onboarding Program
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Getting Started & The HIE Onboarding Program
Step 1: Initial Contact with Health Current Recruitment Department
Step 2: Introductory phone call to be scheduled with potential Participant
Step 3: Identify applicable Health Current Programs for potential Participant
Step 4: Participation Agreement and Amendment (if applicable); sent, signed & returned
Step 5: HIE Account Manager assigned and the Service Planning Kickoff meeting held
Step 6: Desired HIE Services confirmed and implementation initiated
Steps to Participate
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Getting Started: The HIE Onboarding Program
Looking to Get Started?
• Contact Health Current to ensure you are connected soon!
– Jayme Piña at [email protected] or 602-688-7215
• Encourage your provider networks to participate
– HIE participation is most valuable if the other entities in your network of providers
are participating and sharing/accessing HIE data
– Provide contacts for network partners to Health Current
• Get engaged
- Provide input for future services and opportunities
- Send us your ideas or set-up a time to meet
• Stay informed
- Receive Health Current Updates, subscribe at www.healthcurrent.org
- Follow us on social media
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III. APPLICATIONS FOR POST-ACUTE PROVIDERS
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BEATITUDES HAS IMPLEMENTED CONNECTIVITY WITH HEALTH CURRENT
• Primarily for resident continuity.
• Multiple acute care systems follow residents. Complex nature of accessing baseline
information given the various hospitalists, discharge planners, etc.
• Recognize that knowing the baseline for Beatitudes healthcare residents (skilled and
assisted living) use of ED and hospital is essential to documentation of improvement.
• Future Health Current capabilities such as Advanced Directives will enable Beatitudes to be
in regulatory compliance with minimal redundant work.
• Beatitudes desirous of being a strong partner for Health Current in their post-acute
initiatives.
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IV. STRATEGIC OPPORTUNITIES: PRE & POST-ACUTEINTEGRATION – EXPANSION OF THE CONTINUUM
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OPPORTUNITY: MOVE INTO POST-ACUTE INTEGRATION
Total patients-103
Inpatients = 46
Frequent Inpatients = 17
70% of total were Females 44% of patients were inpatients.
37% of all inpatients were admitted multiple times
4 Average visits for frequent fliers – MAX = 7 and MIN = 3
22 Average number of days between inpatient admissions
82 yrs was the average age for frequent fliers
>90% of Inpatient Frequent Fliers were Females
Health Current – the HIE for Arizona now includes data for 97% of hospitals. Now registering post-acute providers and providing $ for connectivity, enabling:
A. Notification when discharged patient or resident has visited the ED or been hospitalized.B. Data to be pulled and studied to highlight need for early intervention – practice
changes. (See below)
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APPLICATION FOR REDUCTION IN READMISSIONS
• Skilled facilities now responsible for full 30-day (to be lengthened)
readmission.
• Health Current enables alerts to be sent if a resident goes to ED or is
admitted. This provides opportunities for providing greater support for
residents because we now know.
• Data enables demonstration of possible resident benefits to payors,
providers and families with alternative services.
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OPPORTUNITY: PHARMACOGENOMIC PROFILES –ONLY IF THEY CAN BE ACCESSED!
A.
Step into this opportunity with Health Current to
better serve our residents.
Thank you!
