The Nation’s First Statewide Health
Information Exchange
Presentation to the Delaware Health Care Commission
May 3, 2007
Robert White DHIN Chair
Delaware Physicians Care, Inc.
Gina B. PerezDHIN Project Director
Advances in Management, Inc.
Agenda
• What is DHIN?• Why do we need it?• Who participates in DHIN?• What does it do?• How is it funded?• What are the benefits?
Vision
Develop a network to exchange real-time clinical information among all health care providers (office practices, hospitals, labs and diagnostic facilities, etc.) across the state to improve patient outcomes and
patient-provider relationships, while reducing service duplication and the rate of
increase in health care spending.
DHIN Governance Structure• Statutorily Created in 1997• Public-Private Board of Directors under
the Delaware Health Care Commission• Active Executive Committee• Multi-Stakeholder Project Management
Team• Consumer Advisory Committee• Clinical User Group
What is DHIN?
• Secure network for distributing clinical results and reports from the hospital, lab or radiology center to the treating physician
• Data is managed by those who order the test and those who perform the test
TimelineYear Activity Funding Source
2001 HIE Concept Embraced DHCC Pilot Funds
2004 Project Director Contracted Longwood Foundation & Federal Funding (beginning in Sept. 2005)
2005 Requirements Definition BeganFederal AHRQ* Funding Secured
State Funding thru DHCC & Federal Funding
2006 IT Vendor Selected System Implementation Began
State, Private and Federal Funding
2007 DHIN CIO Hired Federal Funding
System Go-Live State, Private and Federal Funding
*Agency for Healthcare Research and Quality
Why do we need it?
• Most Doctors receive laboratory results from 5 different labs all sending results in a different format and method
• Clinicians who use computerized records system are more likely to adhere to clinical guidelines
Why do we need itClinical information is missing in
13.6% of primary care visits: • Lab results - 6.1%• Radiology results - 3.8%• History & Physicals - 3.7%
Missing information is Judged to:
• Adversely affect care in 44% of visits• Delay care in 59% of visits (“JAMA”, January 2005)
• Medications - 3.2%
• Dictation - 5.4%
DHIN Phase 1 Priorities
2006-2007
• Secure results/reports delivery to ordering physician
–Lab/Pathology Results–Radiology Reports–Admission, Discharge & Transfer Reports–Admission Face Sheets/Demographics
• Security access controls
• Audit processing & reporting
• Electronic Medical Record (EMR) interfaces
• Consumer participation via Consumer Advisory Committee
Phase 1 Data Senders
• Bayhealth Medical Center– Kent – Milford
• Beebe Medical Center• Christiana Care Health
System– Christiana– Wilmington
• LabCorp
Account for:85%
Laboratory Testing
&81%
HospitalAdmissions
in Delaware
Phase 1 Data Receivers
• Cardiology Consultants – 16 offices statewide – 30 physicians– EMR
• CN-MRI – 2 locations in Kent
County – 9 physicians– EMR
• Nephrology Associates – 8 offices statewide– 21 physicians– Electronic Inbox
• Dover Family Practice – 1 location in Kent County– 4 physicians– Electronic Inbox
• Georgetown Family Medical – 1 locations in Sussex County– 2 physicians– Fax and Electronic Inbox
Total:• 28 practice sites• 66 physicians
A Day in the Life of One Doctor’s Fax
Machine
1 day
1 doctor
115 faxes
10 ads
55 lab results
30 consult reports
19 pharmacy renewals
1 stat abnormal mammogram 1 stat abnormal mammogram that needs immediate attentionthat needs immediate attention
One Standard DHIN Format
Security• HIPAA compliant• Secure Virtual Private Network (VPN) • 128-bit secure socket layer (SSL)
encryption• Complete auditing and logging• Data management at
the source system
DHIN Phase 2 Priorities
2007-2008
• MSDHub – Value Added Services• Patient Centric History• Medication history• Public Health reporting• Consumer participation via Patient
Portal • Electronic order entry
2009-2011
• Chronic Disease Management• Outcomes and Incentive Management• Benefit Eligibility and Claims
Processing
Future Priorities
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Source: University of Delaware Center for Applied Demography and Survey Research, Primary Care Providers in Delaware 2006
Physician Use of Technology
Physician Interest – Next Wave
66 Physician Practices • 21 in Kent County• 18 in New Castle County• 23 in Sussex County• 4 statewide Practices• 29 Primary Care Practices• 33 Specialty Practices • 4 Federally Qualified Health Centers
Benefits of DHIN• Improved Patient Care
– More complete clinical information– Better communication
• Reduced “Hassle Factor”– Information available at appointment– Fewer forms to fill out
Benefits of DHIN
• Reduced Healthcare Costs– Fewer duplicated tests– Better medication management
• Increased Efficiencies– Greater productivity– Reduced delivery/mailing costs
THANK YOU from
For a Decade of Support!For a Decade of Support!
