1.Over 3.7 million unique patients in KHIN
2.Over 25 million patients available for query
3.9800 providers
4.900+ healthcare organizations in production
Kansas Health Information Network (KHIN) Key Statistics
Ambulatory Center
Fragmented Clinical Data
Office Visit
Hospital Stay
Specialist Referral
Post-Acute Care
High-cost patients see 10+ providers annually with data spread across care settings
Unified, Normalized Clinical Data Ready for Analytics
KHIN products/services 2016-2017 Health Information Exchange
• Bi-directional in EHR • Web Based Portal • Secure Clinical Messaging/DIRECT • DIRECT Provider Directory
ONC Certified Personal Health Record
• View Download & Transmit • Patient Education • Secure Messaging • Patient Electronic Access • Certified Immunization Record • Patient Generated Data
8
State level interfaces • Immunizations • Syndromic surveillance • Reportable diseases • Cancer registry • Infectious disease registry • Birth Defect registry • Diabetes registry
Business Intelligence and Analytics
– Dashboards • High Risk • Quality Metrics • Readmissions • Disease Registries • Population Health • Controlled Substances*
– Data Extracts – Alerts
Two Dimensions of Data Quality
Were the data included within a section/entry of a
clinical document?
Syntax
For included data, did it support semantic interoperability?
Completeness
Distribution of Scores for Largest Facilities
50%
55%
60%
65%
70%
75%
80%
85%
90%
78% 80% 82% 84% 86% 88% 90% 92% 94%
Facility C
Facility E
Doc
umen
t Com
plet
enes
s
Document Syntax
Facility A
Facility D Facility B
Lowest Scoring Facilities
C-CDAs S C S C S C S C S C S C S C S C S C S C S C S C S C
Facility A 11,037 92 54 60 68 87 68 100 100 100 58 71 36 100 29 100 0 100 41 100 17 94 46 100 17 100 64
Facility B 60,812 91 55 60 68 82 78 100 100 100 58 73 36 100 29 100 0 100 41 100 17 91 48 100 17 100 65
Facility C 48,303 82 55 84 68 57 52 100 12 100 58 66 36 100 29 100 0 80 71 61 100 80 72 92 17 92 41
Facility D 12,148 93 57 60 68 90 63 100 100 100 58 85 36 100 29 100 0 99 80 97 22 95 44 100 17 100 64
Facility E 39,649 87 60 75 71 87 65 92 24 99 69 87 64 87 36 86 56 93 59 79 69 86 69 87 38 86 45
Total
From left to right: total score, demographics, allergies, encounters, immunizations, medications, payers, plan of care, problems, procedures, results, social history, vital signs
We are receiving 5+ million clinical documents annually.
1 S- Syntax; C- Completeness
1
– Quality – Clinical Practice Improvement – Advancing Care Information
KHIN Can Help Physicians Succeed!
THREE AREAS OF MIPS MEASUREMENT-2017
Percent of Score
60% of Total Score 15% of Total Score 25% of Total Score
MIPS Financial Model
Consider : MIPS Potential Impact on $250,000 Annual Medicare Reimbursement per physician.
Kansas Health Information Network Products ACI Base Score: Required = 50 Points
Protect Patient Health Information, ePrescribing, Send Summary of Care Record,
Accept Summary of Care Record & Patient Electronic Access
1. Secure Clinical Messaging/DIRECT 2. HIE Longitudinal Patient View
Within EHR Web-based Access
3. ONC Certified Personal Health Record Patient Electronic Access
Kansas Health Information Network Products ACI Performance Score: Up to 90 Points
Patient Specific Education, Patient View, Download or Transmit, Patient Secure Messaging, Patient Electronic Access, Send Summary of Care Record, Request Summary of Care Record, Immunization
Registry Reporting & Clinical Data Registry Reporting ONC Certified Personal Health Record View Download & Transmit Patient Education Secure Messaging Patient Electronic Access
Public Health Interfaces • Immunizations • Syndromic Surveillance • Clinical Data Registry
Secure Clinical Messaging/DIRECT HIE Longitudinal Patient View
Within EHR Web-based Access
CPI Activity (choose four) How KHIN Supports Participate in HIE Health Information Exchange
Enhanced Patient Portal Personal Health Record
Provide patient self management materials at appropriate literacy level and language Personal Health Record
Regular review of targeted physicians Preventive Care Dashboards
Empanel patients for providers Preventive Care Dashboards
Proactively manage patient care Preventive Care Dashboards
Identify high risk patients High Risk Dashboard
Improve health status of communities Population Health Dashboard
Measure and improve quality Population Health Dashboard
Participate in research De-identified data extracts
Kansas Health Information Network Products
Clinical Practice Improvement = 15% of MIPS score
Screening for Osteoporosis Influenza immunization Pneumococcal vaccination Breast Cancer Screening Diabetes A1c >9 Colorectal Cancer Screening Cervical Cancer Screening
KHIN Products Quality = 60% of MIPS score
NCQA CERTIFIED QUALITY DASHBOARDS
NCQA Certified eClinical Quality Measures # CMS ID HEDIS
Abbreviation Measure
Clinical Process/Effectiveness
16 CMS159 DRR Depression Remission at Twelve Months
17 CMS160 DMS Depression Utilization of the PHQ-9 Tool
18 CMS165 CBP Controlling High Blood Pressure
Efficient Use of Healthcare Resources
19 CMS146 CWP Appropriate Testing for Children with Pharyngitis
20 CMS154 URI Appropriate Treatment for Children with Upper Respiratory Infection
21 CMS166 LBP Use of Imaging Studies for Low Back Pain
Patient Safety
22 CMS156 DAE Use of High-Risk Medications in the Elderly
Population/Public Health
23 CMS117 CIS Childhood Immunization Status
24 CMS153 CHL Chlamydia Screening for Women
25 CMS155 WCC Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents
# CMS ID HEDIS Abbreviation
Measure
Clinical Process/Effectiveness
1 CMS74 - Primary Caries Prevention Intervention as Offered by Primary Care Providers, including Dentists
2 CMS82 - Maternal Depression Screening
3 CMS2 DSF Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
4 CMS122 CDC Diabetes: Hemoglobin A1c Poor Control
5 CMS123 CDC Diabetes: Foot Exam
6 CMS124 CCS Cervical Cancer Screening
7 CMS125 BCS Breast Cancer Screening
8 CMS126 ASM Use of Appropriate Medications for Asthma
9 CMS127 PNU Pneumonia Vaccination Status for Older Adults
10 CMS128 AMM Anti-depressant Medication Management
11 CMS130 COL Colorectal Cancer Screening
12 CMS131 CDC Diabetes: Eye Exam
13 CMS134 CDC Diabetes: Urine Protein Screening
14 CMS136 ADD
ADHD: Follow-Up Care for Children Prescribed Attention-Deficit/ Hyperactivity Disorder (ADHD) Medication
15 CMS137 IET Initiation and Engagement of Alcohol and Other Drug Dependence Treatment
Identifies patients with 3 or more chronic disease conditions and 5 or more ED visits in the last 12 months across 128 provider groups.
MIPS & APM CPIA Requirement: Identify High Risk Patients = 10 points
Identifies patients from one facility that have 7+ chronic diseases and have visited the ED 51+ times in 12 months.
MIPS & APM CPIA Requirement: Identify High Risk Patients = 10 points
Provides patient level drill down with name and number of ED visits, at home ED and other EDs.
MIPS & APM CPIA Requirements: Routine and Timely Follow Up to ED visits = 10 points
Provides patient level drill down of ED utilization patterns across all EDs.
MIPS & APM CPIA Requirements: Routine and Timely Follow Up to ED visits = 10 points
Provides patient level drill down for diagnosis, procedures and insurance provider.
Provides number of chronic diseases by patient age for patients with 5 or more ED visits.
MIPS & APM CPIA Requirements: Proactively manage chronic care = 10 points
Provides patient level drill down by chronic disease condition and age.
MIPS & APM CPIA Requirements: Proactively manage chronic care = 10 points
MIPS & APM CPIA Requirements: Measure and Improve Quality at the Practice Level = 10 points
Provides real time, preventive care patient level drill down identifying where patients received preventative care, if outside of PCP, for quality reporting.
MIPS & APM CPIA Requirements: Measure and Improve Quality at the Practice Level = 10 points
Provides description of the preventative care received. More detailed information is available in the HIE.
Provides real time readmission information aggregated across multiple hospitals.
MIPS & APM Quality Requirements: All cause hospital readmission.
Provides real time hospital specific information by disease and trend line.
MIPS & APM Quality Requirements: All cause hospital readmission.
Provides real time patient specific information regarding readmit facility and readmit diagnosis.
Provides real time heat map of disease prevalence by provider.
MIPS & APMs CPIA Requirement: Improve Health Status of Communities = 10 points
Provides patient level drill down of disease prevalence by provider
MIPS & APMs CPIA Requirement: Improve Health Status of Communities = 10 points
Provides real time, zip code specific information by disease prevalence, gender and age as permitted by HIPPA.