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March 11, 2010 Paul W. Brient, President & CEO Health Information Exchange and Meaningful Use at the Hospital Level.

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Presentation on theme: "March 11, 2010 Paul W. Brient, President & CEO Health Information Exchange and Meaningful Use at the Hospital Level."— Presentation transcript:

1 March 11, 2010 Paul W. Brient, President & CEO Health Information Exchange and Meaningful Use at the Hospital Level

2 Agenda PatientKeeper Overview HIE and Meaningful Use HIE Case Studies –Healthy Ocala –HealthCare Partners (HCP) Perspectives on Making HIE Successful in Puerto Rico HIE and CPOE demonstration

3 PatientKeeper Experience and Success –11 years of experience developing applications and integrating data for physicians –2 U.S. Patents Synchronization across multiple disparate systems Physician Charge Capture –Large, diverse customer base across all settings of care (Health Systems, AMCs, HIEs, Community Hospitals, Large & Small Physician Practices) Stable and Growing –More than 17,000 active users every day Expected to double over the next 12 months –More than 400 hospitals –Offices in Boston and Chicago

4 Academic Medical Centers Brigham & Womens Georgetown H. Lee Moffitt Cancer Center (USF) Mass General Mt. Sinai – NY North Shore-LIJ Ohio State University SUNY Stonybrook Tulane UCSD VCU National Health Systems Adventist East CHI CHRISTUS Health HCA HMA Lifepoint Tenet Regional Community Hospital Systems BayCare (FL) Bassett Health System (NY) Iowa Health System (IA) Mayo Health (MN) Memorial Health System (FL) Memorial Health System (IL) Norton (KY) Oakwood Health System (MI) Ochsner Community Hospitals (LA) St. Vincent's Catholic Medical Ctr (NY) Stand-Alone Community Hospitals Berger Health (OH) BroMenn (IL) Hardin (KY) Halifax (FL) Mercy (Cedar Rapids, IA) Morris (IL) Opelousas General (LA) RHIO/HIE Healthy OCALA Health Care Partners Long Term Care/Rehab Hebrew Senior Life (MA) Masonicare (CT) Multi-Facility Hospitalist Groups Community Hospitalists Executive Health Resources (PA) HealthCare Partners (CA) Inpatient Physicians Network Group Practices Athens Pulmonary & Allergy (GA) Atlanta Gastroenterology (GA) Carson Tahoe Psychiatry (NV) Charter Health (MA) Digestive Health Specialists (WA) Florida Cardiothoracic Surgery (FL) Highland Family Practice (NC) Midwest Heart (IL) Pulmonary Medical Assoc (CA) Tucson Pulmonology (AZ) We Have The Privilege of Working With A Wide Variety of HealthCare Delivery Organizations

5 And Have Extensive Integration Experience and Expertise HISPractice Management Ambulatory EMR PACS/Imaging/ Video Reference Labs & Pharmacy Cerner Classic Cerner Millennium Childrens Hospital EMR Eclipsys Sunrise Eclipsys Sunrise XA Epic GE/IDX Carecast HCS Medics McKesson Star McKesson Series McKesson Horizon MEDITECH Magic MEDITECH C/S Partners BICS/LMR Siemens MedSeries 4 Siemens Invision Siemens Sorian Quadramed A4 ADS Athena BillWork eClinicalWorks Epic GE Centricity PO GE/IDX Flowcast GE/IDX Groupcast Greenway HealthPack Keane MEDITECH LSS MEDITECH MPM Medical Manager Misys NextGen Sage Intergy Siemens Invision TimeTrade A4 Allscripts eClinicalWorks Epic Greenway GE Centricity EMR MEDITECH/LSS Misys NextGen Partners LMR Quest Wellogic Consult ChartOne GE QS Fetal Monitoring ImageCube/ CannonPACS DR PACS Iatrics MyFreePACS Stentor PACS Sony IR ICU Camera (SNC-RZ25N) GE PACS RxHub Quest SureScripts DEPARTMENTAL SYSTEMS LabRadiology/Path/MicroPharmacyTranscription LabStat MEDITECH Mock Labs MISYS SnQ SoftLab Quest LabCorp CoPath GE/IDX Imagecast Novius SoftPath Medics Mediware RxTFC Arrendale Assistmed Doc-In-A-Row EDIS Medquist/Dictaphone Quadris/Dolbey

6 Agenda PatientKeeper Overview HIE and Meaningful Use HIE Case Studies –Healthy Ocala –HealthCare Partners (HCP) Perspectives on Making HIE Successful in Puerto Rico HIE and CPOE demonstration

7 The HITECH Act and Meaningful Use Is Driving The Last Mile of HealthCare Automation Physicians must install EMR systems and start sharing data Hospitals must exchange information with hospitals, providers, and patients Hospitals are required to implement the last of the physician automation functionality –Physician Order Entry (CPOE) –Physician Documentation --- AND --- Organizations will have to achieve significant adoption/use of the system in three years

8 HealthCare Information Exchange Isnt A New Concept CHIN - Community Health Information Network RHIO - Regional Health Information Organizations HIE - Health Information Exchange And Now

9 HealthCare Information Exchange Has Been A Key Part of HealthCare Reform Among the many problems facing health care today is the inefficient sharing of a patient's medical information. This inefficiency can lead to inaccurate diagnosis, inappropriate treatment, and more frequently duplicated testing. The total cost to US health care because of these problems is significant. For that reason, several of the health care reform proposals offered today include a requirement for a regional database.

10 This Was Written Over 15 Years Ago Among the many problems facing health care today is the inefficient sharing of a patient's medical information. This inefficiency can lead to inaccurate diagnosis, inappropriate treatment, and more frequently duplicated testing. The total cost to US health care because of these problems is significant. For that reason, several of the health care reform proposals offered today include a requirement for a regional database. Wakerly, Ralph. (October 25, 1993). Info networks to be integral in reform. Modern Healthcare,

11 CHIN and RHIO Initiatives Struggled Over 500 CHIN projects nationwide in 1995 –Few got past the planning phase –Funded by National Telecommunications and Information Administration and HRSA Rural Health Telemedicine Grants –Many driven by Regional Bell Operating Companies (RBOCs) About 165 RHIOs established by 2006 –Only 26 fully operational and actually exchanging clinical information –None had demonstrated a sustainable business model –The most celebrated (The Santa Barbara County (Calif.) Care Data Exchange) shut down in March 2007 Source: Scientific Technologies Corporation 2001, eHealth Initiative 2006

12 Common Themes… Most ran out of money or energy before they got into operation Of those that were able exchange healthcare data, many had to shut down or change what they were doing –Very low physician use or physician endorsement –No significant impact on healthcare costs There were a lot of challenges –Few standards –Largely paper-based physician practices –No clear mandate –No off the shelf software

13 We Have Taken A Unique Approach To Health Information Exchange & Meaningful Use Providing both the Health Information Exchange AND the applications necessary to meet Meaningful Use Requirements and ensure physicians actually use the data being exchanged Health Information Exchange + Physician Workflow Applications Successful HIE Deployment And Achievement of Meaningful Use =

14 PatientKeeper Offers A Full-Featured HIE Infrastructure

15 And A Complete Set of Physician Applications PatientKeeper Physician Workflow Applications Access Patient Information Anytime-Anywhere Physician PortalNoteWriterCharge Capture Mobile Clinical ResultsSign-OutCharge Analytics CPOEFormsP4P: PQRI Ambulatory Order EntryProvider Directory Medication HistoryeSignature ePrescription Clinical Suite Documentation & Communication Suite Financial Suite

16 To Create A Single Environment To Support Your Physicians

17 Agenda PatientKeeper Overview HIE and Meaningful Use HIE Case Studies –Healthy Ocala –HealthCare Partners (HCP) Perspectives on Making HIE Successful in Puerto Rico HIE and CPOE demonstration

18 Case Study: Healthy Ocala RHIO A health information exchange serving Marion County, Florida –In the process of expanding to 9 other counties in Central and North Florida A model for a self-sustaining RHIO with broad community participation Utilize PatientKeeper as their health information exchange infrastructure and for physician workflow applications –Tightly integrated with WorldDoc Personal Health Record –Tightly integrated with ambulatory EMRs including Greenway

19 We Offer Healthy Ocala Members Multiple Ways To Enroll Patients opt-in to Healthy Ocala Health Information Exchange –Self-service through WorldDoc PHR and passed through to PatientKeeper –Enrolled at Physicians office using PatientKeeper –Enrolled as part of Prestige 55 PatientKeeper creates a complete longitudinal medical record for all enrolled patients with data from hospitals, physician practices, reference labs, imaging centers, LTC facilities, home care providers, and using patient-reported data from the PHR

20 Healthy Ocala Infrastructure Physicians Ocala Regional Medical Center West Marion Community Hospital Munroe Regional Medical Center Patients PatientKeeper System Physician Offices

21 Case Study: HealthCare Partners HCP uses PatientKeeper to exchange discharge summaries, patient demographics, and discrete clinical information from over 25 hospitals with their practice EMRs HCP Hospitalists enter post-discharge orders into the PatientKeeper system –These orders are routed to the relevant practices EMR and to HCP Care Managers to ensure continuity of care/handoff as patients are transitioned back to their PCPs care

22 Healthcare Partners Infrastructure San Fernando Valley Pasadena/San Gabriel Valley San Dimas Hospital (McKesson Star) Verdugo Hills Hospital (Siemens Medseries4) Methodist Hospital (McKesson Star) San Gabriel Valley Medical Center (Siemens Medseries4) Huntington Hospital (MEDITECH Client Server) Foothill Presbyterian Hospital (MEDITECH Magic) Los Angeles South Bay Long Beach Glendale Memorial Hospital & Health Center (McKesson Star) Beverly Hospital (MEDITECH Magic) California Hospital Medical Center (Siemens Medseries4) Good Samaritan Hospital (MEDITECH Client Server) Monterey Park Hospital (Self-Developed) Torrance Memorial Medical Center (Stockell InsightCS) Long Beach Memorial Medical Center (Keane Patcom Plus) St. Mary Medical Center (McKesson Star) Allscripts EMRGE Centricity Business Mission Community Hospital (McKesson Paragon) Providence Holy Cross Medical Center (Eclipsys 7000) West Hills Hospital and Medical Center (MEDITECH Magic) Valley Presbyterian Hospital (McKesson Precision 2000) PatientKeeper Application Server

23 Keys To Making Health Information Exchange Work Keep costs low by making this an integral part of the overall healthcare IT infrastructure –The Other HITECH initiatives Physician (EMR) Hospital (Order Entry, Physician Documentation) –Physician workflow improvements –Personal Health Records (PHR) –Care Management (UR, Case Management, Disease Management) –Downtime Capabilities Make workflow for physicians as seamless as possible –Physicians should not have to go somewhere else to access external information Enable physicians to drive changes in care delivery –Publish summary data with process metrics and outcome metrics –Encourage research around what is most effective in Puerto Rico –Incorporate learnings into workflow systems (EMR, CPOE) –This must be physician driven to the extent possible

24 Agenda PatientKeeper Overview HIE and Meaningful Use HIE Case Studies –Healthy Ocala –HealthCare Partners (HCP) Perspectives on Making HIE Successful in Puerto Rico HIE and CPOE demonstration

25 There Is An Opportunity To Create An Island- Wide Health Information Exchange SSS MMM MCS Humana Auxilio Mutuo Hospital Cardiovascular Center of Puerto Rico Hospital Buen Samartino Hospital Episcopal San Lucas Metro Pavia Health University of Puerto Rico Hospital Community Health Centers (333s) Health Plans Physician Offices Ancillary Labs SAIL RxPharmacy QIPRO Puerto Rico Exchange

26 This System Can Be Built Incrementally 1.Begin importing data from your hospitals –One HIS system at a time –Make the data available to physician practices via a web browser and smartphones 2.Deploy EMRs to your physician practices –HITECH funds will make this self-funding for physicians 3.Import data from reference labs 4.Import data from each EMR-enabled physician practices 5.Implement island-wide PHR (Personal Health Record) 6.Push data back to each EMR-enabled physician practice 7.Deploy CPOE and Physician Documentation 8.Start developing and implementing quality improvement programs

27 Puerto Rico Has A Unique Opportunity To Use HIE To Understand and Impact HealthCare Delivery Puerto Rico is a fairly closed system Of sufficient scale to be meaningful but not so big/complex that change is impossible With significant potential for cooperation and collaboration across the healthcare continuum –Payers –Care Management –Hospitals –Physicians

28 Agenda PatientKeeper Overview HIE and Meaningful Use HIE Case Studies –Healthy Ocala –HealthCare Partners (HCP) Perspectives on Making HIE Successful in Puerto Rico HIE and CPOE demonstration


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