1. Health Information Exchange Planning Meeting September 3, 2009 HIE Planning Meeting – September 2009

2. Health Information Exchange Planning Meeting Thursday, September 3, 2009 Agenda Welcome and Introductions – Kathy Lively, Executive Director, Connect SI Health Information Exchange: HFS Prospective – Mary McGinnis, HIE Project Manager, Illinois Department of Healthcare and Family Services Health Information Exchange Planning in Southern Illinois – Nick Bonvino, HIE Consultant, Connect SI Questions and Answers

3. Mission & Vision 3 Vision Statement Connect SI will be a national leader for collaborative rural economic transformation fueled by world class broadband and health care. Mission Statement Connect SI will, through regional collaboration, encourage and sustain economic growth while valuing quality of life in southern Illinois.

4. Illinois Department of Healthcare and Family Services Health Information Exchange: HFS Perspective Mary McGinnis HIE Project Manager Illinois Department of Healthcare and Family Services

5. In Illinois – On February 4, 2009, Governor Pat Quinn signed Public Act 95-1030 into law, appropriating $3 million to the Department of Healthcare and Family Services to establish a program for health information exchange planning. Across the Country – The American Reinvestment and Recovery Act (ARRA), signed into law on February 17th, dedicates more than $20 billion nationwide in federal funding to implement electronic health records and health data exchange by 2014. Illinois Department of Healthcare and Family Services

6. The ARRA statute includes the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act), which sets forth a plan for advancing the appropriate use of health information technology to improve quality of care. The Office of the National Coordinator (ONC), which was funded by the HITECH Act, is the principal federal entity charged with coordinating the effort to implement a nationwide HIT infrastructure that allows for the electronic use and exchange of health information. Illinois Department of Healthcare and Family Services

7. The HITECH Act authorizes CMS to administer incentives to eligible professionals and hospitals for meaningful use of electronic health records. These incentives are anticipated to drive the adoption of EHRs. There are three critical prerequisites to qualify for incentives. Illinois Department of Healthcare and Family Services

8. 1.Clinicians and hospitals must acquire and implement certified EHRs in a way that fully integrates these tools into the care delivery process; 2. Technical, legal, and financial supports are needed to enable information to flow securely to wherever it is needed to support health care and population health; 3. A skilled workforce needs to support the adoption of EHRs, information exchange across health care providers and public health authorities, and the redesign of work-flows within health care settings to gain the quality and efficiency benefits of EHRs, while maintaining individual privacy and security. Illinois Department of Healthcare and Family Services

9. Improve healthcare quality and outcomes Reduce medical errors and redundant services Improve patient safety Enhance coordination of patient care among providers Reduce health disparities Deliver healthcare more cost efficiently Illinois Department of Healthcare and Family Services

10. With funding from PA 95-1030, HFS awarded 16 grants across Illinois for HIE planning The goals of HIE Planning Grants are to: establish the governance structures promote provider collaboration develop the social capital necessary to sustain HIE develop an operational framework develop a financially sustainable state-level HIE promote state-level interoperability

11. Illinois Department of Healthcare and Family Services Conduct a state-wide survey to determine the level of EHR adoption in Illinois To leverage federal incentives for EHR adoption and health information exchange outlined in ARRA and the HITECH Act Plan for ability to share protected health information from disparate information systems and service providers within their MTA

12. Illinois Department of Healthcare and Family Services Grantees must encourage Meaningful Use of HIE within their Medical Trading Areas Meaningful use must be consistent with the requirements set forth by HHS, and include: E-prescribing Active exchange of health information Active electronic reporting of quality measures

13. Provide access to comprehensive patient health data for the patients health care team Use evidence-based order sets and Computer- based Provider Order Entry (medication, laboratory, procedures, diagnostic imaging, immunization and referral) Apply clinical decision support at the point of care Illinois Department of Healthcare and Family Services

14. Capability to exchange key clinical information (e.g., problem list, medication list, allergies, test results) among providers of care electronically Perform medication reconciliation at relevant encounters and each transition of care Communicate with public health agencies Illinois Department of Healthcare and Family Services

15. Generate lists of patients who need care, use these lists to reach out to patients (e.g., reminders, care instructions, etc.) Provide patients and families with timely access to data, knowledge, and tools to make informed decisions; manage their health Report to patient registries for quality improvement, public reporting, etc. Illinois Department of Healthcare and Family Services

16. HISPC – Illinois; Multi-state collaborative Ensure privacy and security provisions Developing privacy notices, consent forms for disclosure of PHI Analyzing interstate and intrastate legal concerns Testing provider and consumer education materials Its Safe, Its Secure, Its Time Illinois Department of Healthcare and Family Services

17. http://hie.illinois.gov All MTA maps, details about counties, hospitals, and FQHC contained in each MTA Planning Grant resources, toolkits Educational webinars Best practices lessons learned from HIE projects and initiatives in Illinois and other states

18. HIE PLANNING IN SOUTHERN ILLINOIS KICK-OFF MEETING SEPTEMBER 3, 2009 Nick Bonvino Connect SI *NB Consulting, Inc. 2008 All rights reserved Reproduction or use without permission is prohibited

19. T HE U LTIMATE O BJECTIVE EHRs used interactively at the point of care delivery interoperable with all relevant data sources complimenting the caregiver with a body of knowledge and clinical tools accessible by patients and other providers Enabling the practice of Evidence Based Medicine and Quality Measures

20. M ANAGING P ATIENT B EHAVIOR & C ARE D ELIVERY Reducing the variation of treatment thru alerts and reminders at the point of care (45% of care is either under or over utilized) Providing Quality measures and reporting against evidence based medicine (EBM) standards Managing and influencing patient behavior by increased communications with caregivers and patient health information

21. P ROJECT W ORK P LAN AND B UDGET Produce a Project Work Plan and Budget that plans a program for the mass deployment of EHRs and an HIE. This will take advantage of economies of scale and shared services to most efficiently and effectively transform healthcare in Southern Illinois.

22. S TAKEHOLDERS Coordinate and facilitate HIE planning with a Consortium that represents a minimum of 50% of the covered lives, 75% of medical transactions, 50% of Stakeholder groups including FQHCs & Public Health Departments in our MTA.

23. G OVERNANCE Steering Committee - 15 Members representing stakeholder groups Physician Hospital Nurse Pharmacy Lab Imaging Sustainability & Business Plan - Communications & Education Clinical Priorities Committee Payors Employer Behavioral Health Technical Architecture Public Health and Quality Reporting Privacy & Security Federal & State Requirements

24. G OVERNANCE CONTINUED Steering Committee Members chair associated work groups 15 work groups serve as conduit for interested parties to participate

25. C OMMUNICATIONS & E DUCATION Marketing and communications plan Meaningful Use of EHRs and HIE Collateral materials to support plan and roll-out across the MTA Conduct marketing and education sessions

26. S USTAINABILITY M ODEL Create a Sustainable Business Model that funds the initial investment and ongoing support of this future state vision with all stakeholders contributing their pro-rata share based upon the accrual of benefits.

27. C LINICAL P RIORITIES C OMMITTEE Initial use cases, sequence of applications, and the types of information (initial and long-term) that will be exchanged through the HIE reconciling with the sustainability model, Work Groups, and technical requirements

28. A DMINISTRATION AND O PERATIONS Determine the appropriate neutral entity to serve as the focal point for collaboration representing all stakeholders. This will be the actual provider of shared services to support the governance and operations of the HIE.

29. T ECHNOLOGY A RCHITECTURE Identify the appropriate Technology Architecture consistent with standards outlined by the Office of the National Coordinator (ONC) and as a component of a state-level HIE, including: Certification Privacy & Security Interoperability Governance

30. P RIVACY & S ECURITY W ORK G ROUP Participate with HFS to coordinate MTA policies and procedures consistent with state-level requirements. Coordinate with the ONC and subordinate entities to comply with federal standards. Determine privacy and security standards for use in the EHR & HIE selection processes.

31. C RAFT A PROGRAM FOR THE MASS DEPLOYMENT OF EHR S AND AN HIE Identify opportunities for shared services and economies of scale among stakeholders Endeavor to satisfy the timelines for incentives and penalties in the American Reinvestment and Recovery Act (ARRA)

32. T IMELINE FOR PLANNING PROCESS Kick-off today Completed by June 30, 2010

33. 33 www.connectsi.us

34. If you would like to know more about Connect SI or any of the projects currently underway, please contact: Kathy Lively Connect SI Executive Director 3000 W. De Young Street, Suite 800B Marion IL 62959 kathylively@mantracon.org Phone: (618) 998-0970 ext. 237 Fax: (618) 998-1291 www.connectsi.us