Oregon Health Network (OHN) The Evolution of a Statewide Healthcare Network Oregon Connections 2013 October 24, 2013

Overview: OHN Joins OCHIN Evolution of a Monitored Health Network: From Theory to Practice Use Case Agenda Today

As a nonprofit organization, our goal is simple: To provide solutions that promote access to quality, affordable health care for all. A Coordinated Offering: OHN Joins OCHIN One of the nation’s largest and most successful Health Information Networks In 14 states, coast to coast Touching over 4,500 physicians 12 years of data aggregation; 65% to 75% of physical health claims paid by DMAP in the OCHIN database

What We Do CONNECTIVITY MEMBER ENGAGEMENT FEDERAL AND STATE PROGRAMS CLOUD EHR SOLUTIONS ADVOCACY, OUTREACH, &THOUGHT LEADERSHIP BUSINESS INTELLIGENCE PROFESSIONAL & KNOWLEDGE SERVICES RESEARCH

Financial Overview: Priorities & Focus

OCHIN & OHN: Federal Funding for HIT in Oregon + $20.182m $56,886,296 in federal funding, with the majority given straight back to the community

Retained 100% of the healthcare provider community Expanding healthcare provider community into 4 additional states with another new funded sites through the FCC Healthcare Connect Fund: Washington Idaho Alaska Montana OHN Membership: The Transition to OCHIN

Use of Local Internet Exchange (NWAX) and Network Operations Center to monitor ALL connections to maintain quality – Theory: Keeping traffic in-state would meet/exceed Service Level Agreements (SLAs) Assumption that members would value the monitoring of ALL connections. Telecom providers would overcome their initial resistance to having a third party monitoring solution Evolution: Role of IX & Network Operations Center 2007

Practice: – Role of NWAX & NOC have successfully met our SLAs With increased broadband infrastructure, in-state IX (NWAX) not as important as before, BUT allows local carriers to connect with larger carriers/national exchanges; Members valued primary (not secondary) connections to the NOC (data center, etc.) Partner vs. Competitor: Telecom providers appreciate the role of the NOC in working with other vendors to troubleshoot issues, as well as the role of OHN in helping to convene “trusted” dialogue with vendors/members Evolution: Role of IX & Network Operations Center 2007 – Present

Requirement = 10Mpbs minimum (internet & Ethernet) – Theory: Healthcare providers would see the need for 10Mpbs minimum, and bandwidth needs would continue to increase – Challenge: Difficult to convince people of this need in a landscape where 1.5 T-1 connection as “norm” Evolution: Member Network Design/Use 2007

Requirement = 10Mpbs minimum with a mix of internet/Ethernet configuration – Practice: All healthcare providers are asking for more bandwidth; common average request is 100Mpbs (clinics, hospitals, etc.): Better supports expanding broadband-dependent imaging needs Better addresses spike usage Evolution: Member Network Design/Use Present

Role of Broadband/Internet in Healthcare Delivery – Theory: Members understand the critical role of broadband to support healthcare coordination/ advancement (telehealth, etc.) – Challenge: Other federal programs competed with industry mind-share; focused on meaningful use of EHRs, HIE, etc. Evolution: Broadband in Healthcare 2007

Broadband has FINALLY made it to the conversation! – Practice #1: Initially, members and state discussion thought of broadband as tertiary (at best) to their healthcare transformation efforts – Practice #2: The new Accountable Care/Coordinated care model requires broad and sophisticated technical connectivity and network requirements…and with OHN’s “just in time” statewide infrastructure in place, conversation has been pushed out of CFO /CIO to CMO’s office Evolution: Broadband in Healthcare Present

Broadband has FINALLY made it to the conversation! – Practice #3: Members have experienced the failure of their first-line technology solutions when put to the test on a network that can’t support it – Practice #4: First in country to have an FCC RHCPP merge with an ONC Regional Extension Center Evolution: Broadband in Healthcare (cont’d) Present

And partnering with California Telehealth Network Evolution: The Growth of a Network of Networks

Through OHN and the FCC RHCPP, these agencies were able to get access to a network that sufficiently supported the purchase and use of electronic health records and telehealth services to improve care in the incarceration setting = $$$ millions of dollars of saved taxpayer money: Case Study: Public/Private Coordination Advancement

Oregon Department of Corrections (DOC): 14 locations – Purchase (and almost completely installed) $3.5M of video conferencing to support healthcare delivery; reducing patient costly transports to critical access hospitals AND improve healthcare delivery with the ability to bring in specialists Oregon Youth Authority: 31 locations – Summer 2014; will be implementing electronic health records Case Study: Public/Private Coordination Advancement