July 3, 2015 New HIE Capabilities Enable Breakthroughs In Connected And Coordinated Care Delivery. January 8, 2015 Charissa Fotinos

An individual’s healthcare story cannot be told in pieces As it is Today: Patients Data Spans Many Siloes

Health Information Needs Hierarchy Access to clinically relevant and timely information to support decision-making. Access to real time clinical outcomes and quality data that can be used to drive value-based payment and performance Access to quality care based on complete, clinically relevant record describing care & needs. Access to clinically relevant, evidence-based information supplied by the entire care team. Access to complete and timely patient-level data across delivery system regardless of entity delivering care. Patients Consumers Of Health Care Services Clinicians Decisions at the Point of Care Care Teams Coordination Within Enterprises Community Coordination Across Enterprises Purchaser Value

Meeting Emerging Needs - CDR Sponsor Clinical Data Repository (CDR) Platform More orgs going at risk for performance, need info/analytics to help manage that risk New organizational arrangements (ACOs) require capabilities outside traditional enterprise health IT resources Needs include repository, analytics, reporting and care management tools Data needs go beyond current claims and ADT, include clinical summaries, care plans, assessments

Health IT Ecosystem: Vision for the Future Developed by Office of the National Coordinator

We Asked and The Community Responded HCA/King County RFI 34 Respondents Participation from nearly every major payer and delivery system in Washington “Future care coordination must enable sharing data regardless of geographic boundaries and specific EHR systems.” “Closing the gaps in care coordination & reducing duplication of services are critical to coordinating care, improving health and reducing costs.” “To enhance the efficiency of care, we need to work on better EHR integration with external providers.”

We Asked and The Community Responded “Regional or organizational HIE’s are still silos that do not practice full interoperability across organizational or EHR settings.” “This (HIE) is an evolutionary process and while significant strides have been made, we must continue to improve and add new capabilities every year.” “This is a critical opportunity for state leadership.”

HCA to be first customer of New Clinical Data Repository Service OneHealthPort is launching a new Clinical Data Repository service. Service will enable health care organizations to bring clinical data together in a shared repository for care planning and treatment. HCA will be first customer - sponsoring Medicaid enrollees to address data sharing challenges. Opportunity: Leverage increased availability of more granular, clinical information direct from a patient’s electronic chart currently held within a providers’ electronic health record system.

Clinical Data Information Flow Standard sets of high value clinical data will flow from provider EHR systems to the Clinical Data Repository through OneHealthPort. Data will be integrated from multiple sources using patient matching technology. Access to integrated clinical information for treatment and operations will be available to authorized providers through their EHR or through a web based portal.

Vital Signs Procedures Immunizations Encounters Medical Equipment & Environmental Modifications A Standard for Sharing Care Summaries is Continuity of Care Document (CCD) Functional Status Family history Social history Medications Problem list Plan of Care Lab & imaging results Comparison of CCD data elements to claims data elements at – healthIT.wa.gov

Clinical Data Repository (CDR) Status HCA is finalizing contract arrangements to set up this service for Apple Health enrollees. HCA intends to load Apple Health enrollee demographic data and two years historical claims data – starting with those enrolled in managed care. “First Mover” health care systems will feed clinical data which can be exchanged for the purpose of treatment, operations and payment to CDR as early as fall HCA and OneHealthPort will be hosting informational events as implementation details become available. 11

Clinical Data Repository Clinical Outcomes; Data for HEDIS Measures; Longitudinal Health Record; Population Management Integrated Real Time Medical and Behavioral Health Data Source: Clinical EHR Systems All Payer Claims Database Pricing Transparency; Data For HEDIS Measures; Resource Use Measurement; Practice Variation Aggregated Post Payment Cost Data Source: Payer Claims Systems Leverage and Align State Data Administrative And Clinical Data (Medical And Behavioral Health)

Questions Team and put HIE in the subject line Website: HealthIT.wa.gov