1. Coordinating Care Across California HIMSS 20101

2. Bill Beighe, Chief Information Officer, Physicians Medical Group of Santa Cruz Coordinating Care Across California 2 MONDAY, 3:00 – 3:20 PM

3. Santa Cruz Health Information Exchange »Exchanging Data Since 1996 »Hospitals, Doctors, Labs, Imaging Centers, Surgery Centers »Connecting 350+ providers and more than 650 electronic users and 7 EMR’s »Exchanging demographics, hospital reports, referrals, encounter data, lab results, radiology reports, allergies, and prescribed medication »Utilizing a commercial HIE software solution based on a federated- hybrid data model HIMSS 20103

4. Scenario »Samuel Norcal is a 66 year old male currently living in Santa Cruz, CA who presents to Santa Cruz Hospital Emergency Department with chest pain, belching and a history of chronic atrial fibrillation. »Piecing together the patient’s history from several sites we were able to avoid expensive invasive testing or an admission that might have been done without having this knowledge. The patient went home later the same day. HIMSS 20104

5. Emilie Kralicek, Project Manager, Long Beach Network for Health Coordinating Care Across California MONDAY, 3:00 – 3:20 PM

6. Long Beach Network for Health HIMSS 20106 Non-profit 501(c)(3) HIO incorporated in 2007 Established by Long Beach Public Health Department in metro Los Angeles County in 2003 Connecting to 4 hospitals (1,122 beds), 35 Community Clinic sites, Quest Diagnostics SoCal hub, and Wellpoint web service Exchanging demographics, encounter data, lab results, dictated notes, allergies, and prescribed medication SupportTrustCoordinated CarePublic Service Community Resource

7. Scenario »George presents at Long Beach Memorial Medical Center ER via ambulance for fever to 105, cough, bilateral pneumonia, hypoxia. He is unable to give a history. George’s girlfriend tells the ER physician that George was very sick as a teenager and has been followed by a hematologist since then. She doesn’t know his underlying diagnosis what it was and cannot reach George’s mother. »Laboratory values show WBC of 52,000 with predominantly neutrophils and bands/immature cells, and HGB 7.4, HCT 22, PLT 119,000. Liver function tests include values for AST 250, ALT 320. Flu A positive, H1N1 serology pending. »NHIN is queried for past medical information. Information available from the NHIN confirms that his past diagnosis was Acute Lymphoblastic Leukemia, his primary oncologist is Dr. Steve Manchu and that in the past year, his liver function tests have been normal. HIMSS 20107

8. Appropriate Care »ER Physician therefore, in addition to beginning treatment for influenza is able to: »(1) Diagnose a likely relapse of his Acute Leukemia with liver involvement, and »(2) Notify Dr. Manchu for further information bearing on his management. HIMSS 20108

9. Kim Horowitz, MD, Chief Medical Information Officer, Believe Health, LLC Coordinating Care Across California East Kern County Integrated Technology Association 9

10. »Non-profit 501(c)(3) HIO incorporated in 2006 »Established in rural CA: Tehachapi, Kern County »Connecting 22 providers, that include 1 CAH, 1 medical group, 3 RHCs, and 5 provider offices »Exchanging demographics, encounter data, lab results, radiology reports, allergies, and prescribed medication »Utilizing an open source HIE interface software and hybrid server model »Using Connect version 2.0 to query NHIN Gateway HIMSS 201010

11. Scenario »Scotty Skater, a 18 yo male is in Tehachapi preparing for a skate boarding competition. He was born and raised in Santa Cruz, CA, but recently moved to Long Beach for college. »Scotty presents at Tehachapi Hospital ER via ambulance, not recalling the incident, but complaining of a hurt wrist. His coach witnessed Scotty suddenly becoming stiff, fall (cracking his helmet), and was shaking for about a minute. »Scotty explains to the ER physician that he takes medicine on and off for headaches. »NHIN is queried for past medical information. HIMSS 201011

12. Prevention & Appropriate Care »Prevented allergy interaction with Iodine; resulted in ER physician choosing a non-contrast dye »Record revealed possible seizure disorder, berry aneurysm »ER Physician made proper specialist referral versus treatment and care of possible head injury HIMSS 201012

13. Thank You 13 The participation of any company or organization in the NHIN and CONNECT area within the HIMSS Interoperability showcase does not represent an endorsement by the Office of the National Coordinator for Health Information Technology, the Federal Health Architecture or the Department of Health and Human Services.