September 14 2018 Emily Hartmann Executive Director PHIX Gijs van Oort PHD CEO HASA Agenda What are health information exchanges HIEs Overview of two HIEs in Texas HASA Healthcare Access San Antonio ID: 808185
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Slide1
Health Information Exchange
September 14, 2018
Emily HartmannExecutive DirectorPHIX
Gijs van Oort, PHD
CEO
HASA
Slide2Agenda
What are health information exchanges (HIEs)? Overview of two HIEs in Texas
HASA – Healthcare Access San Antonio PHIX - Paso del Norte Health Information Exchange How do I choose the right network?
Slide3What are health information exchanges (HIEs)?
Slide4One Big Problem: Unreliable and inefficient health information sharing
Lack of medication management
Repeated lab and imaging studies Preventable medical errors Poor care coordination
Slide5Centralized hubs facilitate data exchange
Health Information Exchange (HIE) Repository
Primary Care Clinic
FQHC
Lab
Specialist
ED
Urgent Care
Hospital
FQHC = Federally Qualified Health Center; HIE = Health Information Exchange, ED = Emergency Department
Hospital
Primary Care Clinic
Specialist
Slide6HIEs have the same goal but different approaches
Common goal:
Improve health by ensuring the right information is in the right place at the right time.HIEs can be structured differently: Governance Legal Privacy and Security Financial Patient Consent Functionality
Slide7National effort to connect HIEs
Source: SHIEC. http://strategichie.com/initiatives/pcdh/.
Slide8Future: Single on-ramp for interoperability
Trusted Exchange Framework and Common Agreement There is no “magic bullet” for nationwide interoperability
The goal is to build networks that connectChoose the right network(s) for your organizationNetwork serves as a single on-ramp for interoperability
Slide9Community Health Information Exchange
Benefits and Value
Gijs van Oort, PhDCEO210.918.1357gvanoort@hasatx.org
Slide10Growing Demand for Health Care
Source: UTSA Demographics Center
Source: TX Medicaid and CHIP in Perspective - 11th EditionFederal Budget for HHSC is decreasing
Slide11Increased Demand with Same or Lower Reimbursement
Slide12HASA Capabilities
Aggregated patient lookupData push into customer systems (CCD, ADT)
Real-time, clinical reporting for quality, utilization, public health, care coordinationElectronic referral systemAlerts and discharge notificationConnection to TX HIEs and national HIEsConnectivity to DoD & VA (in development)
Slide13HASA HIE Coverage Area to Date
Nonprofit, with broad community participation
San Angelo RegionWaco Region
Physicians
1703
Hospitals
43
Community Health/ Mental Health
3
FQHC
7
Slide14HASA discussions with Western Plains hospitals
Slide15HASA HIE data exchange
Slide16HASA Landing Dashboard
HASA Data Elements:
DemographicsEncountersLabRadiologyDischargeImmunizations (some)Medications (some)
Slide17From:
Sugumar, Sophia (CMS/CCSQ) [mailto:Sophia.Sugumar@cms.hhs.gov] Sent: Wednesday, March 22, 2017 5:08 PMTo: Andrea Espinosa <aespinosa@HASATX.ORG>; Vince Fonseca <vfonseca@HASATX.ORG>; Phil Beckett <pbeckett@HASATX.ORG>Subject: Action Required: 2017 MIPS Qualified Registry Posting DRAFT: Healthcare Access San AntonioImportance: High Congratulations! You’ve been approved to participate in the Merit-Based Incentive Program (MIPS) for 2017 as a qualified registry.
Slide18Slide19Slide20Social Determinants of Health
Target 2018
Develop an intake platform for CMS five categories for personal risk:Food insecurityUtility needsHousing instabilityInterpersonal violenceTransportation needsImplement intake capability for geographic risk:Categorize zip code and census tract by vulnerability statusCreate holistic patient view for providers to include:Clinical riskSocial/personal riskGeographic risk
Slide21HASA Virtual Health Record – Social Risks
Slide22HASA VHR – Geospatial Risks
Slide2323
HIE Collaboration during Harvey
GHH and HASA decided to collaborate by providing temporary access to each other’ HIEs as most of the affected area was accessible through one or the other:GHH supporting evacuees in HoustonHASA supporting coastal residents cared for outside the regionHASA reached out to ICC for assistance in Austin shelter
HASA established a connection with Louisiana HIE as evacuees reached the Dallas shelter
HIETexas was reactivated for an additional 30 days
Slide24Emily Hartmann
Executive Director
Slide25Non-profit based in El Paso region
Mission to improve health through collaboration and data technology.
PHIX Board includes representatives from each of PHIX’s major partners. Changed name in 2017 to better reflect broader region.
Slide26Provide centralized community health records
HIE = health information exchange
Slide27Connected to VA and Dept. of Defense Nationally
User Story:
Active duty soldier and his family recently moved to Texas from Washington, DC. When his child visited a community specialist for a chronic health need, the specialist used PHIX to review the child’s full care record from the Dept. of Defense in Washington, DC. As a result, they avoided repeating several lab and imaging tests.
Slide28Value of PHIX: Stories from our users
Improved safety
Hospitalist planned to perform a cardiac catheterization for their patient. Prior to the procedure, they queried PHIX and found that a cardiac catheterization had been performed at another hospital. As a result, the patient received better care and avoided an unnecessary procedure. Improved efficiencyPrimary care physician queried PHIX before doing a stroke assessment for their patient. They found results from a stroke assessment performed the previous week at a hospital. As a result, the patient avoided several repeated imaging and lab tests.Improved qualityEmergency Medicine physician had a patient in cardiac arrest who could not speak to her care history. Through PHIX, they found information on her cardiac conditions and medications from other providers. Based on this additional information, her treatment was adjusted.
Slide29Recognized for innovation and collaboration in public health
National Association of County and City Health Officials (NACCHO) selected the City of El Paso Department of Public Health as a Promising Practice for its Paso del Norte Electronic Network for Linkage to Preventive Health Services in 2018.
“This project offers a holistic approach to patients using a medical data hub to evaluate a person’s needs. We are able to use the system by cross referencing our clients’ information to make sure if they need further services such as cancer screenings or vaccinations, then they are either provided the care or are directed to the proper venues.”Robert Resendes, Public Health Director
Slide30Data exchange partners
Data Exchange Partners
Hospitals (6)Outpatient Clinics (6)Veterans Administration*Department of Defense*Texas Tech University Health Sciences Center of El PasoLocal Mental Health Authority Federally Qualified Health Centers (3)City of El Paso Department of Public Health
PHIX is actively recruiting partners throughout west Texas and southern New Mexico
.
*National connections through the eHealth Exchange.
Slide31Support and engage small physician practices
The physician community in our region consists primarily of small practices with one to four physicians.
PHIX supports practices in navigating complex federal regulations, quality reporting requirements, and privacy and security standards. PHIX has an internal technical team to develop HIE interfaces with small practices rather than relying on third-party vendors.HIE = health information exchange
Slide32PHIX Structure
Patient Consent
Generally, patients must opt out to prevent data from being shared. There are exceptions. Patients at mental health and substance abuse facilities must opt in.Governance PHIX Board of Directors includes representatives from PHIX’s partners. PHIX Committees provide feedback on how PHIX should operate and grow.Privacy and Security CommitteePhysician Advisory CommitteeStrategic Planning CommitteeGovernance Committee
Slide33Exploring additional services to benefit PHIX’s partners
Real-time notifications to care managers when patients are admitted, discharged, and transferred
Image exchange Connectivity to other HIEs
Slide34How do I choose the right network?
Slide35Choose the right front door for your community
Choose the “front door” to interoperability that is the best fit for your community.
Technology: What functionality do we need to meet our goals today and in the future?Network: Who do we need in our data sharing network locally? Nationally? Cost: What type of investment would be required?Governance: Who is making decisions on how data is managed?Legal: What can the data be used for? Privacy and Security: What controls are in place? Who is making sure it runs properly?Consent: Would our community prefer an opt-in or opt-out patient consent model? Your front door will serve as a connection point across Texas and nationally. HIEs in Texas are committed to working together.
Slide36Thank you Emily Hartmann, Executive Director, PHIX
ehartmann@phixnetwork.orgOffice: 915.242.0674 |Cell: 217.741.5081
Gijs van Oort, PhD, CEO, HASAgvanoort@hasatx.org210.918.1357