PA eHealth Partnership Authority

Electronic Health Information Exchange in Pennsylvania

Dave Grinberg

May 25, 2016

eHIE and the Triple Aim

• Increased speed and accuracy of diagnosis for individuals and populations

• Improved transitions of care and coordination of care - i.e. admit/discharge alerts, referral support

• Increased patient safety - i.e. drug/allergy interaction avoidance

• Cost control – i.e. reduced ER visits and readmissions, avoidance of redundant tests/procedures

• Increase patient satisfaction by reducing their time spent in the healthcare system and eliminating frustrating duplication

What’s in it for the patient?

What I want from the healthcare system: • Less paperwork • Lower costs • Prevent medical and medication errors • My medical needs quickly known by ER • Less time transferring my records

between providers • Better quality care • Avoid unnecessary testing and

discomfort • Doctors as informed as possible about

my care needs = effective coordination

Can HIT Save the World?

?

Can HIT Save the World?

• Reality Check: Technology is the foundation of reform, not the solution

• The Network Effect

• Long lag ROI for HIE (and most HIT)

• Many cost drivers technology can’t address – Aging population

– Expanding capabilities

– Patient expectations

– Culture/Lifestyle

eHIE in PA • Locally, eHIE occurs within physician practices,

health systems, and other provider organizations through their own electronic health records (EHR) systems (and portals!).

• Regionally, providers connect to a network known as a regional health information organization, or HIO. Patient records held by an HIO-connected provider are available to other providers connected to that same HIO.

• Statewide, regional HIOs connect to the PA Patient & Provider Network, or P3N. A main service of the Pennsylvania eHealth Partnership Authority, the P3N facilitates the secure sharing of patient information across a larger geographic area as well as enhanced provider reporting.

Current HIO Coverage

National Transformation Effort

HIT and Economic Health Act (HITECH) is a major driver of transformation through incentive programs to promote technology usage to achieve improved safety and quality in healthcare

• 56 states and territories incentivized to adopt eHIE

• National goal for a learning interconnected health ecosystem by 2024

Interstate Exchange

Ohio Health Information

Partnership (OHIP)

Statewide Health Information\ Network for New York (SHIN-NY)

West Virginia Health Information Network (WVHIN)

Chesapeake Regional Information System for our Patients (CRISP)

Delaware Health Information

Network (DHIN)

New Jersey Health Information

Network (NJHIN)

Pennsylvania’s Act 121 of 2012 • Independent state agency governed by Board of Directors

• Develop/establish/maintain statewide electronic health information exchange

• Develop/maintain directory of provider contact info

• Develop/adopt interoperability standards

• Develop/maintain statewide consent registry (opt-out model supports opt-back-in for PA’s network – P3N)

• Develop “certification” requirements for connected entities

• Establish/collect fees to sustain Authority services

• Establish advisory groups and election of 2 ex-officio board members

• Develop/conduct public information programs

• Annual Report to Governor/Legislature

Strategic Plan Vision:

Electronic health information exchange enables initiatives striving to improve patient experience,

population health and healthcare cost.

Mission: To establish a statewide interoperable system for participating organizations to electronically move

health information in a manner that ensures the secure and authorized exchange of health information to

provide and improve care to patients.

Guiding Principles: Privacy Security Governance Transparent Inclusive Collaboration Align and Adapt

Interoperability Efficiency Technology Platform Incremental Incentives Operations

P3N: PA Patient and Provider Network

Benefits of Participation Benefits of HIO partnership with the Authority include:

Certification Program – Ensures that all participating HIOs are operating on a level playing field with regard to interoperability standards, privacy, and security. Builds on existing investments and best practices.

Unified Legal Framework – By signing a single, multi-party participation agreement with the Authority, participating HIOs avoid the cost and complexity of creating and maintaining multiple legal agreements with other HIOs.

Grant Programs – The Authority support HIOs in their development or onboarding efforts with funds that are exclusively available to certified HIOs.

Benefits of Participation (Cont’d) Statewide Patient Consent Management – A single, easily

accessed repository for patients’ opt-out and opt-back-in

choices across the P3N, using a statewide Authority opt-

out/opt-back-in form available to all HIOs and connected

providers.

Statewide Patient Identity Management – Achieves global

patient identification, enabling consent management and

clinical document exchange.

Public Health Gateway – Enables “one-stop-shop” connection

to various government agencies, including the Department of

Health and the Department of Human Services (formerly Public

Welfare) to support provider reporting efficiencies.

Authoritative State-Level Provider Directory – A central

provider directory that includes state licensure data for

individual practitioners and facilities and national provider

identifier.

Benefits of Participation (Cont’d) Ongoing interstate eHIE engagement efforts –Facilitates

efforts to establish interstate exchange and establish a legal

framework and technical connections.

HIE and HISP Trust Communities – Enables collaboration

without antitrust concerns.

Stakeholder Committee Facilitation – Coordinates

stakeholder engagement on issues of importance to HIOs and

stakeholders, such as super-protected data.

National Dialogue - The Authority serves as a conduit

between HIOs and stakeholders and various national-level

efforts, and frequently solicits stakeholder input to inform

Authority positions.

HIO Onboarding Status Live

St Luke’s University Health Network eVantageHealth (eVantage)

HealthShare Exchange of Southeastern PA (HSX)

Onboarding for go-live mid 2016

Keystone Health Information Exchange (KeyHIE)

ClinicalConnect Health Information Exchange (CCHIE)

Mount Nittany Exchange (MNX)

In discussions for connection

Additional HIOs

West Virginia Health Information Network

Ohio Health Information Partnership

Discussions started with other states

• * About 27% of PA hospitals, currently HIO affiliated

PHG Status

• Production Ready Capabilities DOH - Electronic Lab Reporting

DOH - Immunizations Registry

DOH - Cancer Registry

DOH - Syndromic Surveillance

DHS - Electronic Clinical Quality Measures Reporting

• In the Future DOH – Immunizations bi-directional communications

Additional PA Agency connections

DOH – Additional Registries

Grant Funding

• FFY 2015 programs closed in April

• FFY 2016 program announcement expected late summer (pending funding approval)

• Open to everyone who treats Medicaid Patients!

Grant Funding (Cont’d)

• Up to $70,000 to onboard facilities

• Up to $35,000 to onboard ambulatory practices

• Up to $5,000 to provision portal users

Actively seeking additional funding!

Additional Current Topics

• “Super protected” data barriers related to HIV/AIDS, Mental Health, Drug and Alcohol

• Education and outreach materials development and promotion

• Innovation model efforts for care delivery and payment reform

• Dialogue and input on national standards and regulations

• DHS Integration

Sign Me Up

• Register as a stakeholder

• Learn more at www.paehealth.org

– eHIE “Soup to Nuts” document

– Survey reports

– SOP/Annual reports

• Visit “Choose Your HIO”

PA eHealth Partnership Authority

Questions?

www.paehealth.org

Twitter: @PAeHealth

ra-paehealth@pa.gov