Martin Prahl, Health IT Architect Contractor, Social Security AdministrationMichael Matthews, CEO, MedVirginia

Patient-Authorized Release of Information to a Trusted Entity

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TUESDAY, 11:00 – 11:20AM

The Face of Disability

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Disability Statistics

Annual Disability Statistics• 3 million initial disability applications per year

• 1 million additional medical disability decisions

• 15 million requests for medical evidence each year (3-4 per case)

• 500,000 sources: doctors, hospitals

• $500 million in payment for evidence

• Over 11.7 million adults and children are receiving benefits based on their disabilities

• Over $11 billion paid each month to these individuals

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Authorized Release of Information to a Trusted Entity

Potential Purposes of Use • Applying for disability benefits• Applying for life insurance or long term care

insurance• Use in a civil court case• Attorney use• Use for a school camp• Immunization records to enter school• Demonstration of need for translators, transportation, housing and other

services• Copy to a friend or relative as a backup record• Copy to a relative for assistance or to set up a family history

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SSA Authorized Release of Information Value Case

All stakeholders can see value• Operational reduction in release of information (locating records,

printing/copying records, assembly, delivery)

• Decrease in turnaround timeframe

• Increase in response rate

• Impacts to disability determinations

• Approval leads to monthly benefit

• Insurance coverage underMedicare/Medicaid

HIMSS 2010 5

MEGAHIT Technical Overview

• MEGAHIT - Medical Evidence Gathering and Analysis through Health IT

• Analysis of structured medical information to identify pertinent information in the medical record that may support an impairment listing

• Initial Health IT Partner (August 2008) - Beth Israel Deaconess Medical Center, Boston, MA

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The SSA – MedVirginia Partnership

• Members of the Nationwide Health Information Network Cooperative

• Started Production Pilot in February 2009

• First production use of the NHIN

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Partnership Results

• About 1,500 disability cases

• Same or next day decisions in 11% of HIT-enabled cases

• Average case processing time ~40% less in HIT-enabled cases

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Michael Matthews, CEO, MedVirginia

Patient-Authorized Release of Information to a Trusted Entity

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TUESDAY, 11:00 – 11:20AM

Commonweath of Virginia

New Communities

Safety Net

NHIN

Richmond

Chesterfield

Hanover

Henrico

H H

H

HH

H

CommonwealthOf Virginia

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First to DURSA

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First to NHIN

• Ave disability determination– 84 days

• With MedVirginia – 46 days

• CCD to SSA

• Algorithms by SSA

• Replication of model

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Case Study: SSA / MedVirginia Use of MEGAHIT

• Commissioned by SSA

• Conducted by Kay Center for eHealth Research

• Perspectives:– Claimant– Provider– SSA

• ROI

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Helping More DisabledsProposal to SSA Sept. 2009

GATEWAY

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C-HIEP

• Normalize data collection– Rehab– SNF– Home health

• One of 3 sub-contractors

• Submission via NHIN

Photo from Sheltering Arms

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CommonwealthRx

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Focus on Safety Net Providers

• Clinical data – Hospital results– Labs– Medications

• Secure messaging

• Practice management– Interfaced with MedVirginia

• Clinical documentation– Meds, allergies, problem lists, vitals

• E-prescribing

• Eligibility screening tool

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Alignment: Medical Home and Meaningful Use

Info

rmat

ion

M

anag

emen

t

Care

Co

ord

inatio

n

HRA

PHR

EHR

ERX

HIL

PHYTEL

Health Information

Patient Education

Health Coaching

Disease Management

Referral Coordination

Post-Discharge CM

Medical HomeInformation System

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No patient left behind…

• Veterans• Active military• Uninsured• Minority• Rural• Mental health• Correctional facilities

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Thank You

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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.

HIMSS 2010