FHIN Business Plan (Version 1) Executive Summary


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  • Speed market to market Economies of Scale 234 HINs in the US in various stages of development or definition 54 of these at various stages of architecture implementation, vendor selection or technology acquisition
  • Senator Pieden: Was excited about the capabilities on medical research. Should be included in the concept. Heekin thinks that it may not be in the first wave because there’s no TPO for research. If it’s de-identified too much, it might not be of value. Technical platform for diffusion of electronic medical record (i.e., ASP service). Add security standards and services.
  • Admin data is available, only has some clinical value – since the data is readily available, use it to prime the pump The Secure communication of Clinical Results starting with lab data has clinical value and there is an economic value to RHIO providing through the exchange.
  • FHIN Business Plan (Version 1) Executive Summary

    1. 1. Florida Health Information Network Corporation Business Plan - Version 1 Executive Summary March 2007
    2. 2. Contents <ul><li>Introduction </li></ul><ul><li>Mission and Vision </li></ul><ul><li>Business Concept </li></ul><ul><li>Market Landscape </li></ul><ul><li>Customer Profile </li></ul><ul><li>Product Strategy </li></ul><ul><li>Marketing and Sales </li></ul><ul><li>Operations </li></ul><ul><li>Assumptions </li></ul><ul><li>Financial Plan </li></ul><ul><li>Risks </li></ul><ul><li>Next Steps </li></ul>
    3. 3. The Cost of Duplication <ul><li>The average first year spend of a start-up RHIO is $2,030,000 to $5,100,000* </li></ul><ul><li>70-80% of that spend is for systems integration (SI)* </li></ul><ul><li>In Florida there are: </li></ul><ul><ul><li>10 RHIOs in various stages of development </li></ul></ul><ul><ul><li>Florida Health Policy Center, an Internet-based think tank, sponsored by six health foundations, calls for 16 Florida RHIOs with an estimated cost of $3 million each </li></ul></ul>FHIN Corp can help Florida save millions in duplicated costs. Introduction * Source: Intel $50M $5.1M High End Est. 1 st year Spend $14M - $35M $20M All 10 RHIOs $1.4M - $3.57 $2M Each RHIOs % SI Costs (est. at 70%) Low End Est. 1 st year Spend Florida
    4. 4. Objectives set for Business Plan Project <ul><li>Reduced RHIO startup and operational costs </li></ul><ul><ul><li>Shared development and maintenance costs </li></ul></ul><ul><ul><li>Efficiency through common infrastructure and architecture </li></ul></ul><ul><ul><li>Flexibility to meet new market-driven products </li></ul></ul><ul><li>Enable RHIO success </li></ul><ul><ul><li>Flexibility to adapt to local needs </li></ul></ul><ul><ul><li>Support adoption </li></ul></ul><ul><ul><li>Generate sufficient profits to sustain operations and future development </li></ul></ul><ul><li>Encourage participation by all stakeholders </li></ul><ul><ul><li>Providers </li></ul></ul><ul><ul><li>State of Florida </li></ul></ul><ul><ul><li>Payers </li></ul></ul>Introduction
    5. 5. Connect Florida’s Health Care System <ul><li>Mission </li></ul><ul><li>To make health care more efficient and improve patient safety by: </li></ul><ul><li>enabling RHIO success </li></ul><ul><li>supporting RHIO exchange of health data, </li></ul><ul><li>offering a foundational RHIO infrastructure, and </li></ul><ul><li>access to state and national health data stores. </li></ul><ul><li>Vision </li></ul><ul><li>Real-time delivery to clinicians of patient medical information at the point of care through a secure, integrated statewide network for the communication of electronic health information. </li></ul>Mission / Vision
    6. 6. FHIN Corp Business Concept <ul><li>FHIN Corp supplies the local RHIOs technology and business services where significant economies of scale can be achieved: </li></ul><ul><ul><li>infrastructure and software, </li></ul></ul><ul><ul><li>interface and integration services, </li></ul></ul><ul><ul><li>data mapping and standardization, </li></ul></ul><ul><ul><li>back office operations, </li></ul></ul><ul><ul><li>education (e.g., train the trainer) </li></ul></ul><ul><ul><li>second tier end user support, </li></ul></ul><ul><ul><li>marketing support (e.g., marketing materials), </li></ul></ul><ul><ul><li>data analysis services (reporting and data queries), </li></ul></ul><ul><ul><li>discounted services/products (e.g., legal services, EMR light for physicians). </li></ul></ul><ul><li>FHIN Corp would also fill in gaps in coverage between local RHIOs (e.g., doctors not within local RHIO coverage), as well as function as the bridge between local RHIOs </li></ul>Business Concept
    7. 7. Competitor Analysis <ul><li>FHIN Corp Strengths </li></ul><ul><li>Market Strength </li></ul><ul><ul><li>Backing and endorsement from the State </li></ul></ul><ul><ul><li>Scale </li></ul></ul><ul><ul><li>De facto standards </li></ul></ul><ul><ul><li>Ability to develop relationships with all stakeholders </li></ul></ul>FHIN Corp strength comes from its State backing and alliance with key stakeholders. Market Landscape Preliminary Capability Assessment Minimal Clinical Database ePrescribing Interfaces with Data bases EMR/PHR-Lite Audit trail and reporting Disaster Recovery Secure Communication Cerner Data Repository Authentication Registration/Certification Connectivity to Payer Data Record Locator Service Master Patient Index Shared Health CogonSystems Intersystems Axolotl Availity Quovadx
    8. 8. <ul><li>Most vendors selling to the RHIOs today </li></ul><ul><ul><li>Have another core business </li></ul></ul><ul><ul><li>View the RHIO market as a possible market expansion opportunity </li></ul></ul><ul><li>Target the RHIO as the customer </li></ul><ul><li>Pricing is typically based on a subscription model </li></ul><ul><li>Annual pricing is generally </li></ul><ul><ul><li>$1 per person or </li></ul></ul><ul><ul><li>$1000 per physician or </li></ul></ul><ul><ul><li>$100,000 per hospital </li></ul></ul>Competitor Analysis <ul><li>FHIN Corp Strengths </li></ul><ul><li>Financial Strength </li></ul><ul><ul><li>capitalized by State </li></ul></ul><ul><ul><li>not-for-profit </li></ul></ul>FHIN Corp’s strength comes from its State backing and alliance with key stakeholders. Market Landscape
    9. 9. Geography of the FHIN <ul><li>Florida’s Health Information Networks </li></ul><ul><li>1. Big Bend RHIO </li></ul><ul><li>2. Central Florida RHIO </li></ul><ul><li>3. Community Health Information Organization </li></ul><ul><li>4. Escambia HIN </li></ul><ul><li>5. Jacksonville Health Information Network </li></ul><ul><li>6. Palm Beach County Community Health Alliance </li></ul><ul><li>7. Pinellas RHIO </li></ul><ul><li>8. Space Coast Health Information Network </li></ul><ul><li>9. South Florida HII </li></ul><ul><li>10. Tampa Bay RHIO </li></ul>FHIN EMPI and RLS Server 10 . TB RHIO 2 . CF RHIO Customer Profile 1 . BBRHIO 6 . PBCCHA 9 . SF HII 3 . CHIO 8 . SC HIN 5 . Jax HIN 4 . ESSHIN 7 . Pinellas RHIO
    10. 10. RHIO Needs and their Customers’ Needs <ul><li>The RHIOs themselves need </li></ul><ul><li>Inexpensive technical infrastructure (solutions) </li></ul><ul><li>Legal, security and privacy expertise </li></ul><ul><li>Leverage with national or large regional vendors </li></ul><ul><li>Ability to focus on the local community and on adoption </li></ul><ul><li>The RHIOs customers’ needs must be met as well </li></ul><ul><li>Easy integration into physician workflow </li></ul><ul><li>Meaningful clinical data available </li></ul><ul><li>Limited burden on hospital systems IT staff / leverage existing investments </li></ul><ul><li>Tangible cost reductions </li></ul>Customer Profile
    11. 11. Product Strategy <ul><li>Develop technical infrastructure backbone of the statewide exchange system </li></ul><ul><li>Access aggregated data sources </li></ul><ul><ul><ul><li>Administrative / claims data </li></ul></ul></ul><ul><li>Secure Communications of clinical results </li></ul><ul><ul><ul><li>Clinical data (e.g., labs, meds, and other components of the minimum data set) </li></ul></ul></ul><ul><li>Create a center of excellence for integration and data terminology mapping </li></ul><ul><li>Leverage data collected for re-use to reduce silos of data & duplicative work </li></ul><ul><li>Leverage combined buying power to obtain discounts </li></ul><ul><li>Incremental approach to product development and product extensions for revenue opportunities </li></ul>Product Strategy Make available to RHIOs an infrastructure and critical data sets needed for the RHIOs to quickly establish exchange of data needed for treatment in their community.
    12. 12. Phased Product Roll-Out <ul><li>Phase 1: </li></ul><ul><ul><li>RHIO Core Capabilities </li></ul></ul><ul><ul><li>Delivery of existing administrative/ claims data </li></ul></ul><ul><ul><li>Secure Communications of Clinical Results </li></ul></ul><ul><ul><li>Negotiate deals for discounted services/products on behalf of RHIOs </li></ul></ul><ul><li>Phase 2: </li></ul><ul><ul><li>Add data collected through secure communication and other data sources </li></ul></ul><ul><ul><li>Work with state agencies to support syndromic surveillance efforts </li></ul></ul><ul><ul><li>Mandatory reporting to state agencies </li></ul></ul><ul><ul><li>Analyze feasibility of statewide e-prescribing effort </li></ul></ul><ul><li>Phase 3: </li></ul><ul><ul><li>Work with stakeholders to provide data analysis for secondary uses </li></ul></ul><ul><ul><li>Roll out e-prescribing, if feasible </li></ul></ul><ul><ul><li>Develop capability to handle mandatory reporting to state agencies starting with AHCA </li></ul></ul>Product Strategy
    13. 13. Timeline of critical products and activities <ul><li>Phase 1 RHIO Core Capabilities, Administrative/Claims Data & Secure Communication </li></ul><ul><li> Phase 2 Add additional data and data sources Phase 3 Mandatory S tate reporting service </li></ul><ul><li>Other feasible services </li></ul><ul><li> 6 mo Yr 1 Yr 2 Yr 3 </li></ul><ul><li> Data analysis for secondary uses </li></ul><ul><li>Work with state to support syndromic surveillance </li></ul><ul><li>Evaluate market for e-prescribing </li></ul><ul><li>Negotiate discounted service/product arrangements </li></ul><ul><li>Start up Operations </li></ul>Product Roll Out Other Activities Product Strategy
    14. 14. Sales and Promotion <ul><li>RHIO Sales and Promotion : FHIN Corp’s products and services will be sold directly to RHIOs </li></ul><ul><ul><li>RHIOs receive sales and marketing support from FHIN Corp </li></ul></ul><ul><ul><li>Assist RHIOs in local marketing efforts </li></ul></ul><ul><ul><ul><li>Sales strategy </li></ul></ul></ul><ul><ul><ul><li>Provider education </li></ul></ul></ul><ul><ul><ul><li>Hospital sales </li></ul></ul></ul><ul><ul><ul><li>FHIN product and service education </li></ul></ul></ul><ul><ul><li>Establish a forum for RHIO collaboration </li></ul></ul><ul><li>Statewide Stakeholders: FHIN’s success is also based on participation of stakeholders with statewide interests. FHIN Corp’s Sales and Marketing will also focus on these relationships: </li></ul><ul><ul><li>Payers: Contribution of claims data. </li></ul></ul><ul><ul><li>State of Florida: Access to state databases. </li></ul></ul><ul><ul><li>Labs </li></ul></ul><ul><ul><li>Pharmaceuticals </li></ul></ul><ul><ul><li>Federal Government </li></ul></ul><ul><ul><li>Organized medicine </li></ul></ul><ul><ul><li>Researchers </li></ul></ul>Sales and Marketing
    15. 15. Sales Plan <ul><li>FHIN Sales to RHIOs </li></ul><ul><li>10 RHIO Customers </li></ul><ul><li>60% Market share by Year 5 </li></ul><ul><li>Tampa Bay, Palm Beach, and South Florida HII are initial customers. </li></ul><ul><li>FHIN Support for RHIO goals </li></ul><ul><li>RHIO/Hospitals enroll 60% of area physicians </li></ul>Sales and Marketing Space Coast Ocala Southwest FL SFHII Palm Beach Northeast Florida Escambia HIN Central Florida Big Bend Tampa Bay Year 5 Year 4 Year 3 Year 2 Year 1
    16. 16. Governance and Operations <ul><li>A Public/Private partnership </li></ul><ul><ul><li>State owned corporation with the ability to generate revenues </li></ul></ul><ul><ul><li>Board of Directors appointed from industry leaders </li></ul></ul><ul><ul><li>Not for profit </li></ul></ul><ul><li>Headquartered in Florida </li></ul><ul><ul><li>Location would balance the need for State Government interaction with the availability of resources and ease of travel throughout the State </li></ul></ul><ul><li>Lean staffing model </li></ul><ul><ul><li>Envisioned to be under 50 employee company </li></ul></ul><ul><ul><ul><li>Estimates show 25 FTEs in the first year, growing to 34 by the third year and then stabilizing </li></ul></ul></ul><ul><li>Leverage existing vendors in the marketplace </li></ul><ul><ul><li>Most technology infrastructure and application software will be purchased from vendors that exist in the marketplace today </li></ul></ul>
    17. 17. Assumptions <ul><li>Commercial payers will make claims data available </li></ul><ul><ul><li>Does not conflict with current payer-based health record initiatives currently in place </li></ul></ul><ul><li>Secure communications will motivate local hospitals to fund physician participation in local RHIO </li></ul><ul><ul><li>Hospitals will recognize cost savings greater than their share of RHIO fees </li></ul></ul><ul><li>RHIO/Hospitals enroll 60% of area physicians </li></ul><ul><li>Medicaid data will be available </li></ul><ul><ul><li>State laws and regulations do not prohibit use </li></ul></ul><ul><li>Additional funding required to deliver add on features </li></ul>
    18. 18. FHIN Corp P&L ($M) <ul><li>* Does not include capital contribution from State of Florida during Y1-Y3 </li></ul>
    19. 19. Key Risks <ul><li>Insufficient revenue generated due to lack of paid participation in local RHIO </li></ul><ul><ul><li>Mitigation Strategy: Expand / leverage use of the secondary use of data to cover costs of infrastructure, seek additional sources of investment capital </li></ul></ul><ul><li>Local RHIO closes or folds </li></ul><ul><ul><li>Mitigation Strategy: FHIN would encourage another RHIO to expand to that market and offer direct FHIN connectivity until a new RHIO is in place </li></ul></ul><ul><li>Funding from the State is lower than requested </li></ul><ul><ul><li>Mitigation Strategy: Evaluate the best mix of scaling back the FHIN functions and increasing the price point closer to market parity </li></ul></ul><ul><li>State of Florida Privacy and Security Statutes limit or are interpreted as limiting exchange </li></ul><ul><ul><li>Mitigation Strategy: Work with the State to revise the statutes and have FHIN develop a consistent interpretation that can used by the RHIOs with their stakeholders </li></ul></ul>
    20. 20. Next Steps <ul><li>March 27 th meeting with RHIO’s </li></ul><ul><li>Validate adoption assumptions and refine financial model </li></ul><ul><li>Develop and issue RFP </li></ul>