Central Illinois HIE Summit, Part 2: How HIE Works

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This is part 2 of the Central Illinois HIE Summit: Patient Care & Connectivity, held Sept. 21, 2011 in East Peoria, Illinois. Joy Duling, Interim Executive Director of the Central Illinois Health Information Exchanges, explains how a Health Information Exchange works. Duling is introduced by Dr. Gail Amundson, President and CEO of Quality Quest for Health of Illinois.

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Central Illinois HIE Summit, Part 2: How HIE Works

  1. 1. How HIE Works<br />September 21, 2011<br />Joy Duling<br />Interim Executive Director <br />Central Illinois HIE<br />www.cihie.org<br />
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  3. 3. Countless Similar Stories<br />My Story<br />What We Heard in Our Planning Process<br />
  4. 4. In a 2010 National Survey<br />The average number of doctors seen for all survey participants was 18.7. <br />For 18-24 year olds, the average was 8.3. <br />For patients over 65, the average was 28.4. <br />Women reported having seen more doctors on average (20.6) than men (16.7).<br />Patients with income under $20,000 a year reported seeing more doctors on average (22.4) than the patients with incomes over $75,000 a year (18.1).<br />
  5. 5. As high as the numbers from the survey are, if you looked at ALL clinicians that these patients have seen, the numbers probably would have been much higher.<br />Anesthesiologists<br />Radiologists<br />Pathologists<br />Physicians assistants<br />Nurse practitioners<br />Chiropractors<br />Physical therapists <br />Etc.<br />
  6. 6. So, What Happens When Clinicians Encounter Pieces?<br />We Fax Things Around.<br />We Mail Things Around.<br />We Call to Get Details.<br />We Ask Patients to Recount Their Treatment From Memory.<br />We Re-Order Tests that May Have Already Been Completed.<br />We Log Into Different Hospital Portals to See What Information Exists.<br />Each Clinician is Their Own Island, Making Decisions Based on What He/She Personally Knows.<br />
  7. 7. The HIE Vision<br />“The right information at the right time”<br />SECURE<br />PORTABLE<br />ACCESSIBLE<br />CONTEXTUAL<br />
  8. 8. “If You’ve Seen One HIE, You’ve Seen One HIE”<br />The eHealth Initiative has been tracking the progress of health information exchange initiatives for seven years. <br />In 2010, eHIidentified 234 active health information exchange initiatives across the country. <br />Clearly, the desire to connect all our disparate medical information is stronger than ever.<br />
  9. 9. 50 percent of respondents reported a reduction in cost of clerical administration time from 2009 to 2010; <br />30 percent saw a reduction in lab and radiology staff time; <br />75 percent reported a reduction in redundant tests; <br />78 percent realized a reduction in medical errors; and <br />133 percent reported a reduction in write-offs or accounts receivables for providers. <br />Respondents also indicated that they were better able to fulfill provisions of the American Recovery and Reinvestment Act (ARRA) that tie incentive payments to the meaningful use of EHRs.<br />
  10. 10. Goals for HIE in Central IL<br />By bringing information together into a more complete picture, we aim to:<br />Improve care coordination<br />Decrease duplicate tests & services<br />Reduce medical errors<br />Provide better information to patients<br />Improve overall health in our communities<br />
  11. 11. How Does HIE Do All This?<br />Whenever there’s a sea of information that makes it difficult to find exactly what you’re looking for, a technology emerges to help people make sense of that information.<br />Websites Google<br />Travel options Expedia<br />Sports Scores Stats.com<br />Global News CNN<br />
  12. 12. Show Me Information on Gardening!<br />
  13. 13. Show Me Information on Travel to New York<br />
  14. 14. Health Information Exchange (HIE) Software<br />Show Me Information on Jane Miller<br />
  15. 15. Top Uses for HIE<br />Emergency Department Scenario 1: A patient presents to a hospital Emergency Department with an acute condition and is able to provide only sketchy details on previous care or conditions.<br />Current Perspective: No info available in hospital’s EHR<br />With HIE: Search of the HIE reveals lab results and reports from other HIE-participating hospitals and clinics<br />
  16. 16. Emergency Department Scenario Two: A patient has been seen by his Primary Care Physician (PCP) on the previous day and now presents to a hospital Emergency Department for care related to that encounter.<br />Current Perspective: PCP may not be connected to or using the hospital EHR.<br />With HIE: Search of the HIE provides encounter and treatment plan from the patient’s PCP.<br />
  17. 17. Hospital Acute Care<br />Scenario One: A hospitalist is working with an unaccompanied, confused patient who is new to the hospital.<br />Current Perspective: Patient is new to hospital, so no history is found in the hospital EHR.<br />With HIE: Search of the HIE provides a problem list, medication list and a documentation of the patient’s recent visits with his PCP.<br />
  18. 18. Hospital Acute Care<br />Scenario Two: A discharge planner has identified a patient who may be at risk for failure to follow through on appointments and obtain necessary care for chronic conditions.<br />Current Perspective: Discharge planner may not be notified that a patient has failed to show for follow-up appointments.<br />With HIE: Search of the HIE provides documentation of the follow-up visit and allows the discharge planner to track progress.<br />
  19. 19. Ambulatory Care<br />Scenario One: A patient arrives for a scheduled follow-up appointment after hospital discharge.<br />Current Perspective: The hospital discharge report may not have been received yet.<br />With HIE: Search of the HIE provides immediate access to hospital record, including labs, procedures, tests and discharge summary.<br />
  20. 20. Ambulatory Care<br />Scenario Two: A patient requires a referral to a specialist.<br />Current Perspective: Specialist needs last office visit documentation including relevant tests and procedures that have been performed. PCP requires consultation note after the visit.<br />With HIE: Through the HIE, patient documentation can be sent to the specialist with confirmation of receipt and reminders can be created for referral tracking.<br />
  21. 21. Health Information Manager<br />Scenario One: A patient requests that her information be sent to another facility or provider.<br />Current Perspective: Release of information form must be signed; patient information must be printed and faxed to facility or provider.<br />With HIE: Through the HIE, patient documentation can be sent instantly and securely to the facility with automatic confirmation of receipt.<br />
  22. 22. What About Patient Privacy?<br />In the original HHS privacy rule, a core component of HIPAA’s purpose was the ability to protect patient privacy while at the same time allowing the sharing of personal health information to facilitate patient care. <br />
  23. 23. The Three A’s of Security<br />Authenticate– validate identity of the user seeking access to data; <br />Authorize– determine user role as the framework for allowing access; <br />Audit– trigger an examination of the system and all user activities, including data collection and audit reporting.<br />
  24. 24.
  25. 25. Where is Health Information Technology Headed?<br />“Information is the lifeblood of modern medicine. Health information technology (HIT) is destined to be its circulatory system. Physicians and institutions trying to practice highest-quality medicine without HIT are like Olympians trying to perform with a failing heart.” <br />David Blumenthal, M.D., M.P.P. <br />Office of National Coordinator for HIT<br />December 2009<br />
  26. 26. HIE, the Future and YOU<br />As a clinician<br />As a health information professional<br />As a consumer<br />As a member of our community<br />
  27. 27. Q&A<br />Dr. Gail Amundson<br />President / CEO<br />Quality Quest for Health of Illinois<br />Joy Duling<br />Interim Executive Director <br />Central Illinois HIE<br />

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