Dave Whitlinger - NYeHC - eCollaborationForum 2012 - 02/23/12


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Presentation slides for Dave Whitlinger, Executive Director of the NY eHealth Collaborative, from the HIMSS'12 eCollaborationForum, February 23rd, 2012

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Dave Whitlinger - NYeHC - eCollaborationForum 2012 - 02/23/12

  1. 1. Developing an Ecosystem of Connected Capabilities: Collaboration with States and Vendors Presented by: Dave Whitlinger, Executive Director, New York eHealth Collaborative February 23, 2012DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
  2. 2. NEW YORK eHEALTH COLLABORATIVENYeC is a not-for-profit organization, working to improve healthcare for allNew Yorkers through health information technology.Promote the adoption and use of electronic health records• Educate the public on the benefits of EHRs• Assist providers transitioning from paper to electronic records• Assist providers to qualify for Meaningful Use reimbursementsBuild the SHIN-NY (State Health Information Network – New York): A securenetwork for sharing electronic medical records across the state• Allow providers to share information• Promote collaborative care so doctors work as a team to benefit the patientDevelop statewide policies regarding HIT• Convene stakeholders and build consensus• Collaborate with NYS Department of Health 2
  3. 3. SHIN-NY: THE NETWORK OF MAJOR HEALTHCAREPROVIDERS WITHIN NY• Through the HEAL grant program, the NY State Department of Health helped create 12 HIEs in New York.• Each HIE has built a local health information exchange network and is in the process of connecting the healthcare providers in their community – SHIN-NY 1.0• SHIN-NY 2.0 will connect together all of the individual HIEs into a statewide network Every state in the country is developing a similar health information exchange network. 3
  4. 4. THE OPPORTUNITY• To improve care and decrease costs, healthcare payment systems are rapidly shifting towards new payment mechanisms that require physicians to collaborate on patient care• The current market of EHR systems does not provide physicians with the tools they need to share patient data and collaborate on patient care across the multiple providers• New York is leading the nation in the development of a state health information exchange network and has established a large community of healthcare organizations who are now connected, and facing the new collaborative care challenges• Through partnership with other states, New York has created an industry forum to establish a standardized “health information exchange” platform that would create the ability to develop software applications that could be easily be installed in many states 4
  5. 5. PAYMENT REFORM REQUIRES NEW INNOVATIONS INNOVATIONS NEEDED: Care Integration Tools Analytics/Data Mining Timely Clinical Decision Support Consumer Engagement Tools 5
  6. 6. HEALTH INFORMATION EXCHANGE PLATFORM Health Information • The HIE Platform is a networked resource that has the ability to provide: APPLICATION PROGRAMING INTERFACE Exchange Software • Patient Records including symptoms, Patient Record treatments, meds, allergies, radiology, Locator Service etc. Patient Database Identity Mgmt & • Patient identity and contact information Authentication for administrative uses Patient Consent • Provider identity and contact information Provider Management for administrative uses Database Message • Legal records to manage and adhere to Routing state privacy and data usage policies • Patient care plans Electronic Health Record Connections • Analytics for population health and A B C X Y Z individual physician panel management • Communications between providers, public health, and patients.HOSPITAL A PRACTICE C PRACTICE Y FQHC B HOSPITAL X HOSPITAL Z 6
  8. 8. 4 FOCUS AREAS EMERGECARE PLAN • A common care plan that provides support for team based care including tools required to support transitions of care.MANAGEMENT • Management of patients by risk categoryANALYTICS • Analytical tools required to support retrospective and predictive analysis related to care coordination, panel management. • Secure Messaging & Alerts at the point of care alerting toPHYSICIAN ALERTS transitions of care • Personal health management solutions that enable patientPATIENT interaction with care teamENGAGEMENT • Telehealth tools that allow for better care at home • Tools that allow patients to make better health care decisions 8
  9. 9. MULTI-STATE/MULTI-VENDOR COLLABORATIVE• NYeC has created the EHR/HIE Interoperability Workgroup to develop technical standards for interoperability between HIE software platforms and the applications that interface with them – predominately electronic health record systems. • State definition of use cases and commitment to buy common standards creates a larger potential market and a clearer development roadmap for vendors. • Vendor collaboration and commitment to common APIs and certification of a common HIE platform creates a potentially larger opportunity for all of them by guaranteeing interoperability. • Support from the federal government through standards setting bodies and grant programs. 9
  10. 10. MAJOR FUNCTIONAL NEEDS ADDRESSED• Statewide Send and Receive Patient Record Exchange • Enables user interaction with a common service to identify the address of an intended recipient such as an individual provider or entity • Defines a recipients application capability to conduct exchange with compatible protocols and provides the ability for receiving systems to process specific payloads• Statewide Patient Data Inquiry Service • Defines a patient inquiry and record retrieval service utilizing message record routing, master patient index, authorization framework and identity management • Extensible and is adaptable to the needs of other interoperability services such as a Statewide Master Patient Index (SMPI) and Record Locator Service (RLS)• Continuity of Care Document (CCD) • Priority was assigned to development of a consistent implementation of the HITSP C32 CCD specification which could be implemented in a repeatable manner between EHRs and HIEs. 10
  11. 11. WIN-WIN-WIN STRATEGY FOR ALL STAKEHOLDERSVendors• Differentiate product in highly fragmented market by developing a product that offers “plug and play” to HIE across multiple states (superior interoperability)• Build interface once, use for many different HIEs and EHRs• Better utilize limited resources to focus on product functionality improvements and customer adoptionState and Regional HIE• Ability to rapidly deploy interconnection of systems by having standard interfaces and interface approaches• Minimize costs associated with connection fees by individual EHRs each time a new connection is madeProviders• Increase value proposition of individual EHRs• Eliminate HIE connection cost as prohibitive barrier for adoption 11
  12. 12. WORKGROUP MEMBERSStates EHRs HIEs • 10 States represent ~ 40% of US PopulationCalifornia Allscripts ApeniMEDColorado Cerner Axolotl • 26 Vendors are leadingIllinois DeFran Systems dbMotion EHR and HIE vendors with significant marketKentucky Dr. First GE shareMaryland eClinicalWorks GSI HealthNew Jersey eMDs HealthUnityNew York ePocrates ICAOregon First Medical Solutions InterSystemsUtah GE MedAlliesVermont Greenway Medicity McKesson Mirth NextGen Misys Open Source Solutions Sage Siemens 12
  13. 13. INTEROPERABILITY STRATEGYPhase I: Develop Phase II: Develop MechanismsImplementation Guides for Compliance to Specifications Form workgroup with states and • Develop test specifications vendors • Leverage REC program to drive Develop priority list of capabilities compliance of specifications Create functional & technical • Engage broader vendor specs community for adoption of Collaborate with state policy specifications advisory groups to ratify criteria • Create mechanisms to promote Harmonize with ONC use of standards in connecting EHRs to HIEs 13
  14. 14. Terms of Participation Agreed to by AllStakeholdersState Responsibilities Vendor Responsibilities Actively participate and obtain buy-in  Vendor Responsibilities with state policy groups  Actively participate in workgroup Agree to develop compliance process  Work collaboratively with potential for interfaces within state competitors Ensure that specifications developed  Utilize off the shelf standards are utilized in their state.  Commit that upon final approval of the Market to the healthcare provider specifications to develop product that community the value of using EHRs meets such specifications within 1-2 and HIEs that pass the “plug and play” major product releases compliance testing
  15. 15. SPECS COMPLETED AND RELEASED NOV 8THFANTASTIC RESPONSE FROM THE HIT MARKETPLACE5,000 website visits, 500 Document Downloads, 125 Membershiprequests from States, EHR Vendors, HIE Vendors, and others 15
  16. 16. DRIVING INNOVATION: ENGAGING WITH THE HITENTREPRENEURIAL COMMUNITY• Develop an API layer on top of HIE infrastructure to support coordinated care • NYeC will be launching an API in early Spring to allow innovative software development companies to provide apps and tools to providers leveraging the statewide network• Incubate Companies that offer Clinical capabilities in support of New Payment Models• Harness innovation by providing educational sessions and market access to healthcare providers to innovative companies 16
  17. 17. SUMMARY• HIE is essential to delivering coordinated, accountable patient-centered models of care• The key to driving adoption of HIE services is agreement on the adoption of common principles, standards, and policies• Collaboration between HIE Programs and Vendor Community is an effective way to show real-world implementation of standards and can help influence national direction• In order to drive sustainability, State HIE programs need to go beyond core capabilities and work with the HIT software development organizations to develop innovation tools for providers on top of the HIE platform
  18. 18. Questions?Anuj DesaiDirector, New York eHealth Collaborativeadesai@nyehealth.org• For More information on the EHR/HIE Interoperability WorkGroup, to download specifications, and to become a member go to:www.interopwg.org