Case Study: A Private HIE Operations, Challenges, Strategy and Analytics

1. A Private HIE
Operations, Challenges, Strategy and Analytics
DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.
Anthony Antinori / Director / NYU Langone Medical Center
Frat M. Iqbal / Manager / NYU Langone Medical Center

2. Objectives:
2
Vision and Strategy behind NYULMC’s private HIE.
Evaluate pains and gains of connecting with 46+ EMR’s
Discuss maturity and shift in strategy of a HIE by pay for performance reform
Plans of NYULMC HIE clinical data analytics
Migration of HIE to Optum 2.0 HIE product

5. Source: National Highway Authority
National Highway System – Act 1956
41,000 Miles of Highway

6. HELPED INTERSTATE COMMERCE
INTERCONNECTED A NATION
ENRICHED US ECONOMY

8. H I E

9. What is a Private HIE?
FOCUSED on a specific region and community.
FUNDED by a Private Organization.
INDEPENDENT strategic goals and policies.

10. Why a Private HIE?
ALLIGNED LOCAL
FOCUSEDAGILE

11. Source: Healthgrades.com
Only in NYC - Private HIE’s can connect…

12. NYC – A Reality Today…
Facility A Facility CFacility B
EMR
AR EMR
CR
EMR
BR
Inefficient Clinical Information Sharing
Phone, Fax, Mail, Courier

13. Facility
C
13
Facility
A
Facility
B
EMR A EMR C
EMR B
Electronic Clinical Information Sharing using HIE
Demographics, Results, Notes, Images, allergies, Meds, history etc.
NYC -Vision for tomorrow….

14. 2011- NYULMC VISION for an HIE
Improve Patient Care
coordination in the
Community.

15. By connecting…
Target 375+Practices
Target Integrating 3500+ Clinicians
42 + EMR’s

16. Who?
EMR’s
Advanced MD - Half Penny MDonline
Amazing Charts MDTotal
Athena MEDENT
Chartmaker Medi-EMR
Comtron, Medgen EMR MERIDIANEMR
Criterions Modernizing Medicine
Cure MD MTBC
ECW Nextech
ENCITE Nextgen
EYEMD Office Practicum - Connexin
GE Centricity/ logician: OmniMD
GloStream Picasso-Doctor.com
GMED Praxis EMR
Greenway Raintree
Health Fusion Sequelmed
Imedicware SRS
IO Practiceware UROcharts (Healthtronics)
iPatientCare Veracity - AllegianceMD
Macpractice Vitera, EMR is Intergy
Mdintellesys

17. What are we doing?
• CCD/ CCDA
• HL7 V2 Messages
• ADT
• Lab results
• Rad results
• Dermatology
• Pathology
• EKG
• Medications
• Allergies
• Provider Notes
• Discharge summaries
• Transfer forms
• Images (X-ray, CT scan, MRI)
• Notes
• Notification
• Result delivery
• Direct Messaging

20. 2010 – First Year Law School

21. 2012 – Permanently Disabled

22. 2 Years to Diagnose MS
(Multiple Sclerosis)
June 2010
August 2012

23. How are we doing it?

24. One Group Practice at a time.
Picking the right Technology
Setting the right expectation
Building the right team
Standardizing processes and technical
requirements

25. …and it was painful.
Interfacing with 42+ EMR’s
PHI Management
Resource, Scheduling, Expectations
Project Prioritization
Technical Incompetency.

26. But worth it.

27. Now we can improve Coordination of Care.
Immediate access and sharing of Clinical Data
Efficient transition of care
Reduction of needless visits
Lower cost of care
Practice evidence-based medicine
Clinical trends and pattern analysis

29. So what did we learn?
Resistance to change.
Technical boundaries.
Talent shortage.
Legislation and legal issues.
Federal and State Policies.

30. Meaningful Use Stages
Shared Savings from Payers.
Accountable Care Organizations.
Program Clinical Integrated Network.
Delivery System Reform Incentive Payment (DSRIP)
Where are we going?

31. Patient
Attribution Registries
Out of
Network
Spend
(Domestic/ Non Domestic)
High Cost
Patients
How do we answer?

32. Analytical Innovation will get us there
Payer Data
EPIC DataHIE Data

33. Optum One Reports
• Population Analytics : Diabetes
• For Oxford patients
• Population Analytics: GIC (last 12 months)
• United Patients

34. Optum One Reports
• Risk Analytics: PMPM reports
• Cost and Utilization by (Current PCP & Practice Category)

35. with a robust HIE Platform.

37. Innovative but a new Product
Customization and Workflow Adjustment
Data Migration per the new standards
New Patient Matching tool
Interface Migration
Training the Users
And we thought we knew pain….

38. 38
DSRIP
Delivery System Reform Incentive
Payment Program

39. No Organization is an Island.

41. Source: National Highway Authority
National Highway System
41,000 Miles of Highway

42. National Healthcare Clinical System

43. Frat M. Iqbal
Senior Manager
Clinical Affairs IT & HIE
1 Park Ave, 3rd Floor | New York, NY | 10016
Tel: (212-404-3628)
Email: Frat.Iqbal@nyumc.org
Questions?
Anthony Antinori
Senior Director
Clinical Affairs IT & HIE
1 Park Ave, 10th Floor | New York, NY |
10016
Tel: (212-404-4330)
Email: Anthony.Antinori@nyumc.org