NC HIE Overview and Governance• Nonprofit organization established as a Statewide Designated Entity (SDE) in April 2010• Board of directors: 25 CEOs and health care leaders in the North Carolina community• Four workgroups: strategy and policy experts on – Clinical and technical operations – Governance – Finance – Legal and policy
Setting the Strategic Agenda – NC HIE Mission NC HIE will provide a set of secure, scalable information services that • Promotes the access, exchange and analysis of health care information • Enables participating organizations to: – Improve medical decision-making and coordination of care – Improve health outcomes – Control health care costs
Why a NC Health Information Exchange?Four focus areas for NC HIE initiatives:
NC HIE Services Overview• HIE Connectivity Fabric – Connectivity with participating systems: CCD, HL7, SSO, Web Services (Rhapsody™). – Storage of clinical information (CDR). – EMPI. – Data normalization. – Privacy and consent• Virtual Patient Record Network – Web-based access to the longitudinal patient record (Clinical Portal). – User subscribed notifications• Data Delivery Services –Lab results• Direct Secure Messaging – Ability to send/receive secure messages with other Direct providers – Support for Direct-enabled EMR systems
Timeline Core Services Phase IA • EMPI/provider • Medication directory management • Security • Immunization registry • Privacy and consent • Practice analytics • Clinical messaging • Lab results • VA Gateway • DIRECT • Web-based clinical portal • Notifications • Virtual QO services • Hosted EMR Phase IB and Beyond • Lab ordering • Referrals • Procedural results • Senior care • Pharmacy • Mobile gateway • Consumer portal • Medical device gateway • Payer gateway • Clinical decision support • Medical imaging • Vital records • Population health analytics • Advanced directives • Syndromic surveillance • Home health • Public health reporting • NwHIN trading partners
Benefits to the Health Ecosystem Across all insurance types,North Carolina has an EHR sites were associatedinbound move rate of 55.4%. with significantly higherAccording to Forbes, Raleigh achievement of care andand Charlotte remain two of outcome standards andthe most popular cities for greater improvement inrelocation. diabetes care.There are almost 200,000deaths a year frompreventable medical errors, American patients have seenpartly because this an average of 18.7 differentinformation is not readily doctors during their lives.available to specialists andemergency rooms.By reducing their Only 6.3% of physicians usedependence on paper a fully-functional electronicrecords, a practice seeing health record system in their3,000 patients annually could practice.save $24,000.At the highest level of health Emergency Departments withIT adoption, only 0.001% of connectivity to an HIE haveprescriptions would require a improved productivity byphone call between a more than 20%pharmacist and physician.
What’s in it for everyone?Providing NC with better, safer,more affordable care• Integration• Communication• Insight• Agility• Custom
Comparing NC and NL situationNorth Carolina Netherlands• Government actively supporting HIEs • Government in doubt how to support• Patiënt consent: opt-in needed (for regional and national HIE sharing, not collecting) • Patiënt consent: opt-in needed (for both• Healthcare data also used for analysis collecting and sharing) on population level • Healthcare data only used on patiënt• Based on international standards (CCD level / HL7) • Based on international standards (CCD• Almost 10 million inhabitants, 3,5 times / HL7) the area of NL.
Prerequisites for successful implementation• Changing the way of working of a multitude of organizations and persons, is a tough job.• Drivers for change are both quantitative and qualitative – Higher quality of care and lower cost (or more income)• Even if both are the projected outcome of a network-project, a couple of objectives must be met to become successful: – The will to exchange the patients data – and be serious about it – A compelling business case for the total value chain – A fair business model promoting the use for each of the participant in the network – An HIE system that is integrated with the current IS of the caregivers • Individual healthcare providers have little influence on development roadmap of ISVs
Thank you, Jeff Miller ! • Thanks for sharing your thoughts and experiences with us today. • "Im Sure its No Coincidence that Were Sitting at this table Together. Some things cannot be Mere Chance; everybody has got an example of this. On the other hand I think its Nonsense to Say Chance doesnt Exist. I mean Whats the Chance that Nothing ever happens by chance"Text and design by Nicole van Schouwenburgfor Royal Delft – Koninklijke Porceleyne Fles
Thank you, and have a great time at HIMSS 2012Jeff Miller Toon van der Werf• CEO NC HIE - Health Information • Consultant Vakgroep Zorg Capgemini Exchange Netherlands• firstname.lastname@example.org • email@example.com • +31(0)629 056 330 • Booth #13642-12