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Sustainability of HIE - A How To Guide

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This presentations provides guidance on the necessary steps needed to build a sustainable health information exchange. For more information, please see the contact information on the final slide.

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Sustainability of HIE - A How To Guide

  1. 1. Better Outcomes. Delivered. Health Information Exchange (HIE) Sustainability: Lessons Learned by the Indiana Health Information Exchange John P. Kansky, MSE, MBA Vice President – Strategy and Planning Indiana Health Information Exchange8/22/2012 Copyright ©2012 Indiana Health Information Exchange, Inc. 1
  2. 2. The Indiana Health Information Exchange• Founded in February 2004• Based on the technology, knowledge, and experience of the Regenstrief Institute• 75 employees• Non-grant revenue in excess of $5 million annually• Participation from 93 hospitals (30 health systems), 19,000 clinicians, and 5 payors• Serving an area with a population of approximately 4 million people Copyright © 2011 Indiana Health Information Exchange, Inc www.ihie.org
  3. 3. The Soapbox and the Green EyeshadeThere are services that a health information exchange could theoretically providefor which there is no apparent business model. There are also services that havebusiness models that are outside the mission of a typical HIE.The The GreenSoapbox Eyeshade Services on Stuff an HIE which you can Stuff an HIE could do to base a could do that help “save the someone will healthcare sustainable pay for system” Health Information Exchange Copyright © 2011 Indiana Health Information Exchange, Inc www.ihie.org
  4. 4. HIE Sustainability – Basic Conceptual PrinciplesBased on the experience of 8 years of operation and an on-going historyof service development, launch, and support, IHIE bases its sustainabilityplans seven basic principles. We believe these principles are key tohealth information exchange being a self-sustaining endeavor.• Principle 1: HIE is a Business• Principle 2: The Leveraging of High-cost, High-value Assets• Principle 3: No Loss Leaders• Principle 4: Independent, Local Sustainability• Principle 5: Natural Monopoly• Principle 6: The Need for Scale• Principle 7: Avoidance of Grants for Operational Cost Copyright © 2011 Indiana Health Information Exchange, Inc www.ihie.org
  5. 5. Principle 1: HIE is a BusinessHIE is a business and as with allbusinesses, creating a sustainable HIErequires: • offering services that the market wants… • at a price the market will bear… • doing so in such a way that revenue exceeds expenses. • services delivered by the HIE must be at a level that healthcare organizations have come to expect from their suppliers. Copyright © 2011 Indiana Health Information Exchange, Inc www.ihie.org
  6. 6. Health Data Sources Value-Added Services • Results Delivery • MU Support • Public Health Integration Hospital Hospital s s • Results Delivery Physician • MU Support • Clinical Quality Services • Community Health Record Access Physician Physician Offices Offices • Results Delivery • Community Health Health Information Exchange Record System Labs / Imaging Labs / Imaging Centers CentersPatient Physician • Biosurveillance • Reportable Conditions Data Network • Results Delivery Public Health Repository Application Public Health s • Quality Reporting • Physician Bonus Administration Payors Payors Physician Data Stewardship • De-identified, longitudinal clinical data Outpatient Researchers Rx Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  7. 7. Health Data Sources Value-Added Services • Results Delivery • MU Support • Public Health Integration Hospitals Hospital s • Results Delivery Physician • MU Support • Clinical Quality ™ Services Physician Physician • Community Health Offices Offices Record Access • Results Delivery • Community Health Information Exchange Health Record System Labs / Imaging Labs / Centers ImagingPatient Physician Centers • Biosurveillance • Reportable Data Network Public Health Conditions Repository Application Public • Results Delivery s Health • Quality Reporting • Physician Bonus Administration Payors Physician Data Stewardship Public Health • De-identified, Emergency Surveillance longitudinal clinical data System (PHESS) Outpatient Rx Researchers Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  8. 8. The Leveraging of High-cost, High-value Assets HIE assets are interdependent and, once created, can be leveraged to deliver additional services. New ED Abstract Inpatient Ambulatory Clinical Value- and Results Results Results Quality New added Review Review Review Services Medication Value- Service New Profile addedPublic Health Clinical Value- ServiceSurveillance Messaging added Layer III: Including Repository Services… Service Layer II: Including Mapped/Normalized Data… Layer I: Including Interface Engine, Community Trust, … A layer of necessary investment Value-added services that can be built upon the HIE investment Copyright © 2011 Indiana Health Information Exchange, Inc www.ihie.org
  9. 9. The Peanut Butter Principle Problem to Solution Byproduct Secondary Outcome Solve Issue SolutionGeorge Soil depleted Plant Peanuts What to do with Make and sell Sustain theWashington by Cotton to replenish all the peanuts? products that use southernCarver lost nutrients peanuts, e.g.: economy in the soil • Peanut butter (Keep growing(early 1900’s) cotton) • Peanut oilHealth • Rising cost of Build HIE How does Offer/sell services Make positive healthcare infrastructure society (or a that use (and contributions toInformation • Need to (and use it to given reuse) the HIE health andExchange community) pay infrastructure, e.g.: healthcare improve address the(2012) healthcare problems) for HIE? • Electronic Results quality and i.e. financially delivery safety sustain it • Clinical Quality Services • Medication profile Copyright © 2011 Indiana Health Information Exchange, Inc www.ihie.org
  10. 10. Questions?For Further Information, Please Contact: John P. KanskyVice President – Strategy and PlanningIndiana Health Information Exchange Jkansky@ihie.org Copyright © 2011 Indiana Health Information Exchange, Inc www.ihie.org

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