This document provides an overview of health information exchange (HIE) in Vermont. It discusses VITL, a non-profit organization that operates the statewide HIE, connecting hospitals, practices, and other providers. It describes how HIE is integrated into Vermont's health reform efforts like the Blueprint for Health, which uses clinical data to support practices' transformation to the patient-centered medical home model and provide population health management. The document also notes some learnings around vendor challenges, interoperability issues, and ensuring HIE sustainability beyond public funding as payment models evolve.
What your organisation needs to know about personal health budgets, communica...CharityComms
Jaimee Lewis, Think Local, Act Personal
Changing the game: positioning your charity to succeed in the new health service market conference
www.charitycomms.org.uk/events
Presentation delivered by Bryan Starnes, Chief Financial Officer, Affinity Living Group at the marcus evanc Long-Term Care & Senior Living Central CXO Summit, October 2016, in Chicago.
What your organisation needs to know about personal health budgets, communica...CharityComms
Jaimee Lewis, Think Local, Act Personal
Changing the game: positioning your charity to succeed in the new health service market conference
www.charitycomms.org.uk/events
Presentation delivered by Bryan Starnes, Chief Financial Officer, Affinity Living Group at the marcus evanc Long-Term Care & Senior Living Central CXO Summit, October 2016, in Chicago.
By Annette Gardner, PhD, MPH
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
The Patient Protection and Affordable Care Act (ACA) is an opportunity to coordinate care among health care providers and transform local nets into seamless systems of care. The study conducted by Dr. Annette Gardner, PhD, MPH, at the Philip R. Lee Institute for Health Policy Studies, UCSF, shows safety net integration activities in five counties—Contra Costa, Humboldt, San Diego, San Joaquin, and San Mateo—suggests much progress has been made to this end in these counties.
This Report describes the factors that affect a local safety net's ability to develop integrated delivery systems and lessons learned from the implementation of 30 safety net integration "best practices".
Supporting Cancer Survivors in the Workplace and Managing CostsHuman Capital Media
There are more cancer survivors in the workplace than ever before — and that’s great news. But this poses a growing challenge to employers who are struggling to control health care costs and help their workers lead healthier lives.
There are tools to help employers meet that challenge through benefit design, online resources, wellness programs and other initiatives. Join this webinar to learn how your company can offer support to employees facing a frightening diagnosis and better manage the high cost of treating cancer.
Cancer costs employers an estimated $264 billion a year in medical care and lost productivity. Thanks to medical advancements, the vast majority of the 14 million survivors today return to work, and their numbers are growing.
We'll talk about:
The evolution of cancer in the workplace from taboo topic to public acceptance and awareness.
The latest research on cancer diagnoses and treatment costs.
Innovative approaches to benefit design and managing pharmacy costs.
An overview of "An Employer’s Guide to Cancer Treatment and Prevention,” a toolkit by the National Business Group on Health and the National Comprehensive Cancer Network (NCCN).
Telehealth Integrators and Competitors LandscapeDonna Cusano
Presentation on telehealth competitive landscape with a focus on \'integrators\' providing care management as option. Overview of marketing opportunities.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
Network physicians, hospitals, and other care continuum providers work collaboratively in active clinical process improvement programs across service lines and specialties to define, establish, implement, monitor, evaluate and periodically update the processes of:
- Evidence-based medicine
- Beneficiary engagement
- Care coordination
- Conservation of healthcare resources
- Clinical data reporting
By Annette Gardner, PhD, MPH
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
The Patient Protection and Affordable Care Act (ACA) is an opportunity to coordinate care among health care providers and transform local nets into seamless systems of care. The study conducted by Dr. Annette Gardner, PhD, MPH, at the Philip R. Lee Institute for Health Policy Studies, UCSF, shows safety net integration activities in five counties—Contra Costa, Humboldt, San Diego, San Joaquin, and San Mateo—suggests much progress has been made to this end in these counties.
This Report describes the factors that affect a local safety net's ability to develop integrated delivery systems and lessons learned from the implementation of 30 safety net integration "best practices".
Supporting Cancer Survivors in the Workplace and Managing CostsHuman Capital Media
There are more cancer survivors in the workplace than ever before — and that’s great news. But this poses a growing challenge to employers who are struggling to control health care costs and help their workers lead healthier lives.
There are tools to help employers meet that challenge through benefit design, online resources, wellness programs and other initiatives. Join this webinar to learn how your company can offer support to employees facing a frightening diagnosis and better manage the high cost of treating cancer.
Cancer costs employers an estimated $264 billion a year in medical care and lost productivity. Thanks to medical advancements, the vast majority of the 14 million survivors today return to work, and their numbers are growing.
We'll talk about:
The evolution of cancer in the workplace from taboo topic to public acceptance and awareness.
The latest research on cancer diagnoses and treatment costs.
Innovative approaches to benefit design and managing pharmacy costs.
An overview of "An Employer’s Guide to Cancer Treatment and Prevention,” a toolkit by the National Business Group on Health and the National Comprehensive Cancer Network (NCCN).
Telehealth Integrators and Competitors LandscapeDonna Cusano
Presentation on telehealth competitive landscape with a focus on \'integrators\' providing care management as option. Overview of marketing opportunities.
The Health Systems Administration program at Georgetown has its students complete case projects for a fictional community, Middleboro. Throughout the program we created several deliverables: Community Profile, Community Health Assessment, Strategic Plan, Marketing Plan, and Business Plan.
Network physicians, hospitals, and other care continuum providers work collaboratively in active clinical process improvement programs across service lines and specialties to define, establish, implement, monitor, evaluate and periodically update the processes of:
- Evidence-based medicine
- Beneficiary engagement
- Care coordination
- Conservation of healthcare resources
- Clinical data reporting
Delivered at Casual Connect Europe 2016
Many believe that HTML5 for games is still a promise that has never materialized. But while the industry has primarily focused on native app-stores and Unity, the app-stores are becoming nearly impenetrable for most game developers and a Flash apocalypse might be close. BoosterMedia’s CEO Laurens Rutten will demonstrate that high quality HTML5 games are successfully published, full 3D HTML5 games are here now and that even Triple-A game companies are choosing HTML5 as an integral part of their cross-platform strategy.
Presentation slides for Dave Whitlinger, Executive Director of the NY eHealth Collaborative, from the HIMSS'12 eCollaborationForum, February 23rd, 2012
ACO = HIE + Analytics - a Healthcare IT PresentationPerficient, Inc.
With the release of the Accountable Care Organization (ACO) regulations, healthcare providers must be able to identify, access, and seamlessly share patient information to drive efficiencies and enjoy a potential share in ACO program incentives. Additionally, more than half of the 93 draft National Committee for Quality Assurance (NCQA) ACO measures are also Meaningful Use measures, which further elevates the need to achieve meaningful use stage 2 or higher.
Given these goals, success will ultimately depend on an organization’s ability to share patient data at the point of care and its ability to gain meaning from historical and longitudinal data for use in managing population health. Healthcare organizations will need to give focused attention to the IT strategies, appropriate architectures, and roadmaps they will use to move from desired state to reality.
We discuss the practical architectural approach for creating an ACO. As Health Information Exchanges (HIEs) evolve into their second generation, they are able to the support the functional ACO tasks of delivering and managing care for a defined population, accept payment, distribute savings to participants, and perform disease management with predictive modeling to improve outcomes. We will also discuss the need to achieve meaningful use stage 2 or higher and the data/analytics requirements for ACO participants.
Presenter Martin Sizemore is the Director of Healthcare Strategy for Perficient. Martin has been a consultant and trusted advisor to CEOs, COOs, CIOs and senior managers for global multi-national companies and healthcare organizations, and is a certified Enterprise Architect with specialized skills in Enterprise Application Integration (EAI) and Service Oriented Architecture (SOA).
We at Boehringer Ingelheim know that there are many issues affecting health care in the United States. In this presentation Dr. Lee Sacks of Advocate Health takes a look at accountable care organizations (ACOs) and their role in health care reform. Understanding the Implications of Accountable Care Organizations for Patients and Providers, was a web conference given on July 31, 2012 and which we hope will provide offer an understanding of best practices among ACOs and tips for helping constituents adopt and participate in ACOs.
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.
Ailsa Claire: Meeting the information needs of clinical commissioning groupsThe King's Fund
Ailsa Claire, Transition Programme Lead patients and Intelligence, NHS Commissioning Board Design Team, discusses the information needs of clinical commissioning groups at The King's Fund's NHS Information Revolution conference.
What Lies Ahead for ONC: Meaningful Use and BeyondBrian Ahier
Farzad Mostashari, MD, ScM serves as Deputy National Coordinator for Programs and Policy within the Office of the National Coordinator for Health Information Technology at the U.S. Department of Health and Human Services.
Overview of Meaningful Use, Stage One. Presented to Georgetown's Health Information System's class on 4/14//11. Only difference from previous lectures is the addition of slides on adoption sentiment.
Healthcare Leadership Forum’s Evidence at the Center of Care focused on implementing IT and evidence-based medicine in every day practice. This meeting brought together clinical and IT leaders in an interactive environment where attendees learned about best practices for integrating evidence into clinical practice, enabling more efficient, high-quality healthcare delivery.
Nov. 14-15, 2013 | Chicago
Sponsored by: ClinicalKey / Elsevier
Presented by: Clinical Innovation + Technology
Radiology Workflow: Recognizing Clinical & Financial Benefits of Implementing...TriMed Media Group
Rutland Regional Medical Center in Vermont, is a 188-bed rural hospital that effectively weds high-tech imaging with patient-centric care. This high-tech hospital with a hometown touch utilizes an intuitive RIS-PACS-reporting solution in its radiology department that is delivering benefits across the health system. The ability to provide local, state-of-the-art imaging is convenient for patients and referring physicians. It keeps patients close to home, which, in turn, improves the medical center’s bottom line.
Inside a Private HIE: Clinical, Economic and Operational Successes at The Was...TriMed Media Group
The Washington Health Information Network (WHIN) is a private health information exchange (HIE) that connects The Washington Hospital and physician practices affiliated with the Washington Physician Hospital Organization (WPHO). MobileMD is the backbone of WHIN. Denise Abraham, the health information exchange coordinator for The Washington Hospital, and Charles R. Vargo, executive director of the WPHO, work closely to keep this vital piece of caregiver connectivity alive. WHIN is having a positive impact on patient care and clinical practice by increasing physician knowledge and boosting efficiency by allowing physicians, nursing and key clinical staff secure access to key information such as lab and radiology reports and EKGs. The private HIE has united 13 EMRs from different vendors via interfaces to provide one data repository for enterprise access. Learn why they chose a private HIE, how it has evolved from 2006 until now and what advice they offer to other healthcare systems ready to embark on a private HIE project.
How Healthcare Reform Is Affecting Radiology, Pam KassingTriMed Media Group
How Healthcare Reform Is Affecting Radiology - Presented by: http://www.healthimaging.com - speaker: Pam Kassing, MS, Senior Director of Health Policy, American College of Radiology. Presented at the GE Virtual Conference, September 14, 2011.
Meaningful Use and Its Impact on Medical Imaging: Part 1 - Presented by http://www.healthimaging.com - invited speaker: Arun Krishnaraj, MD, MPH, Massachusetts General Hospital. Part of the GE Virtual Conference September 14, 2011.
1. HIE:
The Vermont Version
David Cochran, MD
President and CEO
Vermont Information Technology Leaders, Inc.
2. Topics
• VITL Overview
• Vermont Health Reform
• Blueprint for Health
• Health Information Exchange
3. Snapshot of Vermont
637,000 population
9615 square miles
13 Health Service Areas
Few large employers (IBM,
State Government, University
of Vermont)
Little industry
Dairy and Tourism
4. VITL Background
• Started as a project within the Vermont Association of
Hospitals and Health Systems
• Spun off as independent entity in July 2005
• Received 501(c)(3) non-profit status in March 2009
• A public-private partnership with participation from
health care providers, government, employers,
consumers, and health plans
• Shared public investment supporting IT requirements
of Vermont’s health care reform efforts
4
5. VITL
Programs
Vermont REC
Statewide HIE
Blueprint Support
ePrescribing
5
6. Support Based on Practice’s
Technology Maturity
Meaningful Advanced
Paper EHR Labs Blueprint HIE
Use
Paper EHR Lab Patient Clinical, Clinical
(clinical) installed results demo- structured data
practice Standard update graphics data sharing
May have workflows EHR and captured with
a PMS Data May also clinical Quality consent
entry is have summary measures
manual immun- sent to are
ization Registry automatic
6
7. Vermont Health Care Reform
60+ Discrete, Active Initiatives which combine to…
Improve Quality
• Provider Access, Transparency
Increase Coverage • Promote Wellness / Prevention
• New Coverage Options • Blueprint for Health
• Premium Assistance integrated Medical Home &
• H202 – Roadmap to Single Payer Community Health Team
• Health Information Technology
• Accountable Care Organizations
Contain Cost Growth
All of Above PLUS
• Cost Transparency
• Statewide Health Resource Planning and Review
• Prescription Drug Cost Containment
• Administrative Simplification
7
8. HIT & HIE Fully Integrated in
Health Care Reform from start
• In 2005, VT authorized and funded a single statewide
Health Information Exchange
• VITL (Vermont Information Technology Leaders), a
501(c)3 public/private partnership, developed
standards based architecture for statewide HIE and
began operations.
• Investment in EHR adoption and deployment
included in HCR legislation, starting with a primary
care EHR pilot, expanded through creation of HIT
Fund (fee of 0.199 of 1% on each health care claim)
in 2008
8
9. Blueprint for Health
Advanced Primary Care Practices
Community Health Teams
Payment Reforms
Health Information Infrastructure
Expansion & Quality Improvement Program
(EQuIP)
10. Advanced Primary Care
Practice
Doc Site
Centralized Registry
Community Health Team
Medical Home
12. Continuum of Health Services - General
Specialized & Targeted
Services
Higher Community Health • Specialty Care
Acuity &
Teams • Advanced Assessments
Complexity
• Advanced Treatments
• Support Patients & Families • Advanced Case Management
• Support Practices • Social Services
Level of Need
Advanced Primary • Coordinate Care • Economic Services
• Coordinate Services • Community Programs
Care Practice • Referrals & Transitions • Self Management Support
• Health Maintenance • Case Management • Public Health Programs
o DVHA Care Coordinators
• Prevention o SASH Coordinators
• Access • Self Management Support
• Communication • Counseling
• Self Management Support • Population Management
• Guideline Based Care
Lower • Coordinate Referrals
Acuity & • Coordinate Assessments
Complexity • Panel Management
6/15/2011 12
Level of Service & Support
13. Blueprint for Health:
Practice Transformation Engine
Blueprint for Health’s integrated platform:
– web-based registry,
– clinical data repository,
– population-based management tool
Populated through the HIE for bi-directional feeds from practice and
hospital EHR systems, labs, public health registries, other sources to
support:
– clinical messaging,
– care coordination,
– patient and panel management functions
13
14. Hospitals
Medical
Self-Help Recovery Home
Communities
Medical
Social, Economic, & Community Health Team Home
Community Services Nurse Coordinator
Social Workers
Nutrition Specialists
SASH Coordinator Medical
Mental Health & MCAID Care Coordinators Home
Substance Abuse
Programs
Medical
Home
Long Term Care
Public Health
Programs & Services
Health IT Framework
Evaluation Framework
6/15/2011 14
15. Federal HIT/HIE Policy, Oversight, & Standards - Office of the National Coordinator (ONC)
State HIT/HIE Policy, Oversight, & Standards – OVHA/HCR
State Government & Public Health Vermont Health Care Providers & Institutions
NHIN Connectivity
Public Health surveillance, Tertiary and Community Hospitals
registries, & other public
health functions
Primary Care & Specialty Providers
Health Information
Medicaid health programs
case management Exchange “Cloud” Federally Qualified Health Centers
& Rural Health Clinics
functionality and connectivity for secure, privacy protected
interchange of health records, Free Clinics
Other Medicaid & AHS case
management functionality
demographic data, image files,
Mental Health/BH/SA Providers
and connectivity clinical messaging, & other
digitized health information Long Term Care Providers
Other state agency & dept. Statewide HIE Operated by VITL
case management Home Health & Hospice Providers
functionality and connectivity
Community Human Service
Law Enforcement, Agencies (Family Centers, Area
Corrections, & Court System Individual Vermonters: connectivity to EHR Agencies on Aging, etc.)
Portals, Personal Health Records (PHR), Health
2.0 applications and Ix Services
15
16. Blueprint Integrated Pilots
Health Information Infrastructure
Medical
Home
• Visit planners for individual patients
• Reporting for panel management & outreach (Medical Homes, CHTs)
Medical Hospital data warehouse • Clinical information for care coordination (CHTs, OVHA CCs)
Home (hosted EMR) • Tracking for public health services (e.g. cessation counselors)
• Reporting for public health planning
• Reporting & comparative benchmarks to support program evaluation
Medical Core data elements
Home
Medical VITL
Home
HIE
Core data elements Core data elements Central
Medical FQHC
Home (hosted EMR) Registry
Medical
Home
Medical
Home
EMR
Core data
Medical elements
Home
EMR
Access
Medical Community
Access
Web
Web
Home Health Team
No EMR
17. Blueprint Integrated Pilots
Health Information Infrastructure
Medical
Home
• Visit planners for individual patients
• Reporting for panel management & outreach (PCMHs, CHTs)
Medical Hospital data warehouse • Clinical information for care coordination (CHTs, OVHA CCs)
Home (hosted EMR) • Tracking for public health services (e.g. cessation counselors)
• Reporting for public health planning
• Reporting & comparative benchmarks to support program evaluation
Medical
Home
Medical VITL
Home
HIE
Medical FQHC Central
Home (hosted EMR) Registry
Medical
Home
Medical
Home
EMR
Medical
Home
EMR
Access
Community
Access
Web
Web
Medical
Health Team
Home
18. Blueprint Integrated Pilots
Evidence Based Quality Improvement
Data Data Data Data
Source Processing & Storage Analysis Reports & Uses
EMRs used for EMR Databases Data transmission & EMR Clinical Individual Patient
Individual Patient transformation Reporting Tool or Process Care & Support
Care VITL / GE Analyst Measures Services
DocSite used for DocSite Database DocSite Health Population
Individual Patient Reporting Status Management
Care Tool Measures
Contracted Healthcare Quality Quality
Analysis Measures & Standards Improvement
Services
Medical Claims from BISCHA BISCHA Healthcare Provider Payment
Commercial Insurers Multipayer Reports Patterns & Resource for Quality
& Medicaid Database Utilization
VCHIP VCHIP VCHIP Healthcare Program
Chart Review & Databases Analysis & Report Expenditures & Evaluation &
NCQA Scoring Generation Financial Impact Sustainability
Public Health Surveys Public Health VDH Health VDH Health Population Indicators Community
& Data Collection Registries & Surveillance Analytic Surveillance Analyst & Prevention
Databases Database Risk Factors Planning
19. Blueprint Integrated Pilots
Evidence Based Quality Improvement
Data Data Data Data
Source Processing & Storage Analysis Reports & Uses
EMRs used for EMR Databases Data transmission & EMR Clinical Individual Patient
Individual Patient transformation Reporting Tool or Process Care & Support
Care VITL / GE Analyst Measures Services
DocSite used for DocSite Database DocSite Health Population
Individual Patient Reporting Status Management
Care Tool Measures
Contracted Healthcare Quality Quality
Analysis Measures & Standards Improvement
Services
Medical Claims from BISCHA BISCHA Healthcare Provider Payment
Commercial Insurers Multipayer Reports Patterns & Resource for Quality
& Medicaid Database Utilization
VCHIP VCHIP VCHIP Healthcare Program
Chart Review & Databases Analysis & Report Expenditures & Evaluation &
NCQA Scoring Generation Financial Impact Sustainability
Public Health Surveys Public Health VDH Health VDH Health Population Indicators Community
& Data Collection Registries & Surveillance Analytic Surveillance Analyst & Prevention
Databases Database Risk Factors Planning
20. Blueprint Integrated Pilots
Evidence Based Quality Improvement
Data Data Data Data
Source Processing & Storage Analysis Reports & Uses
EMRs used for EMR Databases Data transmission & EMR Clinical Individual Patient
Individual Patient transformation Reporting Tool or Process Care & Support
Care VITL / GE Analyst Measures Services
DocSite used for DocSite Database DocSite Health Population
Individual Patient Reporting Status Management
Care Tool Measures
UVM CCTS Healthcare Quality Quality
Health Informatics Measures & Standards Improvement
Platform
Medical Claims from BISCHA BISCHA Healthcare Provider Payment
Commercial Insurers Multipayer Reports Patterns & Resource for Quality
& Medicaid Database Utilization
VCHIP VCHIP VCHIP Healthcare Program
Chart Review & Databases Analysis & Report Expenditures & Evaluation &
NCQA Scoring Generation Financial Impact Sustainability
Public Health Surveys Public Health VDH Health VDH Health Population Indicators Community
& Data Collection Registries & Surveillance Analytic Surveillance Analyst & Prevention
Databases Database Risk Factors Planning
21. Intermittent Academic Analyses
•Outcomes & Effectiveness Reporting
& Studies
•Guide Health Reform Policies & Programs
Advanced analysis
New analytic models
Routine Analytic data sets Supportive reporting
HIPAA Compliant
DocSite
Environment
Clinical Data Analytic models
Central
Multipayor Repository
High Performance
Claims Data Computing Center
De-
Storage
Identified
Public Health Normalization
Data Processing
Data De-identification
Re-identification Query for experiments
Analytics (Routine)
Other Data Analytics (Exploratory)
Sources Workbench
Reporting
Data Sources UVM CCTS Health Informatics Platform
22. HIE Current State
• Infrastructure
• Connectivity
– Nine hospitals
– 54 practices
– 1 commercial lab
• Blueprint -- 34 practices
• Meaningful Use
23. Learnings and Issues
• Vendor Challenges
– Capabilities
– Business model
– Focus
• “Interoperability”
– State of the standards
• Sustainability
– Beyond the public utility model
– Preparing for reimbursement reform