1. 600 East Superior Street, Suite 404 I Duluth, MN 55802 I Ph. 800.997.6685 or 218.727.9390 I www.ruralcenter.org Health Information Technology Meaningful Use and the Role for Networks Terry Hill National Rural Health Resource Center Executive Director May 2010

4. Delta Rural Hospital Performance Improvement

5. National Rural HIT Coalition

6. Federally funded Technical Assistance and Services Center (TASC)

9. Engage patients and families

10. Improve care coordination

12. 2011 2013 2015 Bending the Curve Towards Transformed Health; Achieving Meaningful Use of Health Data “Phased-in series of improved clinical data capture supporting more rigorous and robust quality measurement and improvement.” Source: Connecting for Health, Markle Foundation “Achieving the Health IT Objectives of the American Recovery and Reinvestment Act” April 2009

14. For hospitals, yes

15. AHA survey and Flex survey

17. AHA Survey Urban hospitals using IT more than rural hospitals

19. CAHs have high use rates for administrative and financial IT application, but much lower rates for clinical applications

20. CAH HIT use rates are lower than overall rates for hospitals

22. Lack of support for HIT systems, programs, software, etc… is also an issue

24. It is difficult for rural providers to make an informed decision about vendors

26. Hard to find physician or administrative leaders/change agents

27. Other business priorities i.e. “surviving”

29. Need to address critical referral pattern issues, disruptions, patient flows, etc.

31. HIT Theme Strategy Map Increased cost efficiency Increased market share Increased revenue Clinical processes Acquire HIT expertise Ensure a skilled workforce Business processes Operational processes Establish an empowering work culture Leadership Instill change management Acquire needed HIT systems Ongoing education Patient safety outcomes Patient satisfaction Increased margin to fund mission Community health outcomes Physician satisfaction Finance As financial stakeholders, how do we intend to meet the goals and objectives in the hospital’s Mission Statement? Customers & Community As customers of the hospital’s services, what do we want, need or expect? Internal Processes As members of the hospital staff, what do we need to do to meet the needs of the patients and healthcare community? Learning & Growth As an organization, what type of culture, skills, training and technology are we going to develop to support our processes?

33. Pulleys

34. Wheels & axles

35. Ramps

36. Wedges

38. A Network as a Simple Machine It increases the effort that is applied to issues affecting your members, so that the benefits are larger than what individual members could reasonably accomplish on their own. It can increase the speed at which these benefits are accomplished. Best of all, you can achieve both of these things at once and so much more.

39. On to the Network Summit December 15-16, 2009, Minnesota Sponsored by the National Rural Health Resource Center and the National Cooperative of Health Networks Funding from the Health Resources and Services Administration, Office of Rural Health Policy

40. On to the Summit

41. Who Attended? Montana Rural Health Care Performance Improvement Network Western Healthcare Alliance The Hospital Cooperative National Cooperative of Health Networks Oregon Rural Healthcare Quality Network Montana AHEC and Office of Rural Health Rural Healthcare Quality Network University of Minnesota, Rural Health Research Center Upper Peninsula Michigan Network Federal Office of Rural Health and Policy Texas Organization of Rural Community Hospitals Illinois Critical Access Hospital Network Rural Wisconsin Health Cooperative

43. Critical success factors

44. Lessons learned

45. National knowledge center

47. Why Do Networks Form? Economies of scale and access to funds Advocacy at the regional, state and national level Develop new products and services Increased manpower and technical expertise Address common needs Share education, information and other resources Networking and peer support Enable benchmarking and improvement Meet future challenges and create opportunities

48. Health Information Technology Challenges included: Agreeing on a common system/ownership of data Achieving interoperability/exchange Shortage of skilled professionals Lack of capital funding to purchase EMR systems

49. Health Information Technology Lessons learned: Networks must be involved in state/regional HIT policy and activities Networks should help formulate a vision for how HIT improves quality, safety, efficiency and productivity Recruit, train and share qualified HIT staff and consultants Seek capital funding, discount pricing and shared services

52. Develops and manages a variety of products and services

53. Assists members to offer high quality, cost effective healthcare

54. Assists Members to partner with others to make their communities healthier

55. Generates additional revenue by services to non-members

57. Promoting efficient use of information technology services

58. Maintaining and further developing specific-type user groups, activities and list serves that promote hospital operational efficiencies and connectivity

59. Offering on-going educational opportunities and resources

60. Developing and offering projects that are self-sustaining and add value

62. Western Colorado Health Alliance 27 Hospital members Since 1989 Numerous business products and services (e.g. collections) Returns cash dividends to members Shared IT staff

63. Upper Peninsula Health Network All 14 hospitals in UP of Michigan Since 1997 Telehealth network Also have a health insurance product Various business products

64. Northern Montana Healthcare Alliance Since 2003 15 hospitals Coordinated fundraising and implementation of EHRs Ongoing education Administer the regional telehealth network Clinical services Conferencing

65. Nevada Rural Hospital Partners 14 hospitals Since 1987 Group purchasing of equipment and support Standardize practices and processes Negotiate discounts Dedicated CIO and IT staff Developing a Health Information Exchange

66. Other HIT Networks Integrated Health System of Alabama (2004) Guadalupe Valley Healthcare Network (1995) Minnesota Rural Health Coop (1995) Lake Okeechobee Rural Health Network (1994) Community Health Network of West Virginia (2000) Ohio State Health Network (2001) Appalachian Health Information Exchange (2008) Susquehanna Valley Rural Health Partnership (2002) St. John’s River Rural Health Network (1994)

68. Strong team/coalition

69. Clear vision and planning framework

70. Ongoing communication

71. Empowerment and engagement of staff

72. Short-term wins

74. Network with other hospitals

75. Seek out the experience of others who have done it already

76. Raise awareness that HIT implementation will be difficult but necessary

77. Involve employees and medical staff throughout the hospital

78. Begin to to clean up/document hospital processes now

81. Terry Hill Executive Director National Rural Health Resource Center 600 East Superior Street, Suite 404 Duluth, MN 55808 (218) 727-9390 ext. 232 thill@ruralcenter.org