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Better Outcomes. Delivered. Impacting the Healthcare of our Community Through Quality Measures and Community Collaboration The nation’s largest health information exchange: over 80 Indiana hospitals and over 18,000 physician participation. www.ihie.org IHIE Network Participation includes over 80: • Hospitals • Long-term care facilities • Immediate Care centers • Rehabilitation centers • Behavioral Health centers • Free-standing labs and imaging centers www.ihie.org Vision and History • IHIE’s vision: — Improve the quality, safety and efficiency of healthcare in the state of Indiana — Create unparalleled research capabilities for health researchers — Establish a model of health information exchange for the rest of the country • IHIE was launched in February 2004 by Regenstrief Institute, 5 major health systems, local and state public health, and other key business and community leaders • The Regenstrief Institute is the key partner – an international leader in health information technology research and development for over 40 years www.ihie.org www.ihie.org Indiana Network for Patient Care™ The INPC™ provides a secure ‘virtual’ patient record for: • Safer, better care through access to a complete, aggregated clinical record • Reduction in redundant testing • Medication lists to improve the quality and reduce the time of med reconciliation • Access to the clinical record in the ED, Inpatient, and outpatient setting • Electronic data sharing into hospital EMRs www.ihie.org INPC Stats • 3 billion pieces of clinical information • 11 million patients • 1,400 interfaces • 5 large payers • laboratories • radiology centers • State and Local public health agencies www.ihie.org www.ihie.org DOCS4DOCS® Service Provides Value By: • Improving provider’s access to data in their offices • Providing incremental step to moving providers to information based practice • Creating data flows from many sources • Engaging physician practices directly • Contributing sustainable funding for HIE • Providing standardization of clinical information www.ihie.org Provider Reach • Over 18,000 physicians • 5,800 practices • 6 million messages/month www.ihie.org www.ihie.org Quality Health First® Program The Quality Health First Program is a multi-payer, value-based reimbursement program: • Helps physicians identify and prioritize health screenings and other testing; provide early interventions and consistent support • Enhances reimbursement for physicians • Focuses on cancer screenings, diabetes care, heart disease care • Payor participants include: Anthem BCBS, UnitedHealthcare, Unified Group Services, Medicare, Medicaid • 1,600 physicians in over 50+ communities participate • Covers over 1 million patients www.ihie.org Quality Health First® Program Uses clinical data from the IHIE and claims data from payers in a multi-payer, value-based reimbursement program. Includes patientspecific alerts and reminders to physicians. • Improved quality of care • Clinical decision support at no cost to hospitals or physicians • Increased reimbursement for primary care practices • More credible and “user friendly” P4P program for physicians www.ihie.org QHF Program Data Sources Medicaid / Medicare Hospitals Commercial Payers Outpatient Rx Labs Public Health Point-of-Care Testing Physicians Office Ambulatory Centers www.ihie.org Process Flow Provider & Patient-specific Reports Providers Patient Level Detail Clinical Data Sources Rules Engine Clinical Data Provider Level Summary Payers Payor-specific Reports www.ihie.org Priority Measures Measure Definition AWC Adolescent Well Care Visit BCS Breast Cancer Screening CCS Cervical Cancer Screening CHL Chlamydia Screening DC1 Diabetic HBA1c Screening DC3 Diabetic LDL-C Screening W15 Well Baby Visits W34 Well Child Visits www.ihie.org View of the Provider Summary Report Delivered regularly, these reports provide an overall view of the provider’s score of each priority measure the provider falls into compared to the Adjusted Peer Score. www.ihie.org QHF Program Web Application View www.ihie.org Unique Attributes The Quality Health First Program: • Is managed by IHIE, an independent non-profit organization • Integrates multiple health plans’ data to assure the provider’s reports represent a significant portion of his/her practice • Allows physicians to reconcile reports and submit “point of care” data • Is not only a “performance measuring program” but also a service to proactively improve individual patient care • Reports measures that are provider-designed and approved by community physicians www.ihie.org Future Plans and Other Services Addition of New Measures • • • • Cardiology Mental Health Immunizations Medication Adherence Addition of Specialties • • Cardiology Endocrinology PQRI Registry • Submit data on a specific set of measures: CMS Initiative Meaningful Use • Work with Regional Extension Centers in guiding practices towards meeting Meaningful Use Objectives. www.ihie.org Projects related to the QHF Program Medicare Health Care Quality Demonstration Section 646 of the Medicare Modernization Act Aligning Forces for Quality The Robert Wood Johnson Foundation Central Indiana Alliance for Health Aligning Forces for Quality Beacon Community Cooperative Agreement Program www.ihie.org Medicare Health Care Quality Demo • Reducing healthcare costs by implementation of community-wide quality measures • A five year project that looks at the impact of the QHF Program on reduction of healthcare costs • Compares medical costs, per year, over a five year period, to like communities • Opportunity to receive up to 50% of healthcare dollars saved • Healthcare dollars saved will be distributed to physicians participating in the Demo through the QHF Program www.ihie.org Aligning Forces for Quality • Robert Wood Johnson Foundation Initiative • One of 17 Communities across the Nation • Grant Funded – Three Phases Phase 1 – Planning Phase 2 – Implementation Phase 3 – Expansion www.ihie.org Aligning Forces for Quality Planning Grant – Phase I • Build a Leadership Team by engaging community leaders • Hospitals • Providers • Health Plans • Employers • Consumer Advocates • Consumers • Build a foundation to create and leverage opportunities to collaborate • Central Indiana Leadership Team • Consumer Participation Group www.ihie.org Aligning Forces for Quality Implementation – Phase II • Central Indiana Alliance for Health • Implement Quality Improvement Models • Ambulatory Care • Inpatient Care • Address Disparities • Race/Ethnicity/Language (REL) data • Standardize how it is collected • Use R/E/L data in QI • Public Report/Consumer Engagement • Report Quality Performance • Patient Satisfaction Measures • Report on >50% providers www.ihie.org Aligning Forces for Quality Phase III – Expansion • Care Coordination across settings • Payment Reform Models • Meaningful Use Measures • Cost/Efficiency Measures • Transparency www.ihie.org AF4Q - Central Indiana Alliance for Health • Website launched February 2011 www.centralindianaallianceforhealth.org • Links to Public Reports www.ihie.org/Solutions/Quality-Health-First-Program/public-reporting.php • Information for Consumers regarding Chronic Disease Management and Prevention • Resource for Consumers and Providers • Future Resource for Payers and Employers www.ihie.org Central Indiana Beacon Community Program • One of 17 communities across the nation selected to participate in the Beacon Community Cooperative Agreement Program. • The Central Indiana Beacon Community works to track outcomes related to Quality, Efficiency and Population Health. www.ihie.org Central Indiana Beacon Community Program Central Indiana Beacon Community Goals: • Increase the proportion of diabetic patients whose blood sugar and cholesterol are under control • Reduce hospital admissions and emergency room visits for patients with conditions that could have been treated in an outpatient setting • Increase screening for cancers of the colon and cervix • Assist Indiana's Regional Extension Centers to support the adoption of electronic health records/Meaningful Use www.ihie.org Objectives to Measurable Outcomes Measured Outcomes National Beacon Objectives Quality Indiana Beacon Objectives Diabetes Control Cost ACSC Admissions Improvement Imaging Population Health Meaningful Use Increase Preventative Screening Meaningful Use www.ihie.org Questions? Jackie Eitel 317.644.1749 [email protected] Jill LeMasters 317.644.1745 [email protected] www.ihie.org www.ihie.org