Paul W. Brient, President & CEO

Transcript Paul W. Brient, President & CEO

Health Information Exchange and Meaningful Use at the Hospital Level

Paul W. Brient, President & CEO March 11, 2010

Agenda

 PatientKeeper Overview  HIE and Meaningful Use  HIE Case Studies – Healthy Ocala – HealthCare Partners (HCP)  Perspectives on Making HIE Successful in Puerto Rico  HIE and CPOE demonstration

PatientKeeper



Experience and Success

– 11 years of experience developing applications and integrating data for physicians – 2 U.S. Patents • Synchronization across multiple disparate systems • Physician Charge Capture – Large, diverse customer base across all settings of care (Health Systems, AMCs, HIEs, Community Hospitals, Large & Small Physician Practices) 

Stable and Growing

– More than 17,000 active users every day • Expected to double over the next 12 months – More than 400 hospitals – Offices in Boston and Chicago

We Have The Privilege of Working With A Wide Variety of HealthCare Delivery Organizations

Academic Medical Centers National Health Systems

 Brigham & Women’s  Georgetown  H. Lee Moffitt Cancer Center (USF)  Mass General  Mt. Sinai – NY  North Shore-LIJ  Ohio State University  SUNY Stonybrook  Tulane  UCSD  VCU  Adventist East  CHI  CHRISTUS Health  HCA  HMA  Lifepoint  Tenet

Stand-Alone Community Hospitals RHIO/HIE Long Term Care/Rehab Multi-Facility Hospitalist Groups Group Practices

 Berger Health (OH)  BroMenn (IL)  Hardin (KY)  Halifax (FL)  Mercy (Cedar Rapids, IA)  Morris (IL)  Opelousas General (LA)  Healthy OCALA  Health Care Partners  Hebrew Senior Life (MA)  Masonicare (CT)

Regional Community Hospital Systems

 BayCare (FL)  Bassett Health System (NY)  Iowa Health System (IA)  Mayo Health (MN)  Memorial Health System (FL)  Memorial Health System (IL)  Norton (KY)  Oakwood Health System (MI)  Ochsner Community Hospitals (LA)  St. Vincent's Catholic Medical Ctr (NY)  Community Hospitalists  Executive Health Resources (PA)  HealthCare Partners (CA)  Inpatient Physicians Network  Athens Pulmonary & Allergy (GA)  Atlanta Gastroenterology (GA)  Carson Tahoe Psychiatry (NV)  Charter Health (MA)  Digestive Health Specialists (WA)  Florida Cardiothoracic Surgery (FL)  Highland Family Practice (NC)  Midwest Heart (IL)  Pulmonary Medical Assoc (CA)  Tucson Pulmonology (AZ)

And Have Extensive Integration Experience and Expertise

HIS

Cerner Classic Cerner Millennium Children’s Hospital EMR Eclipsys Sunrise Eclipsys Sunrise XA Epic GE/IDX Carecast HCS Medics McKesson Star McKesson Series McKesson Horizon MEDITECH Magic MEDITECH C/S Partners BICS/LMR Siemens MedSeries 4 Siemens Invision Siemens Sorian Quadramed

Lab

LabStat MEDITECH Mock Labs MISYS SnQ SoftLab Quest LabCorp

Practice Management

A4 ADS Athena BillWork eClinicalWorks Epic GE Centricity PO GE/IDX Flowcast GE/IDX Groupcast Greenway HealthPack Keane MEDITECH LSS MEDITECH MPM Medical Manager Misys NextGen Sage Intergy Siemens Invision TimeTrade

Ambulatory EMR

A4 Allscripts eClinicalWorks Epic Greenway GE Centricity EMR MEDITECH/LSS Misys NextGen Partners LMR Quest Wellogic Consult

DEPARTMENTAL SYSTEMS Radiology/Path/Micro

CoPath GE/IDX Imagecast Novius SoftPath

Pharmacy

Medics Mediware RxTFC

PACS/Imaging/ Video

ChartOne GE QS Fetal Monitoring ImageCube/ CannonPACS DR PACS Iatrics MyFreePACS Stentor PACS Sony IR ICU Camera (SNC-RZ25N) GE PACS

Reference Labs & Pharmacy

RxHub Quest SureScripts

Transcription

Arrendale Assistmed Doc-In-A-Row EDIS Medquist/Dictaphone Quadris/Dolbey

Agenda

The HITECH Act and Meaningful Use Is Driving The “Last Mile” of HealthCare Automation

 Physicians must install EMR systems and start sharing data  Hospitals must exchange information with hospitals, providers, and patients  Hospitals are required to implement the last of the physician automation functionality – Physician Order Entry (CPOE) – Physician Documentation

--- AND ---

 Organizations will have to achieve significant adoption/use of the system in three years

HealthCare Information Exchange Isn’t A New Concept

CHIN - Community Health Information Network RHIO - Regional Health Information Organizations

And Now

HIE - Health Information Exchange

HealthCare Information Exchange Has Been A Key Part of HealthCare Reform

“Among the many problems facing health care today is the inefficient sharing of a patient's medical information. This inefficiency can lead to inaccurate diagnosis, inappropriate treatment, and more frequently duplicated testing. The total cost to US health care because of these problems is significant. For that reason, several of the health care reform proposals offered today include a requirement for a regional database.”

This Was Written Over 15 Years Ago

―Wakerly, Ralph. (

October 25, 1993

). Info networks to be integral in reform. Modern Healthcare, 54-56.

CHIN and RHIO Initiatives Struggled

 Over 500 CHIN projects nationwide in 1995 – Few got past the planning phase – Funded by National Telecommunications and Information Administration and HRSA Rural Health Telemedicine Grants – Many driven by Regional Bell Operating Companies (RBOCs)  About 165 RHIOs established by 2006 – Only 26 “fully operational” and actually exchanging clinical information – None had demonstrated a sustainable business model – The most celebrated (The Santa Barbara County (Calif.) Care Data Exchange) shut down in March 2007 Source: Scientific Technologies Corporation 2001, eHealth Initiative 2006

Common Themes…

 Most ran out of money or energy before they got into operation  Of those that were able exchange healthcare data, many had to shut down or change what they were doing – Very low physician use or physician endorsement – No significant impact on healthcare costs  There were a lot of challenges – Few standards – Largely paper-based physician practices – No clear mandate – No “off the shelf” software

We Have Taken A Unique Approach To Health Information Exchange & Meaningful Use

 Providing both the Health Information Exchange

AND

the applications necessary to meet Meaningful Use Requirements and ensure physicians actually use the data being exchanged

Health Information Exchange + Physician Workflow Applications = Successful HIE Deployment And Achievement of Meaningful Use

PatientKeeper Offers A Full-Featured HIE Infrastructure

And A Complete Set of Physician Applications

Clinical Suite

Access Patient Information Anytime-Anywhere PatientKeeper Physician Workflow Applications Physician Portal Mobile Clinical Results CPOE Ambulatory Order Entry Medication History ePrescription

Documentation & Communication Suite

NoteWriter Sign-Out Forms Provider Directory eSignature

Financial Suite

Charge Capture Charge Analytics P4P: PQRI

To Create A Single Environment To Support Your Physicians

Agenda

Case Study: Healthy Ocala RHIO

 A health information exchange serving Marion County, Florida – In the process of expanding to 9 other counties in Central and North Florida  A model for a self-sustaining RHIO with broad community participation  Utilize PatientKeeper as their health information exchange infrastructure and for physician workflow applications – Tightly integrated with WorldDoc Personal Health Record – Tightly integrated with ambulatory EMRs including Greenway

We Offer Healthy Ocala Members Multiple Ways To Enroll

 Patients “opt-in” to Healthy Ocala Health Information Exchange – Self-service through WorldDoc PHR and passed through to PatientKeeper – Enrolled at Physicians office using PatientKeeper – Enrolled as part of Prestige 55  PatientKeeper creates a complete longitudinal medical record for all enrolled patients with data from hospitals, physician practices, reference labs, imaging centers, LTC facilities, home care providers, and using patient-reported data from the PHR

Healthy Ocala Infrastructure

Physicians Physician Offices Patients Munroe Regional Medical Center PatientKeeper System Ocala Regional Medical Center West Marion Community Hospital

Case Study: HealthCare Partners

 HCP uses PatientKeeper to exchange discharge summaries, patient demographics, and discrete clinical information from over 25 hospitals with their practice EMRs  HCP Hospitalists enter post-discharge orders into the PatientKeeper system – These orders are routed to the relevant practice’s EMR and to HCP Care Managers to ensure continuity of care/handoff as patients are transitioned back to their PCP’s care

Healthcare Partners Infrastructure

San Fernando Valley  Mission Community Hospital (McKesson Paragon)  Providence Holy Cross Medical Center (Eclipsys 7000)  West Hills Hospital and Medical Center (MEDITECH Magic)  Valley Presbyterian Hospital (McKesson Precision 2000) Pasadena/San Gabriel Valley  San Dimas Hospital (McKesson Star)  Verdugo Hills Hospital (Siemens Medseries4)  Methodist Hospital (McKesson Star)  San Gabriel Valley Medical Center (Siemens Medseries4)  Huntington Hospital (MEDITECH Client Server)  Foothill Presbyterian Hospital (MEDITECH Magic) PatientKeeper Application Server GE Centricity Business Allscripts EMR Los Angeles  Glendale Memorial Hospital & Health Center (McKesson Star)  Beverly Hospital (MEDITECH Magic)  California Hospital Medical Center (Siemens Medseries4)  Good Samaritan Hospital (MEDITECH Client Server)  Monterey Park Hospital (Self-Developed) South Bay  Torrance Memorial Medical Center (Stockell InsightCS) Long Beach  Long Beach Memorial Medical Center (Keane Patcom Plus)  St. Mary Medical Center (McKesson Star)

Keys To Making Health Information Exchange Work



Keep costs low by making this an integral part of the overall healthcare IT infrastructure

– The “Other” HITECH initiatives • Physician (EMR) • Hospital (Order Entry, Physician Documentation) – Physician workflow improvements – Personal Health Records (PHR) – Care Management (UR, Case Management, Disease Management) – Downtime Capabilities 

Make workflow for physicians as seamless as possible

– Physicians should not have to “go somewhere else” to access external information 

Enable physicians to drive changes in care delivery

– Publish summary data with process metrics and outcome metrics – Encourage research around what is most effective in Puerto Rico – Incorporate learnings into workflow systems (EMR, CPOE) – This must be physician driven to the extent possible

Agenda

There Is An Opportunity To Create An Island Wide Health Information Exchange

Ancillary Labs SAIL QIPRO RxPharmacy Physician Offices

Puerto Rico

Exchange Health Plans     SSS MMM MCS Humana Auxilio Mutuo Hospital Cardiovascular Center of Puerto Rico Hospital Buen Samartino Hospital Episcopal San Lucas Metro Pavia Health University of Puerto Rico Hospital Community Health Centers (333’s)

This System Can Be Built Incrementally

Begin importing data from your hospitals

– – One HIS system at a time Make the data available to physician practices via a web browser and smartphones

Deploy EMRs to your physician practices

– HITECH funds will make this self-funding for physicians

Import data from reference labs 4.

Import data from each EMR-enabled physician practices 5.

Implement island-wide PHR (Personal Health Record) 6.

Push data back to each EMR-enabled physician practice 7.

Deploy CPOE and Physician Documentation 8.

Start developing and implementing quality improvement programs

Puerto Rico Has A Unique Opportunity To Use HIE To Understand and Impact HealthCare Delivery

 Puerto Rico is a fairly closed system  Of sufficient scale to be meaningful but not so big/complex that change is impossible  With significant potential for cooperation and collaboration across the healthcare continuum – Payers – Care Management – Hospitals – Physicians