Transcript No Slide Title

Community Health Access
Network (CHAN)
a Health Center Controlled Network
(HCCN)
501(c)(3) Founded 1995
2008 HIMSS Davies Award Winner
Community Health Organization (CHO) Category
CHAN’s HCCN Model
• Non profit, 501(c)(3)
• Board of Directors: CEOs/EDs of our Full
Members
• Fee Structure: Annual Dues, Monthly Shared
Systems Fees (based on # of software licenses)
• Robust Committee Structure
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Health Services Committee (Medical Directors, Site Administrators)
EMR Users Group Committee (Providers)
Business Office Manager Users Group (BOMUG)
Finance Committee (meets quarterly)
Others as needed (ie Due Diligence Committee)
CHAN’s HCCN Members
6 Full FQHC members with 14 sites + 1 Healthcare for the
Homeless van
-Avis Goodwin CHC (1 site; Dover - 1 site; Rochester)
-Families First Health and Support Center (1 site;
Portsmouth plus Healthcare for the Homeless
Program van)
-Health First Family Care Center (2 sites; Franklin and
Laconia)
-Lamprey Health Care, Inc. (4 sites; Raymond,
Newmarket, (2) Nashua )
-Manchester CHC (1site; Manchester)
-Shackelford Community Resource Center-central TX
(4 sites)
4 Affiliate members with 10 sites
-Coos County Family Health Services (2sites; Berlin – 1
site; Gorham)
-Ammonoosuc Community Health Services, Inc. (5
sites; Littleton, Woodsville, Whitefield, Franconia,
Warren)
-Healthcare for the Homeless Program (1 site;
Manchester)
-Harbor Care Clinic, FQHC Healthcare for the
Homeless Program (1 site; Nashua)
What do we offer our members?
• Fully implemented and integrated Meaningful Use Certified GE
Centricity Electronic Health Record/Practice Management
infrastructure (over 37,000 Observation terms, 65,000 active patient records)
– Central server architecture; 37 virtual servers supported on site
• Secure Patient Portal (email, appts, prescription refills, lab results, pt “view
only” access to their records)
• Robust Security Infrastructure (BotNet Filter, Intrusion Protection Software)
– Back up system, including Kohler generator and heptoflouropropane fire
suppression system which will not harm staff or servers in the event of its
release.
– IT staff with 75 years combined CHC experience
– 24 hour Help Desk Support
– e-form authoring
– Staff training
• Robust Data Warehouse with drilldown reporting to support Clinical
and Operational Report Development (i.e. UDS, network dashboard
reports, clinical quality indicators for individual sites)
Mature EHR Infrastructure-Linkages
Advanced Electronic
Prescribing
LAB RESULTS
3+ Reference Labs
MEDICAL EQUIPMENT
EKG (Cardiosoft)
Spirometry (Midmark)
Electronic
Health Record
Outbound Fax
Referral Information to
Specialists
Consultation Reports
SCANNING
State Lab Results
Hospital Documents (if
not linked)
Consultation Reports
HOSPITAL DOCUMENTS
(via Electronic Link)
Diagnostic Testing Results
Emergency Dept Visits
Discharge Summaries /
H&P’s
SECURE MESSAGING
 Referrals to
Specialists
 Consultation Reports
 Provider/Patient
Communication
CARE CATALYST
Patient Entered Data
(BG levels)
Patient Requests for
Refills, Appts., Referral
Requests.
Clinical and Operations Reporting
Infrastructure
• Reporting priorities are determined by members and the
healthcare environment
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UDS
Meaningful Use
NH State reporting requirements
Insurers
Network wide QI initiatives
• CHAN develops and posts reports centrally
• Members have capability to develop their own reports to
meet their individual needs
– Chronic disease management
– Recalls and follow-up
Asthma Case Management Report
Note: The report captures the last value entered for Flu Vax, Sx Free Days,
Severity Assessment, and Peak Flow assessed within the past 365 days.
Visit Hx and medication refills capture data for the past 12 months. Any
upcoming appointments will be listed in the appointment section.
PATIENT NAME
Age 25
Severity Assessment :
ASTHMA, MILD INTERMITTENT, UNSPECIFIED
Mild Intermittent
Symptom Free Days Days (past 2 weeks):
6
Flu Vaccination:
10/23/2008
PFM: 440
05/20/2009
Albuterol Refill History (past year):
ALBUTEROL 90 MCG/ACT AERO
Qty:
1 MDI
Refills:
5/20/2009
Visit History (past year) :
OV
OV
OV
OV
reason:
reason:
reason:
reason:
Asthma follow-up
meds
Asthma exacerbation/anxiety
lesion labia
Scheduled Appointments:
11/18/2009
SITE
PATIENT NAME
Age 51
05/20/2009
04/01/2009
01/15/2009
12/30/2008
Provider Name
Asthma Follow-Up
ASTHMA, MILD INTERMITTENT, UNSPECIFIED
Severity Assessment : Mild Intermittent
Flu Vaccination:
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MU ready reports
Core
 Hypertension: Blood Pressure Measurement (NQF 0013)
Alternate
 Weight Assessment and Counseling for Children and Adolescents
(NQF 0024)
 Childhood Immunization Status (NQF 0038)
Menu
 Asthma Pharmacologic Therapy (NQF 0047, PQRI 53)
 Diabetes: HbA1c Poor Control (NQF 0059, PQRI 1)
 Diabetes: LDL Management & Control (NQF 0064, PQRI 2)
Anticoagulation Office Visit
Network benefits (per a CHC
member)
• Access to centralized knowledge bank for minimal
cost
• Advanced infrastructure
• Creates cooperation and friendly competition
between members –
“Coopitition”
• Upgraded EHR system will meet “Meaningful
Use” certification; direct financial benefits to
CHC’s
Current CHAN Projects which
address meaningful use…
• Data Warehouse Expansion– allows independent agencies
access and utilization of the CHAN DW
• Upgrade of GE EMR to Meaningful Use v9.5
• Upgrade of PM to GE v10 to support 5010 electronic claim
submission required as of 1/1/12
• Preparation for ICD-10, to ensure cross matching will
support reimbursement
• Collaboration with stakeholders for development of NH
HIE
• Network Master Patient Index to support HIE
CHAN MU Core Objectives Scorecard
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Problem List
Medication List
Demographics
Smoking Status
Vital Signs
Drug Interactions
Medication Allergy Lists
Orders
E-prescribing
 Report Clinical Quality
Measures to CMS of State
 Decision Support
 Risk Analysis
Clinical Summaries-in
process
HIE- in process
PHR-in process
CHAN MU Menu Objectives Scorecard
 Drug formulary checks
 Lab test results
 Pt lists by condition
 Patient Education
 Medication Reconciliation
 Immunization Registries –
no State capabilities
 Syndromic Surveillance –
no State capabilities
Pt reminders – in process
Pt electronic access-in
process
Transitions of care-in process
NH HIE
Phase I- Project Initiation and Planning
Phase II – Transition
Phase III - Implementation
NH HIE
American Recovery and Reinvestment Act- Funding
for Health IT includes…..
State HIE Cooperative Agreement Program (ONC);
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announced 8/20/09
Letter of intent submitted to ONC – 9/11/09
(Designated Entity to apply for grant; NH DHHS)
Notification of Federal allocation of $5.5M – 9/22/09
Application submitted to ONC – 10/16/09
NH Health Information Exchange Planning and Implementation
Project (HEIPI) begins - 11/2/09
Phase 1: HEIPI Project
Initiation
• NH DHHS hired staff dedicated to NH HIT/HIE
and HIEPI project
– Dave Towne; State HIT Coordinator
– Elizabeth Shields; Project Manager
• NH DHHS hired Consulting Partner;
Massachusetts eHealth Collaborative (MAeHC) to
lead creation of NH’s HIE Strategic and
Operational Plan
• Stakeholder Engagement. Identify Stakeholders and
subsequent Work Groups
• Establish NH HIT/HIE Website
Phase 1; HEIPI Project
Initiation…cont
• Stakeholders (including, but not limited to)
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Large/Small hospitals
NH State Legislators
CHCs, Bi-State PCA, CHAN
NH Medical Society
NH Hospital Association
AARP NH
Health Plans
NH DHHS
Home Care Association of NH
• Work Groups
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Governance (includes CHAN rep)
Finance (includes CHAN chc rep)
Technical Infrastructure (includes chc rep)
Business and Technical Operations (includes CHAN chc rep)
Legal/Policy
Phase1; HEIPI Planning Phase
• Identify HIE phases
– Phase 1; Secure routing
– Phase 2; Expanded secure routing
– Phase 3; Community record
• Determine Governance Model
– Health Information Organization (HIO)
– Public-Private Partnership
• Determine legality
– Legislation filed as HB489; establishes a HIO for the electronic exchange
of health information.
• Determine market need
• Begin to develop sustainability model; visit key stakeholders
Phase 2; Transition
• Launching of the Interim Advisory Group (IAG);
4/29/11
– The IAG is a transitional, public-private governance
body for the HIE project
– The IAG acts under the authority of the NH DHHS
Commissioner transitioning to a Board with full
authority
– The IAG provides public-private governance to the
state level HIE project pending launch of the HIO
Phase 2; Transition…cont.
• Work Group Tasks/Activities
– Governance Workgroup
• Transition to IAG
• Support Legislative Process
• Set contingency plan and its triggers w/stakeholders
– Finance
• Market test value of proposed HIO services
• Draft the Business Plan
– Technology
• Find and engage a Technical Services Partner (TSP) to set up and
operate the technology platform – RFI and RFP process
• Evaluate, prepare, and certify Health Information Services Providers
(HISPs) to connect
– Legal/Policy
• Support legislative process
• Develop HIO policies and procedures for HIO
Phase 3; Implementation
Stay tuned!!
Contact Information
Kirsten Platte, Executive Director
[email protected]
603-292-7205