Transcript Document

Southeast Michigan Health Information
Exchange
Stakeholder Kick Off Meeting – September 27, 2007
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Agenda
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Health Information Exchange Overview
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Healthcare in Southeast Michigan
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SEMHIE Project and Benefits
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Initial Governance Committee
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Operating Rules
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Participation Agreement and Conflict of Interest Forms
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Major Tasks, Deliverables and Milestones
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SEMHIE Outcomes
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The Current State of Health Information
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Your health records currently reside in multiple
organizations
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Your health plan has information about things they’ve paid
for
Your primary care physician has information about your
health and services he or she has rendered
The specialist you went to last month has information about
what they did
The hospital has info about a surgery you had
The lab, the pharmacy…
Health information is currently ‘organization-centric’
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Organized around the needs of individual organizations
Disparate electronic connections
Connections largely limited to administrative needs
Consumers are left out
Uncoordinated, inefficient transactions
Clinical decisions are not fully informed
Stakeholders and consumers frustrated
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The Future of Health Information with HIEs
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Health Information Exchanges (HIEs) seek to make health
information more ‘patient-centric’
HIEs enable sharing of clinical and administrative information
between organizations
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Streamlined electronic connections
Reduced administrative burden
Consumers are included
Coordinated, efficient transactions
Clinical decisions are more informed
Enhances workflow efficiency
Improves quality of care
Stakeholders and consumers satisfied
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The Future of Health Information with HIEs
Clinical Information Collection
Consumers
Laboratories
Information Communication
Hospitals
Hospitals
Physicians
Employers
Pharmacies
Insurers
HIE
Labs
State Offices
Insurers
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Clinical Messaging
Medication Reconciliation
Results delivery
Secure document transfer
Shared EMR
Clinical Decision Support
Credentialing
Eligibility checking
• Clinical Messaging
• Provider Orders
• Results delivery
• Needs Assessment
• Surveillance
• Reportable conditions
• Clinical Quality Measurement
• Claims Adjudication
• Secure document transfer
State Offices
Physicians
Provides the means to gather and connect
electronic healthcare information
Then securely communicates that
information across organizations
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Healthcare in Southeast Michigan
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Over 43% of Michigan’s population
Over 2 million covered lives
Over 12 million annual visits
Nearly 650,000 annual discharges
Over 7 million lab tests annually
More than half the State’s physicians
245,379 health sector employees
representing $12.1 billion in wages and
salaries
Wayne MTA - Inpatient Payer Mix 10
HMO *
Medicaid
Medicare
45%
Medicare
Other **
Other
4%
Medicaid
13%
PPO
Trad
PPO
10%
HMO
17%
Trad
11%
* Excludes Medicaid and Medicare HMO
** Other incl: Corrections, Mental Health, Other Gov't, Workers Comp, Title V, Self Pay, No Charge
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SEMHIE Initiation
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Kick off of HIE feasibility study by Covisint / 3 autos: February
2006
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Expansion of participants to include other stakeholders:
began April 2006
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Transition to Community Based Initiative:
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Initiation of discussion: June 2006
Adoption of mission and vision statement: August 2006
Initiation of host selection process: September 2006
Formalization of host organizations for planning phase:
November 2006
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Altarum (lead host)
Greater Detroit Area Health Council
Oakland County Medical Society
Wayne County Medical Society
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SEMHIE Project
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The Southeast Michigan Health Information Exchange
planning project will advance the implementation of integrated,
interoperable health information exchange across the region,
supporting the data needs of physicians, health systems /
hospitals, patients, employers, health plans and other regional
constituents.
SEMHIE will provide a platform for the delivery and sharing of
electronic health information in a secure and timely manner to
authorized users across organizational
boundaries.
SEMHIE stakeholders are dedicated to:
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Enhancing patient care quality and safety
Increasing effectiveness/efficiency of
healthcare delivery
Reducing healthcare costs
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SEMHIE Objectives
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Establish a sustainable, self-sufficient business model
that aligns costs with benefits for the stakeholders
Provide for secure, private and efficient crossinstitutional exchange of clinical and administrative
healthcare data
Create a secure, ubiquitous, interoperable health
information technology infrastructure consistent with
state and federal standards / guidelines, where
applicable
Link to national and regional efforts through use of a
common trust framework, business and operating
rules, technical infrastructure, and governance models
for federated identity management and interoperability
Develop and maintain an environment of trust among
the stakeholders
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SEMHIE Benefits to Southeast Michigan
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Facilitating the exchange of information among
stakeholder organizations – and later between those
organizations and consumers – will significantly
enhance coordination, reduce costs, and improve
quality of care…
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Resulting in reductions in duplicative tests and procedures,
improvements in patient safety, more efficient diagnostic
processes, and reductions in the costs of administrative
transactions
Improved access to healthcare information results in
better quality care, healthier populations and
decreased costs…
And better quality of care, healthier populations and
decreased costs increase competitiveness of
Southeast Michigan
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Initial Governance Committee Members
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Membership Class
Associations
Clinician Groups
Community Groups
Consumers
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Employers
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Government
Health Plans
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Health Systems
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Ancillary Services
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Medical Societies
Maximum Number of
Representatives on the GC
Current Participants
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John Kerr, Greater Detroit Area Health Council
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Marsha Manning, General Motors
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Toshiki Masaki, Ford Motor Company
Cassandra Saunders, Chrysler
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Mary Smith, Blue Cross Blue Shield Michigan
Tom Centlivre, Trinity Health
Helen Hill, Henry Ford Health System
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Jeanette Klanow, St. John Health System
Paula Smith, Oakwood Health System
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Adam Jablonowski, Wayne County Medical Society
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Donna LaGosh, Oakland County Medical Society
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Operating Rules
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The SEMHIE Governance Committee has developed
and adopted a set of Operating Rules to serve as a
governance framework for the Consortium
SEMHIE Operating Rules were adopted September
17, 2007
These Operating Rules contain the SEMHIE mission,
vision and objectives, as well as operational
parameters for the Governance Committee,
Participant Committee and work groups
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Joint Participation Agreement and
Conflict of Interest Forms
In order to participate in the SEMHIE efforts, organizations
must complete a Joint Participation Agreement and must
disclose any potential conflicts of interest (COI) that may
impact their ability to participate in an impartial manner
Definition of Conflict of Interest:
A conflict of interest exists when a Participating Member has a clear financial or personal
interest in a matter under consideration by the Exchange. A personal interest of a SEMHIE
Participating Member includes the intention of the Participating Member, an organization that
the member is affiliated with, or member’s employer to market or sell a service or product to
the Exchange, even though the Participating Member may not receive any pecuniary
remuneration as a result. A financial interest of a SEMHIE Participating Member includes
the intention of the Participating Member or member’s employer to receive monetary
remuneration, from the Exchange.
Governing Members need to declare that they have no
conflicts
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Major Tasks
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We have grouped activities into five major tasks for
the 15-month planning phase:
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Engage stakeholders and formalize planning-phase
organizational structure
Determine scope of services and business model
Define requirements, policies and performance metrics
Establish post-planning organizational entity
Evaluate and solicit technical solutions
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Planning Phase Key Deliverables
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The establishment of a formal organization built on
trust and supported by established operating rules
Development and implementation of a solvent and
sustainable business plan
The creation of a solid strategy for community and
stakeholder involvement
The development of a defined scope of services and
technical strategy for the HIE, informed by an
assessment of technological capabilities, market
readiness, and market need
The release of a request for proposal (RFP)
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Planning Milestones
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SEMHIE Outcomes
When successfully deployed, the Southeast Michigan Health
Information Exchange will enhance patient care quality and
safety; increase the effectiveness and efficiency of healthcare
delivery; and reduce healthcare costs.
Consumers
Laboratories
Hospitals
Employers
Pharmacies
Insurers
Secure, electronic
health information
hub
Physicians
State Offices
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