NeHII’s Goals For Statewide Interoperability Connecting Michigan For Health Conference

1. Community Betterment Through HIE“Engaging Community Stakeholders to Create a Sustainable, Large-Scale HIE” NeHII’s Goals For Statewide Interoperability Connecting Michigan For Health Conference Deb Bass, NeHII CEO June 7, 2017

2. Presentation Overview • Brief Overview of NeHII • Achieving Statewide Interoperability Using Revised Pricing Model • Achieving Statewide Interoperability Using Value Add Services • Prescription Drug Monitoring Program Support • Hospital Readmission Reporting • ADT Event Notification Services • Preview of the Future • Q&A

3. Current NeHII Stats Percentage of NE hospital beds connected – 65% Percentage of CAH beds connected – 52.2% Number of results in the system >148,388,705 Percentage of opt outs – 2.3% Number of HIE users – 9,358

4. 2016 Record Setting Year Records were set in 2016 for new user enrollment which include: 2016 Q1 – Most clinical staff added in a quarter (450) 2016 Q3 – Most providers added in a quarter (373) 2016 Q3 – Most pharmacists added in a quarter (149) 2016 Q3 – Most total users added in a quarter (954) 2016 Total – Highest number of providers (742), pharmacists (261), staff (1,423) and total users added in a year (2,426) 2016 Total – 2426 new users added accounts for 26% of total users on the HIE since NeHII’s inception  

5. NeHII Adoption

6. 2016 Financials Ended third straight year of profitability Growth realized through new participants, the State’s support with the legislative appropriation and grant payments Grants funds an important tool to allow NeHII to add functionality Unassigned Net Assets: $826,858 Financing through Mutual of Omaha Bank

7. Grant Funding Summary

8. Details Behind the Pricing Model Eliminate fees for licensed healthcare professionals to have access to the data Share the cost of the exchange evenly between payers and hospitals State of Nebraska considered a payer Utilize the most recent 2015 Medicare Cost Report and adjusted discharges as the tangible number Phased three year implementation schedule to allow for ease of transition

9. Hospitals & Health Systems Based upon adjusted discharge rate $4.96 per adjusted discharge Three year phased implementation schedule Letters distributed March 7, 2017 Calls made to all CEOs Limited number saw increases For CAH minimum fee of $500/month Use SHIP funding to offset HIE participation costs Reminder made of free access to all providers

10. Payers $25,000 annual fee plus PMPM fee Sliding scale based upon number of covered lives Eight tiers in the scale Lowest tier:1 to 74,999 lives = 17 cents PMPM Highest tier: more than 450,000 lives = 10 cents PMPM Includes ADT event notification and other value add services

11. HIE 2.0 Functionality Patient Lists: All My Patients, Favorites, Recently Viewed Printing CCD Exchange Patient Event Subscription Services Demographic Viewing ADT Alerting for Event Notification Readmission Reporting Direct Messaging Services

12. LB 471 and the enhanced PDMPWhere We Were, Where We Are, Where We’re Going

13. LB 471 Summary Introduced by Senator Sara Howard Approved by Governor Ricketts on February 24, 2016 Report all dispensed controlled substance prescriptions by January 1, 2017 Report ALL dispensed prescriptions by January 1, 2018 Prevents opting out Allow prescribers and dispensers to access the system at no cost Establishes Veterinary Prescription Monitoring Task Force Neb. Rev. Stat § 71-2454 Neb. Rev. Stat § 84-712.05(19) Since an emergency exists, this act takes effect when passed and approved according to law.

14. NeHII PDMP Enhanced Functionality • DrFirst medication history functionality • More data sources than any other medication history service in the market • PDMP can be accessed by authorized users directly from within HIE 2.0 in June, 2017 • Appears as a separate tile on NeHII’s dashboard, providing added value to HIE data

15. Reporting All Dispensed Prescriptions Required as of January 1, 2018 Comprehensive medication history Patient safety tool Identify medications from multiple prescribers and pharmacies Identify potential drug interactions, allergies Tool for medication reconciliation

16. Readmission Reporting • Reporting details • Collect admission and discharge information on a 30 day rolling basis • Determine readmits within that 30 or 90 day timeframe • Provide a listing of all readmits to requesting facility • Data provided – initial discharge data from the requesting facility and subsequent admission information • New data – Discharge disposition and discharge location fields recently added to the report • Opted out patients’ information is never shared • Transport medium – secure encrypted email

17. Sample Readmit Report

18. Event Notification Services • Near ‘real time’ or batch notification • Push notification of inpatient admits, discharges and emergency room visits • Clinical results including lab, radiology and transcription reports to third party EHRs • More granular functionality on HIE 2.0 platform • Ability to send notifications based on ordering provider, consulting provider, etc. • Opted out patients’ information is never shared • Delivery methodology • Online access through NeHII viewing screen • Batch delivery of information on a daily basis in spreadsheet format through secured encrypted email or Direct messaging • Delivery to third party EHRs

19. Next Steps for NeHII ONC Interoperability Grant Ending July 2017 Turn our sights to IAPD funded projects and added PDMP functionality Support the storage, transmission and exchange of C-CDAs Expansion of ADT event notification and readmission reporting services Build on lessons learned from integrated communities Support the exchange of data with other states via the PCDH technology

20. Next Steps for NeHII cont. Participate in eHealth Exchange to connect with federal agencies Expand on our connections with State registries Obtain MU certification for the PDMP as a specialized public health registry Offer supporting services and connections to LTPACs Offer a Community Care Plan to support the MCOs Develop a quality reporting strategy to support MACRA and MIPS via NeHII

21. NeHII Contact Information Dr. Michael Westcott - President, NeHII Board of Directors Deb Bass - Chief Executive Officer, NeHII NeHII, Inc. P.O. Box 27842 Omaha, NE 68127 Cell: 402.981.7664 dbass@nehii.org www.nehii.org