Alaska eHealth Network & Health Information Exchange: Connecting Health Data for all Alaskans

1. Alaska eHealth Network & Health Information Exchange: Connecting Health Data for all Alaskans Jim Landon, Consultant, AeHN 4/11/2013

2. Presentation Overview National / State perspectives AeHN overview / services What is health information technology (HIT)? Why is HIT important to me? How is my health information used? How is my health information protected? What is Health Information Exchange (HIE)? What are my options for HIE participation? Projects to date Implementation

3. National Perspective • Bipartisan Initiative – Bush/Obama • Benefits • Improve health quality, safety and efficiency • Engage patients and their families • Improve care coordination • Improve population health and reduce disparities • Ensure privacy and security protections

4. State Perspective SB 133 Statute – 2009 >$2M annually Opt–out model (all in)

5. Alaska eHealth Network Mission To improve the safety, cost effectiveness, and quality of healthcare in Alaska through widespread secure, confidential electronic clinical information systems including promotion of electronic health records and facilitation of health information exchange. Vision A connected Alaska healthcare delivery system. Geographic Service Area State of Alaska and Pacific Northwest

6. History 6 years in planning and modeling 450 Alaskan providers and consumers participated 1.5 years implementing $6M in grants and contracts Time investment from many organizations

7. Public/Private Convergence

9. What is HIT? • Involves conversion of a paper chart to an electronic medical record. Replaces paper process of the past. • Collects, stores, and facilitates exchange of patient data. • Securely stored and shared only with the same providers and insurers who received paper information. • Health data is encrypted, making the data unreadable except by an authorized health care professional. • Supports “meaningful use”.

10. Meaningful Use – a ‘seasonal’ view Meaningful Use of Fishing Rod Fishing Rod

11. Meaningful Use = Health Care Transformation Technology Quality reporting Clinical Decision Support Improving care coordination Engaging patients Meaningful Use Quality Improvement Practice Redesign Exchange

12. Why is HIT important to me? • Provide caregivers information they need to make more informed care decisions resulting in improved patient safety and reduced medical errors • Better administrative efficiency – reduced paperwork and handling, e.g.. referrals • Provide patients with access to their personal health information • Reduce duplicative tests, unnecessary hospital admissions, and treatment caused errors • Improve public health reporting and monitoring • Reduce health related costs

14. How is my health information used? • Health information in the EHR (or paper chart) is protected by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule. Information can be shared with: • doctors, hospitals, and ancillary health providers for treatment purposes, • insurers for billing purposes, and • state and federal health reporting agencies as required by law (e.g., immunization and cancer registries). • Cannot be given to your employer, used for sales or advertising, or any other purposes without signed permission

15. How is my health information protected? AeHN utilizes the highest technology security standards available to protect health information allowing data to be transferred securely and providing an audit of where the data was sent. Every time the information is accessed an “audit trail” is recorded. All HIE participants have trust agreements in place defining who can access and change data. All AeHN participants agree to follow the privacy and security policies that govern data protection and use.

16. Health Information Exchange Replaces costly and non-secure processes Ensures timely record access Follows HIPAA guidelines for data exchange (treatment and payment) Provides audit trails of record access Builds relationships

17. Health Information Exchange • Software as a Service (SaaS) Model • No capital or replacement costs • Rapid deployment • Lower cost of operation • Orion Health • 2nd largest HIE vendor in US, global • 8 SaaS clients • Rhapsody Interface Engine

18. Health Information Exchange • Multiple modes of secure data transport • Master Patient Index • Direct Secure Messaging (DSM) • Interfaces (between EHR and HIE) • Data Repositories • Record Locator Service • Query-Based Clinical Views

19. Health Information Exchange • Multiple message types based on EHR • Continuity of Care Document (CCD) • HL7 Interface Standard • PDF, HTML viewable/printable • Multiple data needs • Labs, meds, x-rays • Allergies, problems, vital signs • Immunization registry

20. Options for HIE Participation • Participation is voluntary and does not impact access to medical care • Opt-in – participation in HIT and data exchange • Opt-out – decline participation • medical information will not be available to help participating providers manage care – even in emergency • all health information about patient will be removed from the system except demographics to ensure no additional information is entered. • PDF, HTML viewable/printable • Partial Opt-out - health information may only be accessed in an emergency. ER doctor will be given a decryption key to view your data and indicate why your record is being accessed.

21. Projects To Date • Fairbanks HIE pilot – over 2 million messages • Direct (DSM) – 4,000 users, 120,000 messages • Lab pilots – direct pass through results to EHR • State of Alaska / LaTouche Pediatrics • ANTHC/rural sites

22. Implementation

23. Thank you For more information contact: jamesjaylandon@gmail.com (907) 854-8210