Cheryl M. Stephens Executive Director Community Health Information Collaborative

1. Community Health Information Collaborative and theNortheast MinnesotaRegional Health Information Organization Cheryl M. Stephens Executive Director Community Health Information Collaborative Melinda Machones HIT Project ManagerThe College of St. Scholastica Clark Averill IT Director, St. Luke’s HospitalChair, CHIC Board of Directors

2. CHIC Overview • Planning started in 1997 • Developed with Federal Office of Rural Health Network grant • Key participants included regional hospitals, physician practices, public health, and the Minnesota Health Data Institute. • Initial focus • To coordinate health information technology in Northeastern Minnesota • To share costs and best practices across the membership • Gained Non-profit 501(c)3 status in 1999

3. Current CHIC Services • Provide secure and encrypted claims submission to Medicare, Medicaid and various commercial Payors. • Lead agency for the Minnesota Immunization Information Connection in 18 counties. • Administrative Coordinator for Emergency Preparedness activities for 16 hospitals in 7 counties in the Arrowhead. • Provide USAC administrative services – brought $185,000 back to the region in 2004

4. CHIC Members Total Sites contributing data – 344 Hospitals – 32 Clinics – 110 Public Health Agencies – 19 Long-term care – 9 Urgent Care Sites – 2 Tribal Health Agencies – 20 Schools – 146 Corrections – 2 Home Care Agencies – 2 Pharmacy – 2

5. Membership Fee Structure • Based on organization size and services used • Hospitals/Health Systems fees are based on bed size and employed physicians • Clinics fees are based on employed physician • Public Health is a set fee • Tribal Health is a set fee • Some members fees are paid by grants that CHIC is administrating

6. Reasons for RHIO • National Focus snapshot • Office of National Coordinator of Health Information Technologies (Dr. David Brailer) • June 6: American Health Information Community Advisory Panel announced • June 7: Four RFP’s focusing on Health Information Exchange • June 8: Capital Hill HIT Showcase • June 16: "Health Technology to Enhance Quality Act of 2005" (Health TEQ)”

7. Reasons for RHIO • Regional Activities • MN e-Health Steering Committee • This Minnesota Rural Health Conference • St. Scholastica focus on HIT and interdisciplinary health sciences programs • SMDC, St. Luke’s, SISU investments in EHR technology CHIC is the logical organization to drive this strategy in NE Minnesota

8. RHIO Definition An organization that facilitates the sharing of health information across all organizations contributing to the continuum of patient care.

9. RHIO Models • Common Community EHR • Not practical, would involve replacing all existing investments • Shared repository of summary EHR data • Costly duplication of technology • Shared access to multiple EHRs • Practical solution in consumer-directed market • Shared electronic clinical transactions • Practical starting point while EHR adoption matures, e.g. immunization registries, Rx histories, e-prescribing

10. RHIO Major Stakeholders • Physicians, hospitals, public health, tribal health and other health care providers • Payers • Patients / Consumers • Employers

11. Criteria for our RHIO Vision • An appropriate and effective Vision must include the following components: • Create the technological infrastructure • Develop processes to make effective use of these systems within and between healthcare systems • Engage all stakeholders with special focus on rural providers

12. RHIO Work Group • CHIC Cheryl Stephens • SISU Medical Systems Mark Schmidt • The College of St. Scholastica Kathy LaTour Melinda Machones • Iron Range Resources Richard Walsh • St. Luke’s Hospital Clark Averill • St. Mary’s/Duluth Clinic Tess Settergren • SuperiorEdge Kelly Peterson • Community Health Board Julie Myhre

13. Challenges • EHR adoption in rural NE Minnesota providers – cost and resources • Lack of comprehensive standards between vendors • Public concern over privacy and security • Available funding

14. Advantages • CHIC’s history and relationships with providers • SMDC and St. Luke’s commitment to the project • National focus and momentum • We can learn from earlier projects around the country

15. RHIO Initiatives in NE MN • Learn from other RHIO projects • Acquire Funding • Assess Environment • Address privacy and security issues • Promote the project

16. Initial Implementation • Share CCR with EPIC and Meditech providers • 2 largest systems in the region • CCR provides basic patient information • Allows us to expand by system or by record data • Provides for a well-defined, early success

17. Thank You! Questions?