Welcome to the South Carolina Chapter Webinar Series Presented by ICA

1. Welcome to theSouth Carolina ChapterWebinar SeriesPresented by ICA

2. SCHIMSS Direct eHealth Exchange Direct – It’s Not Simply Automated Fax Anymore November 14, 2012 www.icainformatics.com

3. An Evolving World of Exchange • 2009-10 ONC pushes NHIN • National Health Information Network • IHE standards based exchange platform • Push-pull standard for community based HIE • Network of networks strategy • 2011 ONC changes direction • Governance challenges stall HIE the verb • Direct Protocol seen as “quick win” solution • NHIN becomes NwHIN • Provider to provider strategy • 2012 Changing owners • Meaningful Use 2 final rule requires Direct • ONC transitions governance to HealtheWay • NwHIN becomes eHealth Exchange Informatics Corporation of America - Proprietary and Confidential Information 3

4. What is eHealth Exchange Direct? • Secure Clinical Email System • Encrypted using Compliant Security Trust Agents (STA) • Decrypted using a set of public and private keys • Able to attach files for transporting information • Requires a health internet services provider (HISP) • Health Internet Services Provider (HISP) • Like: AOL, MindSpring, Gmail, Hotmail • But: with Provider Directory (DNS & LDAP Certificate Services) • And the three A’s of security: • Authentication • Authority • Audit Informatics Corporation of America - Proprietary and Confidential Information 4

5. How Does Direct Work? • Direct Enabled EHRs • EHRs with build in capabilities allow workflow accommodation • Capabilities vary: • Integrate with internal messaging functionality • Identify attachment with ability to insert documents • EHRs Without Direct Enablement • Use email client to interact with Direct participants • Clinician Without EHRs • Use a secure portal to interact with others • Each of these can work inter and intra-organization Informatics Corporation of America - Proprietary and Confidential Information 5

6. Internet Provider Provider Community Hospital Provider Provider External Community Long-Term Care Public Health Providers Provider Provider

7. Why Would I Use Direct? Informatics Corporation of America - Proprietary and Confidential Information 7

8. An Integrated Solution Architecture Informatics Corporation of America - Proprietary and Confidential Information 8

9. Health Information Exchange v2.0

10. How Do I Make It Useful? • Added Value Components • White Listing – creating your frequently dialed numbers • Black Listing – blocking known abusers • Branding – making it you own (doctor@abc_clinic.direct.com) • Private networks – creating subdomains • Automating the front end – triggering events • Automating the backend – distribution of contents • Portal Value Components • Private & public workbaskets – creating workflow • Delegation capabilities – breaking the log jam • Alerting and prioritizing – don’t miss this Informatics Corporation of America - Proprietary and Confidential Information 10

11. How Is Direct Being Used • It’s all about communication – improving care transitions: • ED discharge summaries to PCP • Admission discharge summaries to post-acute setting • Office, schools, home and beyond “Each new participant adds to the expanding use cases available with the state of Kansas.” Laura McCrary – Exec. Dir. KHIN Informatics Corporation of America - Proprietary and Confidential Information 11

12. Coordinating Chronic Disease PTs • Goal – Certify as a Diabetic Practice: • Creates communication channel for disease management • Meets NCQA criteria for virtual teams • Auditable transactions of care delivery • Transports images of the eyes from optometrist to PCP First day of operation: “Within the first fifteen minutes Clinical Communication met an immediate business need in the certification process with NCQA.” Internist 12

13. Coordinating Acute Disease PTs • Goal – Shorten Oncology Diagnostic Time: • Creates communication channel for diagnostic evaluation • Pathological images are transported • Auditable transactions of care delivery “This technology reduces patient anxiety and speeds treatment time because of increased communication.” Oncologist 13

14. Reducing Administrative Burden • Goal – Eliminate fax machines across the interprise: • Approximately 10,000 pages of medical records every day • Estimated that 20% of those pages don’t get there • ROI achieved in weeks and it meets Meaningful Use 2 • HIPAA violations minimized “We’ve freed up valuable human resources for patient care within weeks of implementation.” Practice Administrator 14

15. Linking the Pharmacies • Goal – Reduce hold times and phone tag: • Creates communication channel for therapeutic consultation • Improves patient satisfaction – cost and time • Reduces adverse reactions “We save the patient money and time while eliminating rework and call backs between the pharmacy and doctor’s office.” Pharmacist 15

16. Bringing Mental Health Onboard • Goal – Improve the holistic approach for patients: • Allows the consent to follow the disclosure • Creates a better care plan for mental and medical needs • Reduces adverse effects of therapies “We now have an auditable method of ensuring that patient consent is provided with the passage of sensitive information.” Psychiatrist 16

17. Improving Care Transitions • Goal – Reduce re-admissions and ED returns: • Discharge summaries to PCPs and post acute caregivers • PCP to specialist referral coordination and follow-up • ED summaries are forwarded to follow-up physician & PCP • Even the coroners use it for timely access to cause of death “Research shows that almost 60% of patients who receive follow-up care from acute or urgent episodes of care do not provide documentation to their primary care giver. 17

18. Improving Public Health • Goal – Reduce reporting burden: • Immunization reporting through attachments • Medicaid reporting via CCDs • Fulfilling requests through portal queries • “Our goal is to reduce or eliminate the manual processes associated with populating state health reporting requirements. • State Official 18

19. Providing Leadership & Collaboration • Formal standards-bodies and related initiatives • Initial Direct Project standards development work • ONC’s S&I Workgroup • DirectTrust.org • EHR/HIE Interoperability Workgroup • Inaugural Direct Connectathon & ONC Showcase participant • Open Testing Platform • Collaborative, open testing environment sponsored and managed by ICA • Free of charge to all industry participants • Currently in various states of testing with 35 vendors representing 80% of the US EMR market • Includes Direct, HPD+ and IHE interoperability frameworks Informatics Corporation of America - Proprietary and Confidential Information 19

20. Questions?

21. Thank You for your time today! Visit us at www.icainformatics.com Or our HITme Blog at http://www.icainformatics.com/blog/

22. The South Carolina HIMSS ChapterThanks you for your participation!Thanks to CDWfor webinar sponsorship