community health information network chin n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Community Health Information Network (CHIN) PowerPoint Presentation
Download Presentation
Community Health Information Network (CHIN)

Loading in 2 Seconds...

play fullscreen
1 / 43

Community Health Information Network (CHIN) - PowerPoint PPT Presentation


  • 89 Views
  • Uploaded on

Community Health Information Network (CHIN). Medical Economics Data May 09, 1994 [draft] Author: Carol Sansone, Business Development Manager. Community Health Information Network (CHIN).

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Community Health Information Network (CHIN)' - wade-fulton


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
community health information network chin

Community Health Information Network (CHIN)

Medical Economics Data

May 09, 1994 [draft]

Author: Carol Sansone,

Business Development Manager

community health information network chin1
Community Health Information Network (CHIN)
  • DefinitionIntegrated collection of computer and telecommunications capabilities that facilitates communication of clinical and financial patient information among multiple providers, payers, employers, pharmacies, and related healthcare entities
  • Variables
    • CHIN will live within a health plan
    • Ownership
    • Number of participants
    • Transaction volume
    • Level of integration with other systems
    • Range of applications
    • Model of CHIN
    • ARCHITECTURE
community health information network chin migration path
Community Health Information Network (CHIN) Migration Path
  • Transaction switching from station to station
  • Universal implementation of clinical communications linking hospitals and physicians
  • Payer communication offering electronic data interchange and insurance eligibility information
  • Creation of clinical information (virtual) repositories
  • Utilization of outcome database
  • ORGANZATION
community health information network
Community Health Information Network

Three Phases of CHIN Automation

  • Electronic Ordering – Single Institution
  • Electronic Medical Record – Multiple/Single Institutions
  • Lifetime Health Record/CHIN
  • Development – Multiple Encounters/Multiple Institutions
c ommunity health information network chin
Community Health Information Network (CHIN)

CLINTON’S HEALTHCARE INITIATIVES

  • Cut the cost of healthcare administration.
  • Govern healthcare administration simplification through Federal regulation.
  • Expressed interest in the CHIN marketplace by large Hospital Information Systems (HIS) vendors.
  • Drive outcome measurements through CHIN users (payers, government, research/education, providers, patients, employees, accreditation agents/regulators).
  • MARKET FORCES
envisioned chin benefits
ENVISIONED CHIN BENEFITS

PATIENT BENEFITS

  • Reduce redundancy in forms, exams, tests
  • Facilitate continuity of care
  • Promote knowledgeable choice
  • Lower cost of care

PROVIDER BENEFITS

  • Improve quality of care
  • Reduce isolation of rural physicians
  • Reduce litigation exposure
  • Manage total cost of therapy
  • Build a competitive marketplace advantage
envisioned chin benefits cont d
ENVISIONED CHIN BENEFITS (CONT’D)
  • Employer Benefits
    • Evaluate plan benefit characteristics
    • Compare provider performance
    • Reduce costs of health benefits
    • Improve employer/employee satisfaction with selected healthcare service options
potential chin fee structures
Potential CHIN Fee Structures
  • All participants will pay fees for installation, systems integration, transmission, maintenance, service charges such as flat fees, eligibility fees and transactions fees.
  • Current systems usually omit physician fees to encourage participation.
  • Longer term, physicians will be charged for incremental services.
  • The network is largely transparent to the patient, who pays nothing.
unresolved chin issues
UNRESOLVED CHIN ISSUES
  • Data and image transmission standardization
    • Data standards are evolving (HL7/IEEE/MEDIX)
    • Industry imagery transmission standards are in their infancy stage of development
unresolved chin issues cont d
UNRESOLVED CHIN ISSUES (CONT’D)
  • Data ownership once (value-added) data is on the network
  • Data access role within a local network
  • Data security to both code and protect lifetime health records
community health information network chin2
Community Health Information Network (CHIN)
  • AMERITECH/WHIN/AHC

(AMERITECH HEALTH CONNECTIONS, INC.)

  • Area of Service
    • 7 hospitals with 750 physician users targeted
    • 5 payers targeted for claims
    • 5 billing services
    • 3 labs and 4 clinics interested
    • MILWAUKEE AREA WITH COMMUNITY FOCUS
community health information network chin3
Community Health Information Network (CHIN)
  • AMERITECH/WHIN/AHC
  • Features
    • Open system architecture
    • Host systems include IBM, Tandem, HP, DEC, and Unisys
    • User interface with Windows, so all data can be presented on one screen
    • ARCHITECTURE DESIGNED FOR GROWTH
community health information network chin4
Community Health Information Network (CHIN)
  • AMERITECH/WHIN/AHC
  • Analysis
    • User functionality includes both payer and provider clinical communications
    • Specific applications include the following:
      • E-Mail
      • Bulletin board
      • Deferred results
      • Integrated with practice-management systems
      • STRENGTHS
community health information network chin5
Community Health Information Network (CHIN)
  • AMERITECH/WHIN/AHC Future Applications
  • Insurance enrollment
  • Eligibility Verification
  • Claim payment notifications
  • Radiology images
  • Rx notification
  • Pre-admit
  • Good financial stability
  • Security through a card with microchip-encoded password/ID
  • STRENGTHS
community health information network chin6
Community Health Information Network (CHIN)
  • AMERITECH/WHIN/AHC
  • Analysis
  • Future applications (continued)
    • Scheduling inquiry
    • Orders
    • Medical library
    • Credit histories
    • Insurance change notifications
    • Integrated community database
    • STRENGTHS
community health information network chin7
Community Health Information Network (CHIN)
  • AMERITECH/WHIN/AHC
  • Analysis
    • Limited payer functionality at present
    • Development of clinical database in early stage of development
    • Not fully proven line
    • WEAKNESSES
community health information network chin8
Community Health Information Network (CHIN)
  • AMERITECH/WHIN/AHC
  • Analysis
    • How and when all interfaces will be accomplished
    • Time to market concept
    • Proving cost-justification
    • Development of outcomes/utilization database
    • CHALLENGES
community health information network chin9
Community Health Information Network (CHIN)
  • CHMIS/HARTFORD FOUNDATION
  • Test site in Memphis
  • Comprehensive design created by New York based Benton International (consultants)
  • Features
    • User and payers ATM-style efficiency
    • Not-for-profit John A. Hartford foundation
community health information network chin10
Community Health Information Network (CHIN)
  • CHMIS/HARTFORD FOUNDATION
  • Analysis
    • Combine EDI/WEDI concept of electronic processing and transactional facilitation
    • Meeting shared information needs through community-controlled database
    • Focus on community/cost/quality as goals
    • Straight-forward design
    • Ride the back of existing claims structure and build on an embedded base rather than a perfect system concept
    • STRENGTHS

(WEDI/Workgroup Electronic Data Interchange)

community health information network chin11
Community Health Information Network (CHIN)
  • CHMIS/HARTFORD FOUNDATION
  • Analysis
    • Unproven
    • Database issues of security and confidentiality because of size
    • Focusing on claims and insurance rather than larger vision
    • WEAKNESSES
community health information network chin12
Community Health Information Network (CHIN)
  • CHMIS/HARTFORD FOUNDATION
  • Analysis
    • Community support because of size
    • Operational complexity
    • Time to market
    • System integration and interface issues
    • CHALLENGES
community health information network chin13
Community Health Information Network (CHIN)
  • INTEGRATED MEDICAL SYSTEMS, INC. (IMS)
  • Area of Service
    • Approximately 22 networks are growing reaching more than 40 percent of Colorado hospitals.
    • First alpha site at St. Anthony, Denver
    • EXPANSION THROUGH ACQUISITION STRATEGY FOR NATIONAL COVERAGE
community health information network chin14
Community Health Information Network (CHIN)
  • INTEGRATED MEDICAL SYSTEMS, INC. (IMS)
  • Features
    • For-profit corporate venture
    • Batch system in the works for approximately 3 years
    • Mature clinical messaging capability
      • Transmits voice, data and image
    • Store and forward technology to send messages
    • ARCHITECTURE
community health information network chin15
Community Health Information Network (CHIN)
  • INTEGRATED MEDICAL SYSTEMS, INC. (IMS)
  • Analysis
    • Proven capability
    • Simplicity of use
    • Low costs with batch interfaces means less worry about data loss
    • STRENGTHS
community health information network chin16
Community Health Information Network (CHIN)
  • INTEGRATED MEDICAL SYSTEMS, INC. (IMS)
  • Analysis
    • Limited payer capacity
    • Batch architectural design
    • Limited system integration
    • Costs can be high depending on service and transaction volume
    • WEAKNESSES
community health information network chin17
Community Health Information Network (CHIN)
  • INTEGRATED MEDICAL SYSTEMS, INC. (IMS)
  • Analysis
    • Transaction switch in development stage
    • Company growing rapidly so resources may be stretched
    • Clinical and outcomes databases planned for the future
    • CHALLENGES
community health information network chin18
Community Health Information Network (CHIN)
  • SMS/HDX
  • Area of Service
    • Community focus and open to all participants
    • Total view is national in scope
    • CURRENTLY DIFFERENT STAGES OF DEVELOPMENT IN OHIO, NEW HAMPSHIRE, NEW YORK, AND CALIFORNIA
community health information network chin19
Community Health Information Network (CHIN)
  • SMS/HDX
  • Features
    • For-profit effort by subsidiary of major HIS system vendor with extensive client list nationwide
    • ARCHITECTURE
community health information network chin20
Community Health Information Network (CHIN)
  • SMS/HDX
  • Analysis
    • Extensive design with proven capability in payer-clinical communications
    • Transaction switch scope to be expanded over 4 to 6 years
    • Includes new captive membership, utilization monitoring, payment settlement, and eventually, managed-care functionality
    • STRENGTHS
community health information network chin21
Community Health Information Network (CHIN)
  • SMS/HDX
  • Analysis
    • Data processed from national center in Malvern, PA, rather than regionally
    • Not fully proven in concept
    • Database ownership issues exist for proprietary vendor
    • WEAKNESSES
community health information network chin22
Community Health Information Network (CHIN)
  • SMS/HDX
  • Analysis
    • Developing clinical/outcomes database
    • Physicians want a range of functions
    • How proprietary vendors will interface to foreign systems
    • CHALLENGES
community health information network chin23
Community Health Information Network (CHIN)
  • UNITED HEALTHCARE
  • Area of Service
    • Minnesota is test site
    • REGIONAL GEOGRAPHY
community health information network chin24
Community Health Information Network (CHIN)
  • UNITED HEALTHCARE
  • Features
    • Payer-focus called Providerlink
    • Sponsored by Minnesota-based managed-care company for EDI claims
    • ARCHITECTURE
community health information network chin25
Community Health Information Network (CHIN)
  • UNITED HEALTHCARE
  • Analysis
    • Proven system processing more than 40 million claims from United’s 18 plans and more than 500 hospitals with 2 million vendors ?
    • Architectural design is good for growth and flexibility
    • Users have flexibility in hardware and workstation devices
    • Substantial savings have been shown (more than $1 per claim)
    • STRENGTHS
community health information network chin26
Community Health Information Network (CHIN)
  • UNITED HEALTHCARE
  • Analysis
    • Limited clinical capability
    • Payer owned, so participation by others may be guarded
    • WEAKNESSES
community health information network chin27
Community Health Information Network (CHIN)
  • UNITED HEALTHCARE
  • Analysis
    • Not currently a database repository for clinical data
    • Data ownership issues
    • Plan lab and results reporting
    • CHALLENGES
community health information network other emerging chins
Community Health Information Network – Other Emerging Chins
  • Inova Health Systems of Falls Church, VA
  • San Antonio Healthcare Partnership
  • NO/HIN in New Orleans
  • Henry Ford Health Alliance Plan in Southeastern Michigan
  • Metropolitan Chicago Healthcare Council
  • Praxis, based in Nashville
  • 6 states now receive funding from the Hartford Foundation, with another 9 states applying in the coming months.
  • POPULATION SAMPLING OF CHIN(S) NATIONWIDE
community health information network chin28
Community Health Information Network (CHIN)
  • Topology Models
    • STRATEGIC ALLIANCES
    • INTEGRATION
      • (demonstrate access points)
      • (demonstrate linkages)
community health information network chin29
Community Health Information Network (CHIN)
  • B2B Linkages
    • Banker,
    • Hospital,
    • Physician’s Office or
    • Community Health Center
    • Other Chins
community healthcare information network chin
Community Healthcare Information Network (CHIN)
  • B2B Applications
    • Computerized Patient Record
    • Case Management Results Reporting Physician Direct Order Entry
    • Alerts
      • Nursing Documentation
      • Physician Documentation
community health information network chin30
Community Health Information Network (CHIN)
  • B2B Applications (cont’d)
    • Scheduling
      • Patient Accounting
      • Radiology
      • Laboratory
      • Cardiology
      • Anesthesia
      • Pharmacy
      • Medical Records Abstracts
community health information network chin31
Community Health Information Network (CHIN)
  • B2B Applications (cont’d)
    • Corporate Financials
    • Network
    • ADT
    • Interface Engine
    • E-mail/EDI
    • Imaging
    • Forms Automation
    • Master Patient Index