NeHII, Nebraska’s Statewide HIE Population Health Services Delivery August 3, 2016

Presentation Objectives Overview of the Nebraska Health Information Initiative (NeHII), Inc. Current functionalities of the HIE 1.5 platform Future added functionalities to support population health Contact information

NeHII Adoption

Current NeHII Participants CHI Health (AHS) Bergan Mercy, Creighton University Medical Center, Immanuel Hospital, Lakeside Hospital, Nebraska Spine Hospital, Omaha NE Community Memorial Hospital - Missouri Valley, IA   Memorial Hospital - Schuyler, NE  Mercy Hospital - Council Bluffs, IA  Midlands Hospital - Papillion, NE A Nebraska Heart Hospital – Lincoln, NE Plainview Hospital - Plainview, NE St. Francis – Grand Island, NE Good Samaritan – Kearney, NE St. Elizabeth’s, Nebraska Heart – Lincoln, NE St. Mary’s – Nebraska City, NE Avera Creighton Hospital (ACH) - Creighton, NE  Avera St. Anthony's Hospital (SAH) - O'Neill, NE  Beatrice Community Hospital & Health Center (BCHHC)- Beatrice, NE  Boys Town National Research Hospital  (BTNRH) - Omaha, NE Cass County Health System (CCHS) - Atlantic, IA  Chase County Community Hospital, Imperial, NE Children's Hospital & Medical Center (CHMC) - Omaha, NE  Community Hospital, McCook, NE Columbus Community Hospital (CCH) - Columbus, NE  Great Plains Health (GPRMC) - North Platte, NE  Mary Lanning Healthcare (MLMH) - Hastings, NE  Methodist Health Systems (NMHS)  Methodist Hospital - Omaha, NE  Methodist Women's Hospital - Omaha, NE  Jennie Edmundson - Council Bluffs, IA  Montgomery County Memorial Hospital (MCMH) - Red Oak, IA  Myrtue Medical Center - Harlan, IA Nebraska Medicine (NMC)  University of Nebraska Medical Center - Omaha, NE  Nebraska Medical Center - Omaha, NE  Bellevue Medical Center - Bellevue, NE  Nemaha County Hospital (NCH) - Auburn, NE  Regional West Medical Center (RWMC) - Scottsbluff, NE  Sidney Regional Medical Center (SRMC) - Sidney, NE St. Francis Memorial Hospital (FCS) – West Point, NE  Payer/Insurance Companies: Blue Cross and Blue Shield of Nebraska Arbor Health

NeHII Virtual Health Record Users

Total Number of Results Sent to Exchange

New Users Added by Quarter

Total Clicks for Last 24 Months

Unique Number of Patients Queried in the VHR

Current Value Add Service Offerings Value added service offerings Virtual Health Record (VHR) Direct messaging/Statewide Provider Directory Single Sign-on (SSO) Public Health Gateway (PHG) Syndromic Surveillance Immunization Gateway Admit and discharge for payers Readmission reporting Subscription services for admits and discharges Nebraska’s PDMP

Population Health Support Services - Readmission Reporting Reporting details Collect admission and discharge information on a 30-day rolling basis Determine readmits within that 30-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

Sample Readmit Report Last Name First Name DOB Discharge Facility Discharge Timestamp Discharge MRN Discharge Patient Class Discharge Patient Location Discharge Disposition Discharge Location Admit Patient Location Admit Facility Admit Timestamp Admit MRN Visit Type Content FLOYD PINK 1/31/1972 HOSPITAL A 7/9/2016 15:09 1728654 I 6315 202 HOME 4881 7/18/2016 11:09 Admit/visit notification ZEPPLIN LED 1/16/1977 7/6/2016 18:25 1728655 4475 Home with No 6253 7/18/2016 12:19 FIVE MAROON 4/24/1986 7/12/2016 19:21 1728656 1250 206 Other 4022 7/18/2016 16:36 SHAKES ALABAMA 5/26/1999 6/22/2016 17:20 1728657 6684 Living 2827 HOSPITAL B 7/18/2016 9:57 7775595

Population Health Support Services - 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

Future Added Functionalities

Definitions Identity Management Solution

User Dashboard

Patient Event Subscription Services Moving from querying individual patient to delivering the results automatically Untapped value found in ADT messages of HIE in combination with the MPI from the expanded community beyond the reach of the EHRs Event notification for high utilizers, chronic disease ADT, high risk populations User designs what data will be delivered automatically to his/her EHR Expanded ADT messaging to contain timely, localized, more comprehensive public health data Allows for public health officials to identify hot and cold spots for PH outbreaks/chronic disease mgmt. and then rapidly evaluate impact of interventions 11/7/2018

The Next 12 Months Thank you once again to the payers, providers, hospitals and health systems that have invested heavily in building the exchange to date Vendor relationships with Optum, DrFirst and ICA continues to be effective and valued Working with other networks such as UniNet, Enhance etc. to offer shared services State’s continued support necessary in delivering PDMP services and NeHII must deliver Expanded Medicaid participation in the HIE and working with the MCOs: Well Care, Nebraska Total Care and UHC to deliver value add services in managing their covered lives Need to achieve 85% participation of hospital beds and four payers HITECH 90/10 funding key to next round of adoption and added functionalities such as ELR and enhanced immunization gateway data exchange. Capitalize on the fact that CMS is working much closer with ONC by enhancing statewide provider directory and ADT alerting services. Staffing to support provider training for HIE 2.0 and PDMP adoption activities for dispensers and prescribers Working with partners to deliver HIT enabled communities and analytics using the ONC Interoperability Grant funding Migration to HIE 2.0 platform will be behind us! Continue to expand the social media campaign to raise NeHII awareness with consumers. Please follow NeHII on Twitter and Facebook Implement a consumer facing application to engage consumers Continue to explore value add services including readmission reporting, identification of high ED utilizers, quality reporting, unnecessary testing, public health reporting etc. Develop a new pricing model based upon value added service delivery

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 Follow NeHII on Twitter: @NeHIIorg