Inland Empire Health Information Exchange (IEHIE) Past, Present and Future Dr. Richard Swafford, PhD Executive Director IEHIE rswafford@iehie.org 951-686-1326

Past, Present and Future Overview of IEHIE Timeline of IEHIE Activities Initial Goals versus Current Status Current Activities Future Activities

IEHIE: A Regional HIE The Inland Empire Health Information Exchange (IEHIE) covers the San Bernardino and Riverside Counties with a population of over 4.1 million. The IEHIE represents a large group of hospitals and medical centers, medical groups, IPAs and physician practices. The IEHIE operates as 501(c)3 under the Inland Empire EHR Resource Center.

IEHIE Mission To achieve continuity of care in the Inland Empire community by allowing providers and patients trusted, timely and secure access to patient health information.

What is HIE: 40,000 Foot View Health Information Exchange (HIE) is defined as the mobilization of healthcare information electronically across organizations within a region, community or hospital system. HIE provides the capability to electronically move clinical information among disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care.

Timeline of IEHIE Activities (2009) Apr 2009 – Riverside County Medical Association (RCMA) and Hospital Association of Southern California (HASC) bring together the Inland Empire Health Information Technology Consortia (IEHITC). Health Information Exchange (HIE) is the primary focus. Jul 2009 – IEHITC Founding Board adopted with 27 original members Sep 2009 – Financial model adopted that included fees for IEHITC membership Dec 2009 – Request for Information (RFI) issued for HIE Vendors and HIE Organizations.

Timeline of IEHIE Activities (2010) Apr 2010 – Formal Leadership Group (LG) created and a RFP to hire a consultant is presented and approved. Funding model to pay for consultant is approved. Jun 2010 – Consultant selected – Object Health Sep 2010 – IEHIE IS BORN and becomes a project within the IEEHRC 501.c.3. Nov 2010 – RFP for HIE vendor is approved and sent to 22 HIE vendors. Governing Council (GC) is created and the first elections are accomplished. Subcommittees are also created within the GC. Dec 2010 – 5 HIE finalists are identified.

Timeline of IEHIE Activities (2011) Jan 2011 – IEHIE Charter adopted and IEHIE Financial Model approved. Feb 2011 to Apr 2011 – HIE Vendor selection including demonstrations and site visits is accomplished. May 2011 – Orion Health selected and contract negotiations begin Jul 2011 – Project Director contracted and pilot participants identified. Participation agreement finalized and sent Sep 2011 – Orion Contract negotiations complete and IEHP announces funding of both counties Oct 2011 – IEEHRC Board approves IEHIE 5 year budget and sets financial target for contract signature Nov 2011 – IEHIE Executive Director hired. Dec 2011 – IEHIE web site and marketing materials approved and launched as well as the second GC elections

Timeline of IEHIE Activities (2012) Jan 2012 – Orion contract signed and executed. Pilot launched with 14 pilot participants Feb 2012 – IEHIE awarded CHCF Grant That takes us up to today…

Initial Goals Versus Current Status March 2012 Status: July 2009 IEHITCC Goals: Share information on a specific patient for the care of the patient. Fulfill requirements to receive stimulus funds Facilitate sharing and reporting of data Develop a list of core data fields to share Organize Data in a way that is usable Comply with Privacy Requirements Comply with Meaningful Use Requirements Establish Sustainability Model

Current Activities (Structure)

Current Activities (Structure) IEHIE Governing Council Elected 12.11(15 seats) (4 seats) Hospitals Doug Leeper (LLUMC) Large Rich Gagnon (Redlands Comm. Hosp.) Sm/Med Andrew Robertson, MD (St. Bernardine) At Large Christina Bivona-Tellez) Inland Region HASC (4 Seats) Physicians Leigh Hutchins (Prime Care) IPA/Medical Group (Raincross Med. Grp) Harold Jackson, DO Nabil Razzouk (Arrowhead Orthopedics) Tarek Mahdi, MD RCMA/SBCMS Public Health (1 seat) (Riv. Co. Dept. Public Health) Sarah Mack Other Healthcare Providers Brian Hughes (VNA) Business/Community Bill Davenhall ESRI Health Plans Brad Gilbert, MD (IEHP) Board of Supervisors (2 seats) Supervisor Bob Buster Riverside Seat Supervisor Josie Gonzales San Bernardino Seat LEC Leroy Ounanian, MD

Current Activities Membership and Participation

Current Activities Financial Model Self-sustaining model based on participant and member fees Hospitals – Bed Count Medical Groups – Physician Count Health Plans – Member Lives Project-specific grants Ex: CHCF Grant for HL7 ELINCS Lab Orders

Savings Example - Alabama With a conservative estimate of savings in lab, imaging and ED visits, the benefits of HIE are staggering.

Future Activities Three Phased Implementation approach: Phase 1: Spring 2012 Clinical Portal Patient Portal Site Connectivity Phase 2: Summer 2012 Case Management: Diabetes Orders Phase 3: Fall 2012 Imaging EMR Lite eRX Three Phased Implementation approach: Each facility begins with Phase 1 Facilities can be at any phase at any time Future expansion beyond 2012 available Modules beyond Phase 1 (Base HIE): Menu format for additional modules Pay as you go Fees based on size are available

Future Activities

IEHIE HIE IEHTC RCMA SBCMS HASC IEHIE has come a long way in a relatively short period. The future holds many exciting opportunities.