TITLE GOES HERE September 25, 2018

Slides 3 – 13: About Healthix Slides 14 – 26: Healthix Services Table of Contents Slides 3 – 13: About Healthix Slides 14 – 26: Healthix Services Slides 27 – 32: Healthix Integration Models Slides 33 - 35: Uses of Healthix Data Slides: 36 – 39: Patient Consent Slides that need updating monthly with latest stats: 5,9,14,36 (7,12,38,39)

About Healthix Statistics SHIN-NY Role of Healthix Solutions Sources of data & Types of data Timeline Participants

Largest Public HIE in the Nation More than 17,000,000 patients Healthix contains data from healthcare organizations throughout New York City and Long Island. Healthix uses sophisticated software to reconcile data of over 81.7 million provider Medical Record Numbers (MRNs) to create composite profiles of over 17 million patients.

Healthix Monthly Statistics (Aug. 2018) About Us 57.4 Million inbound clinical messages 1.5 Million Real-time clinical alerts 845K Patient Summary Documents Shared (CCDs) Healthix Monthly Statistics (Aug. 2018) Healthix is the largest public Health Information Exchange (HIE) in the United States Supplies secure data to improve healthcare quality, efficiency and effectiveness Provides a range of clinical information in real-time Facilitates care coordination Over 700 health care organizations at more than 6,100 sites across New York City and Long Island participate in Healthix.

SHIN-NY “Network of Networks” The State Health Information Network – New York (SHIN-NY) is comprised of 8 HIEs or Qualified Entities (QEs) When a user queries for patient data, Healthix automatically returns data from both Healthix and the SHIN-NY.

Role of Healthix in Exchanging Information eHealth exchange and SHIEC HEALTHIX

Healthix: Providing Solutions, Adding Value Coordinated Care: Complete View of Patient Real-time Intervention at the Point of Care Determine Risk and Provide Actionable Data Opportunity for a Richer Patient Portal 1 2 3 4 BETTER OUTCOMES COST EFFICIENCY HIGHER SATISFACTION

Healthix: Uses of Data

Healthix: Sources of Data

Healthix: Types of Data

Timeline: Growth & Milestones 2007 ALL RHIOS certified as QEs . All receive funding from HCRA to cover increase participation, utilization, provide core services and connect through SHIN-NY NYCLIX merges with LIPIX to form HEALTHIX and other RHIOS outsource their IT operations to NYeC 6 different RHIOS established in NYC and Long Island NYS DOH AWARDS HEAL NY GRANTS: $28M to 13 organization s in NYC and Long Island HEALTHIX Receives Grant to form RHIO named NYCLIX HEALTHIX insources its IT resources PATIENT DATA PATIENT DATA HEALTHIX merges with BHIX 2005 2006 New York State starts SHIN-NY 2012 2013 2014 2015 2016 PATIENT DATA 2008

Over 700 Geographic Coverage Healthcare Organizations with more than 6,100 facilities Across New York City and Long Island

Healthix Services Healthix Portal Delivery of Clinical Summaries Clinical Event Notification Direct Messaging Predictive Analytics

Care Management, Treatment, Quality Improvement 1 Querying Patient Data: Gaining a More Complete View View real-time patient data and history -- all sources in Healthix and SHIN-NY: - In Healthix Portal or Import C-CDA document into EHR Clinical Event Notifications: Alerts of New Events Admit/discharge at ED, Inpatient, or SNF; frequent ED visits; incarceration/release from NYC jails - Practice can identify which patients to monitor Determine Risk: Monitor when to Intervene Document a patient’s risk, to enhance care management 2 3

Healthix core services Patient Record Search: Access to a more comprehensive patient profile Statewide Delivery of Clinical Summaries: Ability to push clinical summaries (CCD, C-CDA) and lab results Clinical Event Notifications: 24/7 Custom alerts provide real-time updates for patients in care Direct Messaging: Secure HIPAA-compliant messaging Predictive Analytics: Assessing risk and managing patients to optimize care AUGUST 2018 USAGE PATIENT RECORDS SEARCHED VIA PORTAL 1.240 CLINICAL SUMMARIES DELIVERED 845,591 CENs SENT TO: ALL CLINICAL PROGRAMS 1,451,263 CENs SENT TO: PUBLIC HEALTH (NYSDOH) 687,666 DIRECT MESSAGES SENT 6,649

Search by Demographics Search by MRN Patient Summary Screen Patient Search HEALTHIX PORTAL Search by Demographics Search by MRN Patient Summary Screen

Patient Search

Patient Search by Demographics Name and 2 other fields then hit search

Patient Search by MRN

Patient Summary Screen Side Menu Shows Data Available

Clinical Event Notifications Workflow Current Offerings Future Offerings

Clinical Event Notification Workflow

Healthix Clinical Alerts

Clinical Alerts Essentials Without Healthix Consent With Affirmative Consent Clinical Alerts Participants receiving the Clinical Alert must provide treatment or care management for the patient. Clinical Alerts Essentials Clinical Alerts Plus data Content Patient Identity Location/Date Type of Event Chief Complaint Initial Diagnosis Clinical Results/Data Healthix - 42 CFR Part 2 facilities Cross SHIN-NY √ √ SHIN-NY data HEALTHIX Sources

Clinical Alerts By year-end 2018, Essential Alerts (without Healthix consent) will include data and events from entire SHIN-NY. Until then, they only contain data from Healthix.

Population Health Management Acute Patient Care Management Predictive Analytics Population Health Management Acute Patient Care Management Market Share & Volume Analysis DEMO/TRAINING: http://healthix.org/analytics/

Predictive Risk Scores Population Risk Models Predictive Risk Scores Patient History Patient Risk of Event or Outcome Risk Model Development Multivariate Statistical Modeling – Decision Tree Analysis Machine Learning (predicts future 12 months) Predicted future cost Risk of inpatient admission Risk of emergency department (ED) visit Risk of acute myocardial infarction (AMI) Risk of asthma Risk of cerebrovascular accident (CVA) Risk of congestive heart failure (CHF) Risk of COPD Risk of diabetes Risk of hypertension Risk of mortality Event Based Risk Models (predicts future 30 days) Risk of 30 day readmission Risk of 30 day ED re-visit 1000s of Patient Features Age Gender Geography Income Education Race Diagnoses Procedures Chronic conditions Visit and admission history Outpatient medications Vital signs Lab orders and results Radiology orders Social characteristics Behavioral characteristics

Healthix Integration Methods Standard Integration Single Sign On EHR Integration Flags Hub Models HIE to HIE

Integration methods Standard Integration Single Sign-On EHR Integration Flags Hub Model Integrations HIE to HIE

EHR Integration Flags FLAG Green Yellow Red Consent YES NOT GIVEN N/A Data NO New Data DEMO/TRAINING: http://healthix.org/analytics/

Patient data : Green Message on Mouse Over Consent Status: Yes External Data: Yes New Data: : Yes

Patient data: Yellow Message on Mouse Over Consent Status: Not Given External Data: Yes New Data: : N/A

Patient data: Red Message on Mouse Over Consent Status: N/A External Data: No New Data: N/A

Uses of Healthix Data

to facilitate care management uses of Healthix data to facilitate care management Accessing Patient Data in an Emergency Situation Managing Patients with Serious Medical Conditions using Clinical Event Notifications Providing Transition of Care Documents for Physicians Supporting Secure Direct Messaging Between Providers Providing Alerts for Frequent Users of ED (3+ visits in 30 days) Facilitating Research using De-identified Data Connecting PPS Leads and Partners Delivering Alerts from Health Plans to Providers re: Gaps in Care

to improve public health uses of Healthix data to improve public health Supporting Persons with HIV/AIDS Providing Data for Emergency Patient Search (NYCEPS) Helping in Public Health Outbreaks (e.g. Zika, Legionella) Improving Health of Uninsured - Action Health NYC

Patient Consent

patient consent & engagement Consent to a Single Participant Organization Healthix Community Consent One-to-One Exchange Supporting Patients’ Access to their Health Data IN DEVELOPMENT Working with Employers to Increase Access and Consent for Employees 4,297,587 HEALTHIX UNIQUE PATIENT CONSENTS GRANTED 21,189 PROVIDERS WITH ACCESS TO PATIENT DATA AS OF AUGUST 2018

State Policies Healthix and State Policy governs how providers and patients engage in health information exchange, and how they access patient information Compliance with policy facilitates data sharing across RHIOs Obtaining Consent Consent Audit, User Audit Password Strength / Failed Attempts User Roles, Patient Notices SAMHSA / Sensitive Data Re-disclosures http://healthix.org/who-we-are/healthix-policies/

Patient Gives “Provider Consent” 550 Participants ~ 4,400 Facilities data data Patient Gives Consent Provider queries data from all sources Provider receives CENs of events at all sources HEALTHIX Patient

One-to-One Exchange Participant A Participant B data data Healthix Patients in Common Treatment, Care Management Quality Improvement Participant A Participant B data data Healthix Authorizes Healthix to provide its data to Participant B Participant B can query data from Participant A data NOTE: Participant B can receive Clinical Event Notifications from Participant A Other Participants (1) One-to-One Exchange can be reciprocal – each Participant can authorize exchange of its data with the other (2) Excludes data and CENs from any 42 CFR Part 2 facilities of Participant A (3) Excludes data of any patient who has explicitly denied consent to Participant B (4) One-to-One Exchange allows Healthix to provide one Participant with data of the other Participant, but not data from all of Healthix. 550 Participants ~ 4,400 Sites

Contact Us If you have questions, would like to see a demonstration or are interested in connecting with Healthix Your Name 646.000.0000 yourname@healthix.org