Clinical Data Flow Optimization Integrated Delivery Clinical Data Flow Optimization

Alliance Innovation Fund is Live! Announcement Alliance Innovation Fund is Live! More information at abhealth.us under Funding Opportunities Webinar: May 23rd at 12 noon Workshop: June 6th at 8:30 – 11am Start with alliance intro I want for today’s discussion to be very engagement and introductory, so following Alliance intro and a brief overview of the 3 buckets of work, we will be opening it up to all the folks here and on the line to introduce themselves and their organization – give a very brief background on their organization and talk a bit about which of the buckets of work most resonate From there we will be going into more of tactics quickly – Kyla will be talking about the project management, I will review the first effort and push in needs assessment and then we will be going into Health Together/Unite Us implementation

Agenda - Introductions Welcome and roll call - Hixny overview Why Hixny? Data access Who is accessing & why Portal access and uses cases Data Contribution Who and how data is contributed? Think Hixny First - Hixny Next Steps Current State Questionnaire review In person follow up opportunities - Healthy Together Rollout - Review of March Meeting - Next steps and timeline Project plan status review Next Meeting: June 19th Start with alliance intro I want for today’s discussion to be very engagement and introductory, so following Alliance intro and a brief overview of the 3 buckets of work, we will be opening it up to all the folks here and on the line to introduce themselves and their organization – give a very brief background on their organization and talk a bit about which of the buckets of work most resonate From there we will be going into more of tactics quickly – Kyla will be talking about the project management, I will review the first effort and push in needs assessment and then we will be going into Health Together/Unite Us implementation

What is our WHY? OPPORTUNITY: VISION: GOAL: De-risk planning &, implementation of pilot projects  hand over programs that have clear ROI in a VBP environment GOAL: Prepare our partners to move from volume to value VISION: A united and collaborative care delivery community, fostering health equity for all MISSION: Transform care to improve health What is our WHY?

Background Hixny provides real time information sharing that enables the entire healthcare community to see the same 360o view of each patient. Hixny geography covers 26% of NYS Over 1,500 participating locations in both NY and VT with 4.5 million unique patients SHIN-NY leader in adoption and data contribution Hixny is one of 8 health information exchanges (HIE) in NY. We cover 26% of the state and are he large purple area on the map. In simplest terms an HIE is a centralized repository for all of a patients medical record data that allows for real time sharing so everyone in the healthcare community can see the same 360 view of each patient. It’s the most complete picture of someone's health.

Public Health Departments Hixny Connectivity Hospitals (32 Facilities) Long Term Care (29 Facilities) Home Health (12 Organizations) PCP (879 MDs, 287 Locations) Specialists (1,504 MDs, 331 Locations) Other Providers (142 Locations) Health Plans (3 Plans) Public Health Departments (10 Departments) Patients (8,349 Active Accounts) In Bound Volume: 60 Records per second (1.75 billion annually) Out Bound Volume: 4.8 Records per minute (2.5 million annually) 32 Hospitals . (8)AHI catchment area. I would like to point out a gap for LTC, Hixny doesn't have strong connections in this market. But with the partnership from AHI we are connecting PCC which is an EHR vendor for many LTC centers. Once the initial connection is done (first quarter this year) then enabling data exchange for any LTC with PCC is very easy. For example Elderwood in Lake Placid can be enablable with a simple service request. There is a small yearly fee for the center to send data to the exchange but the DOH does offer serval thousands of $ for the connections. Hixny is committed to making connections and we have a dedicated integrations team to make sure theses connections happen with the least operational overhead possible. Louann and I are working to identify gaps and make strategic gains in 2018.

Connectivity and Communication Tools securely share PHI and communicate with providers via secure email query and pull patient records directly into your workflow query patient records, securely and online get the ICM application through your mobile device Patient Portal Allows patients access to their health records and facilitates provider and patient communication

Value Based Care Dr. Adetona Peer Average EPC Quality Score 97.5% 76.5% Colorectal Screening 87.2% 70.0% Breast Cancer Screening 93.8% 78.0% Diabetic Screening 96.3% 56.7% VBC: On the front cover of our annual report is Dr. Adetona and Dr. Bennett. Dr. Adetona is a single practitioner who serves a medical vulnerable pt pop with 85% of her patients on Medicaid or Medicare. Dr. Adetona participates in CDPHP’s EPC program which follows a similar PCMH or VBC model. Access to Hixny data has helped her succeed. This practice pulls a CCD from Hixny on all of her patients with consent. Her affirmative consent rate is 90%

ED Use Research* demonstrates that Triple Aim is achievable in the ED through use of HIE : Compared to fax, etc. HIE on average was 58.5 minutes faster in locating external information For each hour of reduced access time: -2.5% CT scan -1.6% MRIs -2.4% radiographs -2.4% admission rate $1,187 in savings 52.9 minute shorter visit Quality Cost Satisfaction * Everson J, et al. “Health information exchange associated with improved emergency department care through faster accessing of patient information from outside sources” J Am Med Inform Assoc 2016;0:1-7. http://jamia.oxfordjournals.org/content/early/2016/08/10/jamia.ocw116

St. Mary’s ED Study Hixny worked along side ED providers to pull records to demonstrate value Compared data in the EHR to Hixny for 134 cases: 84.3% of the time Hixny had records not available in the EHR 25.6% of the time the missing data was clinically relevant to the treatment based on the treating physicians review 15% of the time physician indicated that they changed treatment based on information provided by Hixny

Alerts are notifying providers in real-time Event notifications - ED & hospital admissions, discharges, and transitions of care and discharge dispositions Workflow Utilization Hixny Can Help “Cut down the noise.” Alerts Delivery Timeline Alerts are an important piece of the VBC puzzle. Real time pt surveillance supports errors and follow up care at transitions for medication reconciliation, adherence and support to prevent IP admission or readmission. I cant count the number of times that I have heard from a practice that they cant handle all of the alerts for their patients but we have to change that to be successful. I met with a local FQHC and they were considering turning off their alerts……..explain

Hixny Portal Demonstration

Data Quality & Completeness Another part of our basic core is data completeness We are a statewide leader is our focus on data completeness and system interoperability. Hixny is able to receive the many different types of medical record data. We can consume medication orders, procedures codes, vital signs, consult reports and many more. We are requiring all new EHR connections to meet the national standards for CCDA. We are currently connected to 30 different EHR’s vendor’s and we are currently working to connect 9 more by the end of the first quarter in 2018.

Thank you for your time.

Hixny Presentation Why Hixny? Data Access Data Contribution What data is available? Who can access data? How is data accessed? Data Contribution What data is contributed? Who contributes data? How is data contributed? Think Hixny first?

Hixny – Next Steps Questionnaire

Hixny – Next Steps Questionnaire

Hixny – Next Steps Questionnaire

Hixny – Next Steps Continued Conduct follow up discussion with partners to better understand workflows Organizations to identify a Hixny Champion as Alliance’s point of contact Hixny Champions act as the internal subject matter expert or “SME” to facilitate workflow discussions Evaluate clinical data entry and contribution processes Collaborate with Hixny to identify partners’ opportunities Generate personalized and detailed utilization process flows

Healthy Together – Update/Next Steps Network launched successfully April 24, 2018 Referral volume increases seen are standard for Unite Us implementations Participant Newsletter kick off week of May 21, 2018 Onboarding process for August 2018 expansion from 200 licenses to 400 licenses under evaluation AHI contract with Unite Us = Increase referral opportunity for participating providers

Next Steps

Next Meeting Tuesday, June 19th at 2pm