Partnering to Improve Patient Health Outcomes Polly Mullins-Bentley, RN, RHIT, CPHQ Acting Executive Director Governor’s Office of Electronic Health Information State Health I.T. Coordinator

Healthcare Today: A Disconnected System 2 Islands of data Poor coordination Fragmented processes Limited connectivity Patients and clinicians often left without tools and data required

8/19/ NQS Framework

National Quality Initiative: Aims, Priorities and Goals for Improving Quality 1. Making Care Safer 2. Ensuring Person- and Family-Centered Care 3. Promoting Effective Communication and Coordination of Care 4. Promoting the Most Effective Prevention and Treatment of the Leading Causes of Mortality, Starting With Cardiovascular Disease 5. Working With Communities to Promote Wide Use of Best Practices to Enable Healthy Living 6. Making Quality Care More Affordable

eHealth in Kentucky eHealth Milestones March/2005 Legislation (Senate Bill 2) to create a secure interoperable statewide electronic health network Medicaid Transformation Funding - $4.9 million Built the technical infrastructure for the KHIE 2009 ARRA/HITECH Funding - $9.75 million 2010 Kentucky Health Information Exchange LIVE

Polly Mullins-Bentley, Acting Executive Director, CHFS, Governor’s Office of Electronic Health Information (GOEHI) Kentucky Health Information Exchange: Governance Structure

7 Governor’s Office of Electronic Health Information Strategic Priority Goals Promote and increase the adoption and use of health information technology Assist with and facilitate state-wide meaningful use initiatives (with other HITECH programs) Provide governance and oversight to the Kentucky Health Information Exchange Provide HIE Connectivity to as many providers as possible as quickly as possible Build critical mass Demonstrate value Assist providers in meeting meaningful use 2012 Key Goals Immunization Testing for Stage One MU Work with pharmacies to increase electronic prescribing in KY Implement lab results exchange with delivery Facilitate exchange of key clinical information to improve transitions of care Implement Direct Secure Clinical Messaging

How the Exchange ‘Works’ Data Sharing! Community/Master Patient Index Populated by ADT’s/patient demographics Record Locator Service Locates all the patient encounters Consolidates patient information for presentation to the provider Access KHIE Community Portal/Virtual Health Record Provider EHR Portal/Dashboard

KHIE Community Portal (Virtual Health Record)

Implementation Success 226 Participation Agreements Signed Represents 500+ provider organizations Active implementations 82 LIVE Connections Data is being exchanged between providers today Labs, Rads, Transcribed Reports Clinical Summaries (CCD’s) Immunizations routed to the KY IR Policies written, approved and in effect

Participation Agreements Hospitals/Physicians by County 226 Signed PA’s Updated 08/10/12 Adair Allen Anderson Ballard Barren Bath Bell Boone Bourbon Boyd Boyle Bracken Breathitt Breckinridge Bullitt Butler Caldwell Calloway Campbell Carlisle Carroll Carter Casey Christian Clark Clay Clinton Crittenden Cumberland Daviess Edmonson Elliott Estill Fayette Fleming Floyd Franklin Fulton Gallatin Garrard Grant Graves Grayson Green Greenup Hancock Hardin Harlan Harrison Hart Henderson Henry Hickman Hopkins Jackson Jefferson Jessamine Johnson Kenton Knott Knox Larue Laurel Lawrence Lee Leslie Letcher Lewis Lincoln Livingston Logan Lyon McCracken McCreary McLean MadisonMagoffin Marion Marshall Martin Mason Meade Menifee Mercer Metcalfe Monroe Montgomery Morgan Muhlenberg Nelson Nicholas Ohio Oldham Owen Owsley Pendleton Perry Pike Powell Pulaski Robertson Rockcastle Rowan Russell Scott Shelby Simpson Spencer Taylor Todd Trigg Trimble Union Warren Washington Wayne Webster Whitley Wolfe Woodford   Hospital Physician Lab Combination Other Participation Agreements: Kentucky Immunization Registry Kentucky Cancer Registry Kentucky State Laboratory Cumberland Medical Lab Labcorp Congressional District 1 Congressional District 2 Congressional District 3 Congressional District 4 Congressional District 6 Congressional District 5

KHIE Hospital Participation Agreements Hospitals by County 64 Signed PA’s representing 90 Hospitals (22 are CAH) Updated 08/13/2012 Adair Allen Anderson Ballard Barren Bath Bell Boone Bourbon Boyd Boyle Bracken Breathitt Breckinridge Bullitt Butler Caldwell Calloway Campbell Carlisle Carroll Carter Casey Christian Clark Clay Clinton Crittenden Cumberland Daviess Edmonson Elliott Estill Fayette Fleming Floyd Franklin Fulton Gallatin Garrard Grant Graves Grayson Green Greenup Hancock Hardin Harlan Harrison Hart Henderson Henry Hickman Hopkins Jackson Jefferson Jessamine Johnson Kenton Knott Knox Larue Laurel Lawrence Lee Leslie Letcher Lewis Lincoln Livingston Logan Lyon McCracken McCreary McLean MadisonMagoffin Marion Marshall Martin Mason Meade Menifee Mercer Metcalfe Monroe Montgomery Morgan Muhlenberg Nelson Nicholas Ohio Oldham Owen Owsley Pendleton Perry Pike Powell Pulaski Robertson Rockcastle Rowan Russell Scott Shelby Simpson Spencer Taylor Todd Trigg Trimble Union Warren Washington Wayne Webster Whitley Wolfe Woodford    Hospital Congressional District 1 Congressional District 2 Congressional District 3 Congressional District 4 Congressional District 6 Congressional District 5 Critical Assess Hospital

FQHC Participation Agreements FQHC by County 11 Signed PA’s representing 51 Sites Adair Allen Anderson Ballard Barren Bath Bell Boone Bourbon Boyd Boyle Bracken Breathitt Breckinridge Bullitt Butler Caldwell Calloway Campbell Carlisle Carroll Carter Casey Christian Clark Clay Clinton Crittenden Cumberland Daviess Edmonson Elliott Estill Fayette Fleming Floyd Franklin Fulton Gallatin Garrard Grant Graves Grayson Green Greenup Hancock Hardin Harlan Harrison Hart Henderson Henry Hickman Hopkins Jackson Jefferson Jessamine Johnson Kenton Knott Knox Larue Laurel Lawrence Lee Leslie Letcher Lewis Lincoln Livingston Logan Lyon McCracken McCreary McLean MadisonMagoffin Marion Marshall Martin Mason Meade Menifee Mercer Metcalfe Monroe Montgomery Morgan Muhlenberg Nelson Nicholas Ohio Oldham Owen Owsley Pendleton Perry Pike Powell Pulaski Robertson Rockcastle Rowan Russell Scott Shelby Simpson Spencer Taylor Todd Trigg Trimble Union Warren Washington Wayne Webster Whitley Wolfe Woodford    FQHC Congressional District 1 Congressional District 2 Congressional District 3 Congressional District 4 Congressional District 6 Congressional District 5 FQHC Sites live on KHIE

Rural Health Clinics Participation Agreements RHC by County 42 Signed PA’s representing 80 Sites Updated 08/13/2012 Adair Allen Anderson Ballard Barren Bath Bell Boone Bourbon Boyd Boyle Bracken Breathitt Breckinridge Bullitt Butler Caldwell Calloway Campbell Carlisle Carroll Carter Casey Christian Clark Clay Clinton Crittenden Cumberland Daviess Edmonson Elliott Estill Fayette Fleming Floyd Franklin Fulton Gallatin Garrard Grant Graves Grayson Green Greenup Hancock Hardin Harlan Harrison Hart Henderson Henry Hickman Hopkins Jackson Jefferson Jessamine Johnson Kenton Knott Knox Larue Laurel Lawrence Lee Leslie Letcher Lewis Lincoln Livingston Logan Lyon McCracken McCreary McLean MadisonMagoffin Marion Marshall Martin Mason Meade Menifee Mercer Metcalfe Monroe Montgomery Morgan Muhlenberg Nelson Nicholas Ohio Oldham Owen Owsley Pendleton Perry Pike Powell Pulaski Robertson Rockcastle Rowan Russell Scott Shelby Simpson Spencer Taylor Todd Trigg Trimble Union Warren Washington Wayne Webster Whitley Wolfe Woodford    RHC Congressional District 1 Congressional District 2 Congressional District 3 Congressional District 4 Congressional District 6 Congressional District 5

LIVE Connections Adair Allen Anderson Ballard Barren Bath Bell Boone Bourbon Boyd Boyle Bracken Breathitt Breckinridge Bullitt Butler Caldwell Calloway Campbell Carlisle Carroll Carter Casey Christian Clark Clay Clinton Crittenden Cumberland Daviess Edmonson Elliott Estill Fayette Fleming Floyd Franklin Fulton Gallatin Garrard Grant Graves Grayson Green Greenup Hancoc k Hardin Harlan Harrison Hart Henderson Henry Hickman Hopkins Jackson Jefferson Jessamine Johnson Kenton Knott Knox Larue Laurel Lawrence Lee Leslie Letcher Lewis Lincoln Livingston Logan Lyon McCracken McCreary McLean MadisonMagoffin Marion Marshall Martin Mason Meade Menifee Mercer Metcalfe Monroe Montgomery Morgan Muhlenberg Nelson Nicholas Ohio Oldham Owen Owsley Pendleton Perry Pike Powell Pulaski Robertson Rockcastle Rowan Russell Scott Shelby Simpson Spencer Taylor Todd Trigg Trimble Union Warren Washington Wayne Webster Whitley Wolfe Woodford   Hospital Physician/Clinic Lab Combination Others: Kentucky Immunization Registry State Lab (Microbiology) (Franklin) Grundy, VA Congressional District 1 Congressional District 2 Congressional District 3 Congressional District 4 Congressional District 6 Congressional District 5

8/19/2011 Outreach Coordinator Regions Adair Allen Anderson Ballard Barren Bath Bell Boone Bourbon Boyd Boyle Bracken Breathitt Breckinridge Bullitt Butler Caldwell Calloway Campbell Carlisle Carroll Carter Casey Christian Clark Clay Clinton Crittenden Cumberland Daviess Edmonson Elliott Estill Fayette Fleming Floyd Franklin Fulton Gallatin Garrard Grant Graves Grayson Green Greenup Hancock Hardin Harlan Harrison Hart Henderson Henry Hickman Hopkins Jackson Jefferson Jessamine Johnson Kenton Knott Knox Larue Laurel Lawrence Lee Leslie Letcher Lewis Lincoln Livingston Logan Lyon McCracken McCreary McLean MadisonMagoffin Marion Marshall Martin Mason Meade Menifee Mercer Metcalfe Monroe Montgomery Morgan Muhlenberg Nelson Nicholas Ohio Oldham Owen Owsley Pendleton Perry Pike Powell Pulaski Robertson Rockcastle Rowan Russell Scott Shelby Simpson Spencer Taylor Todd Trigg Trimble Union Warren Washington Wayne Webster Whitley Wolfe Woodford    Region 1 – Laura Shonk Region 2 – Teresa Poff Region 3 – Ann O’Hara Region 4 – Dawn Gasser Region 5 – Pat Robinson

GOEHI’s Plan/Scope of Work Assist the existing Pennyroyal Behavioral Health recipient with KHIE connectivity Provide connectivity for other CMHCs Enhance the capability of the KHIE and the current CCD Develop a 42 CFR 2 compliant consent Develop consent training protocols Inform both healthcare providers and consumers about this process

What’s Possible? With a Connected Community Community Pharmacy Imaging Center Loosely Affiliated Physicians Hospitals Patients Tightly Aligned Physicians Better Care Affordable Care Health People/Healthy Community Owned Practices/ Clinics Reference Lab Non-affiliated Practices

More information on the KHIE can be found on the Governor’s Office of Electronic Health Information website at