NATIONAL ROLE OF HIE’S IN HEALTHCARE’S FUTURE: BIOMEDICAL INFORMATICS CHALLENGES APRIL 10, 2014 JAN ROOT, PH.D. & MATT HOFFMAN, M.D. UHIN

PAYMENT REFORM: A CHANGING ENVIRONMENT Fee for Service“Value Based Payment” Financial RiskAll with PayerShared Payer and Providers Incentive to Reduce CostAll with PayerShared Payer and Providers Incentive to Improve QualityAll with PayerShared Payer and Providers Top Three HIT priorities to Accomplish this transition 1 : 1.Population Health: determine individuals at high financial risk (poor health which can be impacted positively) 2.Health Information Exchange: track patients’ risk in real time (know about the heart attack ASAP) 3.Analytics for Care Pathways: create real-time risk reduction care strategies (implement effective care strategies to improve health outcomes at lowest cost) 1: KLAS Report: Accountable Care Timing 2013, November 2013

WHY IS HIE RATED #2 IN IMPORTANCE? cHIE Shared Patients Data 1 1 cHIE Data, October 2013 Patients seek care from many healthcare systems in any one market The shared-risk partnership needs real-time clinical data to effectively manage risk Claim data is not timely enough & lacks clinical depth

WHAT DOES THE CHIE DO? Collect Data and Use it cHIE Warehouse Clean MPI

WHAT INFORMATICS CHALLENGES EXIST? Demonstration of CareAchieve Re-Cap: 1.Population Health: determine individuals at high financial risk (poor health) 2.Health Information Exchange: track patients’ risk in real time (know about the heart attack ASAP) 3.Analytics for Care Pathways: create real-time risk reduction care strategies (implement effective care strategies to improve health outcomes at lowest cost)