Georgia Department of Community Health Georgia Health Information Exchange Network HomeTown Health Event September 25, 2012

Georgia HIE Network 2

Who we are What we do What it matters 3

Who we are… 4

Georgia HIE Network: Who are we? 5 Public-Private Collaborative Organizations in the collaborative –Georgia Health Information Exchange, Inc. (GHIE, Inc.) –Department of Community Health (DCH) –Georgia Health Information Technology Regional Extension Center (GA-HITREC) Work together to produce the Georgia HIE network through –Governance, project management, policy development, business and finance planning, technology deployment, marketing, and stakeholder engagement.

Georgia HIE Network: Who are we? 6 GHIE, Inc. Board of Directors and Committees 28 member Board extending all across Georgia 3 advisory committees –Service Area HIEs Committee—operational experience –Clinical Committee— quality measures and provider participation in e- Prescribing, lab exchange, and use of clinical care summaries –Secondary Use Committee—public health and biosurveillance 3 policy committees –Technology Committee—use cases architecture, standards, and interoperability –Legal and Privacy Committee—policies and privacy and security processes and procedures –Financial Committee—business operations and financial sustainability

Georgia HIE Network: Mission & Vision 7 Mission Georgia’s mission is to facilitate a Georgia HIE network for Georgia that is trusted and valued by all stakeholders in order to improve health care coordination, reduce costs, and establish a solid foundation for long-term financial sustainability. Vision of Coordinated Care Georgia’s vision is to foster a healthier Georgia through the use and exchange of electronic health information by improving patient- centered health care, increasing efficiency, and promoting the health status of the entire state population.

What we do… 8

9 Georgia statewide HIE network is being developed to offer statewide health information exchange services to hospitals and clinicians… … improving the quality, safety, and efficiency of health care by connecting clinicians, consumers, and authorized stakeholders through a secure information exchange. Georgia Health Information Exchange Network

Georgia HIE Network Product and Services GeorgiaDirect Rome Challenge Grant In pilot phase Available in Demonstration project in Rome, GA 10 PatientFinder

GeorgiaDirect Secure Messaging Provides a secure way for health care providers to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. 11

PatientFinder Service Allows authorized clinicians to query and retrieve clinical records from participating sources for patient care. Enables retrieval of records from multiple data sources. –All patient data is stored at its original location, within the provider's local system rather than in a centralized database. –All transactions involving the Georgia HIE network are logged in the Georgia HIE audit log. 12

Why it matters… 13

Georgia HIE Network Why it matters? Enables providers the opportunity to securely and efficiently exchange patient health information. Keeps patient data with the treating provider and only access it when there is authorization and a demonstrated clinical need. Permits visibility into patient records across providers – presenting them with the right information, at the right time to offer their patients the right care. Gives consumers tools to know their health information so they can improve their health. 14

Georgia HIE Network 15

GeorgiaDirect Secure Messaging Benefits of GeorgiaDirect – rely less on FAX, telephone, & mail Referral –A General Practitioner sends an with a referral along with any necessary patient information and lab results to a Specialist Transition of care –A Family Physician sends an with a Treatment Summary of a patient to a Hospital or Long-Term care facility when the patient is admitted. Satisfy Meaningful Use Criteria –Send patient referral via Direct Secure Messaging to an authorized recipient. Forward CCDs with referrals or at transition of care. Transmit required reports to Public Health (when available). Satisfy patient-focused MU measures. 16

PatientFinder Service Benefits of PatientFinder Patient Information –Presents authorized providers with accurate, timely and reliable patient data at the point of care. Interoperability –Enables connectivity services to providers within and outside of Georgia through the Nationwide Health Information Network. Satisfy Meaningful Use Criteria –Hospitals are required under MU to report to public health agencies and share data with other providers who are treating the patient. HIE simplifies the connectivity landscape so that hospitals only have one connection to make. 17

Getting Connected to the Georgia HIE Network 18

Network of Networks Strategy The Georgia HIE network connects local/regional HIEs and other Qualified Entities Qualified Entities –Have permission to access, consume and make available HIE services on the statewide health information exchange network. –Must meet a set of established criteria, successfully completed the approval process, and signed agreements to abide by HIE Statewide Privacy & Security Policy Framework. –Must ensure that participants and vendors with which they have contracts meet the requirements to carry out statewide policies. 19

Network of Networks Strategy The Georgia HIE network connects local/regional HIEs and other Qualified Entities Role of Qualified Entities –Help organize and manage HIE Participants in the Georgia healthcare ecosystem. –Participants can be hospitals, physician practices, long-term care centers, laboratories, public health entities, and/or many other diverse members of the healthcare industry. –Participants have authorization to access the Georgia HIE network services through a Qualified Entity. –In addition to providing a conduit for the Georgia HIE services, a QE organization may choose to provide unique services to the members of their community as well. 20

Network of Networks Strategy The Georgia HIE network connects local/regional HIEs and other Qualified Entities Strategic Benefits –Leverages health information networks in existence and provides a means of making set of core and value-added services available to benefit the entirety of the Georgia healthcare ecosystem. –Operations are manageable and costs remain low. –Supports Georgia HIE and stakeholder sustainability models. GHIE supports local/regional HIEs and other QEs – it does not compete with them. –Allows the State to provide guidance on complex issues and leverage federal funding to strengthen and advance the exchange. 21

Business and Operations Foundation for Georgia’s HIE Business and Operations 22 Financial Sustainability Drafted the Georgia HIE Business and Financial Sustainability Plan for GHIE, Inc. which includes seed funding estimates, potential pricing and revenue models, approach to leveraging public funding and private investment. Statewide Privacy & Security Policy Framework Developed the statewide privacy and security policy framework, including the HIE network ( GeorgiaDirect ) Participation Agreement, Terms and Conditions, and a set of policies to assure trust, effectiveness of security procedures, and enable rapid progress. Technology & Policy Assessment Conducted technical and policy assessment of key stakeholder organizations, local/regional HIEs, and state agencies – the basis to connect Qualified Entities for statewide interoperability.

Become part of the Georgia HIE Network Georgia HIE Getting Connected Guide (in development) Help organizations better understand the requirements and choices available to them when electing to participate in the Georgia HIE network. The guide will be a high level planning tool –Defines characteristics and responsibilities of Qualified Entities: community, business model, governance, and technology. –Overview of legal and technical requirements; minimum standards for each organization participating in the Georgia HIE network. 23

Current Progress 24

Pilot in Progress Developing the GeorgiaDirect Pilot Program Challenge Grant (Rome and Savannah) 25 Urban Hospital SAHIE Rural Hospital Georgia Medicaid Florida Interstate Pilot SAHIE

Powerful Exchange By December 2012 more than 25,000 Georgia providers will have the ability to securely exchange electronic data using GeorgiaDirect Georgia HIE will be the most advanced Directed Exchange in the country 26

Get Engaged and Stay Informed 27

GHIE, Inc. DCH: GA-HITREC: Get Engaged & Stay Informed 28

insert Kelly Gonzalez Director, Division of Health IT State Health IT Coordinator Department of Community Health 29

Appendix 30

Patient Matching Provider Directory Terminology Services Terminology Services Security Services Authorization Layer: Transport, Orchestration, Audit, Reporting Immunization Registry Lab Translation Medication Management Quality Reporting Lab Order & Results Routing CCD Translation Procedures Results Delivery Disease Surveillance Radiology Image Delivery EHR/EMR Clinical Decision Support Personal Health Record GeorgiaDirect Secure Messaging Services Secure Message HISP Certificate Authority The Georgia HIE network menu of services is standards based and is being developed to support a variety of health information exchange needs. The HIE network services will be offered in 3 set of core services: GeorgiaDirect Secure Messaging PatientFinder ( Query-Based Exchange Core Services) Advanced Exchange (Value-Added Services) This overall technology solution consists of a set of core service elements that provide the foundation for the secure exchange of information between authorized providers. Georgia HIE Network Technology Solution and Potential HIE Services 31 PatientFinder (Query-Based Exchange Core Services) Lab Normalization CCD Summary NwHIN Gateway Public Health Advanced Exchange (Value-Added Services)

Patient visits primary care provider; provider needs to refer patient to a specialist 1. Provider uses EHR to initiate referral message and locate specialists Provider’s EHR system looks up specialist practices in GA’S HIE provider directory 3. GA HIE Network documents access to system in audit log 4. Specialist receives referral request and sends response to referring physician through the GA HIE Network 5. Specialist sees patient 2. Referring provider sends referral and reference clinical documents to the specialist system Provider Directory Security Services & Authorization Framework Secure Message Exchange via Direct Project Secure Message Exchange via Direct Project Transaction Audit Log & Reporting Georgia Statewide Health Information Exchange Network 32 GeorgiaDirect (Secure Messaging) Referral to Specialist Use Case

At the Point of Care A patient visits their primary care provider. The provider needs to locate patient’s health information. 1. Provider uses their EHR (or GHIE web portal) to locate patient records. The provider’s system queries the Georgia HIE network. 4. Provider conducts patient examination. 5. Aggregated patient health information is returned to provider and information is incorporated into the provider’s EHR. 2. Georgia HIE uses RLS to locate and retrieve information on identified patient and returns available clinical documents from within the network. Security Services & Authorization Framework Record Locator Service Transaction Audit Log & Reporting 3. Georgia HIE documents access to Network in audit log. Master Patient Index Provider Directory Terminology Services NwHIN Gateway 33 Georgia Statewide HIE Network PatientFinder (Query-Based Exchange) Patient Search Use Case