Information Collaborative Community Health Information Collaborative and the Northeast Minnesota Regional Health Information Organization Cheryl M. Stephens Executive Director Community Health Information Collaborative Melinda Machones HIT Project Manager The College of St. Scholastica Clark Averill IT Director, St. Luke’s Hospital Chair, CHIC Board of Directors

CHIC Overview Planning started in 1997 Initial focus Developed with Federal Office of Rural Health Network grant Key participants included regional hospitals, physician practices, public health, and the Minnesota Health Data Institute. Initial focus To coordinate health information technology in Northeastern Minnesota To share costs and best practices across the membership Gained Non-profit 501(c)3 status in 1999 Hold up map

Current CHIC Services Provide secure and encrypted claims submission to Medicare, Medicaid and various commercial Payors. Lead agency for the Minnesota Immunization Information Connection in 18 counties. Administrative Coordinator for Emergency Preparedness activities for 16 hospitals in 7 counties in the Arrowhead. Provide USAC administrative services – brought $185,000 back to the region in 2004 Hold up map

Total Sites contributing data – 344 CHIC Members Total Sites contributing data – 344 Hospitals – 32 Clinics – 110 Public Health Agencies – 19 Long-term care – 9 Urgent Care Sites – 2 Tribal Health Agencies – 20 Schools – 146 Corrections – 2 Home Care Agencies – 2 Pharmacy – 2 Just beginning to add long-tem care – MDH funded a pilot study to look at the sharing of pneumoccocal vaccine data between hospital, physician offices and LTC.

Membership Fee Structure Based on organization size and services used Hospitals/Health Systems fees are based on bed size and employed physicians Clinics fees are based on employed physician Public Health is a set fee Tribal Health is a set fee Some members fees are paid by grants that CHIC is administrating

Reasons for RHIO National Focus snapshot Office of National Coordinator of Health Information Technologies (Dr. David Brailer) June 6: American Health Information Community Advisory Panel announced June 7: Four RFP’s focusing on Health Information Exchange June 8: Capital Hill HIT Showcase June 16: "Health Technology to Enhance Quality Act of 2005" (Health TEQ)”

Reasons for RHIO Regional Activities MN e-Health Steering Committee This Minnesota Rural Health Conference St. Scholastica focus on HIT and interdisciplinary health sciences programs SMDC, St. Luke’s, SISU investments in EHR technology CHIC is the logical organization to drive this strategy in NE Minnesota

RHIO Definition An organization that facilitates the sharing of health information across all organizations contributing to the continuum of patient care. Very close to the current mission statement of CHIC

RHIO Models Common Community EHR Shared repository of summary EHR data Not practical, would involve replacing all existing investments Shared repository of summary EHR data Costly duplication of technology Shared access to multiple EHRs Practical solution in consumer-directed market Shared electronic clinical transactions Practical starting point while EHR adoption matures, e.g. immunization registries, Rx histories, e-prescribing

RHIO Major Stakeholders Physicians, hospitals, public health, tribal health and other health care providers Payers Patients / Consumers Employers Communities – Winona has a community based EHR up and running E-Health Initiative Steering Committee has members from Payors in the state, there are cost benefits to them –reduced duplicate testing, HEDIS chart pulls could be done electronically Patients – someday we may be able to access our own records electronically. ER visits, medication lists, etc.

Criteria for our RHIO Vision An appropriate and effective Vision must include the following components: Create the technological infrastructure Develop processes to make effective use of these systems within and between healthcare systems Engage all stakeholders with special focus on rural providers We are very early on in the development of RHIOs.

RHIO Work Group CHIC Cheryl Stephens SISU Medical Systems Mark Schmidt The College of St. Scholastica Kathy LaTour Melinda Machones Iron Range Resources Richard Walsh St. Luke’s Hospital Clark Averill St. Mary’s/Duluth Clinic Tess Settergren SuperiorEdge Kelly Peterson Community Health Board Julie Myhre Not written in stone, we may be adding more folks

Challenges EHR adoption in rural NE Minnesota providers – cost and resources Lack of comprehensive standards between vendors Public concern over privacy and security Available funding

Advantages CHIC’s history and relationships with providers SMDC and St. Luke’s commitment to the project National focus and momentum We can learn from earlier projects around the country

RHIO Initiatives in NE MN Learn from other RHIO projects Acquire Funding Assess Environment Address privacy and security issues Promote the project

Initial Implementation Share CCR with EPIC and Meditech providers 2 largest systems in the region CCR provides basic patient information Allows us to expand by system or by record data Provides for a well-defined, early success

Questions? Thank You!