Ohio’s CliniSync Health Information Exchange: Leveraging Interoperability to Improve Patient Care & Revenue Scott Mash, MSLIT, CPHIMS, FHIMSS Director of Consulting Operations & HIE Outreach

2 OVERVIEW History of CliniSync Status of HIE and penetration across care continuum Review available services How the HIE improves care Utilizing the HIE to reduce costs & increase revenue

3 CliniSync is now a financially independent nonprofit. GRANT FUNDING $28.3 Million Assisted 6,000 + primary care providers in EHR adoption and Meaningful Use Achievement – highest of any Regional Extension Center in the nation! REC $14.7 Million Connecting physicians, long-term care, hospitals, behavioral health and other care providers to the state Health Information Exchange HIE

4 GOVERNAN CE We are a grass-roots, community and statewide organization. Ohio Hospital Association, Ohio Osteopathic Association, Ohio State Medical Association and Ohio Department of Education. Founders Physicians, hospitals, health plans, HIT, long- term care, consumer group. Board of Directors Physicians, hospital systems, community and children’s hospitals, health plans, long-term care, behavioral health. CliniSync Advisory Council

5 A top-tier HIE vendor supporting multiple states (DE, HI, MI, VT, WI, CO, SD, GA) TECHNOLOGY PARTNER

6 An HIE moves patient information electronically among physician offices, hospitals and other health professionals directly involved in a patient’s care, such as pharmacies and labs. HEALTH INFORMATION EXCHANGE

7 CARE COORDINATION Hospitals Physicians Behavioral Health Long-Term, Post Acute Care Health Plans Commercial Labs Public Health CliniSync connects care providers to assist in better patient care coordinatio n.

8 OHIO’S CLINISYNC HIE HOSPITALS Total Contracted Hospitals: 141 (soon to be 150) Green: CliniSync Live Hospitals Yellow: In implementation Blue: HealthBridge Live Hospitals (20+) Almost 90% of hospitals in Ohio have committed to an HIE. Over 87% of 11.5M Ohioans are being served.

9 IMPLEMENTATION SLIDE  Community Memorial  Magruder Hospital  The Medical Center at Elizabeth Place  Samaritan Regional  Wood County  O’Bleness Memorial  Wyandot Hospital  Lake Health (2)  Wayne Community  Knox Community Hospital  Firelands  Fisher Titus  Harrison Community  Holzer Health System (2)  Ohio State (6)  Wilson Memorial  Summa Health (4)  MedCentral (2)  Akron Children’s (2)  METROHealth  Adena Health System (3)  Akron General (3)  Alliance Community  Aultman (3) – Lab Only  Avita (2)  Barnesville  Bellevue  Berger Hospital  Blanchard Valley (2)  Cleveland Clinic (12)  Coshocton County  Community Health and Wellness (3)  Dayton Children’s  East Liverpool  Elyria Memorial  Fairfield Med Ctr  Fayette County  Fremont Memorial  Fulton County  Grand Lake/Joint Twp  Genesis (2)  Henry County  Hocking Valley  Humility of Mary (3)  Joel Pomerene Mem Health  Kettering (6)  King’s Daughters - Rad only *Signed off on results delivery  Licking Memorial  Lima Memorial  Marietta Memorial (2)  Mary Rutan  Mercer County  Mercy Canton  Mercy Lorain (2)  Memorial Hospital Union County  Mercy Toledo (7)  Morrow County  Mount Carmel Health System (4) – Rad/Trans only  Nationwide Children’s - Rad only  Parma Community  Premier Health Partners (4)  Robinson Memorial  Salem Community  SEORMC  St. John  Saint Rita’s (2)  St. Vincent Charity  Southern Ohio Med Ctr  Southwest General  Trinity Health (2)  Union Hospital  University Hospitals (9)  University of Toledo Med Ctr  Van Wert  Wooster Community  Western Reserve Data CollectionData Analysis Certification Testing Live 141 Total Active Hospitals As of 10/20/2015

10 CONNECTED PROVIDERS

11 30 EMR Vendors Connected

12 PROGRESS IN LTPAC SECTOR 356 facilities LTC/SNF 48 organizations Home Health 4 organizations Hospice

13 PATIENTS INDEXED Total patients indexed in CliniSync since inception: 7.2 million

14 CHR QUERIES Total number of queries performed during the month.

15 CLINISYNC SERVICES

16 SERVICES OVERVIEW AA Connect IntegrateNotify ContributeConsul t DIRECTor y Community Health Record Clinical Results Inbox DIRECT Messaging Health Plan Services Clinical Results & Reports Delivery Electronic Orders Integrated DIRECT Messaging Admission & Discharge Notifications Public Health Reporting Summary of Care Document (CCD) HL7 Interfaces CliniSync Community Liaisons Meaningful Use & More DIRECT addresses of providers

17 Community Health Record Access a single community record of your patients’ health encounters at hospitals and with other providers through CONNECT. You’ll get a comprehensive picture of a patient’s health history. HealtheWay Certified. Clinical Results Inbox Receive clinical results and reports through CONNECT. You can receive lab results, radiology and transcribed reports directly into a secure, integrated inbox, or into your electronic health record system. Referrals Electronically send and receive customized patient referrals with confirmation and tracking in real time through CONNECT. Your staff can streamline the referral process to reduce phone calls and faxing. DIRECT Messaging CONNECT with other providers using our HISP (Health Information Service Provider) by sending and receiving secure messages, called DIRECT. CliniSync is Direct Trust certified. CONNECT

18 INTEGRATE Clinical Results Delivery INTEGRATE patients’ lab results, radiology and transcribed reports into your EHR system, including, care summaries, history & physicals progress notes and more. Electronic Orders If your hospital chooses to participate in Electronic Orders through INTEGRATE services, you can place orders directly from your EHR system to the hospital without interrupting your workflow. Integrated DIRECT Messaging With Integrated DIRECT messaging, you can send and receive secure messages from within your EHR system to other providers and these become part of your patient’s health record.

19 NOTIFY Admission and Discharge Notifications Receive a notification when one of your patients goes to the Emergency Department or is admitted to a hospital or discharged from it.

20 CONTRIBUTE Public Health Reporting Use CliniSync to report public health data to the Ohio Department of Health. Summary of Care Contribute care summary documents to CliniSync for other providers to access. HL7 Interfaces Contribute clinical results to CliniSync for other providers to access.

21 CONSULT CliniSync Community Outreach Managers Work with a Community Outreach Manager in your region to connect with practices in your area. CliniSyncPLUS Get guidance on Quality Reporting: MU requirements, audits, PQRS, HEDIS.

22 PROVIDER DIRECTORY Access a Provider Directory Gain access to a secure Provider DIRECTory that includes DirectTrust or secure addresses of other physicians and providers to improve transitions of care.

23 WHAT TO EXPECT Receive ADT and/or clinical data real-time Leverage existing data streams Select multiple methods for delivery of data Combine methods to meet your staff needs FLEXIBILITY VOLUME SPEED Access to statewide exchange >27M incoming messages per month More than 6.5M patients facilitated to- date

24 Health information exchange isn’t just about technology, it’s about community and trust.

25 IMPROVING PATIENT CARE

26 Connecting the Medical Neighborhood It is no longer an issue of technology to enable care coordination, but the desire of a community to enable it and putting the policies in place to drive it’s use and to pay for it.

27 Allows providers of care to have information where they need it, when they need it. Reduced physical risks to patients by avoiding unnecessary duplicate tests. Improves the coordination of care for a patient among various care providers to avoid medication and clinical errors. Electronic health records and health information exchange are providing access to better data, especially for the chronically ill. Assists emergency room personnel with information about incoming patients. CLINICAL BENEFITS OF HIEs

28 REDUCING COSTS, INCREASING REVENUE & SURVIVING PAYMENT REFORM

29 Better care, better health, lower cost Value Based vs Fee for Service Bundled Payments for Episodes of Care HIE Coordinated Care Measures & Outcomes Patient- Centered Medical Homes Accountable Care Models PAYMENT REFORM Success with payment reform requires coordinated care across multiple settings, access to a patient’s complete clinical information and discrete data stored within your EHR.

30 When HIE is available to ED physicians, the number of laboratory tests and radiology exams decrease. Reduced costs to patients and rejected claims by avoiding unnecessary duplicate tests. Provides a coordination process to help reduce re-admission rates. Reduced staff hours for faxing and chart pulls. REDUCING COSTS WITH HIEs

31 Serves as a mechanism to expand ancillary services and strategic partnerships. Supports team-based care models (PCMH, ACO & other payment reform models) that reduce Medicare and Medicaid spending (shared savings). Improved and more accurate reimbursement coding with improved documentation and data for highly compensated codes CCM (Chronic Care Management) and TCM (Transitional Care Management) provides higher reimbursement but requires HIEs. INCREASING REVENUE WITH HIEs

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