1. PRESENTATION TO THE NC HIT COLLABORATIVE 1/21/2010 Cindy Oakes, Executive Director Southern Piedmont Community Care Plan Keith McNeice, Chair SPBC Steering Committee The Southern Piedmont Beacon Community (SPBC) Project

2. Does application represent a geographic healthcare community & is one lead organization indicated: The SPBC is comprised of Cabarrus, Rowan, and Stanly Counties. These three counties meet the definition of a community in the FOA Stanly and Rowan are “rural”; Cabarrus is “metropolitan” The SPBC is led by the Southern Piedmont Community Care Plan (SPCCP), a CCNC member and a 501(c )(3) with a consortium of partners and advisers SPCCP is an eligible applicant as a “Public/private partnership aimed at health system improvement and/or community health improvement”

3. Does applicant organization and/or partners possess expertise in the described core competencies: The brief list below shows highlights of SPCCP and key community partners’ expertise in each of the areas:

4. Does the geographic region proposed to be represented by applicant possess an advanced rate of EHR adoption: Threshold: 40% for physicians; 20% for hospitals All four hospitals in the SPBC have EHRs (three non-profit plus a VA hospital)- 100% Our calculations, based on an actual list of virtually all ambulatory providers, indicate that 68% of all providers in the SPBC have EHRs in productive use

5. Does applicant organization and/or partners possess an advanced rate of HIE capabilities: Threshold: 20% of providers use existing HIE services as they relate to meaningful use and for care coordination? From the BC FAQ –  J1. Health Information Exchange services include, but not limited to:  electronic eligibility and claims transactions;  electronic prescribing, refill requests, prescription fill status and/or medication fill history;  electronic clinical laboratory ordering and results delivery;  electronic public health reporting, including immunizations and notifiable laboratory results;  quality reporting; and  clinical summary exchange for care coordination and patient engagement. SPBC can demonstrate extensive deployment and meaningful use via point-to-point exchange in excess of the threshold

6. Does applicant organization and/or partners possess an advanced rate of HIE capabilities: The major affiliated provider groups (2 health systems, 1 VA and three large affiliated practice groups) represent 90+% of all providers in the SPBC. Each of these groups of affiliates routinely share data electronically about common patients among its large set of providers. Virtually all (~100%) of providers do electronic claims. All Cabarrus Family Medicine, Stanly Medical Services, and NE Physicians Network providers use e-RX and electronic claims. This activity alone involves exceeds the threshold for the ambulatory/inpatient providers in the community. SPCCP care managers routinely obtain electronic health information from a wide variety of partner provider systems in the community. SPCCP enrollment system is used by DSS, hospital precertification, hospital patient accounts and Community Free Clinic as part of their indigent care program. The sharing is generally done for care coordination and includes many of the new meaningful use HIE-related objectives (noted on prior slide).

7. Describe goals that directly targets both Beacon community program goals: Patient-focused health care  “[e]nable the transformation to higher quality, more cost-efficient, patient-focused health care through electronic health information access and use by care providers, and by patients and their designees.” Population health  “[e]nable the appropriate, authorized, and timely access and use of electronic health information to benefit public health, biomedical research, quality improvement, and emergency preparedness.”

8. Describe goals that directly targets both Beacon community program goals:

9. Are the proposed goals viable and justified: The goals have been vetted and selected by the key community providers as viable. The goals are derived from recent community health assessments of the three counties. The goals are aligned with supporting meaningful use accomplishments. The goals are aligned with the Medicare 646 program and other CCNC initiatives.

10. Describe a strategy for coordinating with the NC HIE & REC strategies: NC Institute for Public Health (NCIPH) is a key member of the SPBC consortium NCIPH has an established relationship with AHEC in its Regional Extension Center role The Charlotte AHEC services 2 of our counties and is operated by Carolinas HealthCare System, one of the systems in the SPBC A Beacon Community is a demonstration project for innovation, learning and dissemination The highly developed yet diverse EHR deployment in the SPBC is an excellent laboratory for our academic partners to study and document best practices for selection, implementation and integration of HIT This will benefit the SPBC community (REC supported or not), local and state AHEC’s in their REC roles

11. Describe a strategy for coordinating with the NC HIE & REC strategies: Carolinas HealthCare System has staff participating in several NC HIE work groups Both Systems in the SPBC sit on the Board of NCHICA Carolinas HealthCare System has hospitals and physician networks in all 4 of the proposed NC Beacon Communities Both SPBC Systems supported the NC HIE strategy submitted to the ONC and will use as many of the State HIE shared services as feasible A Beacon Community is a demonstration project for innovation, learning and dissemination Develop SPBC community needed services that are not part of the NC HIE – and collaborate to make them available beyond the BC where appropriate – especially as part of a future generation of NC HIE services

12. Describe a plan to leverage HIT to advance community-level care coordination, quality monitoring, and feedback: The goals noted earlier focus on care coordination across the community. The nature of evaluation for the project requires that quality increases due to the interventions associated with the goals be monitored. We plan to report (feedback) these quality improvements to the community and beyond (to support diffusion of successful practices). The operational and evaluation infrastructure will also be available to support non-HIT-enabled quality monitoring. Partnerships with Duke Center for Health Informatics, UNC School of Public Health / SHEPS Center, NC Institute for Public Health, Duke Clinical Research Institute and others for research, population studies and diffusion strategies.

13. Describe process and outcome objectives: Describe a viable measurement plan and benchmark metrics: Each Goal has activities and measures of success (outcome measures). Below is the set of care goals with activities and measures. There are similar activities and measures for population health, HIT Infrastructure and Exchange, Cost efficiency, innovation and evaluation, and diffusion.

14. Target rural community, minority or other underserved populations’ health needs: The SPCCP mission is focused on underserved populations. (43,000+ Medicaid enrollees and 1,500 uninsured) Our partners include organizations with individual missions to serve minority and underserved populations and a joint mission to do so under the SPCCP: Hospitals, Public Health Departments, Department of Social Services, Community Free Clinics, Mental Health, Parish Nurses, School Nurses The areas of care improvement are focused on diseases that disproportionally affect minorities and the underserved.

15. Include collaboration with CCNC? SPCCP is a leading member of CCNC. CCNC representation (ex officio) on the SPBC Steering Committee by Annette Dubard. The project is aligned with CCNC’s Medicare 646 program and other CCNC programs. We plan to continue to work with CCNC in this SPBC context as we do in other contexts.

16. Q&A Thank You!