1. Health Information Technology Erin Aklestad, Account Manager April 2016

2. Alaska eHealth Network AeHN is a non-profit organization operating a secure statewide, standards-based electronic health information exchange which allows individual Alaskans to access their own health record and to authorize their health care providers to exchange electronic medical data for treatment and billing.

3. AeHN Services Direct Secure Messaging (DSM) Health Information Exchange (HIE) Public Health Reporting  Electronic Lab Reporting (Hospitals)  Syndromic Surveillance (Hospitals)  Immunizations (EP’s and Hospitals) Patient Portal EHR and MU Consultation

4. Topics for Review Meaningful Use Health Information Exchange

5. Definitions/Technology Platforms Electronic Health Record (EHR)  Official health record shared among facilities and agencies Health Information Exchange (HIE)  Moving large amounts of PHI securely through the internet, encrypted from end to end Direct Secure Messaging (DSM/Direct)  Moving a single patient record securely through the internet, encrypted from end to end Patient Portal

6. MEANINGFUL USE

7. Stages of Meaningful Use Stage 1 - Data Capture and Sharing Stage 2 - Advance Clinical Processes Stage 3 - Improved Outcomes

8. Meaningful Use Accelerate adoption of Electronic Health Records Using the EHR in a meaningful way Using the EHR in a way that can be measured for quality Secure Exchange and Interoperability

9. Meaningful Use Participation/Financial Incentives  2016 is last year to initiate participation in the Medicaid Incentive Program Payment Adjustments  2015 was the first year of payment reductions starting at 1% Audits

10. Meaningful Use 2015-2017 Modified MU requirements 2015-2017  10 objectives for EP’s Previous-15 core and 5 menu objectives  9 objectives for EH’s and CAH’s Previous- 14 core and 5 menu objectives NEW! Report on the calendar year

11. Attestation Challenges Security Risk Analysis Patient Portal  Secure Messaging HIE Interoperability

12. Reporting Challenges Stringent and changing requirements  Trying to hit a moving target Cost Unstable vendor market Providers are in different stages of adoption and utilization Provider buy-in and expectation

13. Other Mandated Reporting Programs PQRS PCMH Specialty Registries Public Health Reporting

14. What's Next MACRA- Medicare Access and CHIP Reauthorization Act (MACRA)- payment reform  Combine existing quality reporting programs into one new system. MIPS-Merit-Based Incentive Payment System Interoperability Source: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value- Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html

15. What’s next “Allowing providers the flexibility to customize health IT to their individual practice needs, technology must be user-centered and support physicians.“ (DeSalvo & Slavitt, 2015)

16. HEALTH INFORMATION EXCHANGE

17. Health Information Exchange Coordination of Care across organizations  Reduction of duplicate procedures and tests Replaces costly, non-secure processes Ensures timely record access Patient Engagement (Virtual Medical Home) Improved emergency response Improved disaster recovery/treatment

18. Privacy and Security Alaska Law and HIPAA Highest Security Standards  NIST compliant  Separation of clinical and demographic data  Assurances (SOC 2 and 3) – aicpa.org BAA, Policies/Procedures, Contracts Privacy, Security, and Compliance Workgroup (PSC)

19. HIE Patient Participation 3 Options  Opt-in (automatic CFR 164.308(a)(2)(i))  Opt-out full – no data retained  Opt-out partial – data retained but sealed except in emergency

20. What data is shared? Patient Demographics Encounter History Labs Results Radiology Transcriptions C-CDA

22. Direct Secure Messaging Single, encrypted message Statewide Provider Directory Uses  C-CDA  Referrals

24. Other HIE Benefits for End Users: Notifications Delivery options - electronic, email, fax, cellular, print Real time automated delivery Notification Types:  Laboratory Result  Microbiology Result  Radiology Report  Patient Admission  Patient Discharge  Patient is admitted to ER End users choose the notifications to receive

26. How do these services apply to HIM staff? HIE: Request for lab results or C-CDA  HIE is real-time therefore no need to wait on the other facility DIRECT: Transitions of Care/Referrals

27. HIE – Demo

28. Upon login, the user lands on the home page.

31. THANK YOU Erin Aklestad, Account Manager Erin@ak-ehealth.org (907)770-2626, X3