1. Health Information Exchange for Long-Term and Post-Acute Care Alaina Desnoyers April 2, 2019
We are providers who work in the Long-term Care and Post-Acute setting and often need to review hospital records for our fragile geriatric patients
We send out any agenda to about 300 people the Friday before (March 29) and usually have about attend in person and another 20 participate remotely via Zoom. We are looking forward to about a 15 minute presentation and then about 10 minutes for questions..
CMDA, the Colorado Society for Post-acute and Longterm care Medicine, is a non-profit organization representing physicians and other professionals providing care in nursing homes throughout Colorado (formerly known as the Colorado Medical Directors Association).  Our mission is to improve the quality of care for patients in our setting.   
As a physician, I can attest to how invaluable CORHIO is to my daily practice.  I could not provide the same level of care to my patients transferring to and from the nursing home/ subacute rehab without the use of CORHIO.  The recent announcement of your partnership with New West Physicians is exciting and admirable, and I would love to learn more about your impact on patient care communications in Colorado.  Our group includes physicians, physician assistants, nurse practitioners, and medical directors. 
Sing Palat, MD
Physician with Life Care Centers
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2. Colorado’s HIEs Where does CORHIO fit into the ACA?
CORHIO was started back in 2011 with funds from the Affordable Care Act, particularly the HITECH Act. While we are no longer sustained by this funding, and we are self-sustained, we continue to be driven by the same mission of the ACA – to support the transition from fee-for-service to value-based care, and to foster transparency and interoperability
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3. Data Available in the HIE
Hospitals
ADT Info
Transcription Notes
Consult & Operative Reports
History & Physical
Lab/Rad Results
Laboratories & Radiology Centers
Lab Results
Pathology Reports
Radiology Reports (images coming soon)
Public Health Departments
Immunizations
Reportable Conditions
Care Summaries
Ambulatory Providers/LTPAC
Department of Defense/Colorado Springs Military Health System
Kaiser Permanente
Veteran’s Administration
Hospitals
Radiology Centers
Laboratories
Public Health Departments

4. CORHIO By the Numbers 66 Hospitals Sending Data
Last updated 3/1/19
CORHIO By the Numbers
Breakdown by Care Setting (# of facilities)
Behavioral Health – 62
EMS – 21
FQHC – 25
*Home Health – 47
*Hospice – 15
*Long-Term Care – 124
Physician Office – 879
Other – 48
Urgent Care – 11
66 Hospitals Sending Data
5.5 Million Unique Patients
10 Labs Sending Data
16,100 HIE Users
6,100 Providers Participating
829 Million HL7 Messages From Data Senders to Date (2 Million+/Week)
2.3 Million
Ambulatory Care Summaries Available
© 2019 CORHIO – All Rights Reserved – CORHIO Proprietary – Not For Redistribution

5. Hospitals, Labs, Imaging & Payers – Connected
Last updated 3/1/19
Hospitals, Labs, Imaging & Payers – Connected
Payers/ACOs:
Anthem
Bright Health
CCMCN/CACHIE
HealthONE Colorado Care Partners
Colorado Department of Health Care Policy and Financing
Delta Dental of Colorado
Department of Defense
FullWell
Kaiser Permanente
Physician Health Partners
Rocky Mountain Health Plans
UnitedHealth Group
Evans
Independent/Other Hospitals:
Parkview Medical Center
Prowers Medical Center
Conejos County Hospital
Rio Grande Regional Hospital
Craig Hospital (query only)
San Luis Valley Regional Medical Center
Estes Park Medical Center
Melissa Memorial Hospital
Wray Community District Hospital
Mt. San Rafael Hospital
Pagosa Springs Medical Center
Yuma District Hospital
Labs & Imaging Centers:
Colorado Lab Services
Gastroenterology of the Rockies
Health Images/Colorado Springs Imaging
LabCorp
MetroPath
PENRAD Imaging
Quest Diagnostics
Schryver Medical
Touchstone Medical Imaging
UniPath
CORHIO empowers people, providers, and communities by providing the information they need to improve health.

6. Connection to CORHIO PatientCare 360
PatientCare 360 gives you access to the Community Health Record, where providers search for and view a patient's consolidated, longitudinal health record. It allows you to look up a patient and search the system for recent lab results, hospital ADTs, face sheets, treatment plans and ambulatory data.

7. Hospital for Hip Replacement Handover to Post-Acute Setting
LTPAC Use Case
Hospital for Hip Replacement
Patient in hospital for hip replacement surgery
Patient needs further rehab post-discharge from hospital
Hospital sends patient’s inpatient medical information to PatientCare 360®
Post-acute setting queries PatientCare 360 portal for preliminary hospital information to prepare for intake:
Face Sheet
Op Report
Inpatient Labs
Radiology Reports
Patient Referred to Post-Acute Setting
Handover to Post-Acute Setting
Post-acute setting is able to review patient’s longitudinal medical record:
Discharge summary
Final labs
Rehab notes
Discharge orders
Patient Care Plan developed
Post-acute setting discharges patient
PCP queries patient in PatientCare 360 to prepare for follow-up visit
PCP accesses the entire medical history on the patient, including both the hospital visit and post-acute treatments
Follow-up by PCP 11

8. LTPAC-Specific Benefits
• Streamlined access to patients’ medical history, saving valuable time searching through paper charts and faxes or making phone calls • Decreased costs from faxing, printing, mailing paper files, and other administrative tasks • More efficient workflow for discharge planners, helping them focus on more complex cases • Reduced costs and physical risks to patients by avoiding unnecessary duplicate tests
© 2015 CORHIO – All Rights Reserved – CORHIO Proprietary – Not For Redistribution

9. Connection to CORHIO Direct Messaging
CORHIO offers HISP services and Direct addresses to qualified health care providers, regardless of whether they use an EHR.
For providers with an EHR that is not capable of providing HISP services, CORHIO offers EHR-enabled HISP services.
For providers without an EHR, CORHIO offers a standalone, Web-based software application for sending and receiving Direct messages.

10. Connection to CORHIO Patient Event Notifications
Through an electronic report or HL7 interface, we can notify you when patients are hospitalized or visit an emergency department. This timely information can be used to improve care management, prevent hospital readmissions, improve disease management programs and inform quality improvement programs.
Test Results (coming soon) – such as A1C, Lipids, CHF Measures
Sample report

11. Connection to CORHIO Continuity of Care Documents
Continuity of Care Documents, or CCDs, are a type of electronic document that summarize patient information and help providers communicate clinical information during transitions of care.
CCD is a standardized document template for transferring patient information between care settings
Snapshot in time that includes care summary information

12. Supporting changing regulations, payment models, value-based care
CORHIO’s Evolution
Building Phase
Enhanced HIE
Current & Beyond
Web portal for data query, community exchange
Results delivery to more EHRs
Ingesting CCDs
Event notifications
Custom work to meet customer specific needs/programs
Notifications of specific lab values, other data
Discrete data from CCDs
Granular consent/behavioral health data
FHIR-based applications
New data – social determinants of health, PDMP
Supporting changing regulations, payment models, value-based care

13. Colorado Care Connections Program
The Colorado Department of Health Care Policy and Financing (HCPF) is funding this effort to increase continuity of care.
To qualify for the Expanded Colorado Care Connections Program:
“Practices which have a demonstrated referral pattern with a Meaningful Use eligible hospital or provider will be eligible to participate in this program.”
© 2016 CORHIO – All Rights Reserved – CORHIO Proprietary – Not For Redistribution

14. Connection to CORHIO CORHIO Provides: PatientCare360 Direct Messaging
Colorado Care Connections Program HIE Services
CORHIO Provides:
PatientCare360
CORHIO implementation fees covered
Direct Messaging
Continuity of Care Documents (CCD)
Milestone payment up to $5,000 upon successful completion of bi-directional interface
Notifications

15. Questions? Alaina Desnoyers Development & Outreach Manager
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