1. A Plan for a Sustainable Community Behavioral Health Information Network Western States Health-e Connection Summit & Trade Show September 10, 2013

2. What is a BHINAZ? BHINAZ brings together behavioral health providers, consumers, and public agencies around a shared vision: using information technology to make behavioral healthcare safer and more efficient throughout Arizona. The development of a behavioral health driven information network will improve quality, safety, create efficiencies, reduce health disparities, engage patients and their families, improve care coordination, protect patient health information, and improve the population and public health while protecting and maintaining the integrity of the behavioral health system. ©BHINAZ Private and Confidential. Content may not be reused without permission.

3. Key Drivers Health Care Reform / Patient Affordable Care Act (ACA) Heath Information Technology for Economic & Clinical Health (HITECH) Act Meaningful Use of Certified Electronic Health Records (EHR) – Stage 2 coming soon Integration between physical and behavioral health ©BHINAZ Private and Confidential. Content may not be reused without permission.

4. Clinical models like Stanford disease management and WHAM Collaborative Care Development of Health Home Concept Performance Contracting Maricopa County ADHS/DBHS RFP Key Drivers ©BHINAZ Private and Confidential. Content may not be reused without permission.

5. HIE The Vision PCP/Specialist Behavioral Health Health Information Network of Arizona Laboratory Pharmacy Hospital/Health Systems Patient ©BHINAZ Private and Confidential. Content may not be reused without permission.

6. Public Versus Private HIE Public Availability and efficient distribution of a large volume of patient data Efficient exchange of standards- based data (CCD, IHE, etc.) Gateway to the National Health Information Network Arizonas HINAZ Private *Coordination of care among the providers in a community – workflow improvement *Connecting systems and users with different technical capabilities and workflow needs *Access to the community patient chart *Business intelligence service to optimize pay-for-performance and quality improvement *Support for emerging integrated delivery networks ©BHINAZ Private and Confidential. Content may not be reused without permission.

7. Offers additional services EHR Light – This value add would give providers the ability to document within the HIE at an additional cost. Additional costs for expanded EHR light services: Portal Lab Ordering - eLabs SureScripts/RxHub - ePrescribing Basic Individual Referral Management Closed Loop Referral Management Value of a Community-Owned Health Information Exchange ©BHINAZ Private and Confidential. Content may not be reused without permission.

8. Offers additional services (continued) Special Report/Data Analytics Annual Dashboard Service Population Management Patient Portal Secure Messaging (Direct) Value of a Community-Owned Health Information Exchange ©BHINAZ Private and Confidential. Content may not be reused without permission.

9. demographics (Name, date of birth, address, social security number, marital status, sex, and age) diagnosis allergies prescribed medications lab results documents (including progress notes, treatment plans, patient summary, discharge report, crisis plans, etc.) HIE Data that can be shared ©BHINAZ Private and Confidential. Content may not be reused without permission.

10. The ONC recently developed a governance framework to adopt an approach that is less restrictive, more agile, and better able to keep pace with developments in health IT. The governance framework comprises four principles: organization, trust, business, and technical. Privacy & Consent ©BHINAZ Private and Confidential. Content may not be reused without permission.

11. the ONC has enumerated six components that should comprise an organizations HIE policy and enable patients to: access a Notice of Data Practices that explains the purpose(s) for which personally identifiable information (PII) and de-identified data, consistent with applicable laws, would or could be electronically exchanged; Privacy & Consent ©BHINAZ Private and Confidential. Content may not be reused without permission.

12. receive a simple explanation of the privacy and security policies and practices in place to safeguard electronically exchanged patient PII as well as who is permitted to access and use electronic HIE services; be provided with meaningful choice as to whether their PII can be electronically exchanged as consistent with applicable laws (i.e., patient consent); Privacy & Consent ©BHINAZ Private and Confidential. Content may not be reused without permission.

13. request data exchange limits based on data type or source (e.g., substance abuse treatment) as consistent with applicable laws; access and request corrections to their personally identifiable information electronically as consistent with applicable laws; be assured that their PII is consistently and accurately matched when electronically exchanged (i.e., patient matching). Privacy & Consent ©BHINAZ Private and Confidential. Content may not be reused without permission.

14. Patient must OPT OUT Otherwise, they are Opted IN by default Opt Out Patient must OPT IN Otherwise, they are Opted OUT by default Opt In Opt In vs. Opt Out ©BHINAZ Private and Confidential. Content may not be reused without permission.

15. The state of Arizona is an Opt-Out state. BHINAZ operates under an Opt-in model requiring the client to specifically agree to share their protected data from one provider to another. The BHINAZ model ensures that data protected under 42 CFR part 2 is not redisclosed without proper consent Privacy & Consent ©BHINAZ Private and Confidential. Content may not be reused without permission.

16. In Network Participant visits Agency A They sign a consent to allow their Agency A data to be shared/viewed by ALL BHINAZ organizations Agency A Data now flows to all other BHINAZ organizations. Agency A SMI Clinic Crisis Center Detox Center *Participant visits Detox Center *They choose NOT to share their detox data *No detox data can be viewed by any other agency on the network Opt Out Opt-In ©BHINAZ Private and Confidential. Content may not be reused without permission.

17. Viewing Out of Network data Participant receives services at BHINAZ Agency A Provider determines need to access out-of-network data and logs into portal through the EHR Provider searches for data from outside network Provider views and imports data to their EHR BHINAZ Agency A Outside Network ©BHINAZ Private and Confidential. Content may not be reused without permission.

18. Questions? ©BHINAZ Private and Confidential. Content may not be reused without permission.