1. Jersey Health Connect HIE Image Enablement: A Strategic & Executional Model Sponsored by DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

2. Jersey Health Connect Team Largest Independent HIE in New Jersey Lou Hermans Executive Director Coalition lead for NJ HealthNet CIO, JFK Health System in Edison, NJ (former) Jim Cavanagh EHR Interoperability & Member Connectivity Lead Technology Executive responsible for connecting statewide members CIO, St. Joseph’s Health System in Paterson, NJ (former) Jeremy Marut, MBA, CHCIO Chairman of Imaging Taskforce Director of Enterprise Architecture at HackensackUMC

3. Agenda About Jersey Health Connect (JHC) Imaging Technology Approval Process and Selection Workflows and Use Cases Project Articulation to Members Image-enablement Benefits Technical uniqueness and business modeling Next steps

4. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org About Jersey Health Connect Independent, Non-Profit HIE Membership includes 32 of the Largest Acute Care Hospitals & Health Systems in NJ

5. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org 5 About Jersey Health Connect Goals: Accelerate current HIE activity Improve care coordination, access, outcomes and efficiencies through real-time clinical exchange Allow members to leverage existing technologies Patient-centric approach to encourage active and informed participation

6. Confidential and proprietary information. | © 2015 Jersey Health Connect | www.jerseyhealthconnect.org Approval Process and Imaging Technology Selection

7. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org Imaging Internal Selection Process Rigorous RFP process around imaging selection by individual hospital members In all cases – Vital – was selected as the preferred partner Technology focus was originally driven by “Internal” applications Technology focus shifted to “Referral Community” Central Image Repository: Too costly Archive deployment: A different use case Image access: speed was paramount “Streaming” technology replaces tradition store-and-forward Importance of access to community data

8. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org Approval Process Imaging Taskforce Committee The CMIO/Clinical Advisory Committee Executive Board Committee

9. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org 9 Selected Technology Solution VitreaView® & VioStream™ Leverages existing infrastructure Scalable, Virtualized Ability to stream from federated architecture No cache required Multi-browser IE, Safari®, Firefox®, Chrome™ Multi-platform Windows®, Mac®, iOS®, Android™ Browser Based HTML and JavaScript: no plug- ins/downloads Single sign-on, role-based access control Access multiple image archives simultaneously Simple URL-based integration EMR, EHR, PHR and HIE Email a clinician Smartphone/table support *All above trademarks and registered trademarks belong to their respective owners. * When accessed from a mobile device, VitreaView is intended for information purposes and is not intended for diagnostic use.

10. Confidential and proprietary information. | © 2015 Jersey Health Connect | www.jerseyhealthconnect.org Workflows and Use Cases Primary Scenarios

11. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org Server Infrastructure

12. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org 12 Use Cases Access to Universal Viewer via HIE platform 1. 1.Single Study 2. 2.Relevant Studies 3. 3.Encounter Notification

13. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org 13 Patient Information Screen & Vitreaview Launch

14. Confidential and proprietary information. | © 2015 Jersey Health Connect | www.jerseyhealthconnect.org Project Articulation to Membership

15. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org 15 Why “Image Enable”? University of Michigan Research Shows fewer repeat medical images made in ERs of Hospitals taking part in HIE Study focused on patients who went to two different ERs in a thirty day period Findings showed use of repeat CT scans, chest X-rays & Ultrasound scans lower when patients of both ERs participated in a HIE Actual Benefits: Patients 59% less likely to have a redundant CT, 44% less likely on US, and 67% less likely on chest X-ray Researchers pulled data that showed the following 20,139 repeat CTs (14.7%) 13,060 repeat US (21%) 29,703 repeat chest X-Rays (19.5%) “Does Health Information Exchange Reduce Redundant Imaging? Evidence From Emergency Departments” - Medical Care, March 2014, Volume 52, Issue 3

16. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org Benefits HIE Benefits Reduction of duplicate exams savings Increases clinical use of JHC systems Aligns with ACO strategy Utilization measurement for Population Health Management $18M annual savings for the uninsured population EHR Benefits Access to local images from multiple archives through the local EMR(s) Cross-reference capabilities between studies internal and through HIE (future) Reduced costs of specialty viewers Meets elective option for MU2 and potentially MU3 Clinical, Financial and Technical Benefits

17. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org 17 Membership Articulation Business modeling demonstrates member value Focus on total healthcare imaging savings across the network

18. Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org 18 Membership Articulation Membership one pager demonstrating image enable value and internal benefits Members invited to technical discussions, prior to project implementation

19. Next Steps

20. Questions?