1. Keystone Beacon – Information Session

2. Agenda Background Approach Timeframes Pricing Questions

3. Background – Needs Transitions of Care Acute discharge to skilled nursing facility (SNF) Acute discharge to home health agency (HHA) Nursing home discharge to home health Nursing home transfer to emergency department Electronic information barriers for post-acute Majority nursing homes with no EHR Nursing homes with EHR, but no HIE interfaces HIE interfaces, but no standard CCD (SNF and HHA)

4. Background – Opportunity Skilled Nursing Facilities Required to submit Minimum Data Set (MDS) to CMS Contains patient assessment information MDS is unusable by clinicians MDS is an XML structured document AHIMA/ASPE work to codify MDS as a CDA document Home Health Required to submit Outcome and Assessment Information Set (OASIS) to CMS Similar usage to MDS Total Addressable Market (19,399) 12,565 - Medicare Skilled Nursing Facilities 6,834 - Medicare Home Health Agencies

5. Background – Dissemination Creating a national standard Standards and Interoperability (S&I) Framework Longitudinal Coordination of Care Workgroup http://wiki.siframework.org/Longitudinal+Coordination+of+Care Balloting with Health Level 7 (HL7) Implementation Guides Why a Web service? Mission for wide-scale implementation Limited support for open source tools Ease of use

6. 6 MDS or OASIS Clinical Summary 6 Transform™ (Formerly the “Gobbler”) HL7 Balloted. Nationally available Web service. LTPACHIE Background – LTPAC to HIE Copyright 2013 Keystone Beacon Community

7. Agenda Background Approach Timeframes Pricing Questions

8. Approach – High Level Concept KeyHIE Transform™ is an all-inclusive, web-based service that provides for the following features: Register and pay Download and configure Monitor MDS or OASIS files Transform into HL7 CCD and ADT registration message Return CCD and registration message to Customer Publish CCD and registration message to KeyHIE for Direct delivery Customer tools and support

9. Approach – Website Features Education about service Pricing & Sign up Support Self-service troubleshooting Phone & e-mail 3 hours /yr. included

10. Approach – Sign up Online Easy sign up process Provide Account Information Configure service Submit manually or scheduled, Archive data, etc.

11. Approach – Sign up Online Select service subscription options Payment via credit card Payment options: Annually, Semi-annually, Quarterly Download KeyHIE Transform™ Connect Link provided via e-mail after order confirmation

12. Approach – Installation Installation Considerations Where to install Ex. MDS Coordinator’s desktop / server Microsoft Windows based Installation Steps Introduction Choose Install Folder Choose Shortcut Folder Pre-Installation Summary Installing… Install Results Install Complete

13. Approach – Configuration Simple Configuration Steps Login Using account credentials from the sign up process Configure File locations & Transformation options Test

14. Approach – Dashboard Client Self Service View service status, history; Manage account, configuration Configurable e-mail notifications Step-by-step online troubleshooting

15. Approach – Integration Points

16. Agenda Background Approach Timeframes Pricing Questions

17. Dec ‘12 Vendor selected Dec ‘12 HL7 Approval Jan ‘12 Development & Testing Feb ‘13 Early Adopters Mar/Apr ‘13 General availability Timeframes

18. Agenda Background Approach Timeframes Pricing Questions

19. Pricing – Skilled Nursing Facilities (SNF) Small $ 499 /yr. 0 – 49 Residents per SNF ≈ $ 40 /mo. Average $ 699 /yr. 50 – 199 Residents per SNF ≈ $ 60 /mo. Large $ 899 /yr. 200 – 399 Residents per SNF ≈ $ 75 /mo. * For Facilities with more than 400 Residents, contact us for special pricing.

20. Pricing – Home Health Agencies (HHA) Small $ 499 /yr. 0 – 99 Medicare Patients per HHA ≈ $ 40 /mo. Average $ 699 /yr. 100 – 299 Medicare Patients per HHA ≈ $ 60 /mo. Large $ 899 /yr. 300 – 499 Medicare Patients per HHA ≈ $ 75 /mo. * For Agencies with more than 500 Medicare Patients, contact us for special pricing. $ 100 /yr. per additional KeyHIE Transform™ installation Ex.: Agency with multiple branches running independent OASIS software.

21. Questions? BridgeGate International BridgeGateIntl.com Geisinger System Services 100 North Academy Avenue Danville, PA 17822-4307 Phone: (570) 214-8833 Geisinger.org jryounkin@geisinger.edu