1. Information Collaborative
Community Health
Information Collaborative
and the Northeast Minnesota Regional Health Information Organization
Cheryl M. Stephens
Executive Director
Community Health Information Collaborative
Melinda Machones
HIT Project Manager The College of St. Scholastica
Clark Averill
IT Director, St. Luke’s Hospital Chair, CHIC Board of Directors

2. CHIC Overview Planning started in 1997 Initial focus
Developed with Federal Office of Rural Health Network grant
Key participants included regional hospitals, physician practices, public health, and the Minnesota Health Data Institute.
Initial focus
To coordinate health information technology in Northeastern Minnesota
To share costs and best practices across the membership
Gained Non-profit 501(c)3 status in 1999
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3. Current CHIC Services
Provide secure and encrypted claims submission to Medicare, Medicaid and various commercial Payors.
Lead agency for the Minnesota Immunization Information Connection in 18 counties.
Administrative Coordinator for Emergency Preparedness activities for 16 hospitals in 7 counties in the Arrowhead.
Provide USAC administrative services – brought $185,000 back to the region in 2004
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4. Total Sites contributing data – 344
CHIC Members
Total Sites contributing data – 344
Hospitals – 32
Clinics – 110
Public Health Agencies – 19
Long-term care – 9
Urgent Care Sites – 2
Tribal Health Agencies – 20
Schools – 146
Corrections – 2
Home Care Agencies – 2
Pharmacy – 2
Just beginning to add long-tem care – MDH funded a pilot study to look at the sharing of pneumoccocal vaccine data between hospital, physician offices and LTC.

5. Membership Fee Structure
Based on organization size and services used
Hospitals/Health Systems fees are based on bed size and employed physicians
Clinics fees are based on employed physician
Public Health is a set fee
Tribal Health is a set fee
Some members fees are paid by grants that CHIC is administrating

6. Reasons for RHIO National Focus snapshot
Office of National Coordinator of Health Information Technologies (Dr. David Brailer)
June 6: American Health Information Community Advisory Panel announced
June 7: Four RFP’s focusing on Health Information Exchange
June 8: Capital Hill HIT Showcase
June 16: "Health Technology to Enhance Quality Act of 2005" (Health TEQ)”

7. Reasons for RHIO Regional Activities
MN e-Health Steering Committee
This Minnesota Rural Health Conference
St. Scholastica focus on HIT and interdisciplinary health sciences programs
SMDC, St. Luke’s, SISU investments in EHR technology
CHIC is the logical organization to drive this strategy in NE Minnesota

8. RHIO Definition
An organization that facilitates the sharing of health information across all organizations contributing to the continuum of patient care.
Very close to the current mission statement of CHIC

9. RHIO Models Common Community EHR Shared repository of summary EHR data
Not practical, would involve replacing all existing investments
Shared repository of summary EHR data
Costly duplication of technology
Shared access to multiple EHRs
Practical solution in consumer-directed market
Shared electronic clinical transactions
Practical starting point while EHR adoption matures, e.g. immunization registries, Rx histories, e-prescribing

10. RHIO Major Stakeholders
Physicians, hospitals, public health, tribal health and other health care providers
Payers
Patients / Consumers
Employers
Communities – Winona has a community based EHR up and running
E-Health Initiative Steering Committee has members from Payors in the state, there are cost benefits to them –reduced duplicate testing, HEDIS chart pulls could be done electronically
Patients – someday we may be able to access our own records electronically. ER visits, medication lists, etc.

11. Criteria for our RHIO Vision
An appropriate and effective Vision must include the following components:
Create the technological infrastructure
Develop processes to make effective use of these systems within and between healthcare systems
Engage all stakeholders with special focus on rural providers
We are very early on in the development of RHIOs.

12. RHIO Work Group CHIC Cheryl Stephens SISU Medical Systems Mark Schmidt
The College of St. Scholastica Kathy LaTour Melinda Machones
Iron Range Resources Richard Walsh
St. Luke’s Hospital Clark Averill
St. Mary’s/Duluth Clinic Tess Settergren
SuperiorEdge Kelly Peterson
Community Health Board Julie Myhre
Not written in stone, we may be adding more folks

13. Challenges
EHR adoption in rural NE Minnesota providers – cost and resources
Lack of comprehensive standards between vendors
Public concern over privacy and security
Available funding

14. Advantages CHIC’s history and relationships with providers
SMDC and St. Luke’s commitment to the project
National focus and momentum
We can learn from earlier projects around the country

15. RHIO Initiatives in NE MN
Learn from other RHIO projects
Acquire Funding
Assess Environment
Address privacy and security issues
Promote the project

16. Initial Implementation
Share CCR with EPIC and Meditech providers
2 largest systems in the region
CCR provides basic patient information
Allows us to expand by system or by record data
Provides for a well-defined, early success

17. Questions?
Thank You!