1. Cheryl M. Stephens Executive Director Community Health Information Collaborative July 17, 2006 Community Health Information Collaborative and the Northeast Minnesota R egional H ealth I nformation O rganization

2. CHIC Overview Started in 1997 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 Coordinate health information technology in Northeastern Minnesota Share costs and best practices across the membership Non-profit 501(c)3

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 $400,000 back to the region in 2005.

4. 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

5. RHIO Models Common Community EHR 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

6. Criteria for our RHIO Vision 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

7. CHIC-RHIO Work Group CHIC Cheryl Stephens SISU Medical Systems Mark Schmidt The College of St. Scholastica Pam Oachs Melinda Machones St. Lukes Hospital Clark Averill St. Marys/Duluth Clinic Tess Settergren Community Health Board Julie Myhre Iron Range Resources Mike Larson

8. Major 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

9. Key Advantages CHICs history and relationships with providers SMDC, St. Lukes, and SISUs commitment to the project St. Scholasticas involvement and experience with numerous health information technologies National focus and momentum We can learn from projects around the country

10. CHIC RHIO Goals Improved health of patients through more comprehensive sharing of info Increased efficiency / productivity of physicians through more complete and timely access to patient information Creation of a more complete public health picture of the region to better assess and address issues that arise

11. Implementation Phases I.Create a Common Web Portal II.Combine common systems St. Lukes and SISU both have Meditech III.Integrate St. Marys (Epic) using national standards IV.Integrate additional systems throughout the region

12. Phase I of Web Portal Two distinct processes: Remote access to approved systems Hyperlink into remote system(s) No changes to existing systems Request process for access to new systems For use when a physician must request privileges and access

13. Single Sign-On Pilot Sponsoring organizations: Government Services Administration and Health Information Management Systems Society Authentication using PKI technology Certificates from ACES – current federal contractor Test case between three sites in our region one physician and two hospitals CHIC is one of seven (7) RHIOs in the nation to be chosen for this pilot.

14. RHIO Committees & Issues Policy Committee Privacy and Security Ownership of Data Legal barriers Technical Committee Standards Architecture Authentication/Master Patient Index

15. Thank You! Questions? Web portal URL http://www.chic-rhio.org/