1. Presented by: Craig A. Mathews, Executive Director AHRQ Annual Grantee Meeting – October 27, 2007 Transforming Quality Through Health Information Technology in St. Mary and Surrounding Parishes “Building a Rural Health Information Exchange – Opportunities and Challenges”

2. PRESENTATION OUTLINE I. ORGANIZATIONAL HISTORY II. GOVERNANCE FORMATION III. HIT TECHNICAL DESIGN IV. PROJECT EVALUATION

3. ORGANIZATIONAL HISTORY 501c(3), not for profit rural health network, Incorporated in 1998 with a mission to improve access to healthcare for residents of St. Mary and surrounding parishes.

4. NETWORK MEMBERS INCLUDE: ORGANIZATIONAL HISTORY

5. GOVERNANCE FORMATION Network began with the enactment of a Memorandum of Agreement HIT implementation identified early on as a need (single point of patient entry) HIT Governance Committee emerged Developed operating guidelines and established protocols for system access

6. HIE TECHNICAL DESIGN IT Vendor Selection Browsersoft is current IT design firm

7. ByNet’s Original Design Proposed Design at the start of Year 1  2-3 servers  Clinics attached to severs  Secure connection through certificates (same connection as banks) ByNet Server Clinic A Clinic B Access by medical personnel outside ByNet Network Fall Out Server Mirror of original Clinic C

8. Current Approach OSS Software Database HIE TECHNICAL DESIGN

9. The OpenHRE Community is a consortium of communities and organizations throughout America, that are working together to achieve secure and sustainable health information exchange. Established in 2004, this growing community contributes to the continuing design, development, and distribution of the world’s first open source software dedicated to health information exchange - the OpenHRE™ toolkit, developed by Browsersoft, Inc.

10. HIE TECHNICAL DESIGN The OpenHRE™ Toolkit consists of three NHIN compliant services that address the needs of health stakeholders participating in Health Record Exchanges. These services are “configured” by a community to meet their exchange needs: Electronic Health Record  Clinical Data Repository  Summary Patient Record  Clinical Messaging Disease Management Outcomes  Registry  Reporting  On-line Analytical Process (OLAP)

11. The OpenHRE™ toolkit includes: The Authentication and Access Control Service (AACS) - Maintains and enforces the individual access control and data ownership requirements of stakeholders participating in Health Record Exchanges. The Record Locator Service (RLS) - Locates where health records exist - within an enterprise – within a Health Record Exchange - or among multiple Health Record Exchanges. The Record Exchange Service (RES) – Queries, retrieves, and caches data from located sources, and assembles the data into usable information displayed via web browser. HIE TECHNICAL DESIGN

12. PROJECT EVALUATION Normative  Data Sharing – Governance Agreements  Project Environment – LaHIE and LSU  Vendor Formative  Identification of Known Common Patients  Identification of Unknown Common Patients (MPI and RLS analyses )  Estimation of potential reduction in duplication and increased coordination of care.

13. Common Identified Customers that are Care Coordinated (TAC View) MonthLeonard Chabert Hospital (75 Miles) Iberia Comp. (FQHC) (25 Miles) Franklin Foundation (CAC-local) May 2006461219 June 200632612 July 200638918 August 200636522 September 200645726 October 200621317 November 200628526 December 200631315 January 200729618 February 200719522 March 200776419 April 200752916 May 200746211 June 200731617

14. AGENCY CONTACT Rev. Craig A. Mathews Executive Director 1111 Weber Street Franklin, LA 70538 (337) 828-5638 (337) 828-3793 Fax cmathews@bynet-la.org www.bynet-la.org