COMPARING & CONTRASTING HIE ALTERNATIVES Nvember 9, 2017 WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG
INTRODUCTION There are many effrts and initiatives aimed at making clinical data related t encunters elsewhere available fr purpses f clinical decisin-making and care crdinatin These are nt mutually exclusive. This presentatin is intended t prvide a high-level cmparisn f sme f the mst prminent HIE alternatives and suggest sme questins and issues that health care rganizatins shuld cnsider. WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 2
OUTLINE HIE Then & Nw WISHIN/The Wiscnsin Landscape Cmpare & Cntrast: Is There a Right Answer? The Future Questins WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 3
HIE THEN & NOW WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG
HIE ISN T NEW WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 5
DEMAND FOR HIE Health care rganizatins have been exchanging patient infrmatin fr decades but inefficiently Fr yur cnsideratin: HIE is nt a ne-size-fits-all business mdel Patient mbility Our patients stay within the system. Really? Cnsider unknwn unknwns. Trend tward value vs. vlume as basis fr reimbursement. Management f quality, utcmes, readmissins, shared risk. Visibility int clinical encunters elsewhere is mre imprtant than ever. WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 6
BENEFITS OF HIE Scalable ne-t-many architecture (in sme cases) Aggregatin f patient data (in sme cases) Quality f care, timeliness, patient safety and utcmes Wrkflw efficiencies and integratin Reductin f duplicate tests r prcedures Decrease administrative time Imprved patient visits Crdinatin f care amng prviders Prtectin f PHI during transitins f care WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 7
WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 8
WISHIN & THE WISCONSIN LANDSCAPE WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG
HISTORY OF WISHIN WISHIN was funded in 2012 by: WHA WHCQ WMS WHIO Early Adpters included: Watertwn Aurra Wheatn Franciscan Clumbia St. Mary s Ministry Affinity Children s Hspital f WI Fredtert Agnesian WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 10
Pulse is a cmmunity health recrd: WISHIN PULSE An aggregated summary f patient infrmatin frm multiple rganizatins. A lngitudinal, patient-centric view f patient health infrmatin, rather than a series f separate encunter summaries. Pulse is cmprised f: ADT (prblem list, allergies, diagnses, etc.) CCDAs electrnic care summaries Labratry results Radilgy results Pathlgy results Transcriptin reprts EKG reprts PDMP integratin Medicaid Prescriptin WIR integratin WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 11
338,537,553 ADT Transactins Admit, discharge, transfer, diagnsis, allergies, prblem lists, and patient demgraphic data 5,105,173 Unique Patients Unique patients in the WISHIN Pulse Master Patient Index 123,841 EKG Reprts Electrcardigram final reprts WISHIN PULSE DASHBOARD 3,238,036 Care Summaries Care summaries in the frm f CCDA dcuments 3,670,425 Transcriptins Transcribed reprts 76,415,966 Lab & Path Results Labratry and pathlgy final results 2,629,818 Radilgy Reprts Radilgy transcribed reprts 152,309,311 PHSS Public health syndrmic surveillance data submissin t the State f Wiscnsin in supprt f Meaningful Use Updated: September 29, 2017 WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG
WHAT S DRIVING ADOPTION? Visibility int utilizatin elsewhere Aggregated sharing f patient data t supprt transitins f care Autmate a largely manual prcess Optins t cnnect and access fr small rganizatins HIE-related Meaningful Use cmpliance SSO EHR Integrated access Serves Medicaid & Underserved ppulatins Alerts when members visit the emergency department WISCONSIN STATEWIDE HEALTH HEALTH INFORMATION INFORMATION NETWORK NETWORK Ptential fr future slutins and use cases (e.g., analytics, quality measures, and business cntinuity) WWW.WISHIN.ORG
Cmpare & Cntrast: IS THERE A RIGHT ANSWER? WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG
CARE EVERYWHERE/COMMONWELL Vendr- (r multiple-vendr-) based netwrks Cnnectivity utside the netwrk Nt cnnected t WISHIN by default (despite what yu may have heard!) WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 15
Carequality is a bidirectinal prvide-specific querybased netwrk-f-netwrks framewrk t enable sharing between netwrks. CAREQUALITY Carequality is NOT a netwrk; it relies n netwrk infrastructure being in place. In its infancy Fees incurred by Implementers (based n annual revenue) Implementers dictate data shared Paylad limited t CCDAs 23 Implementers and 460 Members: HIEs and sftware vendrs, and healthcare rganizatins Currently >30 Carequality prviders in WI http://sequiaprject.rg/carequality/active-sites-search/ WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 16
WISHIN COMPARISON SUMMARY Epic Care Everywhere CmmnWell Carequality Netwrk Vendr-neutral HIE Netwrked Epic clients Multiple-vendr netwrk Vendr-neutral framewrk; assumes netwrk(s) in place Data Available ADT, CCDA, lab, path, radilgy, PDMP, transcriptin, EKG, WIR, Medicaid Rx Selected prtins f patient recrd CCDA (XCA/XCPD) CCDA (XCA/XCPD) Presented Data Patient-centric cmmunity health recrd & cmprehensive CCDA Sme prviderspecific data Multiple prviderspecific dcuments Multiple prviderspecific dcuments Uses Carequality Technical Standards? Yes Yes Yes Yes WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 17
Questins/Issues fr Cnsideratin WISCONSIN STATEWIDE HEALTH HEALTH INFORMATION INFORMATION NETWORK NETWORK Each ptin has implicit/explicit csts Legal One-time implementatin Onging csts develping/maintaining netwrk These csts are cvered by smene These ptins verlap; they are nt mutually exclusive. WISHIN almst always prvides X+ (an extra layer) Key variables: aggregatin and patientcentricity Secndary use cases ntificatins, payer interactins, etc. Active vs. passive Query vlume hw much d yu want yur live system being pinged? WWW.WISHIN.ORG
THE FUTURE WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG
HIE IS IN ITS ADOLESCENCE We can see future, vaguely Payer access with WISHIN will becme a reality Q1-2018 There will be future csts fr develpment Netwrk adptin will increase Integratin and functinality will evlve remving cmplexity Recrd lcatin will evlve (e.g., FHIR APIs) Market and patients will dictate what s next Think abut ATM netwrk users dn t knw r care wh the players are as lng as their cash is available WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 20
Q & A WISCONSIN STATEWIDE HEALTH INFORMATION NETWORK WWW.WISHIN.ORG PAGE 21