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Better Outcomes. Delivered.




            Overview
         June 12, 2012
Copyright © 2012 Indiana Health Information Exchange, Inc
History




   The nation’s largest health information exchange:
93 Indiana hospitals and 20,000 physician participation.




                        Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                     www.ihie.org
IHIE Statistics

                • Nation’s largest HIE
                • Founded in February 2004
                • Based on the technology,
                  knowledge, and experience of
                  the Regenstrief Institute
                • 75 employees
                • Providing services to 93
                  hospitals (23 health systems),
                  20,000 clinicians, and 5 payers
                • Serving an area with a
                  population of about 4 million
                  people




Copyright © 2012 Indiana Health Information Exchange, Inc

                                                              www.ihie.org
Health Data Services                                                                               Value-Added Services
                                                                                                                                     • Results Delivery
                                                                                                                                     • MU Support
                                                                                                                                     • Public Health
                                                                                                                                       Integration
                                 Hospitals                                                                      Hospitals

                                                                                                                                     •   Results Delivery
               Physician                                                                                                             •   MU Support
                                                                                                                                     •   Clinical Quality Services
                                                                                                                                     •          ™
                                                                                                                                         Community Health
                               Physician                                                                         Physician               Record Access
                                Offices                                                                           Offices

                                                                                                                                     • Results Delivery
                                                                                                                                     • Community Health
                                                    Health Information Exchange                                                        Record System

                           Labs / Imaging Centers                                                              Labs / Imaging
                                                                                                                  Centers
Patient        Physician
                                                                                                                                     • Biosurveillance
                                                                                                                                     • Reportable Conditions
                                                      Data                 Network
                                Public Health       Repository            Applications                                               • Results Delivery
                                                                                                                     Public Health



                                                                                                                                         • Quality Reporting
                                                                                                                                         • Physician Bonus
                                                                                                                                           Administration
                                                                                                                      Payers
                                  Payers
              Physician
                                                                 Data
                                                              Stewardship                                    Public Health
                                                                                                                     • De-identified,
                                                                                                      Emergency Surveillance System
                                                                                                                       longitudinal clinical
                                                                                                                       data
                                                                                                                (PHESS)
                               Outpatient Rx                                                                         Researchers

                                                         Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                                                                           www.ihie.org
IHIE in a State and
 National Context




        Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                    www.ihie.org
ARRA HITECH – Once in a Generation Opportunity
                       ARRA Funding
                         ($787 Billion)

                             HITECH
                          (~$34 Billion)

                     Health Information Exchange
                              ($2 Billion)


Regional Extension       State HIE Cooperative                          Beacon
     Centers              Agreement Program                           Cooperative
  ($598 Million)             ($564 Million)                           Agreement
                                                                       Program



   AL AK AR AZ CA CO - - - - - VA WA WI WV WY
           Funding across all 50 states and US territories

                               Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                           www.ihie.org
Beacon Community Concept




 Copyright © 2012 Indiana Health Information Exchange, Inc

                                                             www.ihie.org
The Beacon Cooperative Agreement Program

IHIE is a Beacon Community:
As part of the ARRA HITECH legislation, IHIE has been selected as one
of 17 Beacon Communities nationwide:
• Beacon Communities were selected based on their levels of HIE
and EHR accomplishment
• $16M investment in HIE and EHR capabilities aimed at improving
health outcomes
• Funding for a 3 year project
• Focuses on Dartmouth Atlas Hospital Referral Region 183… >40
Central Indiana counties
• Beacon Communities are expected to make measurable
improvement in health outcomes:
     – Quality
     – Efficiency
     – Population Health
                                               Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                                           www.ihie.org
IHIE’s Services




      Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                  www.ihie.org
Review of Services


The following services are all based upon tools and
technology developed at Regenstrief Institute:

•   Public Health Emergency Surveillance System
•   DOCS4DOCS® Clinical Messaging Service
•   Indiana Network for Patient Care™ (INPC™)
•   Quality Health First® Program
•   ImageZoneSM Cloud-based Medical Image Sharing



                                                           IHIE is “…at the forefront of the effort to strengthen
                                                           our nation’s chaotic healthcare system.”
                                                           – U.S. News & World Report, August 2005
                         Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                               www.ihie.org
Indiana State
                                                                                       Department of Health

                     Indiana State Department of Health
             Public Health Emergency Surveillance System (PHESS)
PHESS Mandate & Rule
• Statewide infrastructure to analyze data from Indiana emergency
  departments for the early detection of:
   • Acts of bioterrorism
   • Other public health emergencies
• 107 Indiana hospitals connected
   • 1 hospital via MHIN
   • 1 hospital via HealthBridge
• 5300 ED visits per day
• Monitor emergency department “primary complaint” “If I wasearly instead of waiting forI two weeks
                                                         know it
                                                                 having a huge...outbreak, could

                                                                                        or a month.”
                                                                                        – Dr. Virginia Caine, Marion County Health
                                                                                        Department director
                                             Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                                                   www.ihie.org
• IHIE’s DOCS4DOCS clinical messaging service takes text reports (e.g. lab,
  pathology, radiology, transcription, cardiology) from their source
  information systems and delivers those results to physicians associated
  with the source organization (medical staff or non-medical staff) via any
  of three methods:
   • Into “DOCS4DOCS”, a web-based “inbox” that is accessible via the
      hospital portal or other IHIE portal
   • Via fax (if they insist)
   • Directly into the physician practice EHR

• We deliver only what the customers tell us they want us to deliver.

                                                                              “While many major metropolitan areas have
                                                                              similar systems, (IHIE’s) was one of the first
                                                                              and is viewed by many as one of the best…”
                                                                              – Indianapolis Star, June 2007

                                   Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                                         www.ihie.org
Inbox




        www.ihie.org
™




What is The Indiana Network for Patient Care™
   • A patient-centric community health record for a growing number of Indiana
     citizens (the “jig-saw puzzle assembler”)
   • Includes provider, payor, and public Health Data
   • Growing to serve over half the population of Indiana
   • Used primarily in EDs but also accessible to approximately 1/3 of
     ambulatory care physicians in the Indianapolis market




                                   Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                               www.ihie.org
INPC Membership includes:
• 93 hospitals (23 different hospital systems )
• 5 large medical groups and clinics
• 5 payors
• Several free-standing labs and imaging
  centers
• State and local public health agencies

INPC Data:
• 10.75 million unique patients
• 20 million registration events
• 3 billion coded results
• 38 million dictated reports
• 9 million radiology reports
• 12 million drug orders
• 120 million radiology images

    Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                www.ihie.org
www.ihie.org
A chronic disease management and preventive care program:
    • Multi-payor, value-based pay-for-performance
    • Helps physicians identify and prioritize health screenings and other testing;
      provide early interventions and consistent support
    • Enhance reimbursement for physicians
    • Focused on cancer screenings, diabetes care, heart disease care
    • Payor participants include: Anthem BCBS, UnitedHealthcare, Unified Group
      Services, Medicare, Medicaid
    • Over 1,900 physicians in 70 communities participate
    • Covers over 1 million patients



                                          Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                                      www.ihie.org
Initial Quality Measures


Quality improvement measures are grouped the following categories:
    • Asthma Treatment
    • Children’s Health
    • Diabetes Care
    • Heart Health
    • Women’s Health
    • Other Clinical Measures




                                 Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                             www.ihie.org
•Quality Health First® Program




                    Patient
                   Summary
                                                            Physician
                                                             Group




                   Provider
                                                             Payers
                 Performance




                 Community                                      Public
                 Performance



Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                www.ihie.org
QHF Program Patients
1,200,000
                                                                                                                        1,124,383
1,100,000

                                                                                                                        1,032,424
1,000,000

                                                                                                              928,563
 900,000
                                                                                           878,999
                                                                           865,881
 800,000

                                                          720,205
 700,000
                                     634,460

 600,000
                          560,939
                                    556,593
                549,419
 500,000
            Dec-08   Mar-09     Jun-09   Sep-09   Dec-09          Mar-10           Jun-10           Sep-10        Dec-10     Mar-11

                                                  Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                                                           www.ihie.org
Cloud-based Medical Image Sharing

Enables Instant Image Access and Enhances Quality-of-Care for:
  • Trauma Transfers
  • Referrals and consultations
  • Referring physician communications
  • Enhances communication with referring physicians and builds loyalty

                                                               Sharing Images. Saving Lives.

                                    Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                                www.ihie.org
•Medical Center




•Patient                              •4




                                 •Gateway

 •Physician Practice   •1   •3       •hospital IT




                                             •2



                                   Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                                               www.ihie.org
Thank You
317.644.1750
www.ihie.org




    Copyright © 2012 Indiana Health Information Exchange, Inc

                                                                www.ihie.org

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Overview: Indiana Health Information Exchange

  • 1. Better Outcomes. Delivered. Overview June 12, 2012 Copyright © 2012 Indiana Health Information Exchange, Inc
  • 2. History The nation’s largest health information exchange: 93 Indiana hospitals and 20,000 physician participation. Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 3. IHIE Statistics • Nation’s largest HIE • Founded in February 2004 • Based on the technology, knowledge, and experience of the Regenstrief Institute • 75 employees • Providing services to 93 hospitals (23 health systems), 20,000 clinicians, and 5 payers • Serving an area with a population of about 4 million people Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 4. Health Data Services Value-Added Services • Results Delivery • MU Support • Public Health Integration Hospitals Hospitals • Results Delivery Physician • MU Support • Clinical Quality Services • ™ Community Health Physician Physician Record Access Offices Offices • Results Delivery • Community Health Health Information Exchange Record System Labs / Imaging Centers Labs / Imaging Centers Patient Physician • Biosurveillance • Reportable Conditions Data Network Public Health Repository Applications • Results Delivery Public Health • Quality Reporting • Physician Bonus Administration Payers Payers Physician Data Stewardship Public Health • De-identified, Emergency Surveillance System longitudinal clinical data (PHESS) Outpatient Rx Researchers Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 5. IHIE in a State and National Context Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 6. ARRA HITECH – Once in a Generation Opportunity ARRA Funding ($787 Billion) HITECH (~$34 Billion) Health Information Exchange ($2 Billion) Regional Extension State HIE Cooperative Beacon Centers Agreement Program Cooperative ($598 Million) ($564 Million) Agreement Program AL AK AR AZ CA CO - - - - - VA WA WI WV WY Funding across all 50 states and US territories Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 7. Beacon Community Concept Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 8. The Beacon Cooperative Agreement Program IHIE is a Beacon Community: As part of the ARRA HITECH legislation, IHIE has been selected as one of 17 Beacon Communities nationwide: • Beacon Communities were selected based on their levels of HIE and EHR accomplishment • $16M investment in HIE and EHR capabilities aimed at improving health outcomes • Funding for a 3 year project • Focuses on Dartmouth Atlas Hospital Referral Region 183… >40 Central Indiana counties • Beacon Communities are expected to make measurable improvement in health outcomes: – Quality – Efficiency – Population Health Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 9. IHIE’s Services Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 10. Review of Services The following services are all based upon tools and technology developed at Regenstrief Institute: • Public Health Emergency Surveillance System • DOCS4DOCS® Clinical Messaging Service • Indiana Network for Patient Care™ (INPC™) • Quality Health First® Program • ImageZoneSM Cloud-based Medical Image Sharing IHIE is “…at the forefront of the effort to strengthen our nation’s chaotic healthcare system.” – U.S. News & World Report, August 2005 Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 11. Indiana State Department of Health Indiana State Department of Health Public Health Emergency Surveillance System (PHESS) PHESS Mandate & Rule • Statewide infrastructure to analyze data from Indiana emergency departments for the early detection of: • Acts of bioterrorism • Other public health emergencies • 107 Indiana hospitals connected • 1 hospital via MHIN • 1 hospital via HealthBridge • 5300 ED visits per day • Monitor emergency department “primary complaint” “If I wasearly instead of waiting forI two weeks know it having a huge...outbreak, could or a month.” – Dr. Virginia Caine, Marion County Health Department director Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 12. • IHIE’s DOCS4DOCS clinical messaging service takes text reports (e.g. lab, pathology, radiology, transcription, cardiology) from their source information systems and delivers those results to physicians associated with the source organization (medical staff or non-medical staff) via any of three methods: • Into “DOCS4DOCS”, a web-based “inbox” that is accessible via the hospital portal or other IHIE portal • Via fax (if they insist) • Directly into the physician practice EHR • We deliver only what the customers tell us they want us to deliver. “While many major metropolitan areas have similar systems, (IHIE’s) was one of the first and is viewed by many as one of the best…” – Indianapolis Star, June 2007 Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 13. Inbox www.ihie.org
  • 14. ™ What is The Indiana Network for Patient Care™ • A patient-centric community health record for a growing number of Indiana citizens (the “jig-saw puzzle assembler”) • Includes provider, payor, and public Health Data • Growing to serve over half the population of Indiana • Used primarily in EDs but also accessible to approximately 1/3 of ambulatory care physicians in the Indianapolis market Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 15. INPC Membership includes: • 93 hospitals (23 different hospital systems ) • 5 large medical groups and clinics • 5 payors • Several free-standing labs and imaging centers • State and local public health agencies INPC Data: • 10.75 million unique patients • 20 million registration events • 3 billion coded results • 38 million dictated reports • 9 million radiology reports • 12 million drug orders • 120 million radiology images Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 17. A chronic disease management and preventive care program: • Multi-payor, value-based pay-for-performance • Helps physicians identify and prioritize health screenings and other testing; provide early interventions and consistent support • Enhance reimbursement for physicians • Focused on cancer screenings, diabetes care, heart disease care • Payor participants include: Anthem BCBS, UnitedHealthcare, Unified Group Services, Medicare, Medicaid • Over 1,900 physicians in 70 communities participate • Covers over 1 million patients Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 18. Initial Quality Measures Quality improvement measures are grouped the following categories: • Asthma Treatment • Children’s Health • Diabetes Care • Heart Health • Women’s Health • Other Clinical Measures Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 19. •Quality Health First® Program Patient Summary Physician Group Provider Payers Performance Community Public Performance Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 20. QHF Program Patients 1,200,000 1,124,383 1,100,000 1,032,424 1,000,000 928,563 900,000 878,999 865,881 800,000 720,205 700,000 634,460 600,000 560,939 556,593 549,419 500,000 Dec-08 Mar-09 Jun-09 Sep-09 Dec-09 Mar-10 Jun-10 Sep-10 Dec-10 Mar-11 Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 21. Cloud-based Medical Image Sharing Enables Instant Image Access and Enhances Quality-of-Care for: • Trauma Transfers • Referrals and consultations • Referring physician communications • Enhances communication with referring physicians and builds loyalty Sharing Images. Saving Lives. Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 22. •Medical Center •Patient •4 •Gateway •Physician Practice •1 •3 •hospital IT •2 Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org
  • 23. Thank You 317.644.1750 www.ihie.org Copyright © 2012 Indiana Health Information Exchange, Inc www.ihie.org