This document summarizes a presentation about health information exchange (HIE). It discusses CORHIO, the organization leading HIE efforts in Colorado. The presentation outlines CORHIO's vision of universal access to health information, current HIE activity in the state, and technical infrastructure supporting HIE. It also reviews how HIE works, connecting clinicians across the state through a single electronic connection, and CORHIO's additional initiatives in areas like public health, long term care, and Medicaid HIT programs.

1. Health Information Exchange
Connected Communities. Connected Healthcare
Phyllis Albritton Nancye Lahue
Executive Director Technical Director
CORHIO BEACON Program
San Luis Valley Health Information Technology Symposium,
November 4, 2011 1

2. Today’s Session Roadmap
• About CORHIO & Colorado’s Vision for HIE
• What is HIE?
• Current HIE Activity in Colorado
• Technical Infrastructure
• Other HIT Initiatives at CORHIO
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
CORHIO Proprietary - Not For Redistribution

3. New Realities
in Health New
Payment
Care Models
Improved
Technology & Quality of New Care Delivery
Interoperability Care & Models
Value!
Patient
Engagement
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
CORHIO Proprietary - Not For Redistribution

4. Care Coordination and Transitions:
Reality Meets Opportunity
Hospital Readmission
• 19.6% of Medicare patients were readmitted within 30 days of discharge
• 1 in 5 older adults with complex chronic health conditions is readmitted within
30 days of hospital discharge
• 34% were readmitted within 90 days of discharge
• $17.4 billion cost to Medicare for unplanned hospital readmissions in 2004
Chronic Conditions
• 75% of health care expenditures are for chronic illnesses
• 16 physicians – providers an individual with chronic illness may see in a year
Medication Management
• 66% of medication errors occur during transitions: admission, transfer or discharge
Source: National Transitions of Care Coalition: Improving Transitions of Care , Sept. 2010

5. The Consumer Perspective
About Their Providers
• 88% want doctors to use EMRs.
• 92% want doctors to exchange patient info with other doctors.
About Themselves
Few adults have electronic access to records or doctors:
Record access (14%). Schedule appointments (22%). Email doctors (21%). Refill prescriptions (34%).
• 73% would use a secure online healthcare communication solution.
• 50% would consider switching doctors for the ability to communicate and complete
health care tasks online.
Sources:
"A Call for Change: The Commonwealth Fund 2011 Survey of Public Views of The U.S. Health System."
Intuit Health’s second annual Health Care Check-Up Survey.
© 2011 Colorado Regional Health Information Organization (CORHIO)
All Rights Reserved CORHIO Proprietary - Not For Redistribution

6. About CORHIO
• A nonprofit, public- • Shared health
Who We Are
Vision
private partnership information for all
individuals in every
• The state-designated
Colorado community
entity for health
information exchange promoting the right
(HIE) in Colorado care, at the right time
and
the right place.
Goals for 2015
• Health information exchange deployed in every community
• 85% of all providers are meaningful users of EHRs and health
information technology

7. HIE Progress in Colorado
Future
Northern Colorado
Convening
Steamboat Participant Agreement
(QHN)
Grand Connected to HIE (Live)
Boulder
County
NW
Grand Summit Denver Central
Denver Aurora
Junction S. Metro
Aspen Denver Live on CORHIO
(QHN)
(QHN) Salida Implementing CORHIO
Delta CO Springs
(QHN) Gunnison QHN
(QHN)
Montrose Investigating HIE
(QHN) Pueblo
LTPAC Challenge Grant
San Luis Community
Durango Valley
(QHN)
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
CORHIO Proprietary - Not For Redistribution
7

8. Participating Providers
http://www.corhio.org/participating-providers.aspx
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
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CORHIO Proprietary - Not For Redistribution

9. Vision for HIE
• No Wrong Door for Patients
• Providers have access to a patient’s complete health history to
provide high quality, cost effective treatment during the visit
• Providers have access to the information needed to evolve with
health reform (e.g., ACOs)
• Patients are active participants in their healthcare
• Communities and policy makers have accesses to aggregated, de-
identified health data to improve community and public health
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
11/16/2011 CORHIO Proprietary - Not For Redistribution 9

10. What is HIE?
Health information exchange (HIE) is the ability to electronically
exchange patient health information including:
– Lab results – Secure Messaging/Email
– Pathology results – ADTs
– Radiology reports – Orders
– Transcribed notes – Patient care summaries,
meds, allergies, Dx (CCD)
– Referrals & Consults
…when it’s needed for patient care.
(all data shared safely & securely, meeting or exceeding HIPAA standards)
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
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11/16/2011 CORHIO Proprietary - Not For Redistribution

11. Is this your reality?
“The typical primary care
physician has 229 other
physicians working in 117
practices with which care
must be coordinated.”
Source: Annals of Medicine 2011
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
11
CORHIO Proprietary - Not For Redistribution

12. Perhaps, this is Your Reality?
41.9% to 70% of Medicare
patients admitted to the
hospital received services from
an average of 10 or more
physicians during their stay
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
12
CORHIO Proprietary - Not For Redistribution

13. How Does HIE Work?
The Clinician Perspective
Paper & phone based with some limited One electronic connection to the HIE to access/share
electronic connections patient information across the state
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
13
CORHIO Proprietary - Not For Redistribution

14. Public Health Initiatives
• CORHIO Support Services
• Newborn Metabolic Screening Orders and
Results Delivery
• Electronic Laboratory Reporting
• Immunizations
© 2010 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
CORHIO Proprietary - Not For Redistribution

15. Additional CORHIO HIT Initiatives
• CO-REC
• Mental & Behavioral Health Policy Workgroup
• Long Term Care
• Medicaid State HIT Plan
– Meaningful Use/Medicaid EHR Incentive Program
– SDAC
• CIVHC All Payer Claims Database
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
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11/16/2011 CORHIO Proprietary - Not For Redistribution

16. A Roadmap for HIE in
Colorado
Support Data
Analytics
CCDs Health Plan
Participation /
& Funding
Public Health
(CDPHE) Orders
& (2012) Support
Referrals SDAC/RCCO Data
(2011/2012) QHN for Analytics
Integrations
Results (2011/2012)
Delivery Patient Tools
(2011) (2012/2013)
Stakeholder Engagement
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
16
11/16/2011 CORHIO Proprietary - Not For Redistribution

17. “Providers in communities will
become communities of providers”
- Dr. David Ehrenberger, CMO Avista Adventist Hospital
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
17
11/16/2011 CORHIO Proprietary - Not For Redistribution

18. Thank you!
Phyllis Albritton
Executive Director
palbritton@corhio.org
720-285-3200
18
© 2011 Colorado Regional Health Information Organization (CORHIO) - All Rights Reserved
CORHIO Proprietary - Not For Redistribution

19. Governance and
Stakeholder Trust
Nancye Lahue
Technical Director
BEACON Program
San Luis Valley 19
Health Information Technology
Symposium, November 4, 2011 19
November 4, 2011 INHS Business CONFIDENTIAL

20. INHS Introduction
• Founded in 1994
• 501(c)(3) Non-profit
• Healthcare and Healthcare IT Focus
• 1,100 employees across 4 business lines
• 2010 Gross Revenue of $167 million
• Nationally recognized leader in healthcare collaboration
• INHS is governed by our board made up of sponsoring
hospitals and community physicians.
– Customers govern their projects and IT direction independently.
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November 4, 2011 INHS Business CONFIDENTIAL

21. Current Beacon Area
November 4, 2011 INHS
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Business CONFIDENTIAL

22. Information Resource Management (IRM)
• 300+ IT Professionals
• 750+ Physician EMR systems hosted
• 38 Hospital HIT systems operated & hosted
• Nationally recognized programs (Beacon
Community, VLER, SSA, CDC, 21 of 100 Most
Wired Hospitals, 5 HIMSS Level 6 Hospitals)
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November 4, 2011 INHS Business CONFIDENTIAL

23. Key Differentiators
• Owner / Operator of Healthcare Systems
• 100% focused on Hospital HIT and Physician
EMR
• 100+ healthcare entities already committed to
Beacon
• Host and support (24 x 7 x 365)
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November 4, 2011 INHS Business CONFIDENTIAL

24. Journey Through the HIE
Shared
Shared Technology Information Hub
Technology
Other
Hubs
Environment: Environment: Environment:
New business relationships with Population-based approach to
Collaboration based on
decision-making occurring care delivery in a competitive
community relationships and
outside the community health system
individual leaders
Technology: Technology:
Technology:
Disparate information systems Disparate information systems
Shared information systems
relying on health information interacting with shared
with standardized data
exchange to conduct business information hub that supports
common metrics and care
coordination
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25. Health Information Exchange
Primary Care Long Term Care
Provider BCIN HUB
EMR
EMR Quality Measures
Primary Care Care
Provider Coordination
EMR/Disease Tools
Management Electronic Health Pharmacy
Application Record Information
System
Specialty
data
Care
EMR
Hospital Other HIEs
Phase 1 Information
25
System
Phase 2

26. Guiding Principals
• Level the playing field
– Technology agnostic
– Speed of delivery
– Focused set of options
– Incentive Alignment
– Funding Strategy
– ADDS VALUE
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November 4, 2011 INHS Business CONFIDENTIAL

27. Importance of Trust
• Warehousing Data demands trust
– Secure Transfer of Data
– Secure Storage of Data
– Secure Access of Data
• Communication –
– Strategic Planning
– Collaboration
– Advisory Committee
• Sustainability –
– Adding value
– Flexibility for different customers while maintaining
standardization
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November 4, 2011 INHS Business CONFIDENTIAL

28. Questions??
November 4, 2011 INHS
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Business CONFIDENTIAL

29. Thank you
Inland Northwest Health Services (INHS)
Contact: Nancye Lahue
lahuen@inhs.org
(509) 868-8462
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November 4, 2011 INHS Business CONFIDENTIAL