Brief History

1

• Brief History
• Launched in 2005 as an inexpensive secure
  connectivity solution for any provider in the
  South Sound area patients invited to join
• Provider-Patient portals managed by Siemens
  communications functionality by RMD Networks

• Currently 1,500 users 250 patients 250,000
  communications sent
• ROI demonstrated at clinic level
• Interfaces with 1 national lab and 2 radiology
  groups
• SSO relationships with many community partners

2
The Network

• November 2007 Siemens decided to pull back from
  community focus
• NPN received Appropriations award in December
  2007 to build out a health information
  resource.
• NPN and RMD Networks start a joint building
  venture
• Phase 1 (January June 08) Model
• Shared care plan within a medical home framework
• Registry functionality at the core of information
  organizing and communication for diabetes,
  asthma, heart failure and preventive services.
  Disease management for HF is an integrated
  adjunct function.
• Begin upload of 3,000 diabetes and 400 asthma
  registry patients into The Network registry
  recruit patients to use the platform (free)
• Continue to recruit more physician users
• Connect Puget Sound Health Partners as the first
  Plan with secure communication and information
  sharing with providers and patients.
• Phase 2 (July and Beyond)
• Build links to community data sources to more
  fully automate populating the shared care record.

3
Rationale for Approach

• Since 2004 we have been trying to recruit
  patients to use the existing communication
  service (free). We have gathered 250 hardy
  souls. Few use it.
• We have concluded that consumer use is driven by
  current medical need (duh). The number of people
  with a perceived medical need may be smaller than
  we think.
• Those who do people living with a chronic
  condition needing active management adults with
  parents living with many medical conditions
  parents with children who have a chronic medical
  condition.
• These three population groups are our marketing
  targets.

4
Shared Care Plan and PHR
5
Patient Views
6
Patient Inbox
7
PHR Content
8
Family Provider Roster
9
Patients View of Shared Care Plan
10
Patient to-do List
11
Patient Instructions
12
Patient Reminder from Care Team
13
Patient Self Tracking on Targets
14
Request an Appointment
15
Refilling Meds
16
Referral Requests
17
Updating Insurance Coverage Information
18
Patient Account Information
19
Care Team Views
20
Provider Team Patient Flow Sheet
21
Patient Care Plan Dashboard with Guidelines
22
Care Team View of Patients Self Monitoring Log
23
Provider-Patient Tracking on Targets
24
Roster of Patients with Established Care Plans
25
Patient reminder letter setup
26
E Mail/letter reminder to patient
27
Summary

• Our experience since 2004 suggests the following
• The Network solution represents the front end
  of a health banking service. It is designed to
  engage people with medical problems in a way that
  facilitates care with their providers, making
  care coordination and continuity easier and
  safer. It is not a health bank.
• What is missing is the infrastructure to capture
  and provide data (e.g. labs, meds, imaging,
  hospitalizations) for this end-user tool,
  eliminating multiple interfaced feeds mixed with
  manual entry. Feeds from such a utility should
  serve this application or any other user
  interface solution, of which there are several in
  2008.
• If health banks are going to be useful, they need
  to remove the heavy lifting of data gathering.
  Data gathering and safe storage are distinctly
  different market functions than user interface
  solutions developed by provider institutions for
  consumer use and shaped to some extent by local
  market needs and conventions.