DHIN Update

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DHIN Update
Jan Lee, MD Executive Director 12.06.2012
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Agenda

• The Community Health Record
• Continuing Growth of DHIN
• DHIN and Meaningful Use
• A Word about ProAccess
• Near Term Development Initiatives (FY13)
• Vision and Strategic Direction

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The Community Health Record

• Clinical data sent into DHIN hosting center from
  many sources
• Aggregated into a longitudinal Community Health
  Record
• Information may be accessed in several ways
• Directly populate a practice EMR through
  interface
• Auto-print for inclusion in a paper record system
• View over a web portal (ProAccess)
• May be incorporated into a patient-controlled PHR

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Data Receivers
Data Senders
DHIN
Auto-print
Aggregates all known data about each patient
or
Populate EMR

• Lab results
• Radiology reports
• Pathology reports
• Hospital ADTs
• Transcribed reports
• /- Medication Hx

or
View data via web portal
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Provider Adoption of DHIN(as a percent of
Delaware ordering providers Oct 2012)
64 of these receive results exclusively through
DHIN
Denominator 2,746
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Current Membership in DHIN (as of November 2012)
Red new in past year Gray strong prospect

• Radiology Groups (75 by , 95 by vol)
• Tri-State Open MRI
• Papastavros
• Ocean Medical
• Imaging
• Mid-Del Imaging
• DE Diagnostic Gp
• Health Plans (43)
• Medicaid
• State Employees
• BCBS

• Hospitals (100)
• Bayhealth
• Beebe
• Christiana Care
• St Francis
• AI duPont
• Nanticoke
• Atlantic General (MD)
• Labs (99)
• Lab Corp
• Quest
• Drs Pathology Svcs
• Med Labs Diagnostics (NJ)
• Accu Reference Labs
• Ameritox (Bmore)

• Providers (96)
• Over 6,000 users in 616 practices
• FQHCs (100)
• Skilled Nursing (100)
• Assisted Living (62)
• Home Health (4)
• Hospice (3)
• Pharmacies (5)
• Division of Public Health

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Unique Patients in DHIN Database(as of June 2012)
Delaware 787,068
District of Columbia 1,516
Maryland 62,726
New Jersey 25,165
Pennsylvania 54,177
Virginia 7,553
West Virginia 470
All Other States 145,443
No State Assigned 251349
TOTAL UNIQUE PATIENTS 1,401,057
Delaware population per 2010 census 897,934
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• EMR-DHIN interfaces
• (one-way results delivery)

• Potential Practice Impact
• (practices currently enrolled in DHIN)

Availability of DHIN Certified Interface Availability of DHIN Certified Interface Availability of DHIN Certified Interface
Practices 272 57 of all DHIN practices using an EHR
Providers 1146 FY 13 Goal 65 of EHR practices have results- delivery interface available

• Major Challenge
• 62 EHRs used by members of DHIN
• 47 of these are in only one practice
• Interest in interfacing to DHIN is low for the
  vendors with small footprint

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Status of DHIN-EMR Interfaces
McKesson (Practice Partners Horizon) Elekta
iKnowMed MicroMD PhysiciansXpress SequelMed Vari
an
ADS Allscripts (Including Eclipsys) Bizmatics/Prog
nosis GE Healthcare (Centricity) Cerner Office
Practicum (Connexin Software) GEMMS InfoQuest Med
Plus - Care 360 NextGen STI Computer
Services electronic Clinical Works (eCW)
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The Poor Mans Interface

• A composite Continuity of Care Document

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DHIN Supports Meaningful Use

• Stage 1

• Stage 2

• Syndromic surveillance (EH)
• Reportable labs to Public Health (EH)
• Immunization reporting (EH, EP)
• Electronic exchange of clinical information
  (EH,EP)
• Transitions of Care Summary (EH)

• Syndromic surveillance (EH, /- EP)
• ELR to Public Health (EH)
• Immunization reporting (EH, EP)
• Patient engagement (view/download/transmit EH,
  EP)
• Summary of Care at TOC (EH, EP)
• Access to images (EH, EP)
• Cancer registry reporting (EP)
• Other registry reporting (EP)

Gray planned functionality
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Near Term Development Initiatives (FY13)

• Additional data senders
• Small radiology groups
• Prenatal records
• State Public Health Lab
• Maryland, New Jersey labs
• Data exchange with health plans
• Convert to iNexx platform
• Radiology image viewing (MU2)
• Immunization registry reporting (MU2)
• Bi-directional immunization exchange
• eOrders
• CCD exchange (MU2)
• Consumer engagement (view/download/transmit
  secure messaging MU2)
• Connections to Cancer Registry (MU2) and other
  State registries

• More granular privacy and consent tools to
  accommodate behavioral health data exchange
• Newborn screening
• Quality reporting and population analytics
• Connections to other states, other HIEs
• VA, DoD, SSA
• Maryland, Pennsylvania tertiary care centers
• National prescription monitoring databases
• Alerts and notifications
• To PCP for ED visits, hospital admissions/discharg
  es
• To hospitals/EDs regarding 30 day readmissions
• Support for new payment models (PCMH, ACO)

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Long Term Vision Integrate clinical/financial/p
atient satisfaction data sources to inform
decisions (16 Del Code 10303)
A community-based health information network for
the benefit of all citizens of Delaware

• Benefits Desired

• Users of DHIN

• Improved communication within the healthcare
  community
• Efficiency eliminate redundancy
• Monitor community health status (population
  health)
• Reduce healthcare costs
• Trusted information source for consumers,
  purchasers, and providers of care

• All members of the healthcare community
• (Hospitals, labs, pharmacies, imaging centers,
  physicians and staff, nursing homes, home health,
  allied health professionals, etc.)
• Consumers (patients)
• Purchasers (to include employers)
• Health Plans
• Public Health (and other State agencies)

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The Once and Future DHIN

• Phase 1 The Community Health Record

• Phase 2 Population Level Data Aggregation and
  Analysis

• Transactional, patient-centric
• Supports point-of-care clinical activities
• Supports goals of improved communication,
  improved efficiency, reduced duplication, reduced
  cost
• Supports Meaningful Use

• Population-centric
• Supports analysis, clinical research, predictive
  modeling, policy development
• Opportunity to combine clinical and financial/
  administrative data sets

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Think of DHIN as

• The highway system across which all health data
  in Delaware travels
• The post office delivering data where and when it
  is needed
• A utility cooperative many users share in the
  cost of tools needed to support all
• Like a stock exchange brings together buyers and
  sellers, the HIE brings together data producers
  and data users
• Mighty Orbots many components connect to form
  a superhero http//www.youtube.com/watch?v1Gzbo
  BND43Ifeaturerelated

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