State of HIE in California Robert M. Cothren, PhD Executive Director Transforming Health Information Exchange in California 2 November 2017 2017 California Association of Health Information Exchanges Licensed under a Creative Commons Attribution Share-Alike 3.0 License
Statewide HIE There is no single statewide HIE in California HIE (in California) takes place at the regional, state, and national level 2 November 2017 Transforming HIE in California 2
What is CAHIE? California Association of Health Information Exchanges 1. Collection of stakeholders promoting statewide information sharing 2. Community that responds to and participates in state and national activities 3. Voluntary self-governance for statewide HIE in California Find out more about CAHIE at http://www.ca-hie.org/ 2 November 2017 Transforming HIE in California 3
What is CAHIE? Promoting HIE Convene collaborations on important topics Operate a monthly educational webinar http://www.ca-hie.org/resources/knowledge-network/ Monitor current legislation and educate legislators Monitor state and national developments http://www.ca-hie.org/join-our-mailing-list/ 2 November 2017 Transforming HIE in California 4
What is CAHIE? Participating in state and national initiatives Collaborative voice of HIE in California Participated in the development of PULSE Participating in POLST eregistry Pilot Participating in development of a statewide provider directory Active in SHIEC, Carequality, ehealth Exchange, DirectTrust, NATE 2 November 2017 Transforming HIE in California 5
What is CAHIE? Voluntary self-governance of statewide HIE Single, multiparty data sharing agreement to govern exchange across organizational boundaries California Data Use and Reciprocal Services Agreement Technical services to ensure trust among organizations and facilitate secure data sharing California Trusted Exchange Network Find out more about the CalDURSA and CTEN at http://www.ca-hie.org/projects/cten 2 November 2017 Transforming HIE in California 6
What is HIE? The mobilization of health care information electronically across organizations within a region, community or hospital system Allows health care professionals and patients to appropriately access and securely share a patient s vital medical information electronically The capability to electronically move clinical information among disparate healthcare information systems, and maintain the meaning of the information being exchanged The ability of systems to exchange and use electronic health information from other systems without special effort on the part of the user 2 November 2017 Transforming HIE in California 7
Regional Exchange High-fidelity exchange within a community or enterprise 2 November 2017 Transforming HIE in California 8
Community HIOs Set the policies associated with data sharing Provide the technology that moves data Convene stakeholders to solve data sharing problems Establish collaboration and trust 2 November 2017 Transforming HIE in California 9
HIE Coverage More than 15 community HIEs In 39 of 58 counties statewide 2 November 2017 Transforming HIE in California 10
HIE Volume > 20,000,000 ATDs per month > 22,000,000 in MPIs (> 56% of CA population) 2 November 2017 Transforming HIE in California 11
Organizations Served by HIE Acute Care Hospitals County PH Primary Care Specialists Ancillary Services Payers EMS Home Health Mental Health SNF Long-Term Care Other local government Other outpatient Substance Use (inpatient) Other inpatient Social Services Substance Use (outpatient) 0% 100% Percentage Serving these Customers 2 November 2017 Transforming HIE in California 12
Services Provided by HIE Direct Longitudinal Records Alerts Text Reports PH Reporting PHR or Patient Portal Quality Measures Referrals CPOE E-prescribing 0% 100% Percentage Offering this Service 2 November 2017 Transforming HIE in California 13
Data Exchanged through HIE Allergies Lab Results ADTs Text Reports Discharges Immunizations Prescribed Meds Radiology Reports Care Plans Eligibility Claims Filled Meds 0% 100% Percentage Exchanging this Data Type 2 November 2017 Transforming HIE in California 14
Statewide Exchange Connecting communities 2 November 2017 Transforming HIE in California 15
CTEN California Trusted Exchange Network Governance Infrastructure Single, multiparty data sharing agreement to govern exchange across organizational boundaries California Data Use and Reciprocal Services Agreement, or CalDURSA Technical services to ensure trust among organizations and facilitate secure data sharing Find out more about the CalDURSA and CTEN at http://www.ca-hie.org/projects/cten 2 November 2017 Transforming HIE in California 16
CTEN What can you do on the CTEN? Today Query for information about a patient Send information about a patient to another user Support disaster response Find out more about the growing set of transactions at http://www.ca-hie.org/initiatives/cten/specifications/ 2 November 2017 Transforming HIE in California 17
CTEN Signatories 1. Axesson 2. CAHIE 3. California Emergency Medical Services Authority 4. Connect Healthcare 5. Dignity Health 6. Manifest MedEx 7. North Coast Health Information Network 8. OCPRHIO 9. RAIN - Live Oak HIE and Telemedicine Network 10. Redwood MedNet 11. San Diego Health Connect 12. Santa Cruz Health Information Organization 13. San Joaquin Community HIE 14. Sutter Health 15. UC Davis Health System Los Angeles Network for Enhanced Services SacValley MedShare Participants 1. Axesson 2. California EMS Authority 3. Connect Healthcare 4. Manifest MedEx 5. OCPRHIO 6. RAIN Live Oak HIE and Telemedicine Network 7. San Diego Health Connect 8. San Joaquin Community HIE 9. Santa Cruz HIO SacValley MedShare Sutter Health UC Davis Health System Track new participants at http://www.ca-hie.org/projects/cten 2 November 2017 Transforming HIE in California 18
MMPA Model Modular Participants Agreement A model agreement between HIOs and their exchange participants Avoids unnecessary legal costs Compatible with the CalDURSA Common policies across organizations that use it Find out more about the MMPA at http://www.ca-hie.org/resources/publications/ 2 November 2017 Transforming HIE in California 19
Nationwide Exchange Exchange beyond state lines and enterprise boundaries 2 November 2017 Transforming HIE in California 20
Sequoia Project Initiatives A peer-to-peer network of federal agencies and HIOs enabling (primarily) query-based document exchange, governed by the DURSA A (largely vendor-based) network-of-networks framework enabling query-based document exchange, governed by the CCA 2 November 2017 Transforming HIE in California 21
PCDH Patient Centered Data Home Cost-effective, scalable method of exchanging patient data among HIEs based on triggering episode alerts which notify providers a care event has occurred outside of the patient s home HIE 2 November 2017 Transforming HIE in California 22
National Networks ehealth Exchange CommonWell Carequality DirectTrust CTEN Community HIO Provider-centric network Patient-centric network Provider-centric network-to-network trust framework Secure messaging network Provider-centric network w/ personcentric tendencies Person-centric network Peer-to-peer primarily query-based exchange Query-based exchange based on centralized record location Peer-to-peer querybased exchange Peer-to-peer, contentagnostic secure messaging Peer-to-peer transaction- and content-agnostic trust framework Various use cases, including alerts, results delivery, order entry, query, public health reporting, longitudinal records, and analytics Centralized CA and provider-organization directory Centralized MPI and RLS Centralized providerorganization directory Enabling trust framework Centralized providerorganization directory Various levels of centralized resources necessary to meet participant needs Federal agencies, hospital systems, HIEs EHR vendors and networks EHR vendors, networks, HIOs Direct HISPs and certificate authorities HIOs interested in inter-organizational exchange Systems may include nearly any EHR, lab, pharmacy, or other HIT system Learn more at http://www.ca-hie.org/initiatives/hie-in-ca/ 2 November 2017 Transforming HIE in California 23
The score Regional Statewide Nationwide Community HIOs: 15 Parties to CalDURSA: 15 (+2) ehealth Exchange: 8 Enterprise HIOs: 5 CTEN Participants: 9 (+3) MMPA-based PA: 10 Carequality: 2 PCDH: 2 2 November 2017 Transforming HIE in California 24
What did we learn? HIE is alive and well in California 2 November 2017 Transforming HIE in California 25
How do I keep informed? More: http://www.ca-hie.org/initiatives/hie-in-ca/ Follow: http://www.ca-hie.org/join-our-mailing-list/ http://www.ca-hie.org/resources/knowledge-network/ 2 November 2017 Transforming HIE in California 26
Questions? 2 November 2017 Transforming HIE in California 27
Contact Information Robert M. Cothren, PhD Executive Director California Association of Health Information Exchanges p 925-934-2280 e robert.cothren@ca-hie.org w http://www.ca-hie.org 2 November 2017 Transforming HIE in California 28