Updates from Rochester RHIO

Health IT Today

RHIO Backgrounder for FLPPS

October 2015

Agenda

HIE and HIT Today

RHIO Background and History

Rochester RHIO & DSRIP

• Role as a Qualified State Entity (QE)

• Support of FLPPS Initiatives

Rochester RHIO Services

Looking Ahead

The Future is Bright

Health Information Exchange (HIE) becomes

both the noun and the verb in our dynamic and

evolving landscape.

Why?

• Critical for successful healthcare reform

• Fundamental instrument in enabling interoperability

and meaningful use of Health IT

• Data vs actionable information

HIT Today

Federal Initiatives

– Meaningful Use

– Patient Centered Medical Home (PCMH)

New York State Initiatives

– SHIN-NY: Rochester RHIO becomes community

gateway to sharing patient health information across

NY State

– DSRIP: Medicaid Redesign whose purpose is to

fundamentally restructure the health care delivery

system

– Health Homes: GRHHN & HHUNY

Health IT Today

Making “Disruptive Technology” Constructive

Health IT Today Our Community

RHIO Background

and History

RHIO Timeline

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2006-2008 2009-2011 2012-2015

• HEAL 1

• Incorporation

• Stakeholder collaboration

• Policy development

• Technology foundation

• Pilot RHIO services

• Increase in quantity/ types of data avail.

• Full-scale deployment

• Increased physician adoption

• HEAL 5 and 17

• Community health centers

• HIE growth

• EHR adoption & integration

• EHNAC certification as DIRECT HISP

• Accreditation as Qualified Entity of SHIN-NY

• Advanced Interoperability

• Working with Health Systems on Transitions of Care & other Community Initiatives

• Update technology stack

Who We Are• Rochester RHIO expanded from an independent, non-

profit, community health information exchange in 13

counties of NYS’ Finger Lakes region into a Qualified

Entity (QE) of the State Health information Network of NY

(SHIN-NY).

• We provide health information exchange services to

support improved quality and efficiency of healthcare

delivery.

• We provide authorized medical providers electronic

access to:

– Lab reports

– Radiology results

– Radiology images

– Clinical reports

– Discharge Summaries

– Patient Care summaries from

clinical providers in practice

settings (CCD/CCDA)

An up to date full list of data providers is posted on the Rochester RHIO website: http://providerportal.grrhio.org/en/Data%20Providers.aspx

Which hospitals provide data to the RHIO?

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Allegheny County•Jones Memorial Hospital

Chemung County•Arnot Ogden Health System

•St Joseph Hospital

Genesee•United Memorial Medical Center

Livingston County• Nicholas Noyes Hospital

Monroe County•Rochester General Hospital

•Strong Memorial Hospital

•Highland Hospital

•Unity Hospital

Ontario County•Clifton Springs Hospital/Clinic

•Thompson Health

•Geneva General Hospital

Orleans County•Medina Memorial Hospital

Schuyler County•Schuyler Hospital

Steuben County•St James Mercy Hospital

•Ira Davenport

Yates County•Soldiers&Sailors Hospital

Wayne County• Newark Wayne

Wyoming County• Wyoming County Community Hospital

NEXT STEPS – data from practices and community based organizations!

- Patients must provide written consent to allow viewing of their Explore

data using the approved NYS DOH form

- Patients can revoke consent at any time and it is durable until they

change or revoke it

- Patients can request an audit of who has accessed information

- Minor Consent Process

Patient Survey Results & Engagement in Rochester

- Currently 97% of our patients provide consent to their providers when

asked

- Over 3 million consent forms have been signed in our service area

- Approximately 1 million unique patients

**NEW**

- RHIO wide denial option

Patient Consent

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“Break the Glass”

- Emergency access to patient information

without patient consent

• Access to the community RHIO's clinical query portal

to provide comprehensive patient health information

(as appropriate).

• DIRECT 1-to-1 messaging between agency staff and

community, urgent care, or hospital physicians

(accommodates Behavioral Health/Chemical

Dependency data)

• Alerts to provide real-time information to residential

nursing staff in the event of patient hospitalization, ED

visit or ambulance transport, replacing current manual

processes.

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CBOs (Community Based Organizations) without an EHR can still use RHIO:

Rochester RHIO & DSRIP

Role as a Qualified Entity (QE) of the SHIN-NY

Support of FLPPS Initiatives

SHIN-NY

Qualified Entities (RHIO’s) by

Geographic Region

• Rochester RHIO is a local hub of the SHIN-NY

• Responsible for secure, vital access to

patient’s health information statewide

• Community utility, offering core services to

participants at no cost (Dial Tone Services)

Role as a Qualified Entity (QE)

Existing infrastructure to grow from:

• Connected to hospitals in our 13 county service area

• Established connection with over 25 EHRs and counting

• Strong core service offering help support DSRIP and other

State/Federal initiatives

• Data Normalization Efforts

Proven Impact: Prior studies confirm when a patient’s

records from our RHIO were reviewed:

• 30% less likely to be admitted from the ED

• 55% less likely to be re-admitted within 30 days

Supporting DSRIP Initiatives

• We continue to connect with an expanding assembly of

clinical providers in our community, our Health Homes

(GRHHN & HHUNY), ACOs and other care providers to

supply the pipes essential to efficient information

exchange.

• Initiatives like DSRIP open doorways for enhancements to

and expansion of RHIO product offerings.

• As we continue to work closely with FLPPS on connecting

provider & sharing patient information, Rochester RHIO’s

existing infrastructure serves as a foundation for

supporting additional information sharing services in our

region.

Supporting DSRIP Initiatives

SHIN-NY “Dial Tone” Services • Patient Record Look Up Services (Community)

• Patient Record Look Up Services (Statewide)

• Consent Management

• Secure Messaging – Direct

• Notifications (Alerts)

• Identity Management and Security

• Provider and Public Health Clinical Viewer

• Public Health Integration

• Cross RHIO query

• NEW – Imaging services

• NEW – Patient Portal (NYS level)

For additional details, here is a link to the RHIO website: http://grrhio.org/providers/services.aspx

Rochester RHIO Services

RHIO News & Updates

RHIO Explore (Our Clinical Query Portal with Statewide

Query Access)

RHIO Services

RHIO Alerts- Emergency Room and Inpatient

Admit/Discharge Notification, EMS Encounters (patients

with consent)

DIRECT- Nationally accredited HISP with peer to peer

messaging platform

Technical:

• Regional Master Patient Index

• Provider directory

• EMPI & Record locator service

• Query Portal

• Image Exchange services

• Access controls & audit logs

• Extensive interfacing support

Services:

• Adoption Support

• Training

• Audit & Compliance

• Data Normalization

• Community Collaboration

Send ordered/copied tests to connected EHRs

RHIO Services

Forward ordered/copied

tests to other care engines

Receive all clinical data

for consented patients

For additional information on RHIO Services see: http://providerportal.grrhio.org/RHIO%20Services.aspx

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Using the DIRECTory

Search by practice or provider

Available contact information including DIRECT address

DIRECT: A simple, scalable, standard-based way to transport encrypted

health information over Internet to known, trusted recipients

• Secure, HIPAA compliant messaging service

• Supports transitions of care, referrals, peer-to-peer data exchange

• Easy as email with same ability to attach multiple data types including

documents, photos, Excel files or patient summary documents (CCD)

• Can use RHIO Direct web-portal OR integrate within EHR

• Can help support Meaningful Use

WHAT IS A HISP? HISP = Health Information Service Provider

• For a message to flow, HISP A must have a trust relationship with HISP B as well

as the other way around.

What is DIRECT?

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Using Direct

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• Medical Doctor

• Care Manager

• Health Home

• Patient Registration

• Message

• Patient Summary

• CCD

• Referral

• Care Summary (can

include BH information)

• ROI (Release of

Information)

• Medical Doctor

• Care Manager

• Patient Registration

• Coder/ Biller

Sender Direct Recipient

What Do Alerts Look Like?

*Note: Currently the Rochester RHIO receives ADT messages automatically from 18+ hospitals in 13

county region. For more detailed on participating providers: http://www.grrhio.org/patients/doctors.aspx

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Community Initiatives

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• Clinical Document Normalization• Patient Care Networks• Provider Directory• Public Health Analytics• Public Health Access/Services• FQHC project to enable CCD exchange• Customized interfacing and data connectivity to practices• Eldercare data - Senior Care Summary• Perinatal Data - Care Summary• Health Home Connectivity – Care Plans• EMS Prehospital Care Documents• Emergency Department focus and support

What Happens Next?

A Look Ahead

• Rolling out new Query Portal - Explore

–User Migration

• ALL users migrated to Explore by 12/4/15!!

– Training Options & Requirements

–Statewide Query

• Bi-Directional Information Exchange

• DIRECT & Alerts

For additional information on RHIO Services see:

http://providerportal.grrhio.org/RHIO%20Services.aspx

Rochester RHIO News & Updates

RHIO & FLPPS Team continue to work

collaboratively

RHIO Connection Opportunities: Today,

tomorrow, and the next day

1.) Paperwork: Data Sharing Agreement

2.) Meet with Deployment Representative to

discuss unique practice workflow and needs

3.) Coordinate with FLPPS

4.) Work with FLPPS to deploy required

interoperability solutions

What’s Next?

The Future is Bright

A Look Ahead

Paving the Way to the Future

RHIO

Regional Health

Information Organization

Healtheway (NHIN)

National Health

Information Network

SHIN-NY

Statewide Health

Information Network

New York

RHIO Deployment Team

Rochester RHIO Deployment Team

Customer Support Center

Tel: 585.410.6800

Toll Free: 877.865.RHIO (7446)

Fax: 585.410.6801

General Email Inquiries: info@grrhio.org

Thank You

Questions & Answers

Gloria HitchcockDirector, Care Improvement Initiatives

Phone: (585) 481-2967email: Gloria.Hitchcock@grrhio.org