Making NC HIE Work For Your Organization

North Carolina Health Information Exchange (NC HIE)
Making NC HIE Work For Your Organization
NCHICA Annual Meeting
October 6, 2014
+
Agenda

Introduction

Participation and Progress with
Integrations

Initiatives Update

Hospital and Ambulatory Onboarding:
Lessons Learned

NC HIE and Meaningful Use

Leveraging NC HIE for Clinical
Quality Improvements

Stay Updated with NC HIE

Q&A
+
Introduction
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One Connection, Many Data Sources
One connection to NC HIE means access to:
 Provider electronic health record systems
 State systems
 Pharmacies
 Labs
 Behavioral health organizations
 Long-term care entities
 Home health providers
 Health departments
 Disease registries
 Other sources of patient data (claims)
+ Participation and Progress
with Integrations
+
NC HIE Participation Growth:
2013-2014
2013 Participation
Legend:
Hospitals
Physician Practice – Primary Care
+
NC HIE Participation Growth:
2013-2014
2014 Participation (as of October 1)
Legend:
Hospitals
Physician Practice – Primary Care
Physician Practice – Specialist
Long-Term Care
+ Current Hospital Participation
 Ashe Memorial Hospital
 Blowing Rock Rehabilitation &
Davant Extended Care Center
 Cannon Memorial Hospital
 CaroMont Medical Center
 Carteret General Hospital
 Cherokee Indian Hospital
 Hugh Chatham Hospital
 Davie Medical Center
 Granville Medical Center
 Halifax Regional Medical Center
 Harnett Health – Betsy Johnson Hospital
 Harnett Health – Central Harnett Hospital
 High Point Regional Medical Center
 Johnston Medical Center
 Lenoir Memorial Hospital
 Lexington Medical Center
 Maria Parham Medical Center
 Morehead Memorial Hospital
 Nash General Hospital
 Northern Hospital of Surry County
 Onslow Memorial Hospital
 Our Community Hospital
 Person Memorial Hospital
 Randolph Hospital
 Rex Hospital
 UNC Caldwell
 UNC Chatham
 UNC Hospitals
 UNC Pardee
 UNC Wakebrook
 Wake Forest Baptist Medical Center
 Watauga Medical Center
 Wayne Memorial Hospital
 Wilson Medical Center
+ Ambulatory Progress and Goals
Currently, more than 850 ambulatory sites are participants of NC HIE including
practices, clinics, health departments and long-term care and behavioral
health clinics.
1600
1400
Ambulatory
1200
850
1000
800
Note: Increase of
approximately 200
provider sites since
March 2014
600
400
200
Jul-15
May-15
Mar-15
Jan-15
Nov-14
Sep-14
Jul-14
May-14
Mar-14
Jan-14
Nov-13
Sep-13
Jul-13
0
+ NC HIE Integration Progress - Hospitals
Live Today
October 2014
November 2014
Live on ADT:
 Halifax Regional Medical Center
 Morehead Memorial Hospital
 Carteret General Hospital
 Granville Medical Center
 Lenoir Memorial Hospital
Live on ADT:
 Ashe Memorial Hospital
 CaroMont Medical Center
 Hugh Chatham Hospital
Live on ADT:
 UNC Hospitals
 Rex Hospital
 UNC Caldwell Memorial Hospital
 UNC Chatham Hospital
 UNC Pardee Hospital
 Cherokee Indian Hospital
 Central Harnett Hospital
 Betsy Johnson Hospital
Live on DSM:
 Ashe Memorial Hospital
 Onslow Memorial Hospital
 Johnston Medical Center
Live on ORU (Radiology):
 Halifax Regional Medical Center
 Morehead Memorial Hospital
 Lenoir Memorial Hospital
Live on DSM:
 Carteret General Hospital

 CaroMont Medical Center

 Granville Medical Center

 Halifax Regional Medical Center 
 Morehead Memorial Hospital 
 Central Harnett Hospital
 Betsy Johnson Hospital

 Lenoir Memorial Hospital

 Northern Hospital of Surry

County
Live on CCD Inbound:
 Hugh Chatham Hospital
Randolph Hospital
UNC Hospitals
Rex Hospital
UNC Chatham Hospital
UNC Caldwell Memorial
Hospital
UNC Pardee Hospital
Wayne Memorial Hospital
Wilson Medical Center
Live on CCD Exchange/
ITI Transactions:
 Halifax Regional Medical
Center
 Granville Medical Center
 Carteret General Hospital
 Lenoir Memorial Hospital
 Morehead Memorial Hospital
 Ashe Memorial Hospital
Live on CCD Exchange/
ITI Transactions:
 Cherokee Indian Hospital
 Central Harnett Hospital
 Betsy Johnson Hospital
+
Initiatives Update
+ Ongoing Initiatives and Timelines
eHealth Exchange
1.


2.
NC HIE Instance of PHARMACeHOME


3.
Once NC HIE is fully integrated with the nationwide exchange, NC HIE and its
participants will be able to query patient data available in other participant
systems nationwide and at the following federal agencies:
 U.S. Department of Veterans Affairs (VA)
 Social Security Administration (SSA)
 Department of Defense (DOD)
NC HIE is in the queue for go-live late fall 2014.
PHARMACeHOME is a web-based application that was developed in response to
the silos of care related to medication management.
NC HIE is currently in pilot stage with expected go-live late fall 2014.
Radiology


NC HIE is working to build radiology partnerships in order to make radiology
information available at the point of care for quality improvements.
NC HIE is currently working with a large triangle-based radiology group to build
HIE connectivity for orders and results with expected go-live Q1 2015.
+ Ongoing Initiatives Part 2
Community Building
4.


Halifax County: One hospital currently connected to NC HIE (Halifax Regional
Medical Center), one hospital contracted (Our Community Hospital) and currently
connecting Halifax County Health Department, community physician practices, longterm care facilities and federally qualified health centers.
Health Department Connectivity Progress: A year ago, NC HIE didn’t have any
health departments connected. Today, 21 health departments are under contract
with NC HIE and we’re working with the three largest health department EMR
vendors in the state (Netsmart, CureMD, Patagonia Health).
Patient Engagement
5.

2015 Patient Engagement Campaign:
 Proposal to conduct study in collaboration with large triangle-based university to
gauge NC patients’ feedback to current messaging and marketing collateral.
 Producing brief animation to tell a story about how NC HIE helps patients.
 Tailoring educational collateral and website.
 Exploring other tactics for effective multi-channel communications to patients.
CCNC Chronic Disease Registries
6.


Endorsed by American Academy of Family Physicians for Meaningful Use.
In pilot roll-out with Community Health Centers, scheduling additional roll-outs.
+ Ongoing Initiatives Part 3
Exploring Value-Based Services
7.


CCNC and NC HIE have invested in additional informatics platforms to provide
new value-based services to providers.
 Goal: Leverage a single connection to provide as much service as possible
and build in practice support around those services.
Examples of projects in pilot:
 PQRS Reporting and Tracking
 Medicare ACO Application
 PCMH Certification Application
 Well Child Application (CHIPRA-D)
CCNC Informatics Center Transformation
8.



1,800 practices participate (>90% of primary care in NC) in Medicaid claimsbased program to improve quality and reduce cost.
CCNC can leverage all population participant data via NC HIE (with permission
of participant) to provide more advanced, real-time, analytics and support to
practices (Informatics Center 2.0, or IC 2.0).
CCNC’s #1 Priority is connecting Carolina Access II practices to NC HIE to fully
leverage IC 2.0.
EMR Vendor Relationships
9.

Since last year, we have added six new partners.
+
Electronic Medical Record (EMR)
Vendor Partnerships
Established Agreements
Ongoing Conversations/Integrations

Covisint

Allscripts

eClinicalWorks

Greenway

Meditech

Pioneer Rx

Aprima

NextGen

Epic

Relay Health

CompuGroup

SuiteMed

Cerner

Correct Care

athenahealth

Office Practicum

CPSI

Patagonia Health

Care 360

CureMD

Reli-Med

Netsmart
Ambulatory
Hospital
Other
+ Funding and Sustainability

Participant Fees



Currently from 34 hospitals and >850 ambulatory practices, and growing.
Grants

Medicaid HITECH funding to connect 1,500 eligible ambulatory practices to NC HIE and build out Meaningful
Use functionality.

Community Transformation Grant: Available funds for NC HIE to build referral system between providers that
use the NC HIE Network.

Funding from Office of Rural Health for Safety Net Project to connect Federally Qualified Health Centers and
Rural Health Clinics.

NC PATH program leverages BCBSNC funds to connect independent physician practices.
Collaboration with NC DHHS – Hospital Reporting

House Bill 834 passed in Fall 2013 requires hospitals connect to NC HIE to share, at minimum, Medicaid
clinical and demographic data; subsequent data use agreement signed May 12, 2014.

NC HIE and DHHS have agreed upon leveraging ADT and CCD interfaces to achieve data reporting
requirements.

FY 2015 State budget included $2mil appropriation; expected $2mil federal match:

Will impact hospital fees to report to NC HIE

Pricing proposal is being developed with NC DHHS
+ Hospital and Ambulatory
Onboarding: Lessons Learned
+
Hospital Onboarding: Lessons Learned
1.
2.
3.
Direct Secure Messaging is high priority, and a national provider
directory to facilitate messaging is behind.

Solution: NC HIE has been having grassroots discussions with
hospitals, health systems and HISPs that are active in NC to test
intra-HISP messaging and build a NC directory.
Every hospital has its own strategy for implementing HIE.
 Solution: Breaking NC HIE hospital bundled pricing out to an ala-carte model per market demand and to better fit changing
needs for legislated reporting and current state of public health
reporting functionality.
Demand for a more integrated solution than historical core services
offering.

Solution: All hospitals to date implementing via XDS.b
integration method to enable query/retrieve of documents from
NC HIE with ability to import directly from EMR.
+
Ambulatory Onboarding: Lessons Learned
1.
Need to drive down pricing for ambulatory practices.

Solution: NC HIE has established agreements directly with
EMR vendors in order to negotiate costs and technical
specifications on behalf of the practice.
2.
Use cases where a participating provider’s EMR is not able to
translate data to a coherent, acceptable state.

Solution: NC HIE now offers data translation services to
consolidate data into an acceptable format.
3.
Demand for practice support in order for participating providers to
learn how to meaningfully use their EMR.

Solutions: NC HIE is working with AHEC and the CCNC
Networks to provide practice support around EMR usability.
+
NC HIE and Meaningful Use
+ Meaningful Use Initiatives
1.
Electronic Laboratory Reporting (ELR):

2.
DSM Direct and Hospitals (Currently Live):








3.
Working with 9 hospitals to facilitate this reporting via NC HIE.
UNC Hospital
Rex Hospital
UNC Chatham Hospital
Granville Medical Center
CaroMont Medical Center
Randolph Hospital
UNC Pardee
Carteret General Hospital






UNC Caldwell
Morehead Memorial Hospital
Wayne Memorial Hospital
Halifax Regional Medical Center
Harnett Health – Betsy Johnson Hospital
Harnett Health – Central Harnett Hospital
Other Meaningful Use Updates:



Disease Registries: Endorsed by American Academy of Family Physicians in July 2014
and piloting.
Electronic Clinical Quality Measures (eCQMs): Application currently in pilot stage and
planning roll-out of current participants.
NC Immunization Registry (NCIR): Starting user acceptance testing for Non-VFC; NCIR
is doing multiple pilots.
+ Leveraging NC HIE for
Clinical Quality Improvements
+
NC HIE Direct Secure Messaging:
Facilitating Transitions of Care
“Integrating NC HIE’s Direct Secure Messaging solution with Epic@UNC allows
us to exchange patient data with health care providers statewide and fulfill
Meaningful Use requirements,” said Tracy Parham, UNC Health Care’s Chief
Information Officer. “This is another step toward our goal of providing
coordinated, real-time data for both patients and care providers."
+ Valued-Added Services:
Analytics Platform Applications
Functionality: Incorporation of multi-sourced information, both clinical and claims data,
into comprehensive view of evidence-based population health dashboards/utilities to
facilitate systematic approaches to improve care.
 Development of chronic disease registries
 Diabetes
 Asthma
 Heart Failure
 Hypertension
 Reporting of Clinical Quality Measures
 Certified in all 64 CQMs
 Basic data set allows for population of ~28
 Future offerings:
 PQRS
 ACO
+ Stay Updated with NC HIE
+ Stay Updated with NC HIE

Subscribe to our monthly e-newsletter, NC HIE e-News, for automated
updates: http://nchie.org/nc-hie/news/nc-hie-e-news/

Connect with NC HIE on social media for real-time updates:
facebook.com/northcarolinahealthinformationexchange
twitter.com/nc_hie
linkedin.com/company/north-carolina-health-information-exchange

Coming November 2014…NC HIE rebranding
and website redesign:
+
Q+A
+
Questions?
Contact:
Christy Revels, Director, Stakeholder Engagement and Strategic Development, NC HIE
[email protected] / 919.926.3938
Jayson Caracciolo, Director, Stakeholder Services, CCNC
[email protected] / 919.882.0320

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