Changing Healthcare: 4.01 Challenges in Implementing a Statewide Connected Community: Connecting Clinical Care, P .

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Transforming Healthcare: 4.01 Challenges in Implementing a Statewide Connected Community: Connecting Clinical Care, Policies and Technology. Improving Healthcare in North Carolina by Accelerating the Adoption of Information Technology. Outline. Change Drivers HHS and ONCHIT
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Changing Healthcare: 4.01 Challenges in Implementing a Statewide Connected Community: Connecting Clinical Care, Policies and Technology Improving Healthcare in North Carolina by Accelerating the Adoption of Information Technology

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Outline Change Drivers HHS and ONCHIT Different methodologies fit a Community\'s needs NCHICA Background and Activities Participation in ONC Initiatives

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Health Care Challenges Greater attention to therapeutic blunders Frequent failure to give finish data where and when it is required Cost of human services New techniques and medications Defensive nature of routine of solution = expanding tests Lack of Standards Paper-based and wasteful

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Quality, Safety and Cost Medicare Population * 20% have at least 5 incessant conditions Chronic Care represents 70%-80% of uses Average 40 office visits for each year 20% see by and large 14 unique doctors for every year Potential for endorsing mistakes, duplication of requests, tests, and so forth * 2003 Urban Institute Study for CMS

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Compliance Certification NHIN Privacy/Security Biosurveillance Consumer Empowerment Chronic Care Electronic Health Records Breakthroughs Standards Harmonization Coordination of Policies, Resources, and Priorities Office of the National Coordinator - Health IT Policy Council - Federal Health Arch. The Community - Workgroups Industry Transformation Infrastructure Health IT Adoption Consumer Value Health Information Technology Deployment Coordination Health Care Industry Technology Industry

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Privacy and Security Solutions HHS granted an agreement esteemed at $11.5 million to RTI International , a private, non-benefit partnership, to lead the Health Information Security and Privacy Collaboration (HISPC), a joint effort that incorporates the National Governors Association (NGA), up to 40 state and regional governments, and a multi-disciplinary group of experts.  RTI will regulate the HISPC to survey and create arrangements to address varieties in association level business approaches and state laws that influence security and security hones that may posture difficulties to interoperable electronic wellbeing data trade while keeping up protection insurances.

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Nationwide Health Information Network (NHIN) Contracts have been granted by HHS totaling $18.6 million to four consortia of human services and wellbeing data innovation associations to create models for the Nationwide Health Information Network (NHIN) design . The agreements were granted to: Accenture, Computer Sciences Corporation, IBM, and Northrop Grumman , alongside their subsidiary accomplices and human services showcase zones. The four consortia will move the country toward the President\'s objective of individual electronic wellbeing records by making a uniform design for human services data that can take after buyers for the duration of their lives.

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Emerging Models for Connected Communities

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Models for Connected Communities Federation – numerous autonomous/solid endeavors in same locale Co-operation – various undertakings consent to share assets and make focal utility Hybrid – area containing both Federation and Co-operation associations Other ???

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Types of Connected Communities Federations Includes extensive, "independent" endeavors Agreement to network, share, permit access to data they keep up on distributed premise May create arrangement of ordering or potentially finding information (e.g., state or locale wide MPI) In NC (Triangle, Triad, Charlotte Metro, Western NC)

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Types of Connected Communities (cont.) Co-operations Includes for the most part littler ventures Agreement to pool assets and make a consolidated, regular information vault May share innovation and authoritative overhead In NC (Rural NC, Eastern NC, other)

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Types of Connected Communities (cont.) Hybrids Combination of Federations and Co-operations Agreement to network, share, permit access to data they keep up on shared premise Allows total crosswise over substantial regions (statewide or territorial) In NC (Hybrid might be required for Statewide activities)

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Models for Organizational Structure "Utility" Provides Functions Such As: Centralized database Patient data trade Clearinghouse Patient data locator benefit Neutral, Convener, Facilitator Builds Consensus Policies Brings together focused undertakings Bridges various RHIOs in geographic area Seeks Open-gauges approach – non merchant particular

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Models for Organizational Structure (cont.) "Utility" Operator Quicker to execute Fewer beginning members Build association after some time Forces early innovation choice Neutral, Convener, Facilitator Slower to actualize Building accord troublesome and may baffle members who need to begin Open norms approach leaves open doors for more associations and sellers to take part Perhaps best way to connect numerous RHIO endeavors

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Challenges to Broader Exchange of Information Business/Policy Issues Competition Internal strategies Consumer protection concerns/straightforwardness Uncertainties in regards to risk Difficulty in achieving multi-endeavor assentions for trading data Economic components and motivators

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Challenges to Broader Exchange of Information Continued Technical/Security Issues Interoperability among different gatherings Authentication Auditability

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Community Approaches in North Carolina

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Opportunities of Statewide Interoperability: WNC Data Link

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WNC Data Link Long range objective Longitudinal electronic therapeutic record that can be gotten to and redesigned constant by approved human services suppliers in WNC. Fleeting objective Transmit and get to electronic patient data between WNC healing facilities Parameters No focal information storehouse Technology nonpartisan

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Project Benefits Improve persistent wellbeing and quality Reduce duplicative tests Reduce paper outline pulls Improve doctor fulfillment and effectiveness

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Obstacles Sustainability Consensus of basic strategies and methods Maintain intrigue and purchase in IT anticipate needs

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Overcome the Obstacles Buy-in from the most abnormal amount of each taking part substance Financial motivators Educate general society

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Recommendations for Success Statewide interoperability is critical, yet: Interoperability with flanking states might be more essential for a RHIO like WNC:

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WFUBMC Referral Area Hospitals PITTSYLVANIA HENRY CARROLL PATRICK Twin County Regional Memorial of Martinsville & Henry County Danville Regional GRAYSON R.J. Reynolds-Patrick County ALLEGHANY ASHE ROCKINGHAM SURRY STOKES Alleghany Memorial Ashe Memorial Morehead Memorial Northern of Surry Hugh Chatham Stokes-Reynolds Annie Penn WILKES Watauga Med Ctr FORSYTH YADKIN GUILFORD Wilkes Regional Affiliates Blowing Rock Forsyth Med Ctr Hoots Memorial NC Baptist Kindred Moses Cone Other Hospitals CALDWELL DAVIE IREDELL High Point Regional ALEXANDER Davie County Caldwell Memorial Iredell Memorial Community General Alexander Community RANDOLPH BURKE Davis Med Ctr DAVIDSON Valdese General CATAWBA ROWAN Randolph Lexington Memorial Grace Catawba Valley MC Rowan Regional Frye Regional Lake Norman Regional Veterans Hospital Rutherford Hospital Counties of Origin For Approximately 90% of Medical Center\'s Inpatients and Outpatients 11/05

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Alliance for Health Mission Statement The Alliance for Health (AFH) is Wake Forest University Baptist Medical Center\'s system of associated doctors, doctor\'s facilities, and wellbeing administration suppliers committed to enhancing the wellbeing status and access to quality, financially savvy group based administrations in a joint effort with residents, bosses, and payors in North Carolina and southern Virginia.

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Opportunities of Statewide Interoperability Address Institute of Medicine perceptions/suggestions Utilize multi-doctor\'s facility frameworks/systems Pay for execution – state arranges Assign duty regarding usage/base

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Obstacles Costs –Financial and faculty – Small/Rural Hospitals Physician and payer motivations Return on venture Decreasing obligation limit Interoperable models Governance Security and lawful issues

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Overcome the Obstacles Provider interests in interior frameworks Identify financing hotspots for IT and RHIOs Identify benefits for all members Establish guidelines

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Recommendations for Success Identify subsidizing sources and motivators Demonstrate quality, wellbeing, and money saving advantages Establish local partners Governance structure

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Opportunities of Statewide Interoperability Technology is the "empowering influence" Patient Safety All essential/pertinent data accessible to clinicians at the point and desperate hour Clinical choice support to help clinicians prepare tremendous measures of information Resolves neatness issues Quality Standardization of care/benchmarking Efficiency Saves time Eliminates excess methods (costs)

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Obstacles Why is social insurance behind different enterprises (Banking and Airlines)? Information volume and multifaceted nature Debit/Credit Reservation/Cancelation Unique identifiers Bank directing numbers/Airline flight numbers Relationship of the information No relationship between various ledgers or aircraft reservations

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Overcome the Obstacles The Co-Op Model Leverage speculations of the bigger foundations in the state Other suppliers pay incremental expenses to utilize the framework Use of a solitary framework guarantees the interoperability Common patient database Common wording Standardization of work processes and procedures Single integra

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