2

CalHIPSO was founded in 2010 by the California Primary Care Association (CPCA), the California Medical Association (CMA) and the California Association of Public Hospitals and Health Systems (CAPH). As the largest of 62 federally designated Regional Extension Centers (REC), CalHIPSO helped providers in California navigate the complicated world of electronic health record adoption.

Who We Are

3

Originally formed to be the REC for California, CalHIPSO has branched out into many areas. We are currently wrapping up a couple of programs and our pivoting to all things Interoperability

Should you need assistance this month with 2020 Stage 3 Medicaid Meaningful Use, please contact DeeAnne McCallin before the five year DHCS CTAP ends Sept. 30th

deeanne@calhipso.org 510-302-3364

CalHIPSO ProgramsAcross all programs since our inception, CalHIPSO has provided technical assistance to over 15,000 clinicians, spanning more than 1,400 organizations statewide, helping them earn more than $300 million in incentive dollars

4

Date: (tentative) October 22, 2020Time: 12 – 1 pm (PT)

Topic: How do the March 2020 final rules affect Patients & Providers?

o Interoperability and Patient Accesso Information Blockingo ONC HIT Certification Program

Next Webinar

The Presentation will Begin Momentarily

Electronic Case Reporting

Paul Matthews (CTO,CISO)

Meet Your Presenter

Paul Matthews

Chief Technology Officer

Chief Information Security Officer

OCHIN

Introduction to OCHIN

AGEN

DA1.

2.

3.

4.

Brief Introduction to Case Reporting

Electronic Case Reporting

Discussion

44

A driving force for health equity

Technology Research Support Services

Data Analytics

Electronic Health Records

Networking & Broadband

Telehealth

Chronic Pain & Opioids

Diseases Affecting the Safety Net

Health Equity & Health Policy

Social Determinants of Health

Billing

Compliance & Security

Technical Assistance

Staff Augmentation

Nationwide Network500+

health care delivery sites with

20,000providers in

47states

151 M Clinical summaries securely exchanged

171 Peer-Reviewed Research

Publications

ServingRural Access Clinics

Federally Qualified Health Centers

School-Based Clinics

Correctional Facilities

Behavioral Health Providers

Public Health Departments

HIV/AIDS Care Organizations

6M+ Active Patients73% Female | 14% Children

45% At or Below Federal Poverty Level

Diversity42% Racially Diverse | 26% Hispanic

30% Best Served in a Language Other than English

Chronic Conditions67% One or more chronic condition

49% Two or more chronic conditions

60% One or more MH/BH diagnosisamong patients with chronic conditions

The Population We Serve

25%

9%3%

15%

48%

Medicaid Medicare Other Public Insurance Private Insurance Uninsured

Payer Mix

School-Based

Homeless

Migrant/Seasonal Workers

Veterans

Incarcerated

Foster Children 15K

19K

28K

122K

86K

35K

53%

7%3%

14%

23%

MedicaidExpansion

States

Non-Expansion

States

18%

14%

11%24%

33%

1 Chronic Condition

2 Conditions

3 Conditions

4+ Conditions

0 Conditions

50%

8%3%

14%

25%

CumulativeAll States

OCHIN’s Work in California133 Total Organizations*• Broadband: 88• Epic: 33 (25 CA FQHCs on OCHIN Epic)• NextGen: 5• HCCN: 36• Research Partners: 2

*Some customers have more than one product

Special California Program Needs• Alternative Payment Models• CA Telehealth Resource Center• CAIRS2• CHDP• CPSP• Every Woman Counts• FamilyPACT• HCCN HRSA Network Grant• Medi-Cal• OSHPD• 340B

3M annual visits

1M patients

500K Medi-Cal patients

30% of OCHIN EHR visits are in California, more than any other state

33 California groups on OCHIN Epic, all on Managed Medi-Cal

As of August 2020

Organization Headquarters

Clinic Sites

OCHIN’s California Members

Sources: Salesforce, retrieved 5/22/2020; Clarity Reports, retrieved 5/15/2020

29 Members Organizations

1,320,072 OCHIN Network Patients

71%

13%

7%

7%

1%

1%

White

Unknown

Black/African American

Asian

AI/AN

Pacific Islander

47%

45%

8%

Hispanic

Non-Hispanic

Unknown21%

17%

30%

19%

12%

0 - 17 years

18 - 29 years

30 - 49 years

50 - 64 years

65 years or over

56%

44%

1%

Female

Male

Other or Unknown

Brief Introduction to Case Reporting

CALIFORNIA REPORTABLE DISEASE INFORMATION

California Department of Public Health (CDPH) requirement for the reporting of certain diseases and conditions per the California Code of Regulations (CCR) Title 17 Section 2500.Specified diseases and conditions are mandated to be reported by healthcare providers and laboratories to the public health authorities. • Electronic Laboratory Reporting (ELR) - Laboratories may comply with California public health

reporting requirements (California Code of Regulations (CCR) Title 17, Section 2505) by participating in Electronic Laboratory Reporting (ELR), to securely submit notifiable lab results to LHDs.

• electronic Case Reporting (eCR) - Electronic case reporting (eCR) will allow for the electronic transmission of cases of reportable conditions from provider electronic health record (EHR) systems in support of Stage 3 of the Meaningful Use Program beginning January 2018.

Electronic Case Reporting

Electronic Case Reporting (eCR)

The California Reportable Disease Information Exchange - Electronic Case Reporting (CalREDIE eCR) module will allow health care providers and organizations to more easily comply with the California Department of Public Health (CDPH) requirement for the reporting of certain diseases and conditions per the California Code of Regulations (CCR) Title 17 Section 2500.

For more information please review:https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Electronic-Case-Reporting-eCR.aspx#

Why is OCHIN working on eCR?

The Association of Public Health Laboratories Informatics Messaging Services (AIMS) was in pilot until early this year and needed on the ground support to assist in getting the word out to providers. OCHIN and Sutter Health leadership volunteered to help align messaging and support, building implementation cohorts nationally, providing the operational translation needed for providers interested in moving quickly to electronic reporting to improve analytics and contact tracing efforts at Public Health.

Association of Public Health Laboratories

Centers for Disease Control and Prevention

Council of State and Territorial Epidemiologists

State and local public health agencies

*Note: Some of todays slides are produced by the CDC based on this coordination effort.

Legal Framework & Transport Options

Provider organizations that are already participating in the following trust relationships can participate in the eCR / AIMS platform without additional legal agreements.

• eHealth Exchange (DURSA)• Carequality (Carequality Connection Terms)• Additionally: For those organizations that are not participating in the above

agreements, an APHL participation agreement can be executed directly with APHL

From a transport level (getting the reports to Public Health) the following two options are implemented.• Direct Secure Messaging (via a HISP) – this can have a cost impact based on volume

• eHealth Exchange HUB (using XDR) – no cost beyond current agreement

eCR National Gateway for Electronic Case Reporting

15

If a trigger value is detected in the EHR, the eCR is generated and sent to AIMS for evaluation by the Public Health rules engine.

The rules engine will determine if the condition is reportable to a specific jurisdiction and send the report required reporting agency based on place of service and place of residence.

An acknowledgement is returned to the EHR by the AIMS platform for inclusion in the patient chart.

National Gateway

eCR COVID-19 Implementation Sites

Scale of COVID-19 Reporting

• Electronic Case Reporting (eCR) – Since our Go-Live of April 17th 2020, OCHIN member clinics have submitted 171,034 reports triggered by COVID-19 events in the EHR.

• Some states receiving eCR no longer require manual reporting of cases (eg: saving 800-1200 hours per week)

COVID-19 demonstrates that Public Health Departments need to have national coordination for the purpose of monitoring treatment and tracking population health events.

Reliance on manual data entry by providers and jurisdictions starves those organizations of resources that could better serve the public.

Automation of reporting through a national gateway allows for uniform, scalable and accurate reporting both during outbreaks and under normal daily requirements

*as of September 8, 2020

Reportable COVID-19 reports have been sent to 57 public

health agencies

~1.6M

Facilities have implemented eCR for COVID-19

4,800+

Jurisdictions of 59 have received at least one COVID-19 report from eCR

57

All 50 states, DC and 8 large local jurisdictions have published a rule for COVID-19 and can receive electronic

initial case reports from AIMS

59eCR by the Numbers*

What is so important about eCR data

eCR complements ELR and adds consistent reporting on elements often missing in ELR.• Date of Birth, Sex, Race, Ethnicity, Social History• Address, Telephone, Email• Lab Result, Problem List, Medications, Immunizations• Point of Care testing results• Ask on Order Entry responses• More…

eCR arrives at the Public Health agency in both human-readable and machine-readable format. • Jurisdiction receiving eCR could authorize the removal of manual reporting based on the human

readable report alone. Providers would win through reduced manual reporting and the community would win through more accurate and timely data.

eCR is designed to expand beyond COVID-19 and allow for all reportable conditions and is available today.

It is important to note that Case reporting is mandatory to public health, eCR does not replace the Hospital reporting required by HHS and electronic laboratory reporting (ELR) is leaving significant gaps in patient data that eCR closes.

eCR COVID-19 Production Implementers (as of September 8, 2020)

Sutter Health (CA) OCHIN (19 states) Contra Costa Health Services (CA) MemorialCare (CA) UCLA (CA) UC Health (San Diego/Irvine/Riverside) (CA) Memorial Healthcare System (FL) University of Utah (UT) ThedaCare (WI) Bellin (WI) Skagit Regional Health (WA) Eisenhower Health (CA) John Muir Health (CA) PeaceHealth (AK, OR, WA) Watson Clinic (FL)

Leon Medical Centers (FL) Confluence Health (WA) Premise Health (42 states) University Hospital System (TX) Advocate Aurora (WI, IL) Gundersen Health (IA, WI, MN) Vernon Memorial Healthcare (WI) Children’s Hospital of Wisconsin (WI) AltaMed (CA) Stanford Health (CA) UNC Health (NC) St. Elizabeth Healthcare (KY, IN, OH) UC San Francisco (CA) Lee Health (FL) Metro Health (OH) Hendricks Regional Health (IN)

NY Health and Hospitals (NY) Sanford Health (7 states) Hospital Sisters (WI) Group Health Cooperative

of South Central Wisconsin (WI)

Upstate University Medical Center (NY)

Implementing full eCR

Lawrence Memorial Hospital (KS) - Cerner Calhoun County LHD (MI) – Netsmart

Community Medical Centers (CA) Washington Hospital Healthcare System (CA) Northeast Georgia Health System (GA) UMC of Southern Nevada (NV) Vidant (NC) Baptist Health (KY, IN) Norton Healthcare (KY) Kaiser Permanente Northwest (OR, WA) The Portland Clinic (OR) Johns Hopkins (MD) Brookdale Hospital (NY) Valley Medical Center (CA) BSW Health (TX)

Onboarding with eCR Now for COVID-19 (as of September 8, 2020)

Jurisdictions that have received COVID-19 eICRs

www.ochin.org

Thank you!

www.ochin.org

If you have questions, please reach out to us today.

5