Oregon Health Network (OHN)

The Evolution of a Statewide Healthcare Network

Oregon Connections 2013October 24, 2013

• Overview: OHN Joins OCHIN• Evolution of a Monitored Health Network: From Theory

to Practice• Use Case

Agenda

Today

• As a nonprofit organization, our goal is simple: To provide solutions that promote access to quality, affordable health care for all.

A Coordinated Offering: OHN Joins OCHIN

One of the nation’s largest and most successful Health Information Networks

In 14 states, coast to coast

Touching over 4,500 physicians

12 years of data aggregation; 65% to 75% of physical health claims paid by DMAP in the OCHIN database

What We Do

CONNECTIVITY

MEMBER ENGAGEMENT

FEDERAL AND STATE

PROGRAMS

CLOUD EHR SOLUTIONS

ADVOCACY, OUTREACH, &THOUGHT LEADERSHIP

BUSINESS INTELLIGENCE

PROFESSIONAL & KNOWLEDGE SERVICES

RESEARCH

Financial Overview: Priorities & Focus

Hosted HIT Services

57%

Innovation & Research

27%

Outsourced Administrative Service Offer-

ings22%

OCHIN & OHN: Federal Funding for HIT in Oregon

+$20.182m

$56,886,296 in federal funding, with the majority given straight back to

the community

Retained 100% of the healthcare provider community

Expanding healthcare provider community into 4 additional states with another 135-150 new funded sites through the FCC Healthcare Connect Fund:• Washington• Idaho• Alaska• Montana

OHN Membership: The Transition to OCHIN

• Use of Local Internet Exchange (NWAX) and Network Operations Center to monitor ALL connections to maintain quality– Theory:

• Keeping traffic in-state would meet/exceed Service Level Agreements (SLAs)

• Assumption that members would value the monitoring of ALL connections.

• Telecom providers would overcome their initial resistance to having a third party monitoring solution

Evolution: Role of IX & Network Operations Center

2007

• Practice: – Role of NWAX & NOC have successfully met our SLAs

• With increased broadband infrastructure, in-state IX (NWAX) not as important as before, BUT allows local carriers to connect with larger carriers/national exchanges;

• Members valued primary (not secondary) connections to the NOC (data center, etc.)

• Partner vs. Competitor: Telecom providers appreciate the role of the NOC in working with other vendors to troubleshoot issues, as well as the role of OHN in helping to convene “trusted” dialogue with vendors/members

Evolution: Role of IX & Network Operations Center

2007 – Present

• Requirement = 10Mpbs minimum (internet & Ethernet)– Theory: Healthcare providers would see the need for

10Mpbs minimum, and bandwidth needs would continue to increase

– Challenge: Difficult to convince people of this need in a landscape where 1.5 T-1 connection as “norm”

Evolution: Member Network Design/Use

2007

• Requirement = 10Mpbs minimum with a mix of internet/Ethernet configuration– Practice: All healthcare providers are asking for more

bandwidth; common average request is 100Mpbs (clinics, hospitals, etc.):• Better supports expanding broadband-dependent imaging needs • Better addresses spike usage

Evolution: Member Network Design/Use

2007 - Present

• Role of Broadband/Internet in Healthcare Delivery– Theory: Members understand the critical role of

broadband to support healthcare coordination/ advancement (telehealth, etc.)

– Challenge: Other federal programs competed with industry mind-share; focused on meaningful use of EHRs, HIE, etc.

Evolution: Broadband in Healthcare

2007

• Broadband has FINALLY made it to the conversation!– Practice #1: Initially, members and state discussion

thought of broadband as tertiary (at best) to their healthcare transformation efforts

– Practice #2: The new Accountable Care/Coordinated care model requires broad and sophisticated technical connectivity and network requirements…and with OHN’s “just in time” statewide infrastructure in place, conversation has been pushed out of CFO /CIO to CMO’s office

Evolution: Broadband in Healthcare

2007 - Present

• Broadband has FINALLY made it to the conversation!– Practice #3: Members have experienced the failure of

their first-line technology solutions when put to the test on a network that can’t support it

– Practice #4: First in country to have an FCC RHCPP merge with an ONC Regional Extension Center

Evolution: Broadband in Healthcare (cont’d)

2007 - Present

And partnering with California Telehealth Network

Evolution: The Growth of a Network of Networks

Through OHN and the FCC RHCPP, these agencies were able to get access to a network that sufficiently supported the purchase and use of electronic health records and telehealth services to

improve care in the incarceration setting = $$$ millions of dollars of saved taxpayer money:

Case Study: Public/Private Coordination Advancement

• Oregon Department of Corrections (DOC): 14 locations– Purchase (and almost completely installed) $3.5M of

video conferencing to support healthcare delivery; reducing patient costly transports to critical access hospitals AND improve healthcare delivery with the ability to bring in specialists

• Oregon Youth Authority: 31 locations– Summer 2014; will be implementing electronic health

records

Case Study: Public/Private Coordination Advancement