Presentation for HIT SUMMIT WEST March 8, 2005 Presenter: Mike Skinner

Presentation forHIT SUMMIT WEST

March 8, 2005Presenter: Mike Skinner

SBCCDE, Inc.a 501c3 company

Mike SkinnerExecutive Director

(818) [email protected]

Initial Funding Support

California HealthCare Foundation (www.CHCF.org)

Foundation for eHealth Initiative http://ccbh.ehealthinitiative.org/profiles/SBCCDE.mspxThis project is funded in part through a contract with the Foundation for eHealth Initiative (“FeHI”) and their cooperative agreement with HRSA, Office for the Advancement for Telehealth (“HRSA/OAT”). The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official view of HRSA/OAT or FeHI.

RHIOs Regional Health Information Organizations (RHIOs) are being formed across

the country in response to the “Framework for Strategic Action”, published by Dr. David Brailer, National Coordinator for Health Information Technology, as a guide for national adoption of community-based, interconnected Electronic Health Records (EHRs) within 10 years.

SBCCDE was Dr. Brailer’s vision of what we know today as a RHIO

SBCCDE is oriented around decision-making improvements at the time of care

Current & future RHIOs may also focus on other community health care functions such as post-care analysis, disease management, and disease and immunization registry

Governance 501c3

Tax Exempt Status Funding Opportunities

Board of Directors representation Physician community Business community Consumers

Mr. Phillip Greene, COO, Santa Barbara Regional Health AuthorityChairman, SBCCDE(805) 685-9525, [email protected]

Mr. Paul Jaconette, CFO, Sansum-Santa Barbara Medical Foundation ClinicTreasurer, SBCCDE(805) 681-7700 [email protected]

Mr. Dan Herlinger, Consumer & Business AdvocateSecretary, SBCCDE(805) 966-7697, [email protected]

Dr. George Hiester, President, MidCoast IPA, Board Member, SBCCDE(805) 925-2521, [email protected]

Mr. Roger Heroux, COO, Santa Barbara Public Health DepartmentBoard Member, [email protected]

Dr. Owen Stormo, Cottage ER PhysicianBoard Member, SBCCDE(805) 886-1326, [email protected]

Mr. Alberto Kywi, CIO, Cottage Health SystemsBoard Member, SBCCDE(805) 682-7111, [email protected]

Mr. Jim RaggioCFO, Lompoc Valley Community Healthcare OrganizationBoard Member, SBCCDE(805) 737-3301, [email protected]

Ms. Sue Anderson, CFO, Marian Medical CenterBoard Member, SBCCDE(805) 739-3110, [email protected]

Board of Directors

Financial Sustainability Benefactors still not well understood or measured “If you build it, they will come” it still needs to be built, then see

who comes Public/grant funding for startup costs (need to be a 501c3) Large stakeholders and/or data contributors

Community hospitals Reference laboratory Community medical groups Large companies with high employee base Private health plans State plans Pharmacy companies

Local tax support

Access to Data is the Key“Content is King”

Timely access to data saves lives Above all, orient your RHIO around access to current and historical data Keeping data access in mind, fashion your mission statement; then, proceed

with RFIs/RFPs and focus on solutions that most closely match your mission Questions to ask:

Is the goal more ambulatory/point-of-care (as in SBCCDE)? Is the goal to provide post-encounter functions such as outcomes,

disease management? Is the goal to improve financial operations by automating admin

functions? Or all of the above?

Have a long-term plan, but start small & build to your mission

Technology Peer-to-Peer (P2P) NO centralized database Not an EMR; rather, a community EMR

broker/switch Think of as highly secured clinical search engine

CDE-OOGLE.com – query for patient, then follow links (see ILS)

“Look & Leave”

Identity Correlation Service (ICS)

Be bathed in demographics, and use all of them Educate/train providers on improving match data Be prepared to manually manage mis-matches Conduct periodic assessments (have a policy &

procedure for this) For SBCCDE, this is the only database in the system

Clinical Data Repository (CDR)

Don’t exclude legacy (non-P2P) sources [essential to collect & expose as much data as possible]

But, don’t build centralized databases to overcome Use separate hosted CDRs to manage HL7-collected

data, with links to these databases from ILS Re-direct the link once the source system is P2P

compliant

Information Locator Service (ILS)

Maintains the list of “links” Follow the links most useful for the current

condition of the patient Links are sort able by type of data and date range

(MySBCCDE approach depending on role) Oriented around patient care at the time of care ILS can be redirected as legacy systems upgrade

to P2P

Project Status Testing & Certification

Data Feed Integrity & Verification Security, HIPAA Compliance Physician & Staff Testing

Deployment & On-Going Training – Spring 05

Measuring Success Stable and financially-secure operations Number of users and inquiries increasing

steadily Number of lives covered Physician & Patient testimonials of real-

world impact Consumer support

Consumer Understand the consumer in your community

Engage the local university to set up consumer focus groups & surveys

Work with local school districts to build interest in high schools Don’t leave out, but don’t over-engage prematurely Win the support of the physician first, let the physician be your

champion to reach the consumer Be prepared to respond to serious concerns from consumers and

consumer groups – have an informational tri-fold that physicians can hand out to consumers as an educational device (specify Privacy Officer, complaint procedures, etc)

At the right time, build consumer “user groups” and co-opt the consumer advocacy groups in your community

Lessons Learned Invite everyone to the table Establish governance early, and follow By Laws procedures If 501c3, apply for federal exemption ASAP – it takes time & energy Hire an experienced legal firm, and keep them in the loop at all times Execute agreements early, especially data provider and user

agreements Don’t try to pop all the corn in the field – set achievable goals & march

toward them Don’t let the seemingly impossible list of challenges overwhelm you –

block and tackle Spell out all interface & data specifications in excruciating detail, and

hold everyone to them Hold your vendor to their obligations, but meet your own obligations too

CareScience, Inc.CareScience.com

A Quovadx CompanyContact: Jerry Rankin (415) 546-3009

[email protected]__________________________

https://cde.carescience.com

Presentation for HIT SUMMIT WEST March 8, 2005 Presenter: Mike Skinner

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