The Louisville Health Record Bank An opportunity to contain costs and improve care for everyone in t

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The Louisville Health Record Bank An
opportunity to contain costs and improve care for
everyone in the greater Louisville area
Developed by the Louisville Health Information
Exchange, Inc.

• December 5, 2006

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• What is LouHIE?
• A community health information exchange using a
  health record bank model
• Why implement a health information exchange?
• Improve health care quality
• Lower health care costs
• Why make it a consumer-driven and community-wide
  approach?
• Consumers privacy rights must be protected
• Consumers receive services from multiple
  providers
• Consumers use different insurance carriers over
  time
• A shared health record is vital to coordinated,
  high quality care

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Louisville Health Information Exchange
Consumer
Community
Collaboration
Connection
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Louisville Health Information Exchange, Inc.

• History
• April, 2004 University of Louisville received
  state grant to research formation of health
  information exchanges
• January, 2006 LouHIE formed community board
• March, 2006 All-community stakeholder board
  held its first meeting
• August, 2006 Consensus on vision/mission,
  business model and implementation plan.

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LouHIE Vision/Mission

• To contain rising costs and improve quality of
  healthcare in the Louisville area by providing
  consumers and their providers anytime, anywhere
  access to complete healthcare information and
  decision-support.

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LouHIE Goal
A community-wide health record bank to facilitate
electronic exchange of health information in the
greater Louisville area

• Consumers have access and control of health
  information
• Connectivity to area providers will be free of
  charge
• Enhanced coordination through connected
  information
• Supports the national goal for each American to
  have an electronic health record by 2015

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Unsustainable National Cost Trends
A new survey of large employers finds businesses
and retirees experienced double-digit increase in
retiree health costs, with further increases
expected. - Findings from the Kaiser/Hewitt
2004 Survey on Retiree Health Benefits
UPS Inc. forecast a health care cost trend rate
of 8.5 percent for 2005 - Louisville Courier
Journal Sep 29, 2006 1,500 is added to the
price of every single GM vehicle simply to cover
healthcare costs GM CEO Richard Wagoner - Feb
2006
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Louisville as a Microcosm
Louisville as a Microcosm

• Healthcare Challenges in Louisville
• Louisville projected to spend 7.9 billion on
  healthcare in 2006
• Could reach 11.1 billion by 2011
• Rising type II diabetes incidence
• Rising untreated asthma incidence
• Rising un- and under-insured populations
• Emergency room over-utilization.

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Cost/Quality Improvement Potential

• Savings of 480 million per year for a population
  of 1.1 Million by avoiding
• 22 million in hospitalizations for adverse drug
  reactions
• 50 million in unnecessary prescriptions
• 44 million in duplicate tests and procedures
• 50 cents per transaction on tens of millions of
  fax/paper/phone messages
• Millions from incentives for healthier consumer
  behaviors

Each identified cost-saving category also
improves care quality and outcomes
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Dying for Data (IEEE Spectrum Oct. 2006)

• Cheryl and Tom Conrad
• In ER, he begins slipping into coma because they
  couldnt find his medical records and couldnt
  reach his physician, though his wife knew exactly
  what he needed to get well

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All-Community Input/Representation

• Based on research on collaborative community
  networks
• All stakeholders represented through board and
  committees
• Includes Purchasers, Payers, Providers and
  Practitioners
• Supports consensus decision-making process

University Health Care/ Passport
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Start-up Timeline
Get Subscriptions
Install Infrastructure Months 7-12
Organize Months 1-6
Drugs, Labs Radiology Months 13-24
Consumer Services Months 25

• Organize board and committees
• Develop business plan
• Develop fund-raising strategy
• Community Input

• Raise 800,000
• Choose vendors and negotiate vendor investment
• Launch Health Record Bank services

• Implement drugs, labs, radiology
• Pre-populate consumer records
• Basic services free to consumers, hospitals,
  physicians

• Bundle service payment into benefits plans
• Start rebates and incentives
• Start consumer messaging

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Projected Purchaser Benefit
Purchasers (individuals, employers, payers,
safetynet funders, etc) representing 500,000
people in Louisville can achieve benefits of 655
Million in 6 years

• Better care and oversight
• Chronic condition management
• Waste
• Reduced inpatient admissions
• Reduced repeat outpatient visits
• Lower ED expenditures
• Decrease in diagnostic procedures

• Medications and e-Prescribing
• ADE savings
• Formulary-driven savings
• Problem driven medication ordering
• Reduction in medication waste
• Fraud and abuse
• Drug abuse and diversion

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Preliminary Costs and Revenues
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Technology is Available

• Several vendors have made feasible proposals to
  LouHIE
• Viable open-source technology anticipated in
  2007

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Everyone participates, everyone wins.Thank You

• Consumer
• Community
• Collaboration
• Connection