New Jersey Health Information Network (NJHIN) RFI Response Evaluation

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Theme 3 Exchange and Health Information
Organizations This slide starts the third theme
of the Health IT Champion Program This theme
will be the topic that we focus on for the next 2
months
www.nj.gov/njhit
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Introduction to Exchange and Health Information
Organizations

• Based on www.healthit.gov

www.nj.gov/njhit
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Health Information Exchange or Health Information
Organization

• Health Information Exchange (HIE)
• Verb The electronic sharing of health-related
  information among organizations
• Health Information Organization (HIO)
• Noun An organization that provides services to
  enable the electronic sharing of health-related
  information. Sometimes referred to as an HIE.

Source http//www.healthit.gov/providers-professi
onals/health-information-exchange
www.nj.gov/njhit
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HIOs/IDNs

• Jersey Health Connect (McKesson RelayHealth)
• Hospitals
• CentraState Medical Center
• Children's Specialized Hospital
• Clara Maass Medical Center
• Hackensack University Medical Center
• Holy Name Medical Center
• Hunterdon Medical Center
• JFK Medical Center
• Morristown Memorial Hospital
• Newton Memorial Hospital
• Overlook Hospital
• Robert Wood Johnson University Hospital (New
  Brunswick, Hamilton, Rahway)
• Saint Barnabas Medical Center
• Saint Clare's Hospital (Denville Campus, Dover
  General, Sussex)
• Saint Peter's University Hospital
• Somerset Medical Center
• Trinitas Regional Medical Center
• Physicians

• Health-e-cITi-NJ (IGI Health / ORBIT)
• Hospitals
• Christ Hospital
• East Orange General Hospital
• Jersey City Medical Center
• Meadowlands Hospital Medical Center
• Newark Beth Israel Medical Center
• Saint Michael's Medical Center
• St. Joseph's Hospital (Paterson, Wayne)
• UMDNJ-University Hospital
• Federally Qualified Health Centers
• Newark Community Health Centers, Inc.
• Newark Homeless Health Care
• Horizon Health Center
• North Hudson Community Action Corporation Health
  Center
• Metropolitan Family Health Network
• Paterson Community Health Center
• Home Health
• Visiting Nurse Association of Central Jersey

• Trenton Health Team (Covisint)
• Public Health Department
• City of Trenton
• Hospitals
• Capital Health Regional Medical Center
• Capital Health Medical Center Hopewell
• St. Francis Medical Center
• Federally Qualified Health Center
• Henry J. Austin Health Center, Inc.

• MOHIE (ICA)
• Hospitals
• Bayshore Community Hospital
• Community Medical Center
• Jersey Shore University Medical Center
• Kimball Medical Center
• Monmouth Medical Center
• Ocean Medical Center
• Riverview Medical Center
• Southern Ocean Medical Center
• Federally Qualified Health Center
• Monmouth Family Health Center

• Camden (Noteworthy)
• Hospitals
• Cooper University Hospital
• Kennedy University Hospital (Turnersville, Cherry
  Hill, Stratford)
• Lourdes Medical Center of Burlington County
• Our Lady of Lourdes Medical Center
• Underwood Memorial Hospital
• Virtua Hospital (Berlin, Marlton, Memorial,
  Voorhees)
• Federally Qualified Health Centers
• CAMcare Health Corporation
• Project Hope, Inc.

Salem

• Integrated Delivery Networks
• Hospitals
• AtlantiCare Regional Medical Center (Atlantic
  City, Mainland Campus)
• South Jersey Healthcare (Regional Medical Center,
  Elmer Hospital)

www.nj.gov/njhit
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What's in an Electronic Health Record (EHR)?
An EHR may contain such information as

• Medical history
• Diagnoses
• Medications
• Immunization dates
• Allergies
• Radiology images
• Lab and test results

Source http//www.healthit.gov/patients-families/
faqs/what-information-does-electronic-health-recor
d-ehr-contain
www.nj.gov/njhit
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Where Does Information Come From/Go?
Potential sources of information involving EHRs
Medical History Allergies Diagnosis Medications Im
munizations
Medications
EHR
Lab
Specialist
Medical History
Hospital
Imaging
HIO
www.nj.gov/njhit
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Where Does Information Come From/Go?
EHRs may be connected to the community hospital
EHR
HIO
EHR
Hospital
EHR
EHR
www.nj.gov/njhit
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Where Does Information Come From/Go?
Hospitals and physicians join together in HIOs
Hospital
EHR
Hospital
EHR
EHR
HIO
Hospital
EHR
Hospital
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Why do EHRs Share Information?

• EHRs provide a single resource
• Created, managed and consulted by authorized
  providers and staff across more than one health
  care organization
• To improve coordination of care
• Information comes from all the providers involved
  in a patients care and links to information in
  other providers EHR systems
• To provide higher quality and safer care
• Information can move with the patientto the
  specialist, the hospital, the nursing home, the
  next state
• To allow information sharing beyond the health
  care provider who first collects information
• Information can be shared with patients and with
  other providers, such as labs and specialists
• To help provide patients with access to their
  health information
• Information can be viewed and updated by the
  patient

www.nj.gov/njhit
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EHRs Privacy and Security

• HIPAA Privacy Rule and HIPAA Security Rule
  provide Federal protections for individually
  identifiable health information called protected
  health information (PHI).

• Privacy Rule protects paper, electronic, and oral
  information.
• Security Rule applies only to information
  maintained in electronic form, sometimes referred
  to as e-PHI. This includes information in EHRs.

Source http//www.healthit.gov/providers-professi
onals/privacy-security
www.nj.gov/njhit
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Why Health Information Exchange Is Important

• Exchanging health information electronically is
  the foundation of efforts to improve health care
  quality and safety. HIE can provide
• The connecting point for an organized,
  standardized process of data exchange across
  statewide, regional, and local initiatives
• The means to reduce duplication of services
  (resulting in lower health care costs)
• The means to reduce operational costs by
  automating many administrative tasks
• Governance and management of the data exchange
  process

Source http//www.healthit.gov/providers-professi
onals/health-information-exchange
www.nj.gov/njhit
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NwHIN, Health Plans
Conceptual Technical Architecture Full Operation

• NJHIN
• Onboarding
• Security Compliance

State Govt HIO

• State Data Sources
• Immunizations
• Medicaid
• Blood Screening
• Bio surveillance
• DMV Demographics
• Other registries

GATEWAY

• Health Entity Directory
• Web Services Registry
• Provider Directory
• (supporting DIRECT)
• Provider Credentialing

• State Gateway Services
• Relay Service (External Queries)
• Patient Discovery Document Exchange
• Statewide Data Aggregation

Certificate Authority
NJHIN Core Services
Health-e-cITi
Trenton Health Team
Camden
MOHIE
Jersey Health Connect
Surescripts Labs
Physician Office
IDN
Hospital
Long Term Care
EMS
EMS
Home Health

• NJHIO Nodes
• Pt Discovery Document Exchange Gateways
• HIO-level MPI
• HIO-level Record Locator
• Consent Mgmt (interim)
• DIRECT Services
• Security Compliance

Hospital
Assisted Living
Behavioral Health
Physician Office
www.nj.gov/njhit
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Health-e-cITi-NJ HIO Snapshot
http//healthecitinj.org/
HIO Area HIO Details
Counties Passaic, Essex, Hudson
Hospitals Christ Hospital East Orange General Hospital Jersey City Medical Center Meadowlands Hospital Medical Center Newark Beth Israel Medical Center Saint Michael's Medical Center St. Joseph's Hospital (Paterson, Wayne) UMDNJ-University Hospital
FQHCs Newark Community Health Centers, Inc. Newark Homeless Health Care Horizon Health Center North Hudson Community Action Corporation Health Center Metropolitan Family Health Network
Other Key Partners Horizon Health Center VNA of Central Jersey MONOC Visiting Nurse Association of Central Jersey
Technology Vendor IGI
Highlights Improving care to the significant Medicaid population served by the participating entities and providers in the greater Newark area. Facilitating HIE will improve quality, coordination of care, reduce costs, and result in measurable outcomes.
www.nj.gov/njhit
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Jersey Health Connect Snapshot
http//www.jerseyhealthconnect.org/
HIO Area HIO Details
Counties Bergen, Essex, Hunterdon, Mercer, Middlesex, Monmouth, Morris, Somerset, Sussex, Union
Hospitals CentraState Medical Center Children's Specialized Hospital Clara Maass Medical Center Hackensack University Medical Center Holy Name Medical Center Hunterdon Medical Center JFK Medical Center Morristown Memorial Hospital Newton Memorial Hospital Overlook Hospital Robert Wood Johnson University Hospital (New Brunswick, Hamilton, Rahway) Saint Barnabas Medical Center Saint Clare's Hospital (Denville Campus, Dover General, Sussex) Saint Peter's University Hospital Somerset Medical Center Trinitas Regional Medical Center
FQHCs
Technology Vendor Relay Health
Highlights New Jerseys largest HIO Focused Personal Health Record roll-out to give patients access to their own health data Driven to improve care coordination, access, outcomes and efficiencies through the use of technologies that facilitate real-time clinical data exchange.
www.nj.gov/njhit
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Camden HIE Snapshot
http//www.camdenhealth.org/
HIO Area HIO Details
Counties Burlington, Camden, Gloucester
Member Health Systems and Hospitals Cooper University Hospital Kennedy University Hospital (Turnersville, Cherry Hill, Stratford) Lourdes Medical Center of Burlington County Our Lady of Lourdes Medical Center Underwood Memorial Hospital Virtua Hospital (Berlin, Marlton, Memorial, Voorhees)
FQHCs CAMcare Project H.O.P.E.
Technology Vendor CompuGroup Medical (formerly Noteworthy)
Highlights Governed by Camden Coalition of Healthcare Providers HIE used as a tool to provide more coordinated care, drive improved patient outcomes, and bend the cost curve HIE data filtered for Camden ZIP codes only (to start) Currently used by 100 Camden healthcare providers to access patient information
www.nj.gov/njhit
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Trenton Health Team Snapshot
http//trentonhealthteam.org/tht/
HIO Area HIO Details
Counties Mercer
Hospitals Capital Health Regional Medical Center Capital Health Medical Center Hopewell St. Francis Medical Center
FQHCs Henry J. Austin Health Center
Other Key Partners City of Trenton Greater Trenton Behavioral Health Catholic Charities Others (see http//trentonhealthteam.org)
Technology Vendor Covisint
Highlights Built on strong community partnership Focused on concentrated geography of 114,000 people within the City of Trenton Immediate aim is to address the 1,800 high-cost/high-utilizers
www.nj.gov/njhit
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MOHIE HIO Snapshot
HIO Area HIO Details
Counties Monmouth, Ocean
Health Systems and Hospitals Bayshore Community Hospital Community Medical Center Jersey Shore University Medical Center Kimball Medical Center Monmouth Medical Center Ocean Medical Center Riverview Medical Center Southern Ocean Medical Center
FQHCs Monmouth Family Health Center
Technology Vendor ICA
Highlights Monomouth and Ocean counties have a very high long-term care patient base and see large seasonal fluxes in its population These factors provide compelling needs for Model of statewide HIE Health information exchange across state lines Personal Health Records
www.nj.gov/njhit
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HIO Participation
Number of Participating Organizations
Metrics Camden Health-e-cITi Jersey Health Connect MOHIE Trenton Total
Hospitals 11 9 20 8 3 51
Other Acute Care Facilities 1 2 0 0 0 3
FQHCs 2 5 0 1 1 9
Long-Term Care Facilities 0 1 1 5 0 7
Labs In House 7 8 8 8 3 34
Labs External 0 0 1 0 0 1
Radiology In House 7 9 8 8 3 35
Radiology External 0 2 0 0 0 2
Mar. 2012
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Tools

• Federal Health IT Website http//www.healthit.gov
  /providers-professionals/compatibility-information
  -exchange
• National eHealth Collaboratives HIE
  ReportHealth Information Exchange Roadmap The
  Landscape and a Path Forward
  http//www.nationalehealth.org/hie-roadmap
• eHealth Initiative on Health Information
  Exchange http//www.ehealthinitiative.org/issues/
  health-information-exchange-hie.html
• Camden Coalition
• Zakaria 5 of U.S. patients account for 50 of
  health care costshttp//globalpublicsquare.blogs.
  cnn.com/2012/03/15/zakaria-5-of-u-s-patients-accou
  nt-for-50-of-health-care-costs/?irefallsearch
• Healthcare in our Camden Jail Video
  http//www.cochs.org/health_reform/hie_conf/unseen
  _provider

www.nj.gov/njhit
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ONC/Federal Health IT Program Resources
Talking to Your Patients About EHRs
Health IT Advancing Americas Health Care
www.healthit.gov
Protecting Your Privacy and Security
Note All four documents are available at
www.nj.gov/njhit
What Patients Need to Know About EHRs -- Trifold
www.nj.gov/njhit
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NJ Health IT Program Resources
www.njhitec.org
www.nj.gov/njhit
New Jersey Health IT Program Overview
www.nj.gov/njhit/ehr
www.nj.gov/njhit