Connecting Healthcare Stakeholders Through HIT and Health Information Exchange

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Connecting Healthcare Stakeholders Through HIT
and Health Information Exchange

• The Inland Northwest Health Services Story
• Thomas Fritz, CEO

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Inland Northwest Health Services

• INHS is a not-for-profit 501(c)3 corporation
  created in 1994, owned by the hospitals in
  Spokane and serving residents of WA, ID, MT, OR
  and Canada. We facilitate clinical care by
• Improving clinical outcomes through information
  access and integrated clinical systems for
  physicians, hospitals, clinics and other health
  providers
• Acting as the trusted party and secure
  custodian for the regional clinical data
  repository and a community-wide electronic
  medical record and serving as a neutral party for
  all hospital-based collaboration
• Leveraging collaborative assets to control costs
  and provide high levels of expertise using shared
  resources

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Scope of System

• 32 hospitals, with over 3,000 beds, participating
  in the integrated information system
• More than 400 Physician practices are able to
  view hospital, laboratory and imaging data via a
  private network.
• More than 700 physicians accessing patient
  records and 225 wirelessly in hospitals via
  personal digital assistants
• 67 hospitals, clinics and public health agencies
  connected to the regions telemedicine network
• 180 member technical staff serving over 18,000
  end users

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Community RHIO Governance

• Inland Northwest Community Health Information
  Project (INCHIP)
• Advisory and decision-making body on
  community-wide health information standards and
  processes
• Voluntary coalition, with members meeting
  regularly to discuss and make recommendations and
  decisions
• Governed by Board of Directors with physician,
  non-physician, and community representatives
• Obtain agreement on key issues, I.e. data
  exchange processes and standards

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500,000 Local Area Population
Largest Healthcare Service Availability Between
Seattle and Minneapolis
9,000,000 Regional Population
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INHS Regional Network 3 to 5 Years
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Physician EMR Views per Month
EMR Views per Month Office Staff 36,000
Physicians 49,000
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Accomplishments

• We have improved clinical outcomes through
  information access and integrated clinical
  systems for physicians, hospitals, clinics and
  other health providers
• We have become the trusted party and secure
  custodian for a regional clinical data
  repository.
• We have leveraged collaborative assets to control
  costs and provide high levels of expertise using
  shared resources

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Accomplishments

• We established a regional Master Patient Index
  standard that has allowed us to gather and
  distribute patient data to the caregivers in our
  region
• We established standard data sets, allowing
  comparison of clinical data and enhancing the
  longitudinal patient record
• We created a regional integrated information
  system that connects hospitals, clinics and
  physician offices, providing a community
  Electronic Medical Record

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Accomplishments

• We connected Physicians throughout the region,
  directly in their offices and wirelessly within
  our hospitals, providing relevant clinical data
  when and where they need it
• We enhanced care in rural areas by connecting
  residents and clinicians to specialists through
  an extensive regional telemedicine network
• We increased patient safety by utilizing advanced
  systems

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Obstacles and Challenges

• Limited funds from rural hospitals slows their
  adoption of key clinical systems
• Each new hospital brings new challenges wanting
  everything for nothing
• Minimal physician office automation has slowed
  the longitudinal electronic medical record
• Poor IT investment decisions hospitals and
  physicians are buying IT without knowing enough

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What we have learned

• Creating a sustainable business model
• Leverage assets
• Provide an efficient cost plus model
• Create standardization
• Assure value-added services
• Assure quality of services
• Get lowest cost from vendors
• If you do these things, customers will stay and
  the business will be sustainable

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What we have learned

• Drivers are what affect joint ventures
• Are the drivers financial? Probably should look
  at standardization of information systems
• Are the drivers clinical (data exchange)? Can
  focus on data standards for information sharing
• Identify the real business needs of the
  participants and their communities

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What we have learned

• How do you create sharing among competitors?
• Let competitors run on the same network
• Governance needs to be neutral, not favoring any
  competitor
• Neutral governance organization can promote
  agreements on common issues (MPI, network
  standards, etc)

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What we have learned

• Community governance organizations take work
• Members continuously jockey for position
• Members have to be willing to set aside
  self-interest
• Everyone has to keep working at it
• Organization must have structure. expectations
  for conduct, and ground rules for communication
  and problem-solving

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Thank You
Tom Fritz fritzt_at_inhs.org Fred
Galusha galushf_at_inhs.org Jac Davies daviesjc_at_inhs
.org www.inhs.org