The grant enables VIM to partner with NoMoreClipboard, a company based in Fort Wayne that operates “personal health records,” a complete summary of a person’s medical history accessible online at NoMoreClipboard.com; and a “health information exchange,” a system that electronically moves a patient’s clinical health care information among health care providers in a particular community or region.

NoMoreClipboard.com is an online, patient-controlled health record management system that consolidates medical information securely for easy retrieval and updates. It enables patients to share medical information with professionals electronically, reducing the need to complete repetitive paperwork.

“A personal health record provides a way for patients to actively manage and monitor their health information,” said Elizabeth Thompson, VIM’s executive director. “A patient can use it to keep track online of his allergies, chronic diseases, medications, family history and X-ray reports and print it out and take to the doctor’s office with him; or go to the doctor’s office and look up the information with a phone or smart phone.”

The partnership calls for the personal health record to be filled with health information that exists in the HealthLINC clinical messaging system used by more than 270 physicians and medical staff in Bloomington.

Within the next month, one group of VIM patients will be provided with a personal health record they’ll be able to access primarily by computer — either at home, a public library or the VIM clinic.

A second group will be provided with additional access to their personal health record via a smart phone with a data plan, and will be given a $20 monthly stipend to help subsidize their data plan. They will be asked to input their glucose readings into their phone, which will upload to their personal health record. A third group, which will serve as a control group, will not use a personal health record.

“This will enable us to determine the potential impact that using a personal health record can have in improving diabetic compliance, improving clinical outcomes and reducing costs,” Thompson said. “It will also will enable VIM to determine the potential value of offering a personal health record application to its entire patient population.”

Thompson said many VIM patients are referred to doctors and specialists in the area who provide free or low-cost care.

“But coordinating care can be a challenge because these patients move from provider to provider,” she said. “Without a means of easily sharing patient information, providers lack access to clinical data, including medication lists, allergies, conditions and lab results. This lack of data invariably contributes to service duplication, unnecessary costs and avoidable errors.”

Thompson said if the program involving diabetic patients goes well, VIM will expand its offer of personal health records to all its patients. That project will be funded by part of a $1.25 million federal grant to NoMoreClipboard and Indiana Health Information Technology Inc. that will provide patients in the state with access to health information exchange data.

Thompson said Indiana has five health information exchanges that routinely move health information among physicians, hospitals, and labs on behalf of patients — but without patients being active participants. The grant will enable patients to electronically monitor their personal health records.

“It’s exciting that VIM is part of this,” Thompson said. “It will be huge news if we can show that this program can help people, particularly highly vulnerable people like VIM patients, improve their health over time.”

Source:  HeraldTimesOnline.com 2011

To view the PowerPoint slides used by speakers, click on the presenter’s name.

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Proposed Agenda

7:30a—Registration & Breakfast
8:00a—Meeting Begins
10:00a—Break/Networking
12N—Lunch (provided)
4:00p—Meeting Adjourns
4:30p—Vendor Exhibits Close

Topics to Include

• EPrescribing
• Personal Health Records
• Meaningful Use/CMS Incentives
• Quality Reporting
• Selecting a cost-effective EHR
• Privacy/Security
• Community Repository of Electronic Health Info

Education session 20, “HIE Connectivity Using the NHIN: Lessons from the SSA, C-HIEP and NHIN Projects,” Thursday at 11:30 AM-12:30 PM CST highlights real-world interoperability projects that have successfully enabled entities to exchange patient data.

Todd Rowland, MD, executive director of HealthLINC, and Rodney Cain, chief technology architect of HealthBridge, will discuss their respective HIE projects, which include collaborating with the Social Security Administration and the Centers for Medicare & Medicaid Services, among other federal and private-sector partners.

The projects range from the NHIN Prototype Architecture, CMS’ CARE Health Information Exchange Project (C-HIEP) and SSA’s electronic disability determination.

Leaders of HealthLINC, a community-based organization serving South Central Indiana, applied for NHIN grants in 2008 as a way to achieve enhanced interoperability, according to Rowland. HealthLINC partnered with HealthBridge on each phase of the NHIN work it participated in, he said.

“The ongoing work with NHIN and other interconnecting projects clearly demonstrates the power of interoperability,” Rowland said. He pointed out that enhanced interoperability will enable providers to integrate and reuse clinical information.

In addition, technology companies can contribute to significantly improving patient safety by developing applications and services that deliver enhanced interoperability.

“NHIN has become an essential method for federal agencies like CMS, SSA, DOD (Department of Defense) and VA (Veterans Affairs) to connect to each other and with the private sector,” he said. “We are likely to see a significant growth in reporting requirements with federal agencies as healthcare reform unfolds, so all providers will need to have this capacity.”

November 03, 2010 | Patty Enrado, Special Projects Editor

Source:  Healthcare ITNews

Why is that important? It gives caregivers the information they need at the time they need it to improve patient outcomes.

“The single most important thing,” said Andrew VanZee, state health IT director, “is to provide information at the point of care.”

Imagine your aging parent falls ill while visiting you from another part of the state. Then think about taking this loved one to your local ER knowing physicians there can call up a medical record and learn about your parent’s chronic conditions, medications or recent surgeries. Or, what if you were that ER doctor; how helpful would the information be in your treatment plan?

Devising a roadmap
Our state has a strategic roadmap for health information technology projects and electronic connectivity, as well as funding to move us down that road over the next five years. VanZee detailed those plans at a CME session offered during the ISMA convention last month.

Strategies encompass the five pillars shown in the diagram, working with Indiana’s current health information exchanges: HealthBridge, HealthLINC, MedWeb, MHIN (Michiana Health Information Exchange) and IHIE or Indiana Health Information Exchange.

Connectivity goals call for helping an additional 30 rural/critical access hospitals to exchange information, as well as 100 federal qualified health centers and rural health clinics, and 50 lab and radiology facilities. Most existing connectivity is in large metropolitan areas and along major highways.

Already efforts are underway to complete data mapping and normalization that will provide preferred standards for data elements. “That is so the various information exchanges around the state can talk to each other,” explained Van Zee.

The standards will cover patient identification, radiology and lab results, and clinical documents.

Privacy and security are part of the plan, too. Funding already granted will help with policy development, gap analyses and planning to address any gaps discovered in the safeguarding of information.

“The goal is to improve the process to help information flow both ways,” VanZee explained. For example, physician offices will send text or exam results to hospitals, as well as receive information from those hospitals.

Read more on the Indiana Health IT website.

View Full ISMA e-Report  
 10/20/2010

What belongs in an HIE RFP? Specifics vary, but the best RFPs include:

•Specifications based on extensive input from stakeholders
•A clear vision of the tasks the HIE will perform
•Well-defined technical expectations
•Maintenance and upgrade needs
•And be sure to include that the vendor must be cooperative and roll with technological and administrative changes.

‘The ability to connect’
In October 2009, when the West Virginia Health Information Network released its RFP for a statewide HIE platform, “we were looking at the ability to connect with a number of healthcare providers throughout the state and certainly to connect the provider community and insurance companies, along with hospitals,” says Dennis Belter, CIO of the network.

Connecting with state registries also was important, says Belter. “We wanted to be able to look at things like public health and immunization,” he notes. 

The RFP results? Twelve companies submitted proposals, 11 were considered in the first round of evaluations and five were selected to demonstrate their capabilities before a group of stakeholders. The group hopes to name two finalists after the vendor demonstrations are complete, then move into negotiations and select a final vendor this month.

“We are planning an implementation for the fall, with a plan of going live sometime mid- to late fall,” Belter says.

In the beginning, the network determined that connectivity requirements and technical specifications would be the central components of the RFP, Belter says. “We were aiming for those companies that had been involved in other statewide HIEs or … those that had been involved in putting together community information networks or regional health information networks.”

To develop its RFP, the network enlisted a consulting firm, a physician advisory group, and Functionality, Data Standards, Privacy and Security, and Technology task force groups totaling 60 stakeholders from across the state. The groups also were charged with ensuring that the RFP was responsive to the Office of the National Coordinator for Health Technology (ONC) requirements around meaningful use. Hospitals and government agencies throughout the state were contacted for input as part of the effort.

Twelve companies responded to the RFP, and 11 were found to have met the RFP’s minimum guidelines, Belter says. Those vendors were entered into a “pretty extensive scoring process,” that focused on technical capabilities, functionality, and implementation and training sections.

Five vendors emerged from this process, and moved on to the next round—full-day product demos for a group of 20 to 25 stakeholders, representing physicians, hospitals and state agency representatives, based on scripts provided by the evaluation group, Belter says. “We put together a whole new scoring structure, so the vendors who made it through the scoring process all started out at square one again.”
Making the Cut
Here are four things that every RFP should include, but are often overlooked in the development process.

•Flexibility. With healthcare reform and meaningful use requirements likely to change over time, it is important to focus on flexibility throughout the process. “We put a lot more in the RFP, so we would have more of our bases covered,” says West Virginia Health Information Network CIO Dennis Belter.
•Expertise. RFPs should be tailored to attract vendors that have experience with the organization’s particular type of HIE, and will be “more of a partner than just a vendor,” Belter advises.
•Stakeholder involvement. In order for the eventual implementation of an HIE to be successful,  “there needs to be a very significant community physician engagement process, in any selection of system that we expect multiple physicians to use,” says Todd Rowland, MD, executive director of HealthLINC.
•Business specifics. “People should go into these efforts with a good business case in mind,” says Holt Anderson, executive director of the North Carolina Healthcare Information and Communications Alliance (NCHICA). The facility or group must determine “why are we doing this?” he says.
 
Regional approach
One RFP won’t fit all; each community involved follows a different pathway to HIE selection and implementation, says Todd Rowland, MD, executive director of HealthLINC, an HIE in Southern Indiana.

In the case of HealthLINC, the process “was lengthy, and required significant community physician engagement, as would any selection of a system that we expected multiple physicians to use,” Rowland says.

Committees had to be developed for the creation of a RFP that would include multiple organizations and stakeholders, including tech support staff from hospitals, large physician practices and radiology facilities, Rowland says. “With multiple organizations weighing in, we had a pretty good level of participation for that process,” he says.

A detailed RFP was developed and deployed in 2006. “We received eight responses [and] were able to narrow the choices to six immediately, because two of the vendors did not meet basic requirements that were seen as mission-critical,” recalls Rowland. These included a requirement to work with HL7 codes. If the organization were creating an RFP today, prospective vendors’ products would need to be compatible with additional standards, such as Continuity of Care Document (CCD) and RxNorm, he adds.

“We also wanted to know if [the vendors] had experience with scaling to a community of our size, and we wanted to [know] the number of deployed sites,” he says. This was a challenge in 2006, because there was much less information regarding HIE successes and failures than is available today. “Many people didn’t know what HIE was at the time,” he notes. “We had really excellent consultants, however, who understood how this related to any other community process or technology, and helped us through this process.”

Technical assessment was a big part of the RFP process: “We wanted to make sure a lot of options presented to the larger medical community would be technologically supportable,” he says. Two vendors emerged from the technical assessment phase.

The final evaluation was “a two-day process where we had 65 people involved, including a technical group, physicians, practice administrators and hospital leaders, all having the opportunity to see the different software systems and ask their different sets of questions.”

Participants then completed a formal survey. “We basically spent two full days running the vendors through the paces, and in that process it was clear that the Axolotl/Healthbridge combination came out of that process for us,” he says. 

A Gateway RFP
On February, the North Carolina Healthcare Information and Communications Alliance (NCHICA) released an RFP for the NCHICA Gateway, a platform that would connect the data link of the Western North Carolina Health Network—a health information exchange organization that links 16 hospitals—to the Nationwide Health information Network (NHIN).

Throughout the RFP process, a group of contractors led by Andrew Weniger, project manager of NCHICA, the agency “attempted to give as much information as they could to get a tight group of proposals in return,” says Holt Anderson, executive director of the alliance.

The RFP included technology requirements, implementation and testing provisions, as well as operational and maintenance conditions. However, “I think sometimes we focus too much on the technical side, so we spent approximately half our time on policies and procedures,” says Anderson.

Ongoing upgrades were a key requirement for the Gateway, he says. “We needed to know what the gateway would be beyond just the implementation and first phase. We had to know what it would take to keep it running.” In addition, the RFP included the requirement that the Gateway support all nationally recognized data code sets and exchange standards, including HL7, X12, DICOM and NCPDP.

“We had a lot of interest, and nine vendor proposals,” recalls Anderson. This group was whittled to three and eventually, Mirth was selected. Testing is now under way, with actual production slated for early fall.
Last Updated ( Tuesday, July 27 2010 )

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Cincinnati, OH – HealthBridge, a not-for-profit health information organization serving the Greater Cincinnati tri-state area, has launched its new Tri-State Regional Extension Center (REC).  The Tri-State REC will help physicians and other medical professionals switch from paper records to using cutting-edge information technology to improve patient care.

“This program is fundamentally about improving patient care,” said David Groves, Executive Director of the Tri-State REC.  “The Tri-State REC will be a vital source of information for physicians and other health care professionals who are interested in using technology to provide high quality, cost-effective care.“

The Tri-State REC was founded through a $9.7 million federal grant. The goal of this new initiative is to help more than 1,700 physicians with the switch to electronic health records.

The launch of this new initiative was part of a Meaningful Use Conference hosted by HealthBridge that had roughly 300 people in attendance. The conference provided valuable information to physicians and practice staff about new federal funding under the economic stimulus bill for physicians who use health IT to improve patient care.  Overall federal incentive payments could bring in as much as $75 million in additional federal funding for the tri-state region.

The kickoff was attended by state and regional leaders who were supportive in bringing this new initiative to the tri-state area, including state officials from the Ohio Governor’s Office, the Kentucky Cabinet for Health and Family Services, and the Indiana Family and Social Services Administration.

“This new program is another example of our region’s national leadership in the use of health information technology and exchange,” said Bob Steffel, Executive Director of HealthBridge.

The Tri-State REC will serve southwestern Ohio, northern and northeastern Kentucky and southeastern Indiana.  HealthBridge has partnered with other health information technology leaders to implement the program, including  the University of Kentucky, Northern Kentucky University, Collaborating Communities Health Information Exchange, HealthLINC, Northeast Kentucky Regional Health Information Organization, Health Care Excel and Ohio KePRO as well as a variety of other supporting organizations from across the region.

View Detailed Agenda at www.heatlhbridge.org

“We are taking initial calls now and are already meeting with small practices,” said Monica Arrowsmith, director of the REC at Purdue.

Todd Rowland, M.D., executive director of HealthLinc, a HealthBridge partner, said “Achieving federal incentives for meaningful use will take time, so it is important to get started.” HealthBridge has several hundred practices already committed.

Here are answers to some questions about RECs as they open for your business.

What exactly is a REC?

Across the country, these centers will serve defined geographic areas to support at least 100,000 primary care physicians and providers (small practices and those serving safety-net populations) to achieve meaningful use of EHRs for nationwide health information exchange.

What can a REC do for me – and what can’t it do?

RECs cannot give you money to purchase an EHR, software or hardware. Also, you can receive federal incentive dollars only if you achieve all 25 meaningful use criteria by specified deadlines.

However, the RECs can help you maximize available funding through direct, on-site support so you can:

• Select the certified EHR product that best meets your needs
• Enhance and expand your use of an existing EHR
• Implement an EHR within federal timelines
• Enhance workflow, maximizing your system to improve quality of care
• Avoid common mistakes and check all the boxes to qualify for incentives
• Comply with legal, regulatory, professional and ethical requirements to protect privacy and security of patient information

Why should I have an EHR system?

While there is little consistent evidence EHRs improve quality or cost, the real promise of EHRs is:

• Practice operations will be more efficient.
• Patient records will be accessible to you anywhere, anytime.
• Medical errors and redundant costs will be reduced.
• Integration of evidence into care practices will be accelerated.

Should my patient referral patterns determine which REC I use?

You should not alter your referral patterns in any way for EHRs or RECs because by 2012, all health information exchanges in the state (currently five) must be able to exchange data with each other. So, no matter where you refer patients, their medical records should be accessible.

See the HealthBridge 19-county target area in the map here.

What do I need to do to get started?

Find information about the Purdue REC here; you’ll need to complete a short survey to get started.

Find information about HealthBridge Tri-State here; an “Interest Form” is available on the site.

Do I have to pay for REC services?

The RECs charge some fees, but they cost far less than other consultants since RECs are non-profit and supported by federal grants. The Tri-State REC does not charge to assist practices already using EHRs attain meaningful use.

I’m a specialist; can the RECs help me?

RECs will provide education to all health care providers about health information technology, EHR and information exchange, as well as process redesign, workforce support and quality improvement.

Will the RECs direct me to certain vendors?

RECs are moving through a vetting process right now to develop a list of preferred vendors that will enable them to offer group discounts on proven, certified products. Vendors are responding to a Request for Proposal issued in early May.

What if I already have an EHR, can a REC help me?

Yes, the REC will assist you to reach the maximum benefit from your EHR system.

What amount am I eligible to receive for reaching meaningful use?

Each eligible professional may qualify for incentives up to $44,000 for Medicare or up to $63,750 for Medicaid (not both) over the next few years for meeting meaningful use of health information technology.

For background on RECs, see the March 8 and April 5 issues of ISMA Reports on the ISMA website.
 

The award winners include several chief medical informatics officers and an executive director of a regional health information organization. They are:

• Russ Cucina, medical director of information technology, UCSF Medical Center, San Francisco.
• C. Martin Harris, chief information officer, Cleveland Clinic, and executive director, e-Cleveland Clinic.
• Ted Kremer, executive director, Greater Rochester (N.Y.) Health Information Organization.
• Michael Oppenheim, vice president and chief medical information officer, North Shore-Long Island Jewish Health System, Great Neck, N.Y.
• Todd Rowland, executive director, HealthLINC, Bloomington, Ind.
• Chris Snyder, chief medical information officer, Peninsula Regional Medical Center, Salisbury, Md.
• Jonathan Sykes, chief medical informatics officer, Allegiance Health, Jackson, Mich.
• Marilou Terpenning, managing partner, Santa Monica (Calif.) Hematology-Oncology Consultants.
• Sidna Tulledge-Scheitel, medical director for global products and services, Mayo Clinic, Rochester, Minn.

This year’s winners were chosen from among 63 applicants, and they will be honored July 14 at the 19th annual Physician-Computer Connection Symposium in Ojai, Calif., said Rich Rydell, CEO of AMDIS.

More at AMDIS.org