NATIONAL ROLE OF HIE’S IN HEALTHCARE’S FUTURE: BIOMEDICAL

INFORMATICS CHALLENGESAPRIL 10, 2014

JAN ROOT, PH.D. & MATT HOFFMAN, M.D.

UHIN

PAYMENT REFORM: A CHANGING ENVIRONMENT

Fee for Service “Value Based Payment”

Financial Risk All with Payer Shared Payer and Providers

Incentive to Reduce Cost All with Payer Shared Payer and Providers

Incentive to Improve Quality All with Payer Shared Payer and Providers

• Top Three HIT priorities to Accomplish this transition1:

1. Population Health: determine individuals at high financial risk (poor health which can be impacted positively)

2. Health Information Exchange: track patients’ risk in real time (know about the heart attack ASAP)

3. Analytics for Care Pathways: create real-time risk reduction care strategies (implement effective care strategies to improve health outcomes at lowest cost)

1: KLAS Report: Accountable Care Timing 2013, November 2013

WHY IS HIE RATED #2 IN IMPORTANCE?

Hospital A

Unique Shared

Hospital B Hospital C Hospital D

cHIE Shared Patients Data 1

1 cHIE Data, October 2013

• Patients seek care from many healthcare systems in any one market• The shared-risk partnership needs real-time clinical data to

effectively manage risk• Claim data is not timely enough & lacks clinical depth

WHAT DOES THE CHIE DO?• Collect Data and Use it

cHIE

Warehouse

Clean

WHAT INFORMATICS CHALLENGES EXIST?

•Demonstration of CareAchieve• Re-Cap:

1. Population Health: determine individuals at high financial risk (poor health)

2. Health Information Exchange: track patients’ risk in real time (know about the heart attack ASAP)

3. Analytics for Care Pathways: create real-time risk reduction care strategies (implement effective care strategies to improve health outcomes at lowest cost)