Founded January 2005

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Founded January 2005 www.bbrhio.com
Presentation by Dan Kaelin
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ChairmanDan Kaelin, MDVascular Surgery
Associates Co-Vice ChairSharon Roush,
CEO Capital Regional Medical Center
Co-Vice ChairMark O'Bryant, President
CEOTallahassee Memorial Healthcare
Executive DirectorAllen Byington, President
CEOElectroNet Broadband Communications
Board Members
Capital Health PlanJohn Hogan, CEO Capital
Medical Society Karen Wendland, Exec.
Director ElectroNet Broadband CommunicationsAllen
Byington, President CEO KWB Pathology
AssociatesJerry Harris, MD Medical Group of
North FloridaDebra Weller, Administrator Patients
FirstRandy R Reese, MD Rural Medicaid Coalition
of North FloridaRob Lombardo, Director
Radiology AssociatesJohn Detelich, CEO /
Practice Manager Southern Medical Group Debra
Sundberg Tallahassee Community College Dr. Bill
Law, President Tallahassee Ear Nose
ThroatDuncan Postma, MD Tallahassee Orthopedic
Clinic Martin Shipman, President
CEO Tallahassee Primary Care Associates Tom
Harrison, CEO
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Service Area
In collaboration with the Rural Medicaid
Coalition of North Florida
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BBRHIO Mission
Improve the safety, outcomes, privacy and
efficiency of healthcare

• Objectives
• Create a unified healthcare community that is
  electronically connected.
• Provide technical business support to providers.
• Help practices focus on patient care by reducing
  the burdens of patient data sharing for
  providers, thus producing a safer and more
  enjoyable experience for patients.
• Help streamline office workflow for community
  interaction by providing efficiencies and cost
  savings for the healthcare community through
  reductions in paper based communication.

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CRMC
TMH
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Infrastructure
CRMC
TMH
Radiology
TDI
Non Medical
VSA
CHP
CHP.
VPN
CHP.
Remote VPN Users
TNC
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Hospitals _at_ Level 4
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Governance Stakeholder Participation

• Board ratified policy and procedures
• Board ratified Participant agreement
• Committee ratified standard intake form
• Committee ratified e-referral form

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RHIN building blocks

• Master Patient Index/Regional Master Patient
  Index (MPI/RMPI) required to identify and match
  patients from different systems
• Record Locator Service (RLS) identify patient
  encounters at each point of care
• Data paper, electronic, shared, interfaces

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Without the RHIN
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BBRHIO RHIN Architecture
VPN
Small organizations can connect either directly
to the RHIN or through a VPN gateway
Organizations can connect bi-directly to feed
their data and receive data directly into their
EMR
In the early Phases CHP, CRMC TMH will provide
a one way feed of their data. They have the
largest repositories and the priority is to make
their data available as soon as possible
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Current RHIN Services

• pMAN Connectivity Dedicated fiber-based Private
  Medical Area Network VPN gateway
• Core RHIN Platform
• Data Sharing Patient demographic and clinical
  data feeds
• RHIN Web Portal Secure web interface for
  clinicians
• User Access Audit Control Detailed audit logs
  across the entire system
• Disaster Recovery Business Continuity
• RHIN Applications
• e-Prescribing
• Document Imaging
• Patient Portal Web interface for electronic
  patient registration form and Personal Health
  Record (PHR).

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Current Funding

• GHIIAB/AHCA grants
• 1st Grant Jan 2006 July 2006
• 2nd Grant July 2006 July 2007
• 3rd Grant July 2007 July 2008
• Contributions from board members
• Cash
• Resources

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2007 2008 Goals

• The overarching goals for Phase III is
• Further refine our strategic roadmap based on
  lessons learned
• Implement business operational infrastructure
• Begin generating revenue
• Identify a viable sustainability model.
• Broaden stakeholder outreach

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07-08 Grant Focus
The focus for this grant cycle will be to garner
acceptance and consensus plus identify and
combine the elements that will create the most
improvement in efficiency and return on
investment for stakeholders.

• Education and adoption
• Business operational infrastructures
• Production integration of current applications
• Expanding the suite of applications
• Increasing the number of provider data feeds
• Combining the right ingredients of technology,
  services, education, stakeholder consensus,
  privacy security and governance to achieve
  sustainability.

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Adoption

• To ensure adoption we must successfully market
• Safer more private and secure way to share health
  information

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Education for Adoption

• A more formalized approach to reach a larger and
  more diversified audience through
• Securing a high profile local or regional
  champion and spokesperson
• Audience specific content and media
• Traditional higher profile marketing methods
• Pursuing buy-in of local regional community
  officials, patients and employers

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Operational Infrastructure

• Hardware Network Resources
• Billing Invoicing System
• Continued Marketing Education
• Operational Staff
• Support Staff

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Production - RHIN Platform
RHIN Web Portal patient search
Secure Internet Access
Clinical data display including labs, radiology
reports, allergies, problems, providers, and
medication history
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Production - RHIN Apps
Patient Portal (PHR)
eRx
Document Imaging
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Proposed New RHIN Apps

• Lab Messaging
• Electronic Referrals Secure Messaging
• Community EMR-Lite via VistA
• Physician Directory On-call List
• Electronic Home Healthcare Orders
• Patient Education Material from Patient EDU
• Medication Reconciliation Pilot with HCS

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Rural Providers
CRMC
TMH
CHP
FHIN
Radiology

RHIN
RHIN ENABLED EMR
Pathology
Vascular
P Ps

• RMPI/RLS
• e-RX
• Document Management
• Secure Messaging
• Referrals

• Intake Form
• PHR
• Personal Documents

Patient Portal
RHIN Portal
Other EMRs
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Sustainability

• Stakeholder return on investment either in time
  savings, reduced cost, reduced liability or
  improved patient satisfaction is ultimately where
  sustainability will emerge.
• A RHIN App is as a business defined module that
  snaps into the RHIN platform taking advantage of
  the unified login for providers and the patient
  index search.
• The goal and base concept of a RHIN App is to
  provide a better service through electronic means
  compared to the current primarily manual
  telephonic and paper based operations.
• A RHIN App operates under the principle that it
  will save a provider X dollars so they can then
  pay the BBRHIO a percentage of X dollar savings
  in service fees.

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Existing Paper Workflow(8 Steps)

• Phone request -gt fax patient release of
  information form -gt pull record -gt copy/fax/mail
  record -gt record to unverified recipient -gt no
  audit -gt redo fax/phone call(s) -gt receiving end
  manually file/scan into record

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BBRHIO Workflow

• Internet to RMPI/RLS gt e-request gt print or
  import data into EMR
• Paper practice gt scan gt RMPI gt RHIN
• Improved privacy compliance
• Provides audit trail
• Creates significant efficiency

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Community Benefits

• Enhances provider capabilities
• Local
• Regional
• IMPROVES PATIENT SAFETY OUTCOMES
• Creates personal health record
• Reduces impact to employees and employers
• Increases productivity
• Reduces healthcare cost
• Improved outcomes

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Questions?