West Michigan Health Information Exchange Business Plan Overview

1
West Michigan Health Information
ExchangeBusiness Plan Overview

• November 5, 2008
• HIE AF4Q Workgroup Members

2
Background

• Service area 13 counties in West Michigan 1.5
  million citizens
• 25 Hospitals 1,900 physicians other providers
• Four workgroups CIO subgroup
• MiHIN Planning Grant Funding
• Plante Moran Assistance

3
Solution
Present State
Desired State
Represents a combination of paper-based, fax,
phone and non-standard electronic connections
Represents an electronic connection with standard
communication and messaging protocols
Source Adapted from MiHIA
4
Services

• Clinical Messaging (Level 1)
• Test results pushed to providers
• Federated Repository (Level 2)
• Information not pushed can be pulled from other
  sources
• Central Repository (Level 3)
• Information pushed, pulled and stored in one HIE
  system

5
West Michigan HIELevel 1 Clinical Messaging
Practices
HIE
Results Reporting (push)
Hospitals
Practice EMR
Results Forwarding
Labs
Secure Messaging
Practice Electronic Box
Radiology
Referral/Consult Requests
Fax/Printer
Pharma/Other
Dx Orders/Results
Prior Results
Adapted from Strategies for Tomorrow,
2008 Source HCV 2020 Clinical Work Group
6
Value to Community, Patients

• Improved quality of care
• Reduce unnecessary test duplication
• Patients can access their own information
• Improved community health efforts

7
Value to Employers, Payers

• Cost savings through reduction in unnecessary
  testing
• Cost savings through automation of manual records
  processing tasks
• Less duplication of payer efforts to provide
  utilization data to providers
• Less work time missed due to inappropriate and
  unnecessary care

8
Value to Healthcare Systems, Physicians

• Cost savings through automation of manual tasks
  for data senders and receivers
• Information more accessible to physicians when
  needed improved decision-making
• Duplicative interface costs with multiple health
  systems and payers will be avoided
• Will complement the data exchange work already
  underway in each healthcare system

9
Perspective

• The State should continue to work aggressively
  with regional groups to develop an electronic
  medical information network.
• Grand Rapids Press. High Tech Healthcare (August
  28, 2008)

10
Alignment With State and National Efforts

• National Health Information Network
• Michigan Health Information Network

There are 42 HIEs currently operating throughout
the United States
11
Business Model

• Not-For-Profit Organization
• Governed, operated and financed by key
  stakeholders
• Hospital systems, physician organizations,
  employers, payers, other providers

12
Financial Projections Assumptions

• Income types Board seat fees, membership fees,
  transaction fees
• Participation by all major stakeholders
• Rapid ramp-up of clinical messaging (60 of
  doctors in first year)
• Potential common IT platform (Novo)

13
Annual Membership Fees

• Physicians 250
• Labs, radiology centers 5,000
• Insurer/payer 5,000
• Hospitals (lt100 beds) 25,000
• Hospitals (gt100 beds) 25,000
• Other facilities 2,000

14
Transaction Fees

• Clinical transactions (providers) 0.27
• PMPM (for payers, SF employers) 0.27

Note Transaction fees will decline each year
reaching 0.19 in Year 5.
15
Financial Projections (Medium)
16
Financial Projections (Medium) (Cont)
17
Return on Investment
approximately 11 million transactions processed
through HIE in 2010 (first full year of
operation annual estimated savings
18
Key Strategies

• Multi-stakeholder revenue mix
• Engage stakeholders early
• Accelerate adoption rate
• Employ incremental approach
• Maintain flexibility

19
Timelines

• October December 2008
• Present Business Plan to key stakeholders
• January June, 2009
• Implementation prep
• July December, 2009
• Begin level one (messaging)
• January July, 2010
• Begin level two (federated repository)
• July, 2010
• Begin level three (central repository)

20
Where there is will there is a way

• This business plan is not perfect. It is a
  snapshot in time. Circumstances change
  frequently.
• If you feel an HIE wont work in our area, the
  weaknesses of this business plan will provide
  reasons to support your position.
• If you feel an HIE can work in our area, this
  business plan will provide good additional
  information as a basis for continued work in the
  future.

21
Thank You