The Nation

1
The Nations First Statewide Health Information
Exchange
Presentation to the
Delaware Health Care Commission May 3,
2007
Robert White DHIN Chair Delaware Physicians
Care, Inc.
Gina B. Perez DHIN Project Director Advances in
Management, Inc.
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Agenda

• What is DHIN?
• Why do we need it?
• Who participates in DHIN?
• What does it do?
• How is it funded?
• What are the benefits?

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Vision
Develop a network to exchange real-time clinical
information among all health care providers
(office practices, hospitals, labs and diagnostic
facilities, etc.) across the state to improve
patient outcomes and patient-provider
relationships, while reducing service duplication
and the rate of increase in health care spending.
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DHIN Governance Structure

• Statutorily Created in 1997
• Public-Private Board of Directors under the
  Delaware Health Care Commission
• Active Executive Committee
• Multi-Stakeholder Project Management Team
• Consumer Advisory Committee
• Clinical User Group

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What is DHIN?

• Secure network for distributing clinical results
  and reports from the hospital, lab or radiology
  center to the treating physician
• Data is managed by those who order the test and
  those who perform the test

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Timeline
Year Activity Funding Source
2001 HIE Concept Embraced DHCC Pilot Funds
2004 Project Director Contracted Longwood Foundation Federal Funding (beginning in Sept. 2005)
2005 Requirements Definition Began Federal AHRQ Funding Secured State Funding thru DHCC Federal Funding
2006 IT Vendor Selected System Implementation Began State, Private and Federal Funding
2007 DHIN CIO Hired Federal Funding
2007 System Go-Live State, Private and Federal Funding
Agency for Healthcare Research and Quality
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Why do we need it?

• Most Doctors receive laboratory results from 5
  different labs all sending results in a different
  format and method
• Clinicians who use computerized records system
  are more likely to adhere to clinical guidelines

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Why do we need it

• Clinical information is missing in 13.6 of
  primary care visits
• Lab results - 6.1
• Radiology results - 3.8
• History Physicals - 3.7
• Missing information is Judged to
• Adversely affect care in 44 of visits
• Delay care in 59 of visits

• Medications - 3.2
• Dictation - 5.4

(JAMA, January 2005)
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DHIN Phase 1 Priorities
2006-2007 Secure results/reports delivery to ordering physician Lab/Pathology Results Radiology Reports Admission, Discharge Transfer Reports Admission Face Sheets/Demographics Security access controls Audit processing reporting Electronic Medical Record (EMR) interfaces Consumer participation via Consumer Advisory Committee
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Phase 1 Data Senders

• Bayhealth Medical Center
• Kent
• Milford
• Beebe Medical Center
• Christiana Care Health System
• Christiana
• Wilmington
• LabCorp

Account for 85 Laboratory Testing 81
Hospital Admissions in Delaware
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Phase 1 Data Receivers

• Cardiology Consultants
• 16 offices statewide
• 30 physicians
• EMR
• CN-MRI
• 2 locations in Kent County
• 9 physicians
• EMR
• Nephrology Associates
• 8 offices statewide
• 21 physicians
• Electronic Inbox

• Dover Family Practice
• 1 location in Kent County
• 4 physicians
• Electronic Inbox
• Georgetown Family Medical
• 1 locations in Sussex County
• 2 physicians
• Fax and Electronic Inbox

Total 28 practice sites 66 physicians
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A Day in the Life of One Doctors Fax Machine
1 day 1 doctor 115 faxes 10 ads 55 lab results 30
consult reports 19 pharmacy renewals 1 stat
abnormal mammogram that needs immediate attention
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(No Transcript)
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One Standard DHIN Format
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(No Transcript)
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Security

• HIPAA compliant
• Secure Virtual Private Network (VPN)
• 128-bit secure socket layer (SSL) encryption
• Complete auditing and logging
• Data management at
  the source system

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DHIN Phase 2 Priorities
2007-2008 MSDHub Value Added Services Patient Centric History Medication history Public Health reporting Consumer participation via Patient Portal Electronic order entry
Future Priorities
2009-2011 Chronic Disease Management Outcomes and Incentive Management Benefit Eligibility and Claims Processing
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Physician Use of Technology
Source University of Delaware Center for Applied
Demography and Survey Research, Primary Care
Providers in Delaware 2006
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Physician Interest Next Wave

• 66 Physician Practices
• 21 in Kent County
• 18 in New Castle County
• 23 in Sussex County
• 4 statewide Practices
• 29 Primary Care Practices
• 33 Specialty Practices
• 4 Federally Qualified Health Centers

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Benefits of DHIN

• Improved Patient Care
• More complete clinical information
• Better communication
• Reduced Hassle Factor
• Information available at appointment
• Fewer forms to fill out

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Benefits of DHIN

• Reduced Healthcare Costs
• Fewer duplicated tests
• Better medication management
• Increased Efficiencies
• Greater productivity
• Reduced delivery/mailing costs

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THANK YOU from

• For a Decade of Support!