HIE / RHIO Products and Services:

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HIE / RHIO Products and Services Planning
Framework
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HIE / RHIO Products and Services Planning
Framework
The purpose of these materials is to assist HIEs
and RHIOs with product and service definitions,
users, beneficiaries, benefits and alternate
service fee approaches The following three pages
are product and service matrices that list the
recommended product / service segments for each
of three categories of products and services that
an HIE/RHIO may offer. The first matrix is
digital healthcare information exchange services,
the second is patient centric healthcare record
summaries/aggregations and the third is
supplemental systems and services. Pages 5-9
describe the five column headings (target users,
beneficiaries, service fee basis, benefits and
values), and list examples for each column.
These materials have been developed by HNS to
assist HIEs with the development of their product
offerings, and are based on experience working
with local, regional and state HIEs and RHIOs
throughout the country. They should be reviewed,
internalized and modified as needed to reflect
the specifics of your HIE / RHIO. HNS has not
filled in the cells with our reflections on the
project and a beginning set of recommendations.
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HIE / RHIO Products and Services Planning
Framework Digital Information Phase I

HIE Products and Services (Digital Clinical Data) Target Users Beneficiaries Service Fee Basis Benefit Descriptions (Examples) Value (Examples)
Results, Reports, and Clinical Data Exchange and Delivery Service
Clinical Data Interface Services (To physician practice EMRs)
Physician to Physician Referrals and Consults
Physician Practice Workflow Tools / Applications
Service Requests / Orders
Public Health Clinical Data Capture and Exchange
Patient Authorized Clinical Data Exchange Services
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HIE / RHIO Products and Services Planning
Framework Patient History Phase II

HIE Products and Services (Access to Historical Patient Data) Target Users Beneficiaries Service Fee Basis Benefit Descriptions Value
Patient Record Summary from Service Providers Historical Results, Referrals Orders
Patient Record Summary from Physician Practices Historical Clinical Data
Clinical Data Export Services to Disease Management and Chronic Care Systems
Insurance and / or Government Program-Specific Beneficiary Database
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HIE / RHIO Products and Services Planning
Framework Supplemental Products and Services

HIE Products and Services (Specialty Applications) Target Users Beneficiaries Service Fee Basis Benefit Descriptions (Examples) Value (Examples)
Disease Management / Chronic Care Coordination Systems
Patient Summary Record / Decision Support Tools
HIE Hosted EMRs
Public Health Applications
Shared PACS / Image Storage Systems
Hospital Portal Services
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HIE / RHIO Planning Framework Explanation Target
Users (A)

• Target users are those people or entities whose
  effective use of the system and services to make
  decisions and take actions will be most important
  to achieving the desired benefits. Therefore,
  involving them in the design and testing should
  be considered, as their early and comprehensive
  adoption of the system will be essential to its
  success.
• Physicians / Practice Staff
• Service Provider Staff
• Chronic Care Coordinators
• Disease Management Staff
• Public Health Program Staff
• Patients
• Pharmacists

(Revise to reflect your HIE/RHIOs specific
circumstances.)
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HIE / RHIO Planning Framework Explanation Benefic
iaries (B)

• Beneficiaries are those people and/or
  organizations to which the benefits will accrue
  from the effective use of the system by the
  target users. An important part of the planning
  and implementation is to develop and measure the
  metrics that will be used to document these
  results.
• Service Providers
• Physicians / Physician Practice
• Insurers
• Employers
• Patients
• Government Programs
• Public Health Programs
• Clinical Data Contractors / Program Coordinators
• Disease Management
• Chronic Care Program
• Personal Health Record
• 9. Community-Wide Safety Net Sponsors

(Revise to reflect your HIE/RHIOs specific
circumstances.)
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HIE / RHIO Planning Framework Explanation Service
Fee Basis Payment Options for Beneficiaries (C)

• Service Fee Basis is the range of payment options
  for the beneficiaries who will pay for the
  products and services. The alternative approaches
  or methods should be carefully selected to match
  the costs or benefits. Some of the options will
  work best when the organization is new with a few
  sponsors and customers. A transition to more
  advanced options will fit better when there are
  many customers and much operational history.
• Monthly Subscription
• Membership Fee
• Transaction Fees
• Per Person Per Month Fee
• Indexed Per Person Per Month Fee
• Per Physician Per Month Fee
• Per Physician Practice Staff Per Month Fee
• Per Application Per Month Fee
• Allocation or Appointment of Expenses (all or
  part)
• Gain Sharing Based on Benefits
• Payment Based on Type and Size of Organization

(Revise to reflect your HIE/RHIOs specific
circumstances.)
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HIE / RHIO Planning Framework Explanation Benefit
s (D)

• Benefits are the measurable results achieved by
  using the HIE / RHIO. They should be specific to
  each RHIO, based on stated goals or objectives.
  Examples are listed below.
• Cost Reductions
• Cost Avoidance
• Risk or Liability Reduction
• Regulatory Requirements
• Service Level Improvements
• a. Reliability
• b. Customer Satisfaction
• c. Turnaround Time
• d. Security
• e. Work Flow Improvement
• f. Flexibility in Formatting, Packaging of
  Information
• g. Reduction of Duplicate or Missing Reports
• h. Ability to Audit delivery and other service
  metrics
• Patient Safety (medications, allergies, duplicate
  testing, diagnosis)
• Quality of Patient Care
• Health Promotion and Prevention

(Revise to reflect your HIE/RHIOs specific
circumstances.)
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HIE RHIO Planning Framework Explanation Value (E)

• Value is the perceived advantage between service
  fees and benefits for each product and service.
  Value relates to the goals and objectives
  established for the HIE / RHIO and the reasons
  for its development. It is frequently described
  in the HIE / RHIOs vision, mission statement,
  high level goals or main strategies. A few
  examples are listed below.
• Community-wide advances in patient care
• Community-wide health status improvements
• Providing information tools to support
  improvements in the Capital area health economy
  and enhance its competitive posture
• Improved care and outcomes for Medicaid and
  underserved populations
• Streamlined communication of clinical information
  among physicians, service providers, and other
  appropriate organizations
• A balanced approach toward the support of medical
  care and public health information
• An organized program to provide personalized
  medical and health promotion information to the
  people in our medical trading area.

(Revise to reflect your HIE/RHIOs specific
circumstances.)
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Questions and Discussion .
Thank you.
Jay C. McCutcheon Health Network
Services Jcm8838_at_aol.com 574-274-0252
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