Community Health Access Network CHAN a Health Center

Community Health Access Network (CHAN) a Health Center Controlled Network (HCCN) 501(c)(3) Founded 1995 2008 HIMSS Davies Award Winner Community Health Organization (CHO) Category

CHAN’s HCCN Model • Non profit, 501(c)(3) • Board of Directors: CEOs/EDs of our Full Members • Fee Structure: Annual Dues, Monthly Shared Systems Fees (based on # of software licenses) • Robust Committee Structure – – – Health Services Committee (Medical Directors, Site Administrators) EMR Users Group Committee (Providers) Business Office Manager Users Group (BOMUG) Finance Committee (meets quarterly) Others as needed (ie Due Diligence Committee)

CHAN’s HCCN Members 6 Full FQHC members with 14 sites + 1 Healthcare for the Homeless van -Avis Goodwin CHC (1 site; Dover - 1 site; Rochester) -Families First Health and Support Center (1 site; Portsmouth plus Healthcare for the Homeless Program van) -Health First Family Care Center (2 sites; Franklin and Laconia) -Lamprey Health Care, Inc. (4 sites; Raymond, Newmarket, (2) Nashua ) -Manchester CHC (1 site; Manchester) -Shackelford Community Resource Center-central TX (4 sites) 4 Affiliate members with 10 sites -Coos County Family Health Services (2 sites; Berlin – 1 site; Gorham) -Ammonoosuc Community Health Services, Inc. (5 sites; Littleton, Woodsville, Whitefield, Franconia, Warren) -Healthcare for the Homeless Program (1 site; Manchester) -Harbor Care Clinic, FQHC Healthcare for the Homeless Program (1 site; Nashua)

What do we offer our members? • Fully implemented and integrated Meaningful Use Certified GE Centricity Electronic Health Record/Practice Management infrastructure (over 37, 000 Observation terms, 65, 000 active patient records) – Central server architecture; 37 virtual servers supported on site • Secure Patient Portal (email, appts, prescription refills, lab results, pt “view only” access to their records) • Robust Security Infrastructure (Bot. Net Filter, Intrusion Protection Software) – Back up system, including Kohler generator and heptoflouropropane fire suppression system which will not harm staff or servers in the event of its release. – IT staff with 75 years combined CHC experience – 24 hour Help Desk Support – e-form authoring – Staff training • Robust Data Warehouse with drilldown reporting to support Clinical and Operational Report Development (i. e. UDS, network dashboard reports, clinical quality indicators for individual sites)

Mature EHR Infrastructure-Linkages Advanced Electronic Prescribing LAB RESULTS 3+ Reference Labs MEDICAL EQUIPMENT EKG (Cardiosoft) Spirometry (Midmark) Electronic Health Record Outbound Fax ØReferral Information to Specialists ØConsultation Reports SCANNING ØState Lab Results ØHospital Documents (if not linked) ØConsultation Reports HOSPITAL DOCUMENTS (via Electronic Link) ØDiagnostic Testing Results ØEmergency Dept Visits ØDischarge Summaries / H&P’s SECURE MESSAGING Ø Referrals to Specialists Ø Consultation Reports Ø Provider/Patient Communication CARE CATALYST ØPatient Entered Data (BG levels) ØPatient Requests for Refills, Appts. , Referral Requests.

Clinical and Operations Reporting Infrastructure • Reporting priorities are determined by members and the healthcare environment – – – UDS Meaningful Use NH State reporting requirements Insurers Network wide QI initiatives • CHAN develops and posts reports centrally • Members have capability to develop their own reports to meet their individual needs – Chronic disease management – Recalls and follow-up

MU ready reports Core ü Hypertension: Blood Pressure Measurement (NQF 0013) Alternate ü Weight Assessment and Counseling for Children and Adolescents (NQF 0024) ü Childhood Immunization Status (NQF 0038) Menu ü Asthma Pharmacologic Therapy (NQF 0047, PQRI 53) ü Diabetes: Hb. A 1 c Poor Control (NQF 0059, PQRI 1) ü Diabetes: LDL Management & Control (NQF 0064, PQRI 2)

Anticoagulation Office Visit

Network benefits (per a CHC member) • Access to centralized knowledge bank for minimal cost • Advanced infrastructure • Creates cooperation and friendly competition between members – “Coopitition” • Upgraded EHR system will meet “Meaningful Use” certification; direct financial benefits to CHC’s

Current CHAN Projects which address meaningful use… • Data Warehouse Expansion– allows independent agencies access and utilization of the CHAN DW • Upgrade of GE EMR to Meaningful Use v 9. 5 • Upgrade of PM to GE v 10 to support 5010 electronic claim submission required as of 1/1/12 • Preparation for ICD-10, to ensure cross matching will support reimbursement • Collaboration with stakeholders for development of NH HIE • Network Master Patient Index to support HIE

CHAN MU Core Objectives Scorecard ü ü ü ü ü Problem List Medication List Demographics Smoking Status Vital Signs Drug Interactions Medication Allergy Lists Orders E-prescribing ü Report Clinical Quality Measures to CMS of State ü Decision Support ü Risk Analysis Clinical Summaries-in process HIE- in process PHR-in process

CHAN MU Menu Objectives Scorecard ü Drug formulary checks ü Lab test results ü Pt lists by condition ü Patient Education ü Medication Reconciliation v Immunization Registries – no State capabilities v Syndromic Surveillance – no State capabilities Pt reminders – in process Pt electronic access-in process Transitions of care-in process

NH HIE Phase I- Project Initiation and Planning Phase II – Transition Phase III - Implementation

NH HIE American Recovery and Reinvestment Act- Funding for Health IT includes…. . State HIE Cooperative Agreement Program (ONC); Ø Ø announced 8/20/09 Letter of intent submitted to ONC – 9/11/09 (Designated Entity to apply for grant; NH DHHS) Notification of Federal allocation of $5. 5 M – 9/22/09 Application submitted to ONC – 10/16/09 NH Health Information Exchange Planning and Implementation Project (HEIPI) begins - 11/2/09

Phase 1: HEIPI Project Initiation • NH DHHS hired staff dedicated to NH HIT/HIE and HIEPI project – Dave Towne; State HIT Coordinator – Elizabeth Shields; Project Manager • NH DHHS hired Consulting Partner; Massachusetts e. Health Collaborative (MAe. HC) to lead creation of NH’s HIE Strategic and Operational Plan • Stakeholder Engagement. Identify Stakeholders and subsequent Work Groups • Establish NH HIT/HIE Website

Phase 1; HEIPI Project Initiation…cont • Stakeholders (including, but not limited to) – – – – – Large/Small hospitals NH State Legislators CHCs, Bi-State PCA, CHAN NH Medical Society NH Hospital Association AARP NH Health Plans NH DHHS Home Care Association of NH • Work Groups – – – Governance (includes CHAN rep) Finance (includes CHAN chc rep) Technical Infrastructure (includes chc rep) Business and Technical Operations (includes CHAN chc rep) Legal/Policy

Phase 1; HEIPI Planning Phase • Identify HIE phases – Phase 1; Secure routing – Phase 2; Expanded secure routing – Phase 3; Community record • Determine Governance Model – Health Information Organization (HIO) – Public-Private Partnership • Determine legality – Legislation filed as HB 489; establishes a HIO for the electronic exchange of health information. • Determine market need • Begin to develop sustainability model; visit key stakeholders

Phase 2; Transition • Launching of the Interim Advisory Group (IAG); 4/29/11 – The IAG is a transitional, public-private governance body for the HIE project – The IAG acts under the authority of the NH DHHS Commissioner transitioning to a Board with full authority – The IAG provides public-private governance to the state level HIE project pending launch of the HIO

Phase 2; Transition…cont. • Work Group Tasks/Activities – Governance Workgroup • Transition to IAG • Support Legislative Process • Set contingency plan and its triggers w/stakeholders – Finance • Market test value of proposed HIO services • Draft the Business Plan – Technology • Find and engage a Technical Services Partner (TSP) to set up and operate the technology platform – RFI and RFP process • Evaluate, prepare, and certify Health Information Services Providers (HISPs) to connect – Legal/Policy • Support legislative process • Develop HIO policies and procedures for HIO

Phase 3; Implementation Stay tuned!!

Contact Information Kirsten Platte, Executive Director kplatte@chan-nh. org 603 -292 -7205