Health Info Net Overview What is Health Info

Health. Info. Net Overview

What is Health. Info. Net? • Health. Info. Net operates Maine’s statewide Health Information Exchange (HIE). This is a secure, electronic way to share medical information between healthcare providers. • Click here to view the Health. Info. Net Video • The HIE data is accessed via a web based “Clinical Portal” to support: – Care coordination across multiple systems of care – Care Management & transitions of care follow up for at-risk patients – Save time and reduce paper workflows – Reducing medical errors and conflicting treatment recommendations – Avoid repeating tests and procedures and avoid unnecessary costs © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

© 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

What is Health. Info. Net? • Maine-based: The Board of Directors are active and prominent in the Maine medical community and represent a variety of organizations and interests. • Multi-stakeholder: Involves Consumers, Providers, Payers, Business and Government. • Independent: Health. Info. Net is independent and is not owned by insurance companies, health care organizations, associations, employers or government. • Nonprofit: Health. Info. Net is a private nonprofit organization. It is funded by many sources including charitable foundations, Maine health care providers, and state and federal government. © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Why Does Maine need Health. Info. Net? Health. Info. Net delivers a unique statewide information system that enables ongoing collaboration between competing health care organizations to achieve efficient and comprehensive electronic exchange of patient health information regardless of where care is provided Without Health. Info. Net, this collaboration would not exist • On average 84% of patients in Maine have been seen at two or more unaffiliated facilities (physician offices or hospitals) connected to HIN in the last 24 months – – 70% of Maine. General Health’s patients 97% of Southern Maine Healthcare’s patients 95% of St. Joseph’s Healthcare’s patients 85% of Eastern Maine Healthcare’s patients © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

How does it work? • Health. Info. Net’s system combines information from separate health care sites to create a single electronic patient health record. • Patient health information is automatically uploaded from a provider’s electronic health record system. • The information is standardized and aggregated across sites. • Health. Info. Net automates reporting for hospitals public health needs such as syndromic surveillance for Maine CDC & electronic lab reporting for Meaningful Use requirements. © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

HIE Connections - 750+ Acute Care Hospitals Critical Access Hospitals 18 16 Mental Health Hospitals Ambulatory Behavioral Health FQHCs Post-Acute Care VA Locations 1 464 151 68 48 12 Labs Health Systems Emergency Medical Service Pharmacy Payers 5 5 3 2 1 © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution Complete list of connections at www. hinfonet. org 7

What is in HIN’s Portal? • Patient Identifier, demographics & PCP (registration data) • Encounter/Visit History • Laboratory and Microbiology Results • Vital signs (new data) • Radiology Reports • Adverse Reactions/Allergies • Medication History from Pharmacies & Medicaid Claims • Diagnosis/Conditions/Problems (primary and secondary) • Immunizations (primarily adult) • Documents (Discharge summaries, office notes, reports, etc. ) • Continuity of Care Documents (CCD) © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Health. Info. Net’s Statistics 2017 960, 000 Patient Records Accessed 267, 534 Patients Managed in Analytics 50, 000 Real-time Notifications/Month 500, 000 Data transmissions sent to Maine CDC in support of Electronic Lab Reporting, Syndromic Surveillance and Immunization Reporting (Meaningful Use Measures)/month 1. 5 Million Unique Lives Managed 14 Predictive Risk Models (Utilization and Chronic Illness Risk) @2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution 9

Security Processes • Uses a Virtual Private Network (VPN) and protected by a dedicated Firewall. • Data is encrypted at all times (in motion and at rest) and stored separately from clinical data. • All users are given unique passwords approved and managed by their employer. • System user activity logs are audited daily by Health. Info. Net staff and the employers identified auditor who will access the “Audit Portal” at any time. • Users must confirm they have a relationship with the patient and a need to see their information. This is recorded in the system. © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Common Clinical Workflows 1. Review medical information in preparation for each visit; view recent visits and clinical results to support your clinical decision making workflow 2. Identify medication prescriptions you are unaware of and prevent duplicate or conflicting prescriptions 3. Identify medical diagnosis you are unaware of, review lab & radiology results and coordinate care with PCP, specialists, etc. 4. Set up real-time/daily summary emails for follow up to ED/hospital events of care to provide integrated care management and time sensitive patient intervention 5. Follow up with external care partners that share the “care plan” with you and your patient population © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

HIE Users • • • More than 50% of users are RNs, LPNs, and Medical Assistants Pharmacists • Behavioral Health • Quality Hospitalists Care Managers Emergency staff Physicians VA © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Patient Consent Educating staff and patients about choices for participation © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

HIE Consent & Maine State Law • The responsibility to manage consent options is Health. Info. Net’s, not the participating organizations. • The consent relationship is between the individual and Health. Info. Net. • Participating organizations are required to educate patients/clients about their consent options. © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Implementing Patient Consent • Must be active with patient education at point of care prior to participating with HIN • Determine which leadership and staff to educate about requirements • HIN will train your staff on requirements and provide patient hand outs and consent form PDF’s for distribution © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Health. Info. Net Consent Policy for Medical Information • Maine law requires Health. Info. Net & all participants follow an opt-out consent policy. • Patients can opt-out online, on paper, or over the phone. • When patients choose to opt-out, they only opt-out once for all care locations at which time their clinical data is removed from the HIE. • Patients can opt back in, however their records will start from that day forward. The system does not go back. © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

What about Sensitive Information? • Per state law, access to some mental health and HIV/AIDS information is limited. This includes: – Information from a licensed mental/behavioral health provider or facility – HIV diagnoses and results of HIV tests • Patients give consent in one of two ways: – for each provider at the time of care or admission for that time only – using a consent form available from Health. Info. Net to opt-in all information all the time • State law permits providers access without patient consent in an emergency situation. Providers record this in the system. © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Patient Consent Education Requirements Per Maine State law, ALL participating organizations must: – Give opt-out form to all patients at least one time at the point of “initial contact” following connection to Health. Info. Net. – Send any signed opt-out forms to Health. Info. Net within 2 business days (fax is most common) – Provide a way for patient to opt-out at no cost to the patient. © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Patient HIE Participation Choices 1 2 3 4 STEP 1: STEP 2: Your Choices Action You Need to Take Impact on: General Medical Information Available to all participating providers Mental Health & HIV Information Available only in medical emergencies Share your medical information only Do nothing Share your mental health information, HIV information, or both Fill out a consent form available from your participating provider or Health. Info. Net and consent to share mental health, HIV or both During your visit, tell your participating provider they have your consent to access your mental health, HIV information or both Available to all participating providers The type of information you choose will be available to all participating providers Available to that individual provider during that visit. You will need to give permission next time you want them to have access Fill out an opt-out form available from Health. Info. Net, your provider, or online at www. hinfonet. org/optout All information is removed from the HIE and will not be available to your participating providers, even in an emergency All information is removed from your record and will not be available to your participating providers, even in an emergency Share your mental health information, HIV information, or both, with an individual provider Remove all your medical information from Health. Info. Net © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Education and Training • HIE education and trainings are offered in-person and virtually by our Clinical Education team. • Online videos and reference guides can be found at www. hinfonet. org/training-tools • We also offer online training through the Health. Info. Net Academy at hinfonetacademy. org © 2018 Health. Info. Net (HIN) – All Rights Reserved HIN Proprietary – Not for Redistribution

Portland Hall, Suite 230 60 Pineland Drive New Gloucester, ME 04260 (866) 592 -4352 toll free (207) 541 -9250 local (207) 541 -9258 fax Monday-Friday from 8 am – 4: 30 pm www. hinfonet. org info@hinfonet. org Customer. Care@hinfonet. org