+ Leveraging the power of North Carolina’s health information exchange to improve patient outcomes...

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+ Leveraging the power of North Carolina’s health information exchange to improve patient outcomes Organization Name Date

Transcript of + Leveraging the power of North Carolina’s health information exchange to improve patient outcomes...

Page 1: + Leveraging the power of North Carolina’s health information exchange to improve patient outcomes Organization Name Date.

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Leveraging the power of North Carolina’s health information exchange to improve patient

outcomesOrganization Name

Date

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+What is NC HIE?

NC HIE operates North Carolina’s statewide health information exchange, a secure, standardized electronic system in which providers can share important patient health information.

The use of this system promotes the access, exchange, and analysis of health information.

Enables participating organizations to: Save time and reduce paperwork

Facilitate more informed treatment decision-making

Leads to improved care coordination, higher quality of care, and better health outcomes

ACCESS

EXCHANGE

ANALYSIS

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+What is NC HIE?

NC-based: The Board of Directors are active and prominent in the North Carolina medical community and represent a variety of organizations and interests.

Independent: NC HIE is independent and is not owned by insurance companies, health care organizations, associations, employers or government.

Nonprofit: NC HIE is a private nonprofit organization. It is funded by many sources including North Carolina health care organizations and grants.

Multi-stakeholder: Involves Consumers, Providers, Payers, Business, and Government.

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+How does it work?

NC HIE’s network combines information from separate health care sites to create a single virtual patient health record.

Patient health information is automatically uploaded or linked from a provider’s electronic medical record system.

The information is standardized and aggregated across care sites.

Clinicians can seamlessly access their patient’s information in NC HIE from within their EMR.

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+Why use NC HIE?

Healthier patients: Fewer medical errors, improved patient safety, improved continuity of care, and better patient outcomes

More efficient: Automated sharing of information, less paperwork, reduced time to access clinical information at the point of care, fewer repeat tests and procedures

Informed treatment decisions: A more complete and up-to-date patient medical record, including information from all a patient's health care providers

Supports public health: Automates process of reporting mandatory reportable conditions to the NC Department of Public Health

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+Why do patients care?

Care is more coordinated

Less duplicate tests and procedures

Less paperwork

Fewer errors and safer care

Lower out-of-pocket costs

Important health information is accessible when care is administered

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+What is in the network?

In the NC HIE Network: Patient Identifier and Demographics

Encounter History

Laboratory and Microbiology Results

Radiology Reports and Images

Adverse Reactions/Allergies

Medication History

Diagnosis/Conditions/Problems (primary and secondary)

Immunizations

Dictated/Transcribed Documents

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+What is not in the network?

Not in the HIE Network: Information created by a substance abuse facility or

psychotherapy notes

Please note that information indicating a sensitive health condition may be referenced to in certain situations:

Medications for these conditions are included if paid for by Medicare/Medicaid or commercial insurance

Visit notes from a non-mental health provider may include reference to one of these conditions

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+What does it look like?

Every provider can customize the look and feel of their interface. The process for this is covered during HIE training. Here is an example interface.

Every provider can customize the look and feel of their interface. The process for this is covered during HIE training. Here is an example interface.

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+Security Processes

Connection to the HIE network is secured through the use of a Virtual Private Network (VPN) and is protected by a dedicated Firewall.

All access to NC HIE is password protected. Some organizations may facilitate access through their EHR and under those circumstances, a new password is not required.

Data is encrypted at all times (in motion and at rest).

Provider activity logs are audited by NC HIE and patients may request a report on the access of their health record.

Users can only access patient information with whom they have a relationship. In emergency situations, physicians can access a record for a new patient.

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+Consent Policy

Consumers are automatically part of NC HIE if their health care provider is a participant. North Carolina law requires NC HIE follow an opt-out consent policy allowing patients the choice of not participating.

This policy was written with input from stakeholders representing patients, providers, employers, payers, and government.

Consumers may opt-out by mail using the opt-out form or by phone. In the future, consumers will be able to opt-out online.

State law requires participating providers give the patient a state-approved form the first time they visit that provider location.

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+Mandatory Opt-Out Disclosure

Per North Carolina State law, participating organizations must give an Opt-Out Form to all patients at point of initial contact following connection to NC HIE.

Opt-Out Forms will be provided to participants by NC HIE and can be re-ordered at any time by contacting NC HIE’s call center

NC HIE can provide participants with a sample “Notice of Privacy Policy” to help explain NC HIE procedures

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+Opt-OutThree opt-out options are available to patients:

By physician – health records ascribed to the physicians identified by the patient will not be part of the patient’s health record in the HIE network.

By organization – health records collected and maintained by the organizations identified by the patient will not be part of the patient’s health record in the HIE network.

Full Opt-Out – no health records will be in the HIE network.

What if a patient changes their mind? Rescind Opt-Out – a patient who has previously opted out can rescind their

decision at any time and participate in the HIE by filling out the opt out form or calling NC HIE’s call center.

Please Note: Opting out will not prevent caregivers from sharing health information with authorized entities when necessary for public health or research purposes that are permitted or required by NC and federal law. In cases of medical emergency, a caregiver doctor may request to view a health record to diagnose or treat an emergency medical condition. NC HIE audits such requests and makes records available to patients.

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+How to inform your patients

Communication Tools: Talking points for all staff

Scripts for registration and patient relations areas

Patient hand-outs (Opt-Out and Brochure)

Detailed FAQs

Call NC HIE for support and to answer questions from patients

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+Sample Go-Live Experience(conducted by HealthInfoNet, Maine’s HIE)

Primary care multi-site practice sent mailing to their 39,000 patients

Total calls to telephone number indicated: 62

Gender: Male - 26, Female - 33, Anonymous - 3

Age: Generally over 40, with 61% being over age 60 

43 of the 62 chose to opt-out

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+Patient Reactions

Most patients have no questions and choose to remain in the system

Some patients have a few questions (answered in 30-90 seconds) and choose to remain in the system

A few patients have extensive questions and require extra time or a call to NC HIE

NC HIE estimates that 1%-5% of patients will opt-out

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+Patient Questions and Concerns Recurring questions:

What is this and what is the point?

Is my information on the Internet?

Is my information going to be sold?

Who has access to this system?

General concerns:

Feel privacy violated

Do not trust that the system is secure

Worried their information will be available to insurance companies, government or their employer

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+Questions