Behavioral Health Information Network of Arizona · Access to health information exchange data...

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© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission. Behavioral Health Information Network of Arizona Behavioral HIE: Statewide Roadmap and Update

Transcript of Behavioral Health Information Network of Arizona · Access to health information exchange data...

Page 1: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Behavioral Health Information Network of Arizona

Behavioral HIE: Statewide Roadmap and Update

Page 2: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Learning objective #1:

Learn the basics of what an HIE is and does. Learn how Behavioral Health Information Exchange goes beyond traditional HIE.

Page 3: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Definitions

EHR

Electronic Health Record

An electronic record of health-related

information on an individual that conforms

to nationally recognized interoperability

standards and that can be created,

managed and consulted by authorized

clinicians and staff across more than one

healthcare organization.

ADTAdmit/ Discharge/ Transfer Message

A message that is triggered by an event (such as patient admit, discharge, transfer,

registration, etc.) that is generated from an EHR system.

HIEHealth Information Exchange

BHINAZ

The electronic movement of health-related information among organizations according to

nationally recognized standards.

PHR Personal Health Record

An electronic record of health-related information on an individual that conforms to

nationally recognized interoperability standards and that can be drawn from multiple

sources while being managed, shared and controlled by the individual.

DirectDirect Secure Messaging

a HIPAA-compliant, encrypted email system that encrypts both the message body and any

attachments. Users are validated and have been assigned a specific email address which insures the individual on the receiving end of the message is also a HIPAA-covered entity.

Page 4: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Meet Carlos

Meet Carlos

http://www.bhinaz.com/media/com_allvideoshare/general/carlos 3.14.20141203.mp4
Page 5: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Who is Behavioral Health Information Network of Arizona (BHINAZ)?

• Community Stakeholder Owned

• Official formed as a Limited Liability Company (LLC) in Arizona – June 2013

• Arizona statewide initiative – Behavioral Health Providers, Public Agencies, Health Information Network of Arizona, and consumers

Page 6: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Key Drivers

• Health Care Reform / Patient Affordable Care Act (ACA)

• Heath Information Technology for Economic & Clinical Health (HITECH) Act

• Meaningful Use of Certified Electronic Health Records (EHR)

• Integration between physical and behavioral health

• Health / Medical Home Models

Page 7: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Why a Separate BH HIE Initiative?

• Complicated Federal Laws around Privacy - 42 CFR Part 2

• Maintains integrity of Behavioral Health system in Arizona

• Provides a platform for emerging business opportunities

• Allows behavioral health providers to collectively own new technology

Page 8: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Access to health information exchange data saves nearly $2,000 per patient annually.1

82% of 231 clinicians surveyed said that valuable time was saved, reporting a mean

time savings of 105 minutes per patient. 1

1. Health Information Exchange Saves $1 Million in Emergency Care Costs for Medicare, Oct 14, 2015; American College of Emergency Physicians2. Ben-Assuli et al.: The impact of EHR and HIE on reducing avoidable admissions: controlling main differential diagnoses. BMC Medical Informatics and Decision Making 2013 13:493. HIE can help identify ED 'frequent fliers' for care coordination, Dec 11, 2013; FierceHealthIT4. The Comparative Value of 3 Electronic Sources of Medication Data, Oct 20, 2014; Am J Pharm Benefits

HIE use reduced seven-day readmissions by 48%.2

Nearly 90 percent of 231 clinicians surveyed said that quality of patient

care was improved through HIE use. 1

data from HIEs more accurately identifies patients who visit EDs frequently than a single site's records.3

Combining medication history information from three sources

improved accuracy and patient safety. 4

HIE Benefits*

Page 9: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Public Versus Private HIE

Public

• Availability and efficient distribution of a large volume of patient data

• Efficient exchange of standards-based data (CCD, IHE, etc.)

• Gateway to the National Health Information Network

• Arizona’s HINAZ

Page 10: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Public Versus Private HIE

Private• Coordination of care among the providers in a community –

workflow improvement

• Connecting systems and users with different technical capabilities and workflow needs

• Access to the community patient chart

• Business intelligence service to optimize pay-for-performance and quality improvement

• Support for emerging integrated delivery networks

Page 11: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Vision: Interoperability for Seamless, Integrated, Comprehensive Health Care

Page 12: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

HIE Partnership

BHINAZ connection to The Network allows easy access to more complete patient information

Currently 50% of hospital discharges statewide Expect 80 – 90% hospital discharge representation by end of 2015Expect to connect to all FQHCs, FQHC-LAs and RHCs by 2016

Page 13: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

The BHINAZ Network

• Behavioral Health Providers

• Public and Private External HIE’s

• Community Health Centers

• Advocacy Groups

• Public Agencies

• Primary Care

• Laboratory Companies (LabCorp, Sonora Quest, etc.)

• SureScripts/RxHub

• Specialists

• Hospital Systems

Page 14: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

BHINAZ HIE Solution

• Clinical Data Repository (On demand CCD/CCDA/CCR/HL7)

• XCA/XCPD Gateway Services

• Master Patient Index

• Granular Consent Management

• Provider & Resource Directory

• Data Analytics & Reporting

• Orders & Medication Reconciliation

Page 15: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

BHINAZ HIE Solution

• Secure, Web-Based Portal Access

• Support for Single Sign-on

• Security, Auditing & Network Management

• Support Core Integrated Healthcare Enterprise (IHE) Profiles

• Individual Referral Management between disparate EHRs

• Population Management

• Direct Exchange

Page 16: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Goals Around Care Integration-Care Coordination Platform

• Enrollment and Care Team Assignment

• Integrated Care Plan

• Centralized Referral Management

• Patient Engagement & Communication

• Population Management

• Reporting and Data Analytics

Page 17: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Learning objective #2:

Learn about types of behavioral and physical health data that can be exchanged and how efficiencies can be gained by receiving referral information real-time, electronically. See how real-time alerts about hospital admissions and discharges can help coordinate care.

Page 18: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Exchange & Clinical Information

• Structured Data Elements

• Demographics, Labs, Medications, Allergies, & Diagnosis

• Clinical Documents

• Psychiatric Evaluations, Assessments, Crisis & Safety Plans, Discharge/Transitions Plans, Individual Service/Recovery Plans, Progress Notes, etc.

Page 19: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

The Crisis Use Case

• BHINAZ will have 6 Maricopa County PNO’s connected for bi-directional exchange by 10/1/15

• Data from the PNO’s will be available via the portal viewer for Maricopa County crisis providers

• Allows for consolidated look-up

• Specific crisis information will be available for view

• Real-time Crisis Alerts will route to BHINAZ connected providers anytime their client has interacted with a crisis provider

Page 20: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Real-time Alerts

• We route real-time ADT information received from The Network and other sources to our connected providers.

• We can also configure custom alerts for out-of-range lab values, medication concerns or for other meaningful data.

Page 21: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Lab Ordering through the BHINAZ Network

• BHINAZ has the functionality to allow providers to place a lab order directly through their EHR and route to appropriate lab. Results will be received electronically back to the EHR.

• Saves providers from having to complete individual lab connections to lab companies.

Page 22: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Data Where You Want It*

• BHINAZ offers the flexibility to have data download directly to your EHR• Choose from medication history, labs or any available documents

• Data is also always viewable via our data viewer

*Viewable data is always based on applicable patient consent

Page 23: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Electronic Referrals

• BHINAZ supports the ability to route referrals from one provider to another electronically• Provider can choose which data elements and documents to include in the referral

• The receiving provider can choose to pull the referral directly into their EHR rather than create a new record

• Allows for closed-loop tracking

Page 24: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

The TechnologyPowered by Mirth

Page 25: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Navigating the HIE

Page 26: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Mirth Results

Page 27: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Mirth Results

Page 28: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Mirth Results

Page 29: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Mirth Mail (Direct Secure Messaging)

Page 30: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

Learning objective #3:

Learn about different consent models and see how consent keeps data secure.

Page 31: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Consent Management

Page 32: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Opt In vs. Opt Out

•Patient must OPT OUT

•Otherwise, they are Opted IN by default

Opt Out

•Patient must OPT IN

•Otherwise, they are Opted OUT by default

Opt In

Page 33: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Privacy & Consent

The state of Arizona is an “Opt-Out” state.

BHINAZ operates under an “Opt-in” model requiring the client to specifically agree to share their protected data from one provider to another.

The BHINAZ model ensures that data protected under 42 CFR part 2 is not re-disclosed without proper consent.

All BHINAZ data is treated as Part 2 data.

Page 34: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

BHINAZ Consent Facts

Consent is captured electronically at the point of care

Opt-in consent is valid for 365 days, then a new consent is collected

Patients can revoke at any time

The consent is “all or nothing” per agency/entity. We are not doing data segmentation at this time

Page 35: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

BHINAZ Consent Facts

We require the additional consent of minors aged 12-17. Minors can revoke without parents.

Opt-in status reverts to “no consent on file” at the age of 18 or age 12. A new consent is required.

Break-the-Glass is allowed regardless of consent status for valid emergency situations.

Page 36: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Consent Model

• Participant visits Agency A

• They sign a consent to allow their Agency A data to be

shared/viewed by ALL BHINAZ organizations

• Agency A Data now flows to all other BHINAZ organizations.

Agency A

SMI Clinic

Crisis Center

Detox Center

• Participant visits Detox Center• They choose NOT to share their

detox data• No detox data can be viewed by any

other agency on the network

Opt-In

Page 37: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

BHINAZ Roadmap

Current

•Live with Granular Opt-in Consent

•Live with Connection from BHINAZ to Mercy Maricopa HIN

•Live with 7 connections including 3 PNO connections

•Live with Sonora Quest Labs Connection

•Live with ADT feed from The Network

•Live with ADT alerts to providers

1-2 Months

• All 6 Maricopa County PNOs connected

• Crisis data look up live for Crisis providers

• Live with Crisis Alerts to all connected providers

3-12 Months

• Live with bi-directional exchange with the Network

• Crisis Response Referral System

• Full Break-the-Glass functionality

• Enhanced Consent Portal

Page 38: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Questions?

Page 39: Behavioral Health Information Network of Arizona · Access to health information exchange data saves nearly $2,000 per patient annually.1 82% of 231 clinicians surveyed said that

© Behavioral Health Information Network of Arizona Do not duplicate or distribute without explicit permission.

Contact

Laura Young, Executive [email protected]

www.BHINAZ.com602-567-8356


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