Healthcare Today: A Disconnected System

Partnering to Improve Patient Health Outcomes

Polly Mullins-Bentley, RN, RHIT, CPHQActing Executive Director

Governor’s Office of Electronic Health InformationState Health I.T. Coordinator

Healthcare Today: A Disconnected System

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• Islands of data

• Poor coordination

• Fragmented processes

• Limited connectivity

• Patients and clinicians often left without tools and data required

8/19/2011 3

NQS Framework

National Quality Initiative: Aims, Priorities and Goals for Improving Quality

1. Making Care Safer2. Ensuring Person- and Family-Centered Care 3. Promoting Effective Communication and

Coordination of Care 4. Promoting the Most Effective Prevention and

Treatment of the Leading Causes of Mortality, Starting With Cardiovascular Disease

5. Working With Communities to Promote Wide Use of Best Practices to Enable Healthy Living

6. Making Quality Care More Affordable

eHealth in Kentucky

• eHealth Milestones• March/2005

• Legislation (Senate Bill 2) to create a secure interoperable statewide electronic health network

• 2007 -2008• Medicaid Transformation Funding - $4.9 million• Built the technical infrastructure for the KHIE

• 2009• ARRA/HITECH Funding - $9.75 million

• 2010• Kentucky Health Information Exchange LIVE

Polly Mullins-Bentley, Acting Executive Director, CHFS, Governor’s Office of Electronic Health Information (GOEHI)

Kentucky Health Information Exchange:Governance Structure

7

Governor’s Office of Electronic Health InformationStrategic Priority Goals

• Promote and increase the adoption and use of health information technology

• Assist with and facilitate state-wide meaningful use initiatives (with other HITECH programs)

• Provide governance and oversight to the Kentucky Health Information Exchange

• Provide HIE Connectivity to as many providers as possible as quickly as possible

• Build critical mass• Demonstrate value

• Assist providers in meeting meaningful use

• 2012 Key Goals• Immunization Testing for Stage One MU• Work with pharmacies to increase electronic prescribing in KY• Implement lab results exchange with delivery• Facilitate exchange of key clinical information to improve transitions of care• Implement Direct Secure Clinical Messaging

How the Exchange ‘Works’Data Sharing!Community/Master Patient Index

• Populated by ADT’s/patient demographics

Record Locator Service• Locates all the patient encounters• Consolidates patient information for presentation to the provider

Access • KHIE Community Portal/Virtual Health Record• Provider EHR Portal/Dashboard

KHIE Community Portal (Virtual Health Record)

Implementation Success

• 226 Participation Agreements Signed• Represents 500+ provider organizations• Active implementations

• 82 LIVE Connections• Data is being exchanged between providers today

• Labs, Rads, Transcribed Reports• Clinical Summaries (CCD’s)• Immunizations routed to the KY IR

• Policies written, approved and in effect

Participation AgreementsHospitals/Physicians by County

226 Signed PA’sUpdated 08/10/12

Adair

Allen

Anderson

Ballard

Barren

Bath

Bell

Boone

Bourbon

Boyd

Boyle

Bracken

Breathitt

Breckinridge

Bullitt

ButlerCaldwell

Calloway

Campbell

Carlisle

Carroll

Carter

Casey

Christian

Clark

Clay

Clinton

Crittenden

Cumberland

Daviess

Edmonson

Elliott

Estill

Fayette

Fleming

Floyd

Franklin

Fulton

Gallatin

Garrard

Grant

Graves

Grayson

Green

Greenup

Hancock

Hardin

Harlan

Harrison

Hart

Henderson

Henry

Hickman

Hopkins

Jackson

Jefferson

JessamineJohnson

Kenton

Knott

Knox

Larue

Laurel

Lawrence

Lee

Leslie Letcher

Lewis

Lincoln

Livingston

Logan

LyonMcCracken

McCreary

McLean

Madison Magoffin

Marion

Marshall

Martin

Mason

MeadeMenifee

Mercer

Metcalfe

Monroe

Montgomery

Morgan

Muhlenberg

Nelson

Nicholas

Ohio

Oldham

Owen

Owsley

Pendleton

Perry

Pike

Powell

Pulaski

Robertson

Rockcastle

Rowan

Russell

ScottShelby

Simpson

Spencer

Taylor

ToddTrigg

Trimble

Union

Warren

Washington

Wayne

Webster

Whitley

Wolfe

Woodford

Hospital Physician Lab Combination

Other Participation Agreements:• Kentucky Immunization Registry• Kentucky Cancer Registry• Kentucky State Laboratory• Cumberland Medical Lab• Labcorp

Congressional District 1



Congressional District 4 Congressional District 6


KHIE Hospital Participation AgreementsHospitals by County

64 Signed PA’s representing 90 Hospitals (22 are CAH)Updated 08/13/2012

Adair

Allen

Anderson

Ballard

Barren

Bath

Bell

Boone

Bourbon

Boyd

Boyle

Bracken

Breathitt

Breckinridge

Bullitt

ButlerCaldwell

Calloway

Campbell

Carlisle

Carroll

Carter

Casey

Christian

Clark

Clay

Clinton

Crittenden

Cumberland

Daviess

Edmonson

Elliott

Estill

Fayette

Fleming

Floyd

Franklin

Fulton

Gallatin

Garrard

Grant

Graves

Grayson

Green

Greenup

Hancock

Hardin

Harlan

Harrison

Hart

Henderson

Henry

Hickman

Hopkins

Jackson

Jefferson

JessamineJohnson

Kenton

Knott

Knox

Larue

Laurel

Lawrence

Lee

Leslie Letcher

Lewis

Lincoln

Livingston

Logan

LyonMcCracken

McCreary

McLean

Madison Magoffin

Marion

Marshall

Martin

Mason

MeadeMenifee

Mercer

Metcalfe

Monroe

Montgomery

Morgan

Muhlenberg

Nelson

Nicholas

Ohio

Oldham

Owen

Owsley

Pendleton

Perry

Pike

Powell

Pulaski

Robertson

Rockcastle

Rowan

Russell

ScottShelby

Simpson

Spencer

Taylor

ToddTrigg

Trimble

Union

Warren

Washington

Wayne

Webster

Whitley

Wolfe

Woodford

Hospital






Critical Assess Hospital

FQHC Participation AgreementsFQHC by County

11 Signed PA’s representing 51 Sites

Adair

Allen

Anderson

Ballard

Barren

Bath

Bell

Boone

Bourbon

Boyd

Boyle

Bracken

Breathitt

Breckinridge

Bullitt

ButlerCaldwell

Calloway

Campbell

Carlisle

Carroll

Carter

Casey

Christian

Clark

Clay

Clinton

Crittenden

Cumberland

Daviess

Edmonson

Elliott

Estill

Fayette

Fleming

Floyd

Franklin

Fulton

Gallatin

Garrard

Grant

Graves

Grayson

Green

Greenup

Hancock

Hardin

Harlan

Harrison

Hart

Henderson

Henry

Hickman

Hopkins

Jackson

Jefferson

JessamineJohnson

Kenton

Knott

Knox

Larue

Laurel

Lawrence

Lee

Leslie Letcher

Lewis

Lincoln

Livingston

Logan

LyonMcCracken

McCreary

McLean

Madison Magoffin

Marion

Marshall

Martin

Mason

MeadeMenifee

Mercer

Metcalfe

Monroe

Montgomery

Morgan

Muhlenberg

Nelson

Nicholas

Ohio

Oldham

Owen

Owsley

Pendleton

Perry

Pike

Powell

Pulaski

Robertson

Rockcastle

Rowan

Russell

ScottShelby

Simpson

Spencer

Taylor

ToddTrigg

Trimble

Union

Warren

Washington

Wayne

Webster

Whitley

Wolfe

Woodford

FQHC






FQHC Sites live on KHIE

Rural Health Clinics Participation Agreements

RHC by County42 Signed PA’s representing 80 Sites

Updated 08/13/2012

Adair

Allen

Anderson

Ballard

Barren

Bath

Bell

Boone

Bourbon

Boyd

Boyle

Bracken

Breathitt

Breckinridge

Bullitt

ButlerCaldwell

Calloway

Campbell

Carlisle

Carroll

Carter

Casey

Christian

Clark

Clay

Clinton

Crittenden

Cumberland

Daviess

Edmonson

Elliott

Estill

Fayette

Fleming

Floyd

Franklin

Fulton

Gallatin

Garrard

Grant

Graves

Grayson

Green

Greenup

Hancock

Hardin

Harlan

Harrison

Hart

Henderson

Henry

Hickman

Hopkins

Jackson

Jefferson

JessamineJohnson

Kenton

Knott

Knox

Larue

Laurel

Lawrence

Lee

Leslie Letcher

Lewis

Lincoln

Livingston

Logan

LyonMcCracken

McCreary

McLean

Madison Magoffin

Marion

Marshall

Martin

Mason

MeadeMenifee

Mercer

Metcalfe

Monroe

Montgomery

Morgan

Muhlenberg

Nelson

Nicholas

Ohio

Oldham

Owen

Owsley

Pendleton

Perry

Pike

Powell

Pulaski

Robertson

Rockcastle

Rowan

Russell

ScottShelby

Simpson

Spencer

Taylor

ToddTrigg

Trimble

Union

Warren

Washington

Wayne

Webster

Whitley

Wolfe

Woodford

RHC






LIVE Connections

Adair

Allen

Anderson

Ballard

Barren

Bath

Bell

Boone

Bourbon

Boyd

Boyle

Bracken

Breathitt

Breckinridge

Bullitt

ButlerCaldwell

Calloway

Campbell

Carlisle

Carroll

Carter

Casey

Christian

Clark

Clay

Clinton

Crittenden

Cumberland

Daviess

Edmonson

Elliott

Estill

Fayette

Fleming

Floyd

Franklin

Fulton

Gallatin

Garrard

Grant

Graves

Grayson

Green

Greenup

Hancock

Hardin

Harlan

Harrison

Hart

Henderson

Henry

Hickman

Hopkins

Jackson

Jefferson

JessamineJohnson

Kenton

Knott

Knox

Larue

Laurel

Lawrence

Lee

Leslie Letcher

Lewis

Lincoln

Livingston

Logan

LyonMcCracken

McCreary

McLean

Madison Magoffin

Marion

Marshall

Martin

Mason

MeadeMenifee

Mercer

Metcalfe

Monroe

Montgomery

Morgan

Muhlenberg

Nelson

Nicholas

Ohio

Oldham

Owen

Owsley

Pendleton

Perry

Pike

Powell

Pulaski

Robertson

Rockcastle

Rowan

Russell

ScottShelby

Simpson

Spencer

Taylor

ToddTrigg

Trimble

Union

Warren

Washington

Wayne

Webster

Whitley

Wolfe

Woodford

Hospital Physician/Clinic Lab Combination

Others:• Kentucky Immunization Registry• State Lab (Microbiology)

(Franklin)• Grundy, VA






8/19/2011

Outreach Coordinator Regions

Adair

Allen

Anderson

Ballard

Barren

Bath

Bell

Boone

Bourbon

Boyd

Boyle

Bracken

Breathitt

Breckinridge

Bullitt

ButlerCaldwell

Calloway

Campbell

Carlisle

Carroll

Carter

Casey

Christian

Clark

Clay

Clinton

Crittenden

Cumberland

Daviess

Edmonson

Elliott

Estill

Fayette

Fleming

Floyd

Franklin

Fulton

Gallatin

Garrard

Grant

Graves

Grayson

Green

Greenup

Hancock

Hardin

Harlan

Harrison

Hart

Henderson

Henry

Hickman

Hopkins

Jackson

Jefferson

JessamineJohnson

Kenton

Knott

Knox

Larue

Laurel

Lawrence

Lee

Leslie Letcher

Lewis

Lincoln

Livingston

Logan

LyonMcCracken

McCreary

McLean

Madison Magoffin

Marion

Marshall

Martin

Mason

MeadeMenifee

Mercer

Metcalfe

Monroe

Montgomery

Morgan

Muhlenberg

Nelson

Nicholas

Ohio

Oldham

Owen

Owsley

Pendleton

Perry

Pike

Powell

Pulaski

Robertson

Rockcastle

Rowan

Russell

ScottShelby

Simpson

Spencer

Taylor

ToddTrigg

Trimble

Union

Warren

Washington

Wayne

Webster

Whitley

Wolfe

Woodford

Region 1 – Laura ShonkRegion 2 – Teresa PoffRegion 3 – Ann O’HaraRegion 4 – Dawn GasserRegion 5 – Pat Robinson

GOEHI’s Plan/Scope of Work

• Assist the existing Pennyroyal Behavioral Health recipient with KHIE connectivity

• Provide connectivity for other CMHCs

• Enhance the capability of the KHIE and the current CCD

• Develop a 42 CFR 2 compliant consent

• Develop consent training protocols

• Inform both healthcare providers and consumers about this process

What’s Possible? With a Connected Community

CommunityPharmacy

ImagingCenter

Loosely Affiliated Physicians

Hospitals

Patients

Tightly Aligned Physicians

Better CareAffordable CareHealth People/Healthy Community

Owned Practices/

ClinicsReference

Lab

Non-affiliated Practices

More information on the KHIE can be found on the Governor’s Office of Electronic Health Information website athttp://khie.ky.gov

[email protected]

http://khie.ky.gov/

mailto:[email protected]

Healthcare Today: A Disconnected System

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