(PUBLIC) VITL Update for VT HHCC - 2015-01-23

What VITL Does

Overview

Board of Directors

Vision

Adam Buckley, MD

Bruce Bullock, MD

Andrea Dinneen

John K. Evans

Don George

Bea Grause

Paul Harrington

Gertrude Hodge

Ron Keen

Robin Lunge

Todd Moore

Amy Putnam

Rep. Tristan Toleno

The UVM Medical Center

Marble Valley Healthworks, LLC.

Northeastern Vermont Regional Hospital

Vermont Information Technology Leaders

Blue Cross Blue Shield of Vermont

Vermont Association of Hospitals and Health Systems

Vermont Medical Society

Consumer Advocate

Health Care Entrepreneur

Vermont Agency of Administration

OneCare Vermont

Northwestern Counseling & Support Services

Vermont House of Representatives

A transformed health care system where health information is secure and readily available when people need it, positioning Vermont as a national example of high quality, cost effective care.

• Develops statewide health information technology for providers and the delivery system: the Vermont Health Information Exchange (VHIE).

• Assists Vermont health care providers with the adoption and use of health information technology.

• Leverages the VHIE to offer capabilities and tools to providers designed to improve clinical and financial outcomes.

• Incorporated July, 2005 as a 501(c)(3) nonprofit organization
• 14 member representative board
• Two offices: Burlington and Montpelier
• Staff of 35
• Revenue: FY13 $5.8m; FY14 $6.6m; Projected FY15 $9.3m

Introducing the IHI Triple Aim

• Developed in 2007 by the Institute for Healthcare Improvement, the Triple Aim is the simultaneous pursuit of three goals:

• Improving the patient experience,
• Improving the health of populations, and
• Reducing the per capita cost of health care.

• We will explore how VITL's efforts support the IHI Triple Aim framework.

The IHI Triple Aim framework was developed by the Institute for Healthcare Improvement in Cambridge, Massachusetts (www.ihi.org).

IHI is one of the world's leading innovators, convenors, and leaders in ways to improve health and health care.

Summary

Vermont Consent Policy

Encouraging Patients to Engage with Their Clinicians

Consent Statistics (as of 12/31/2014)

Patient Centered Information

Video:

How VITL Informs Health Care

10,720

433

• Improved patient safety by eliminating unneeded tests and X-rays.

• Eliminated lost time from work (parent) / school (Sarah).

• Eliminated cost of redundant tests.

• The VHIE collects and indexes information using a state-wide master patient index (MPI).
• Highly secure network:
• Data is encrypted.
• Data stored in separate organizational vaults.
• Best practices in health care and exceeds HIPAA.
• Access only allowed for providers involved in that patient's care.
• Patients must give consent.

Number of consumers who have given consent:

Number of consumers who have opted-out:

• VITL is reaching out to Vermont health care consumers through an awareness campaign

• VITL Summit features nationally recognized patient engagement speaker

• Investigating state-wide patient portal for better access to data

• Reducing duplicate services with VITLAccess resulting in fewer tests and reduced co-pays

• Vermont Consent Policy provides Global Consent.

• Patient must give written consent for provider access to their health information in the VHIE.

• Once granted, any provider involved in the patient’s care is allowed access data for that patient.

• Each health care organization must verify a patient has provided consent, or receive a patient’s written consent before viewing the patient’s information.

EHR's

Hospitals: 100%

Primary Care Practices: 97%

FQHC's: 90%

Home Health: 100%

Mental Health, Long Term Care, Specialists, Other Providers

Point of Care Decision Making

Transitions of Care

Population Health Data Management

Problem:

• Clinicians do not have information generated by other providers involved in their patient's care, so they are not completely informed.

VITL Solutions:

• VITLAccess so that informed clinicians can consider:
• Are additional tests needed?
• Does a procedure need to be performed?
• Does the patient need to be admitted?

Expected Outcomes:

• More informed decision making.
• Improved patient safety.
• Reduced costs.

Problem:

• As patients transition from one care setting to another, communications and information regarding the patient is often inadequate, resulting in delays and uninformed care.

VITL Solutions:

• VITLAccess to view previously generated patient data.
• VITLDirect to send secure communications between providers.
• VITLNotify to alert providers when their patients are admitted, discharged, or transferred (planned).

Expected Outcomes:

• Improved "hand-offs" between providers.
• Improved care.
• Improved patient satisfaction.

Problem:

• Provider organizations need to proactively develop strategies and interventions for defined groups of individuals in an effort to improve their health.

VITL Solutions:

• Technology and gap remediation to capture and transmit clinical data that comprise the ACO performance measures.
• Technology and data quality improvement to support the Blueprint for Health management of primary care chronic disease populations.
• VITLNotify to alert providers when their patients are admitted, discharged, or transferred (planned).
• Predictive analytics (planned).

Expected Outcomes:

• Improved quality by achieving performance measures.
• Better manage certain populations of patients.
• Reduced admissions, ER visits, and need for more costly care.

4 of 16 Designated Mental Health Agencies

• Health Care and Rehabilitative Services
• Counseling Services of Addison County
• Northwestern Counseling & Support Services
• Northeast Kingdom Human Services

Five VNAs of Vermont

Sending Clinical Data

Central Vermont Home Health and Hospice

Franklin County Home Health Agency, Inc.

Rutland Area Visiting Nurse Association and Hospice

Visiting Nurse Association of Chittenden and Grand Isle Counties

Visiting Nurse and Hospice for Vermont and New Hampshire

Clinical Data:

Two Nursing Homes

Receiving Lab Results

• Admissions, Discharge & Transfer Information
• Patient Demographics
• Lab Test Results
• Radiology Reports
• Pathology Reports
• Other Transcribed Reports
• Clinical Summaries
• Immunizations
• Medication History

Helen Porter Healthcare and Rehabilitation Center

The Manor

Three Commercial Labs

Sending Results

Burlington Labs, Inc

LabCorp

Quest Diagnostics

VITLDirect

• Secure provider to provider messaging system.
• Send and receive patient protected health information
• Contents of messages and attachments sent between providers are not stored in the VHIE
• Patient data are sent in a standard encrypted format, in compliance with the national Direct Project specifications.
• Current users: 20 users at 4 health care organizations

VITLAccess

• Secure statewide provider portal giving complete, accurate, and up-to-date patient information.
• Requires patient consent to view.
• Information is available from all VHIE contributing organizations across Vermont, New York and New Hampshire.
• 24 hours a day x 7 days a week.
• Available anywhere there is Internet service.
• Users within 90 days of launch: 294 users at 29 health care locations.

VITLNotify (coming in 2015)

• Provides automatic system alerts to providers when their patients are admitted, discharged or transferred from an acute care facility.
• VITL will begin a VITLNotify pilot program in 2015.

VITL Services to Blueprint:

• Assist Blueprint providers in the adoption of health care technology
• Provides clinical data from Blueprint primary care providers that is used for:
• Clinical decision support.
• Quality performance management.
• Comparative information and profiles.
• Reducing the cost of care
• Jointly work with providers to improve the quality of data
• Without the VHIE, this would require a separate data network

Blueprint for Health Initiative

• Vermont's signature primary care health reform initiative

• Patient Centered Medical Home (PCMH)

• Focus on care communities and chronic disease management

VITL Services to the ACOs

• Developing the technical architecture or "gateways".

• Supporting the collection of accurate clinical data that comprises the performance measures.

• Identifying and remediating gaps in ACO provider technology and ability to transmit data to the VHIE.

Accountable Care Organizations (ACO)

• Health care organizations characterized by a payment and care delivery model that seeks to tie provider reimbursements to quality metrics, and reductions in the total cost of care for an assigned population of patients.

• Important health care reform initiative in Vermont: 3 ACOs.

• Seeking to analyze data in order to achieve pre-established performance measures.

Vermont Care Network and

Vermont Department of Mental Health

Vermont Department of Health Immunization Registry

• Electronic health record (EHR) system selection assistance.
• Support workflow analysis and data quality improvement.
• 42 CFR Part 2 Project (planned).

• 52 Health care organizations now sending immunization data electronically through the VHIE.
• Utilizes VITL custom infrastructure.
• Complies with Centers for Disease Control and Prevention data transmission specifications (PHINMS).

Point of Care

Decision Making

Informing clinicians with data at the time they are treating a patient.

Health Care Challenges

Analytics

Population Health

Data Management

Analyzing data to improve patient outcomes.

Using data for a population of patients to determine best practices outcomes.

VITL Update for Vermont House Health Care Committee

January 23, 2015