# Presentation: 469363

## Health Information Exchange and Consumer Services

**Health Information Exchange and Consumer Services**
- AHIC Consumer Empowerment Workgroup
- June 17th, 2008
**Chris Muir**
- Senior Program Analyst
- Office of the National Coordinator for
- Health Information Technology (ONC)

**Notes:**
NGA and ONC are partners

ONC Team
 Jodi Daniel, Co-Project Officer
 Betsy Ranslow, Co-Project Officer
 Steve Posnack, HISPC Liaison
 Chris Muir, SLHIE Liaison

## Presentation Outline

- Overview of health information exchange
- Describe RHIOs/HIOs
- Discuss RHIOs/HIOs involvement with consumer services
- Discuss NHIN and PHR/consumer services

## Definition of “Health Information Exchange”

- “The electronic _movement_ of health-related information _among_ organizations according to nationally recognized standards.”

- Definition taken NAHIT report funded by ONC found at www.nahit.org

## Definition “Health Information Organization”

- “An organization that _oversees and governs_ the exchange of health-related information _among_ organizations according to nationally recognized standards.”
- Examples: data exchange based on populations, diseases/conditions, etc.

- Definition taken NAHIT report funded by ONC found at www.nahit.org

## Definition “Regional Health Information 	Organization”

- “A health information organization that brings together health care stakeholders within a _defined geographic area_ and governs health information exchange among them for a purpose of improving heath and care in that community.”

- Definition taken NAHIT report funded by ONC found at www.nahit.org

## Attributes of a RHIO/HIO

- Goals for the public good
- Public-private partnership
- Inclusive with balanced representation of stakeholders
- Transparency in decision making and other processes
- Usually not-for-profit
- Exchange services provisioned either         in-house or outsource

## RHIO/HIO Services Operating in 2007

| Service | Operational |
| --- | --- |
| Results Delivery  | 75% |
| Clinical Documentation  | 63% |
| Consultation/Referral | 54% |
| Enrollment or Eligibility Checking | 54% |
| Alerts to Providers | 48% |
| /////////////////////////////////////////////////////////////////// | ///////////////////////// |
| Patient Access to Information Through the Exchange | 12% |
| Patient-Provider Clinical Data Exchange Through the Exchange | 12% |
| Patient-Provider Communication—Other | 12% |

**From eHI’s 2007 Annual HIE Survey found at http://www.ehealthinitiative.org/2007HIESurvey/**

## RHIOs/HIOs and Services to Consumers	

- Fairly new area for RHIOs/HIOs
- Requires robust infrastructure to support—especially data access
- Three ways HIOs are handling services to consumers:
- Business-to-business connection—RHIO to provide connectivity to PHR service providers
- HIO architecture based on Personally Controlled Model
- HIO to provide a patient data access service

## RHIOs/HIOs and Services to Consumers	

- Examples of HIO architectures based on  personally controlled  models:
- State of Washington RFP to award contracts to start community Health Data Banks--$2 million
- State of Oregon using a Health Data Bank Model for Medicaid population funded by a CMS Transformation Grant
- City of Louisville following Health Data Bank Model

## RHIOs/HIOs and Services to Consumers

- Example of RHIO/HIO offering patient data access: **Rhode Island Quality Institute—State Level HIO**
- Plans to offer web-based patient portal
- Self-enroll in state HIE
- View their own clinical data through HIE
- View who has accessed their data

## Challenges to RHIOs/HIOs in Offering PHR/Consumer Services

- In many markets consumers are not engaged
- Requires data access and infrastructure beyond current means of most RHIOs
- Competition with partners including hospitals and payers
- Business case—how does the RHIO get reimbursed for the service

## The Nationwide Health Information Network

**The Nationwide Health Information Network**

**Mobilizing Health Information Nationwide**

**The Internet**

**Standards, Specifications and Agreements****for Secure Connections**

## Questions & Comments

**www.hhs.gov/healthit**