Market Trends and Practical Examples
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Agenda
• Market Trends in Interoperability
• Integrating Clinic and Hospital EMRs
• HL7 FHIR
Today’s Speakers
• Brian Fugere, GM, Global Marketing, Value-Based
Care Solutions, GE Healthcare
• Geoffrey Lay, Sr. Product Management Leader, GE
Healthcare
• Tim Fitzgerald, Director of IT, The Oregon Clinic
• Keith Boone, Interoperability Guru, GE Healthcare
Survey Conducted With eHealth Initiative in Fall 2016
Payer
8%
Health
Information
Exchange
(HIE)
18%
Healthcare
Delivery
74%
Perspectives on Interoperability and
Value-Based Care
• 95% agree that strong interoperability capabilities are a key IT
requirement for a successful transition to value-based care
• 85% agree that current interoperability solutions in the market are not
meeting their needs as they transition to value-based care
eHealth Initiative Survey Fall 2016
Rate Your Current Interoperability Solutions Ability to
Drive Value-Based Care Outcomes
70.0%
63.9%
60.0%
50.0%
40.0%
30.0%
20.8%
15.3%
20.0%
10.0%
0.0%
Table stakes – we
Some value add – Significant value add
have the basics,
interoperability is
– interoperability is
interoperability is not driving some benefits driving significant
driving outcomes
benefits
eHealth Initiative Survey Fall 2016
Overwhelming Agreement That Strong Interoperability is
Key to Successful Transition to Value-Based Care
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
1%
1%
3%
15%
3%
3%
4%
5%
1%
17%
37%
25%
25%
79%
48%
31%
1%
Since 2008,
technology has
helped decrease
healthcare costs
Strong
Current
interoperability
interoperability
capabilities are a
solutions in the
market are not
key IT requirement
for a successful
meeting our needs
transition to VBC. as we transition to
VBC.
Agree Completely
Agree Somewhat
eHealth Initiative Survey Fall 2016
1%
4%
10%
10%
6%
8%
18%
57%
49%
18%
19%
Since 2008,
technology has
helped increase
healthcare quality
Technology has
helped promote
team-based care
concepts
Neither Agree nor Disagree
Interoperability Budget Changes Over Next 2-3 Years
Decrease
significantly,
2.9%
Decrease a
little, 5.7%
Increase
significantly,
28.6%
No change,
17.1%
Increase a little,
40.0%
eHealth Initiative Survey Fall 2016
Willingness to Pay…
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
10%
10%
43%
48%
28%
49%
55%
47%
38%
42%
16%
13%
…readily available via an …readily available AND …readily available, easy …readily available, easy
always-on connection
also easy to locate
to locate AND also
to locate, integrated into
integrated into clinicians clinician's workflow AND
workflow
also drives significant
practice outcomes
Significant value add - I would pay premium fee for this capacity
Some Value add - I would pay a nominal fee for this capacity
Table stakes - Iam not willing to pay for this
eHealth Initiative Survey Fall 2016
Comments from Respondents
Need for
Standardization
• Lack of standardization among vendors.
• Need for standardized vocabulary and well-defined
operational definitions of data fields.
Integration with
EMR
• Information coming from another provider needs to
be integrated in our EMR.
• There should be a query and retrieve function.
Strong
Business Case
Data Ownership
• There needs to be increased willingness to share
patient data among providers.
• Currently difficult to directly show improved
outcomes as a result of investment.
• Payers still own data, so it is difficult to retrieve.
eHealth Initiative Survey Fall 2016
“Inability to convert all
the data from over
300 systems into one
data warehouse in a
usable fashion”
“Integration with
outside data,
integration into
workflow”
“Access to data
from disparate
platforms due to
cost, politics, and
restrictions on
proprietary code”
“Depends on
how you define
interoperability.”
Overall Trends
• Strong agreement that interoperability is needed for value-based
care
• Majority of respondents did not feel interoperability was decreasing
healthcare costs in their organizations, and many expect their
budgets for IT to increase in the coming years
eHealth Initiative Survey Fall 2016
Overall Trends
• Connectivity across provider organizations is most important to
organizations. Exchanging data for regulatory reporting and industry
wide data for research purposes is not as important connectivity area
for payer, provider and HIE organizations.
• Majority felt federal policies and regulations are not currently
sufficient to help the nation achieve interoperability by 2020, however
majority believe more federal incentives are needed.
eHealth Initiative Survey Fall 2016
Give Clinicians an Hour Back Each Day: Interoperability with
Epic® Care Everywhere
• Geoffrey Lay, Sr. Product Management Leader,
Interoperability, GE Healthcare
• Tim Fitzgerald, Director of IT, The Oregon Clinic
ROI Disclaimer
HYPOTHETICAL EXAMPLE. Information presented in this example is hypothetical and for illustrative purposes only. Any analysis or information derived from
this example is for general information purposes only and is being furnished free of charge without representation or warranty of any kind whatsoever. This
example contains certain assumptions that may not be valid for your specific facts and circumstances. This example and any analysis are provided for your use
only and may not be transferred to any third party.
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information provided by this example. Any reliance shall be at your sole risk, and we shall have no liability to you or any third party for any reason. Nothing in
this example and no analysis derived therefrom should be construed as constituting tax, accounting, legal or financial advice. You should consult your own
professional advisors for such advice. Nothing herein constitutes a proposal or commitment for any particular transaction. Any such transaction would be
subject to execution of documentation in form and substance satisfactory to GE.
HEALTH CARE PROFESSIONALS ARE RESPONSIBLE FOR MAKING INDEPENDENT CLINICAL DECISIONS AND APPROPRIATELY BILLING, CODING
AND DOCUMENTATION THEIR SERVICES. This example is not intended to interfere with a health care professional’s independent clinical decision making.
Other important considerations should be taken into account when making purchasing decisions, including clinical value. The health care provider has the
responsibility, when billing to government and other payers (including patients), to submit claims or invoices for payment only for procedures which are
appropriate and medically necessary and in accordance with applicable laws. Consult with your reimbursement manager or a healthcare consultant, as well as
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© 2017 General Electric Company
Give Clinicians an Hour Back Each Day:
Interoperability with Epic Care Everywhere
Objective
Agenda
• Increase clinical efficiency and enhance
care quality by improving connectivity
between ambulatory practice and referring
hospitals.
• Challenges associated with care
coordination
• Benefits of clinical integration
• Anticipated outcomes
• Next steps
Background/Overview
• Multi-specialty ambulatory clinic, 230 providers
• Physician-owned, autonomous
• Provide specialty care for two large hospital systems who use Epic
Care Everywhere
• Ongoing dialogue with hospital leadership about care
coordination/improving communication
• Ongoing internal dialogue about efficiency, clerical burden, and time
spent with patients
• Dr. Craig Fausel
Challenges Associated With Care
Coordination
CHALLENGE: Current Referral Process Costs Providers and
Staff Time and Lacks Agility
Via Fax,
phone
Hospital System
Ambulatory Practice
Create
Chart
e-Referral
Schedule
Visit(s)
Review
Chart
Med Asst.
Chart Review
MD Chart
Review
Via
PDF/Fax
Document
Visits
Visits Occur
Chart Notes
Sent
Via
PDF/Fax
Request
Records
Attach Records
Into Chart
Key challenges
1. Staff invest significant time retrieving and
attaching data to chart
2. Physicians lose time reviewing attached
data that isn’t integrated into chart
3. Important data can be overlooked
4. Missing data is not easy to obtain in real
time
Benefits of Clinical Integration
INNOVATION: Interface with Hospital System Increases Clinical
Efficiency and Enhances Care Quality
Hospital System
Via CCDA
Ambulatory Practice
Create
Chart
e-Referral
Schedule
Visit(s)
Request
Records
Review
Chart
Med Asst.
Chart Review
MD Chart
Review
Key benefits
Via CCDA
Document
Visits
Chart Notes
Sent
Visits Occur
Via CCDA
Integrate data
Into Chart
1. Referral data integrated into chart
2. Physicians spend less time searching for
data
3. Administrative staff spend less time.
preparing charts
4. Missing clinical data easy to obtain in real
time before patient leaves
Anticipated Outcomes
Ambulatory Practices Gain Efficiency
The Oregon Clinic expects providers to gain 60
chart efficiency.
min/day per provider in
“Normally changing healthcare is hard, but in this case we think it will be really
easy.”
- Tim Fitzgerald, Director of IT, The Oregon Clinic
Health System Sees Clinical Benefits From the Integration
“Working in the ED on Saturday night, I was able to access labs recently
done at The Oregon Clinic for a patient I was seeing. Having the recent labs
for comparison was so helpful in the clinical care of this patient. Access
from the Epic side was seamless and looks just like other local (Epic)
facilities in Care Everywhere. Thanks so much for your hard work on this
important tool that will no doubt help countless patients our organizations
care for together.”
- Dr. Andy Zechnich, CMIO, Providence Health System
The Workflow
2
4
Start a Chart Update and Open the Reconcile Form
Type of document
(CCD or Progress
Note)
Filters and Actions
Summary
of Results
Returned
Source of
Document
Date of Service
Select the Latest CCDA and Reconcile
Reconcile this
CCDA
Select and
Reconcile
Medications
Review/Compare
Select and Reconcile Medications
Select Medication
to Import
Select and
Reconcile
Problems
Select Problems
to Import
Select and
Reconcile
Allergies
Compare known
allergies
Reconciled
Medications
in Centricity™
Practice
Solution
Reconciled Problems in EMR
Current Status
Current Status at The Oregon Clinic
•
•
•
Rolling out to HIM department and each specialty with very
positive feedback from clinicians. Expected completion
Q/2017.
The connectivity has created hope for clinicians. It’s clear that
there is an urgent, significant need out there.
Two additional Health Systems in progress.
Any descriptions of future functionality reflect current product direction, are for informational purposes only and do not constitute a
commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.
Carequality and GE Healthcare
Carequality and GE Healthcare
•
•
•
•
Building out our cloud based endpoint now
Establishing our pilot sites
Participation on Carequality production calls
Goal: General Availability in Q3 of 2017
Any descriptions of future functionality reflect current product direction, are for informational purposes only and do not constitute a
commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.
The Commitment to Interoperability
The GE Commitment Continues
•
•
•
•
•
•
•
•
•
Added three development teams globally
Trained more than 100 engineers in FHIR
Onboarded numerous partners in our API program
Demonstrated two FHIR prototypes at Centricity Live
Continued our commitment to FHIR development
Brought new product to Connectathons in HL7 and IHE
Piloted use of IHE profiles with an ambulatory clinic and three hospitals
Spinning up our Carequality Implementer program
Piloted FHIR development with customers and partners
Looking Forward in 2017
• Introducing use of HL7 FHIR APIs in for release in mid 2017:
– Centricity Practice Solution 12.3
– Centricity EMR 9.12
• 33 FHIR Resources supported for Clinical & Practice Management use.
• FHIR infrastructure also appearing in our Project Northstar program.
• Future plans include:
– Cloud support of FHIR APIs
– Connecting payers and providers with FHIR APIs
• More Interoperability to show at Centricity LIVE, Boston, May 17-20, 2017
Any descriptions of future functionality reflect current product direction, are for informational purposes only and do not constitute a
commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.
The Magic of FHIR
•
We’ve enabled John Halamka’s “Magic Button” using HL7 FHIR®
•
Entering pilot stage at Fenway Health and Beth-Israel Deaconess Medical Center
Any descriptions of future functionality reflect current product direction, are for informational purposes only and do not constitute a
commitment to provide specific functionality. Timing and availability are subject to change and applicable regulatory approvals.
New Standards? No Problems
Alliance of Chicago demonstrating use of Centricity Practice Solution 12.2 with
• our new API Server
• our new CDA Generator
Built with 10 years of Connectathon experience to produce a new standards based document
Demonstrating Interoperability Across the
Spectrum
Summary
GE Healthcare's commitment
• It’s all about the customer and outcomes
– Enhance Care Quality, Improved Provider Efficiency,
Strengthen Financial Performance
• It’s all about standards
– Carequality, FHIR
• Five use cases in the Interoperability Showcase
– Come see us!
Providers Will Not Succeed in the
World of Value-Based Care
Without Interoperating With Their
Environment.
Let’s Join Together to Help Them!
Thank you for joining us.
Questions?