Funnels and Quilts · Indiana Health Information Exchange Funnels and Quilts J. Marc Overhage, MD, PhD, FACMI, FACP. Senior Scientist, Regenstrief Institute. Professor of Medicine,
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Funnels and QuiltsJ. Marc Overhage, MD, PhD, FACMI, FACP
Senior Scientist, Regenstrief InstituteProfessor of Medicine, Indiana University School of Medicine
President and CEO, Indiana Health Information Exchange
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ge Participants• “All” Indianapolis med/surg hospitals• Physician offices• Community health centers• Homeless care network• Public school clinics• County and state public health departments• National laboratories• Public schools• Pharmacies• PBMs
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ge Data shared by all institutions• All ED and outpatient visits• All hospital discharges (dx, procedures)• All inpatient laboratory results• All outpatient laboratory results• Immunizations• All discharge summaries/admissions summaries• All operative notes• All radiology reports• All surgical pathology reports• Inpatient medications• Tumor registry data
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20%
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50%
60%
70%
80%
90%
100%
Adjusted Patient Days Laboratory Results Medications Dispensed Physicain Practices Payors
Other
Indiana Oral & Maxillofacial Surgery Associates
Central Indiana Cancer Centers
Indiana Nephrology & Internal Medicine PC
Otolaryngology Associates
Indianapolis Neurosurgicla Grup
Indiana Heart Physicians
Midw est Eye Instiute
Josephson-Wallack-Munshow er Neurotology PC
Urology of IN
Respiratory and Critical Care Consultants
Northw est Radiology
CorVasc
Women's Health Partnership
Orthopaedics Indianapolis
Methodist Medical Group
Northside Anesthesia
Indiana Radiology partners
American Health Netw ork
Care Group LLC
IUMG-PC
IUMG-SC
AHN
Medicaid
Prescription Solutions
Anthem
Medco Helath Solutions
Express Scripts
Caremark Rx
Advantage
M-Plan
Humana
Cigna
United
Wellpoint
Medicaid
Medicare
Westview
Riverview Hospital
Madison Avenue
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Data management
Hospital
Data repository
Health Information Exchange
Network applications
Payers
Labs
tpatient RX
Physician office
Ambulatory centers Public health
Data access and use
Hospitals
Physicians
Labs
Publichealth
Payer
• Results delivery• Secure document transfer• Shared EMR• Credentialing• Eligibility checking• Results delivery• Secure document transfer• Shared EMR• CPOE• Credentialing• Eligibility checking
• Results delivery
• Surveillance• Reportable conditions• Results delivery
• Secure document transfer
• De-identified, longitudinal clinical dataResearchers
Payer
Negotiated Access
Data Reuse
Ou
Level 1Level 2Level 3Level 4
$(200)
$(100)
$0
$100
$200
$300
$400
0 1 2 3 4 5 6 7 8 9 10
Years
in b
illio
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Total value: $560M
Provider
Public Health
Pharmacy Laboratory
PayerOther Provider
$138M
$1M
$14M
$321M
$86M
N/A
-$56M
-$23M
$696M
$166M
$281M
$353M
Radiology
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0
20
40
60
80
100
120
140
Credentialing Eligibilitychecking
Public health Results delivery Research Decisionsupport
Disease mgmt
Annualeconomicvalue ($M)
•Patients•Physicians•Hospitals•Labs
•Physicians•Hospitals
•Patients•Physicians•Hospitals•Payors
•Patients•Physicians•Hospitals•Payors•Employers
•Patients•Physicians•Hospitals•Public health•Payors•Employers
Beneficiaries1 •Patients•Hospitals•Labs•Public health
•Patients•Researchers•Investigators•Pharma companies
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(1) Includes quality of care/other non-economic beneficiaries as wellSource: BCG Analysis & Estimates
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Increasingly structured clinical data
Patient data
Direct support of
patient care
Research
Decision-supportDisease management & community health
improvementPublic health lab reporting
Public health surveillance
Research
Clinical trials screening & management
Adminfunctions
Credentialing
Claims clearing
Eligibility/referrals/pre-certification
8
9
10
Applications & tools
2
3
4
5
6
7
Results delivery1
Major urban hospitals Non-hospital labs Pharmacies
Physician offices Biological samples Payors
Key question: How to orchestrate infrastructure build to target areas of highest value?
Sequencing
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J. Marc Overhage, MD, PhDIndiana Health Information Exchange, Inc.351 West 10th St., Suite 252 Indianapolis, IN 46202
Voice: 317-278-7423Facsimile: (317) 278-4753 E-mail: marc.overhage@ihie.orgWeb address: www.ihie.org
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Donald Duck
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Public Health Emergency Surveillance
System(PHESS)
•56 Hospitals connected•> 4,000 ED visits per day
Indiana StateDepartment of Health
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Clinical Data
Sources
Primary care physician
Payors
Clinical Data
In office Tests
Claims (no $)
RulesEngine
PatientLevelDetail
DoctorLevel
Summary
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• Improve quality of care• Improve efficiency of care• Broad involvement
– >90% primary care providers– ≈900,000 lives
• Expanding to other markets– Lafayette– Bloomington– Ft. Wayne
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