Building an Employer Sponsored Rural Medical Neighborhood: A Case Study in Today’s Interoperability Challenges and Solutions DISCLAIMER: The views and.

Building an Employer Sponsored Rural Medical Neighborhood: 

A Case Study in Today’s Interoperability Challenges and Solutions

DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

Mohawk Industries Health Plan Vision: The safest and healthiest workforce in industryClinical integration is key component to reach vision

Strategy: Evolved from cost control to create healthier members in our health plan

• Initiatives

– Population health management

– Effective utilization of healthcare services

– Engagement and accountability

• Members – education, incentives

and surcharges

– Your Choice Health Plan

• Health care professionals treating

our members

• Increase services: preventive,

Primary care and specialty care for

condition management

• Compliance to recommended

condition care paths

Strategy: Evolved from cost control to create healthier members in our health plan

• Infrastructure to achieve:

– Services accessible and convenient

– Mohawk Medical Neighborhood – a clinically integrated network (narrow) to support engagement, collaboration and data integration

– On-site clinics

– On-site and telephonic coaching

– Consistent messaging

– Mobile solutions: Dental, Mammography

Strategy: Evolved from cost control to create healthier members in our health plan

• Dilemmas (especially in NWGA where over 15,000 members purchase healthcare services)

– Health information exchange - How to effectively share medical information between community providers and our On-site clinics

– How to engage members

– How to engage community providers – we have learned this is a totally new concept to most health care professionals unless they are a Patient Centered Home primary care practice

Phase 1: Actors in Data Flow

• Data Flow:

– Mohawk Healthy Life Center (HLC)

• Sends referrals to orthopedics

• Sends encounter information to HealthVault

– Orthopedics Practice

• Sends result Mohawk HLC

• Schedule physical therapy (PT)

• Sends copy of result to HealthVault Therapists

• Send or update patient's adherence to Health Coach

– Health Coach

• Access to patient information from e-MD or HealthVault

Phase 1: “Dilemmas”

• Health information exchange

• EHR\DIRECT Version Upgrade Status

• Security Policy Reconciliation

• Trust!

– Authorization\Authentication

• Workflow Redesign

– “totally new concept to most health care professionals”

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Phase 1: Solution

• Health information exchange

– ‘Re-platformed’ to Holon Solutions

– “Perfect is the enemy of Good”

• Simple replacement of fax & document flow

• Platform for resolving other dilemmas

– Member engagement

– Provider engagement & workflow redesign

• Flexibility to enhance to DIRECT & FHIR as available on nodes

– “Start small & smart, release early & often”

Holon SolutionsCollaborNet®