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March-April 2013

Hospital participation hits milestone

This spring KHIN achieved a significant milestone, Kansas hospital participation in KHIN surpassed the 50 percent mark. KHIN now has 70 Kansas hospital participants. KHIN staff is working hard to ensure that all hospitals meet their Meaningful Use requirements and receive their incentive payments. To achieve this, KHIN is actively working to bring Kansas hospitals into production where the data from the hospital can be shared and viewed by others. As of April 30, 2013 KHIN has more than 30 hospitals in production and another 11 are actively testing their data with KHIN. Other hospital participants will begin the KHIN integration process in the upcoming months.

Participation by the Kansas hospitals in KHIN is extremely important for health information exchange to be successful. Kansas hospitals have a large amount of health care data and having this information available to physicians and other health care providers can assist in providing better health outcomes for patients.

Kansas is known for having many hospitals and it is considered to have the largest number of critical access hospitals of any state with 83. The total number of Kansas hospitals is 132. KHIN is proud of its partnership with Kansas hospitals. For more information or to discuss how your hospital can participate in KHIN please contact Laura McCrary Ed.D at lmccrary@khinonline.org.

Seeking input on imaging vendor neutral archive

KHIN is requesting input from Kansas health care providers on the applicability and potential value of a statewide vendor neutral archive (VNA) that could be used to store DICOM images in one location in a standard format for all patients in Kansas. KHIN is considering whether a VNA could provide value to Kansas health care providers and Kansas patients.

The proposed VNA could be accessed in a vendor neutral manner by any health care provider in Kansas non dependent on the type of Picture Archiving and Communication Systems (PACS) system available or even access to a PACS system. Most VNA vendors have a virtual PACS viewer as a part of their technology package. So even if a provider did not have access to a PACS they could still review the DICOM image.

A statewide VNA would allow all health care providers in Kansas to view images for patients they are treating even if the image came from another health system. For example, when a provider accessed KHIN to search for their patient, the VNA would also be searched and return any images available for the patient. The radiology report would also be available in KHIN. So a provider would have access to both the DICOM image and the radiology report on their patient.

This could assist providers and patients in the following ways:

  • It would no longer be necessary to burn an image to a CD for a patient to carry to another provider.
  • It could minimize expenditures related to repeat exams thus decreasing associated cost of healthcare for all patients.
  • It could allow providers to compare images over time even if the image was from another healthcare organization.
  • It could provide patients and their health care providers a comprehensive list of all dose exposure radiation that a patient has received over a specified time period (this may be a MU3 requirement).
  • It could serve as back-up storage for a health system' DICOM images. This could be beneficial in the event of a disaster or if a health system needed to migrate their images to another PACS vendor.
  • It could allow organizations to maintain independence from their PACS vendors thus decreasing lifetime exam storage costs and costs associated with implementing new solutions.

To provide input on whether a VNA would provide value to Kansas providers please contact Laura McCrary Ed.D at lmccrary@khinonline.org or 785-409-5200.

Focus on physicians: eClinicalWorks hub live

On April 10, Wichita Family Medicine Specialists (WFMS), began sharing "live" clinical data through the new KHIN eClinicalWorks hub. This is an important milestone and sets the stage for other providers using eCW to begin sharing data quickly and efficiently with KHIN and other Kansas health care providers.

In 2012, the KHIN Board of Directors determined that the large number of eClinicalWorks (eCW) customers in Kansas would be best served if KHIN built a hub that would allow all eCW Kansas customers to join KHIN through one connection. The KHIN Board negotiated with eCW to determine favorable rates for Kansas eCW practices. Final rates for eCW providers include no connection fee to the hub and a reduction in eCW monthly hub maintenance fees by 66 percent. KHIN negotiated these rates on behalf of its providers for two years with a commitment from eCW to not increase them by more than 5 percent annually thereafter.

Wichita Family Medicine Specialists, led by Ron Brown MD, was the pilot eCW practice to connect to the eCW KHIN hub. Wichita Family Medicine Specialists provides a full spectrum of services including evaluation and management of both simple and complex health problems. KHIN and the Wichita Health Information Exchange (WHIE) project managers worked closely with eCW project managers over the last six months to ensure that the data from the practice was populating the exchange correctly. After KHIN, ICA, WFMS and eCW all agreed that the data was in the proper format WFMS went into production (live sharing of real time data) on the morning of April 10.

KHIN has a number of other eCW providers who have patiently been waiting for their turn to share data with KHIN. The next eCW clinic to connect to the KHIN hub is a FQHC in Wichita, GraceMed. GraceMed provides care to the underserved in Sedgwick County. After GraceMed, five other eCW clinics are already in queue.

If you practice is interested in joining KHIN please contact Laura McCrary Ed.D at lmccrary@khinonline.org or at 785-409-5200.

NoMoreClipBoard.com to provide statewide PHR

KHIN is pleased to announce that it is in the final stages of contract negotiations with NoMoreClipBoard to provide a statewide PHR that can be used at no additional cost by all KHIN members to meet their patient engagement MU2 requirements.

NoMoreClipBoard (NMC) was chosen by the KHIN PHR committee as the best vendor due in large part to NMCs experience in working with Health Information Exchanges and the ONC. NoMoreClipBoard already has ONC certification as an EHR and is seeking modular certification as a PHR this summer.

The NoMoreClipBoard PHR will be branded as a KHIN PHR and will meet all the MU2 patient engagement requirements including secure exchange of information between patients and providers, appropriate educational materials, the ability for a patient to view, download and transfer a summary of care document and the ability to receive a summary of care document. Among many other options, the PHR will provide additional services to Kansas patients including the following:

  • Creation of a comprehensive health record including contact information, employment information, insurance information, medications lists, prior surgeries and illnesses, allergies and family history
  • Tracking and graphing of key health measures including weight, cholesterol and blood pressure
  • Uploading of documents such as advance directives and other medical records
  • Creation of a 911 emergency medical card
  • Management of health records from smart phone

Phase 1 of the PHR implementation will include providers sending care summaries via DIRECT to the patient's PHR. Phase 2 will include direct integration with KHIN so that the data in KHIN is available for patients.

For more information on the KHIN PHR or NoMoreClipBoard please contact Laura McCrary Ed.D at lmccrary@khinonline.org or at 785-409-5200.

Amazing growth, expanding opportunity

KHIN has seen amazing growth since data sharing began in August 2012. As of April 20, 2013 KHIN had almost 280,000 unique Kansas patients in the exchange and this number is growing by about 10,000 patients each week. Another approximately 100,000 patients are available through KHIN's connection to the University of Kansas Hospital. This growth is important as it allows health care providers to access a great deal of important health information on their patients simply by querying for their patient within their electronic health record system or by accessing the KHIN Provider Portal.

KHIN currently has 30 hospitals sharing data, two FQHCs, and two large clinics with multiple locations. Each week new provider organizations are coming on line.

KHIN is also working very hard to ensure that all Kansas providers are able to meet their Meaningful User (MU) requirements that are necessary to receive Medicare and Medicaid Incentive Payments. Meeting all of the MU2 requirements in 2014 will be a significant challenge for most Kansas health care providers. KHIN is helping Kansas providers in two ways.

  • Public Health Measures: KHIN is working closely with KDHE to make sure that KHIN participants can meet all of the public health measures including sending immunizations to WebIZ and syndromic surveillance data to the CDC. KHIN is currently sending data to both and at the end of March 2013 KHIN had sent over 800,000 transactions to the CDC and 18,000 immunizations to WebIZ. KHIN has also established a pilot site at HCA Wesley Medical Center to send reportable lab results to EpiTrax and Kansas City Dermatology is the pilot site to send cancer information to the Kansas Cancer Registry.
  • Patient Engagement Measures: KHIN is in the final contractual negotiations with NoMoreClipBoard (see related article) to provide a statewide personal health record that KHIN members can provide to their patients at no cost that will share care summaries, provide appropriate educational resources and securely communicate with patients.

Meeting MU requirements will be a significant undertaking for all Kansas health care providers. KHIN's rapid growth and commitment to supporting Kansas providers will help to ensure that all providers have the resources necessary to receive their incentive payments and improve care for patients. For more information please contact Laura McCrary at lmccrary@khinonline.org.

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