Axolotl

Hear from today’s leading, sustainable HIEs to understand how they fund operations and meet their near term and long term goals. Speakers will share how they achieved a sustainable business model, determined their HIE value proposition, got stakeholder buy in, put a payment method in place and how they are using it to fund their initiatives for today and the future.

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Franciscan established an HIE in 1999 with the primary goal of streamlining the delivery of Franciscan Health System clinical results to physicians and beginning to link the care community. This resulted in a repository of patient data that has since evolved into the largest HIE in Western Washington. Over the last 5 years, the focus has been on increasing the use of an interoperable EMR in ambulatory clinics – as it immediately connects any physician to the HIE and will get them to meaningful use and in providing tools to assist with handoffs between hospitals, physicians, skilled nursing facilities (SNFs), and numerous other providers – which is becoming increasingly essential as they move to a more managed care environment Today:

• More than 900,000 patients in the 'community patient index'
• 6,200 users of the system including 1,800 physicians
• 400+ different organizations use the system: hospitals, clinics, HMO's, skilled nursing homes, laboratories, radiology groups, independent physicians – open to all health care organizations that have physicians/licensed providers caring for patients in our region, regardless of health system affiliation.
• More than 8 million clinical results transmitted over the network annually
• Local support team dedicated to HIE – 24/7/365 for all users
• 21 major health system vendors integrated in data exchange and transmitted over exchange
• Full integration with voice recognition tools for physicians
• Secure, web based platform, requiring no software installs for physicians
• Sophisticated interface engine that intakes and routes clinical results from different systems to multiple EHR's cost effectively
• Daily use by physicians in competing hospitals, HMO's, emergency departments and military medical center
• Electronic sharing of diagnostic quality medical images from multiple radiology and cardiology locations with referring physicians and other participating health care providers

Ms. Kasal will share how they built a financial model, value proposition, a competitive advantage, increased quality of care, and have met physicians need for comprehensive information. She will also highlight how their most recent enhancement, image exchange, will further enhance value by reducing the costs of sharing medical images, improving efficiencies and speed to treatment, and reducing duplicate procedures, all contributing to the goal of better care at a lower cost.

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With the accelerating momentum of HIE, the financial incentives now available for deploying EMR, and the continued growth in imaging procedures as an valuable tool for diagnosis and treatment, health care providers are seeking ubiquitous access to diagnostic quality medical images along with other components of patient medical records. However, there are a number of significant challenges associated with achieving this objective:

• Medical images are inherently large, making it difficult and expensive to store and transfer them over the variety of networks to community-based users.
• Most images today are shared outside the originating facility via CD or DVD, which is costly, inefficient, slow, and places an undue burden on radiology providers, patients, and the referring physician community.
• Community-wide access using web-based access to PACS has been largely unsuccessful for a variety of reasons, including the complexity of working with multiple PACS web viewing environments, high IT support costs, as well as patient consent and privacy concerns.
• Relying on routing of DICOM images between locations has also failed to be broadly accepted for a variety of reasons, including inconsistencies in how DICOM is implemented, its lack of built-in security, challenges associated with managing multiple patient identifier schemes, and overall network bandwidth consumption.

This webinar will explore the myths and realities associated with the sharing of images. It will compare and contrast various architectures such as centralized, federated and hybrid federated. It will explore the advantages and disadvantages of using a “stand alone” approach vs. incorporating image sharing into an overall HIE service. It will illustrate how it is possible to readily deliver a unified diagnostic quality image viewing solution to large numbers of community users using technologies such as streaming and server side computing. The speakers will also highlight how some of the more common objections in the radiology community can be overcome with a properly-designed image exchange solution.

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