Sun HealthCare Business Solutions for Health Information Exchange and Interoperable Connectivity Built on a foundation of integration with unified capabilities for Single Patient View”… …combining all integration technologies in one easy-to-use environment. Sun Confidential: Internal Only Health Information Exchange Sun Confidential: Internal Only 2 What is an Health Information Exchange (HIE)? • Electronic Exchange of Healthcare Information between parties, across institutional boundaries • Similar to a Regional Health Information Organization (RHIO), but without a Regional Restriction • Precursor to a NHIN – National Health Information Network • Facilitates access to and retrieval of clinical data to provide patient centric care Sun Confidential: Internal Only 3 Why an HIE? • Goal is to provide more accurate information to Health Providers for the Patients Benefit • Reduce Costs > Reduce duplicate clinical tests • Provide Patient Centric Clinical Care > All inclusive view of patients health > More information should lead to better diagnosis • Better delivery of clinical results • Research Capabilities > De-personalize clinical data Sun Confidential: Internal Only 4 Health Information Exchange Interoperability National Health Information Network (NHIN) Regional Health Information Organizations Electronic Health Records Electronic Medical Records Personal Health Records Public Health Participation Physician Portals Patient Portals Payer Portals Sun Confidential: Internal Only 5 Digitization of HealthCare Patients The Underlying Problem - Finding the information ` Composite Applications: EHR System EHR System Sun Confidential: Internal Only 6 RHIOs: “Wiring” Healthcare HIE Current system fragments patient information Future system will consolidate information and and creates redundant, inefficient efforts provide a foundation for unifying efforts Hospitals Public Hospitals Public health health Primary care Primary care Laboratory physician Laboratory physician Health Pharmacy Pharmacy Information Exchange Specialty Specialty physician physician Payors Payors Ambulatory Ambulatory center (e.g. center (e.g. imaging imaging centers) centers) Source: Indiana Health Information Exchange Sun Confidential: Internal Only 7 Realizing the Goals Need Solution • Consumer-directed Healthcare • Personal Health Records – Health records Clinicians • Long Term Care Management For Higher for care and cost management (Patient-centric) Quality And Lower Cost • Disease Management Platforms - Best • Single Entity View practice guidelines, treatment plans • Electronic Medical Records – patient • Reduce Costs centric for cost-effective, specific and real- Payers • Genomic Profiling And Pharma Data time guidance • Guidance Based On Best Practices • Identity Management & Security – • Data Privacy Regulate, track and audit access • Health Information Networks – Infrastructure • Digital Information Flow for secure data exchange and access • Administration Management Of Escalating Data • • Regulatory Privacy& Access Control Federated IdM and Compliance for data access and audit trails • Vendor Mergers & Acquisitions • Business Integration & Composite • SOA-based Architectures Leverage Legacy Applications– Enable new business IT Management Systems processes without rip and replace • Image Archiving Sun Confidential: Internal Only 8 Health Care Solutions • Single Entity View > Provides a secure, real-time & high quality single entity (patient / provider) view across disparate systems, networks & health services with no common identifier. Delivers matching, duplicate eliminating, and unifying across all records in an Enterprise. Uses all the information available to cleanse & probabilistically evaluate all records in real time and link related records. Leverages eIndex, EMPI & Java CAPS. Success: McKesson, HealthNow, Excellus BCBS • Health Information Exchange > Connects Applications, Businesses & Caregivers delivering a 360° view of Patients and Procedures. Enables providers and payers to share more information thereby improving efficiency and quality of care, at the same reducing costs. Leverages eIndex, EMPI, iProvider & Record Locater System. Success: Colorado RHIO, British Columbia PLIS, UK NHS Sun Confidential: Internal Only 9 Without Consistent Master Data The Problems of Piecemeal Knowledge... Patient Perspective IT Perspective Business Perspective • Medical errors and other • Fragmented information non-optimum results and poor data quality • Physician retention leads to inefficient issues • Patients feel business operations. disenfranchised from • Billing and AR Issues their care givers • More complex process to blend data sets • Tarnished reputation for customer service • Loyalty diminishes • Larger systems footprint through duplication • Poor Care • News of poor customer experiences spreads • Higher operational costs • Lost Patients fast on the Internet and lower efficiency “Through 2011, 70% of SOA projects in complex, heterogeneous environments will fail to yield expected business benefits unless MDM is included.” - Gartner, Inc. “Predicts 2008: Master Data Management” by Andrew White, John Radcliffe - 25 February 2008 10 Sun Confidential: Internal Only 10 How do you link Related Information across Disparate Systems without a Common Identifier? System A System B Clare Smith Claire Smith Same Person, Different ID ID: 667788 ID: 4444444 Medicare: 123-45-6789 Medicare: 123-45-6788 DOB: 10/07/1954 DOB: 10/07/1954 • No unique identifier exists between the systems Historically healthcare facilities have identified their patients uniquely per facility eg. MRN on Patient Master Index, DVA, etc With increasing complexity and the need to provide cross-facility and interdisciplinary services the facility based MRN no longer provides satisfactory identification ie UPI is required to form the basis of the EHR, CMR, etc Sun Confidential: Internal Only 11 The Root of the Problem Multiple Entity Views Dispersed, un-integrated data Test Results Procedure Orders Enterprise Patient View Monolithic, Master Patient Index Master Patient Index Master Patient Index Independent Applications Registration Registration Registration Radiology Pharmacy Laboratory Data Data External Repositories Payers Providers Hospitals Finance Warehouse Providers Sun Confidential: Internal Only 12 Single Entity View • Link related patient / provider information across Challenge disparate systems with a common identifier ● Provide comprehensive management tools to ensure data quality in real-time Solution/Benefits ● Cross-indexing solution that delivers single customer (patient / provider) view ● Provides real-time automated person matching system Products • Sun Master Index • Java CAPS • Open SSO • Service Registry Partners • McKesson • Excellus Blue Cross Blue Shield Success • McKesson • HealthNow Sun Confidential: Internal Only 13 A Smarter Approach Single Entity View Test Results Procedure Orders Enterprise Patient View Other Composite Composite Applications Applications Master Reusable Registration Laboratory Radiology Pharmacy Services Patient Index Data Payers Providers Hospitals Finance Data External Repositories Warehouse Providers Sun Confidential: Internal Only 14 Health Information Exchange • Enable clinicians, public/private health caregivers, Challenge payers & providers to share & access vital health information when & where needed ● Using Sun’s Single Entity View and HIE Framework, Solution/Benefits caregivers can consolidate and aggregate clinical results from the hospitals and clinics enhancing patient safety & care Products • Sun Master Index • Sun Business Process Manager • Java CAPS Success • Colorado, USA RHIO • British Columbia, Canada PLIS • United Kingdom NHS Sun Confidential: Internal Only 15 Sun’s 360° Health Information Exchange Network Specialty Finance Research Academic Clinic and Education Medical Center Home Health Long-Term Payers Care Public Health Hospital Diagnostic Pharmacy Imaging Center Pharmacy Benefit Management Medical Supplier Clinical Physicians Documents Employer Single-Patient View Private Ambulatory Insurance Centers Screening Government Registers Emergency Reference Insurance Services Laboratory Sun Confidential: Internal Only 16 Health Information Exchange Portal and Presentation Layer District Nurses, Hospice Framework for Security and GPs, Practice Nurses, Hospital Clinicians, Staff, Community Identity Management Health Visitors Regional Specialists Practitioners Enterprise Patient/Provider Views Transaction Processes Electronic Health Records A Single Enterprise Master Patient Single Entity View Record Patient Record Matching, Enterprise Master Patient Index Cleansing, Merging and Linking Connectivity and Integration Services Reliable, Scalable Storage Solutions Primary Hospital Outpatient Care Other Care Proven, Sustainable Hardware Sun Confidential: Internal Only 17 Claims Lifecycle Manager • Single entry point to search transactions Challenge • Single entity reporting “receipt to completion” transaction activity ● Solution/Benefits A transaction monitoring system ● Central entity for reporting process errors ● Collects data for Search & Reporting ● Supports standards based HIPAA transactions Products ` • Sun Patient Master Index • Sun Master Index • Java CAPS Partners • ServiceSpan • Caremark Success • Blue Cross Blue Shields Massachusetts • eMDeon (formerly known as WebMD) Sun Confidential: Internal Only 18 Claims Lifecycle Manager HIPAA Transactions Diagnosis Codes District Nurses, Hospice GPs, Practice Nurses, Hospital Clinicians,