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Intel's Purchasing Power Drives EHR Interoperability

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Brian DeVore, Director Healthcare Strategy and Ecosystem Intel Corporation
Prashant Shah, Health IT Architect Intel Corporation
Alice Borrelli, Director Global Healthcare Policy Intel Corporation

As Meaningful Use Stage 3 comments are being filed this week, we'd like to highlight another approach to EHR interoperability - the role of the employer.  At Intel, we realized a few years ago  that our members were not getting the right care by traditional means, so we engaged directly with the healthcare supply chain to simplify the experience and drive toward the Triple Aim.  Our goal is to have the healthiest employees on the planet.  By launching the corporate version of an ACO, we found that the Health IT framework became an integral part of how Intel delivers care which is described in the newly released white paper, “Advancing Interoperability for Healthcare.”

In 2013 we launched the Connected Care program in Albuquerque, New Mexico, essentially an employer-sponsored and facilitated accountable care organization (ACO). From focus groups we heard that our employees and their families wanted streamlined access to primary care and specialists. As one of the state’s larger private employers and commercial customers, Intel’s changes to care delivery requirements could have a ripple effect in the state.

We partnered with Presbyterian Health System, New Mexico’s largest locally owned healthcare system, serving more than one in three state residents. PHS includes a statewide healthcare delivery network, a health plan, and a medical group with more than 700 providers and in 2014 was named the nation’s most wired hospital.

Although we achieved success in most of the metrics we set through a risk shared arrangement, we found that costs were challenging. Hitting the Triple Aim is hard. For more on the results of Intel’s first year as an employer, ACO, go to http://www.intel.com/content/www/us/en/healthcare-it/healthcare-presbyterian-paper.html

Oregon Launch

Successful results in New Mexico drove the decision to launch Connected Care in Hillsboro, OR on 1/1/15. This time we had two hospital-based systems - Kaiser and Providence Health System and a separate ambulatory system The Portland Clinic. As a result, access to employee’s health records system wide became critical – we needed to call in the interoperability team.

Intel was uniquely positioned to drive data liquidity.
1. We contracted with the hospitals requiring seamless care and excellent member experiences where interoperability of patient records was essential. All parties agreed to the goal since Intel provided the business case.
2. We had experience through creating patient engagement entities like Dossia and Continua/ Personal Connected Health Alliance.
3. We have in-house software and hardware experts to partner with the providers in finding the solution.

1. Originally providers had read-only patient charts
2. Direct communication lacked the contextual detail needed by the PCP and was difficult to upload into the EHR
3. One of the hospitals and the clinics needed to be on-boarded to Healtheway, the HIE selected for exchange
4. Incompatible HISPS needed to be harmonized
5. Reconciling CCDA into an EHR required customization.

1. Established 4 teams of technical experts from the Kaiser, Providence, Health for Life Centers and Intel.
2. On-boarded to eHealth exchange (Healtheway) – the Health for Life Centers (HFLC) used the Greenway EHR to Healtheway, the first ambulatory EHR in the industry to join.
3. Enabled ‘Direct Messaging’ workflows between on-site clinics and providers.
4. Clinicians at the HFLC centers queried the providers for clinical data for the employees in real time (‘Pull’ workflows) using HIE protocols.
5. Direct Messaging allows the clinicians at HFLC to communicate with providers over secure email and exchange clinical data (‘Push’ Workflows).

The Impossible Dream of interoperability for employees was achieved by enabling and accelerating key workflows thru healthcare partners Kaiser and Providence and the EHR vendors who created a team approach to achieving a leading edge solution. For more information, please refer to the white paper.