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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®