WISHIN's eNewsletter
Welcome to WISHIN Connections, the monthly e-Newsletter for the Wisconsin Statewide Health Information Network (WISHIN).  We will keep you up to date with WISHIN activities, news on health information exchange (HIE) and new product developments.
Recent WISHIN Beat Posts


Moving the Meaningful Use Goalposts


After months of speculation, the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) have officially announced changes in the timing of certain milestones in the Meaningful Use (MU) program.  Read more


Happy Holidays


The year has only a few weeks remaining, and if you're like me, you wonder where the time went. 

I've read the theory that our perception of the passage of time is related to the number of unique or novel experiences we have.  Read more



Milestone Achieved: WISHIN is Eligible to Participate in the eHealth Exchange


WISHIN's application to participate in the eHealth Exchange (formerly the Nationwide Health Information Network, or NwHIN) has been accepted.


What Does this Mean for WISHIN's Customers?


This is good news for WISHIN customers.


WISHIN's participation in the eHealth Exchange removes several financial and technical barriers that Wisconsin health care organizations might otherwise face in dealing with Meaningful Use Stage 2 (MU2) requirements. In addition, it helps facilitate the efficient exchange of health care information across state lines and with federal government agencies.


Exchanging care summaries through an eHealth Exchange participant is one of the allowable methods for achieving the MU2 Transitions of Care objective.


WISHIN customers will have access to the eHealth Exchange through WISHIN Pulse, WISHIN's community health record product. This means that, through WISHIN Pulse, WISHIN customers can exchange care summaries with other health systems or state health information exchanges (HIEs) that are also part of the eHealth Exchange. Customers of WISHIN do not have to separately onboard to the eHealth Exchange; participation in the eHealth Exchange is included at no extra charge as a benefit of a WISHIN Pulse subscription.


This is important because it means that WISHIN Pulse customers can:

  • Avoid the lengthy and complex Data Use and Reciprocal Services Agreement (DURSA) process,
  • Avoid paying substantial testing fees and the lengthy testing process, and
  • Avoid the annual eHealth Exchange subscription fee.

What Are the Next Steps?


For WISHIN, the next step is to complete the participant testing process. WISHIN will begin testing in early February 2014, with a goal of completing the onboarding process before the end of March 2014. For customers, the next step is to begin the onboarding process with WISHIN to take advantage of the additional benefits of being a member of the eHealth Exchange through your subscription to WISHIN Pulse.


Meaningful Use Stage 2 Transitions of Care


WISHIN can support customers looking to begin their MU2 attestation periods starting in May 2014. For customers seeking an earlier attestation period, WISHIN can support your MU2 Transitions of Care goals with our WISHIN Direct+ product, which gives WISHIN customers access to WISHIN's HISP - another acceptable method of exchanging care summaries for MU2.


Beyond Meaningful Use


We have a mobile society - and health care needs don't stop at state borders. The ability to share care summaries with other providers - regardless of where the patient has received care - is essential for patient safety and informed care. WISHIN Pulse gives providers access to care summaries from many Wisconsin providers (see list of WISHIN Pulse participants here).


Once WISHIN's eHealth Exchange testing is complete, care summaries from providers in other states will also be available through our eHealth Exchange connection. In addition, two key federal agencies - the Social Security Administration and the U.S. Department of Veterans Affairs - will be linking to state HIEs through the eHealth Exchange. This will allow WISHIN Pulse customers to exchange care summaries with the SSA and VA through their WISHIN Pulse connection.




WISHIN Moves Ahead with Interstate HIE


By Bethany Phillips, Operations Project Manager


WISHIN is working to ensure that Wisconsinites will soon benefit from a community health record that includes critical information from their health care encounters in other states. Patients who live along Wisconsin's borders, or who travel south during the winter, may see some of the largest benefits.


WISHIN is forging connections with other state health information exchanges (HIEs) by connecting Pulse to the HIE technology in the other state. This is a different process than connecting providers with other individual providers through Direct secure messaging, and provides more robust functionality than does the current national exchange (the eHealth Exchange governed by HealtheWay). WISHIN Pulse will communicate directly with another state's HIE platform to locate patient records and exchange information.


For example, if a Wisconsinite is seen at an emergency room in Minnesota, the emergency-room doctor could see critical health information from the patient's primary care provider in Wisconsin through a connection between HIE Bridge, Minnesota's health information exchange, and WISHIN Pulse. The doctor back home in Wisconsin could then use WISHIN Pulse to access the patient's information from the emergency-room visit to provide more informed follow-up care.

WISHIN has identified six priority states for establishing HIE-to-HIE connections: our neighbor states of Illinois, Iowa, Michigan, and Minnesota, and our "snowbird" states of Arizona and Florida. We're working with these state HIEs to ensure compliance with state and federal laws. Timelines vary for each partner state connection, but WISHIN anticipates testing some initial connections as early as April 2014.

WISHIN on the Move
HIMSS Conference Highlights Value of HIE
By Jim Paddock, Project Manager

The Wisconsin Dairyland, Greater Chicago, Indiana, Iowa, Michigan, and Minnesota Chapters of the Healthcare Information and Management Systems Society (HIMSS) held their annual Midwest Fall Technology Conference on November 11 and 12 in Milwaukee. The event attracted more than 500 attendees, with presentations provided by industry leaders from throughout the U.S. Breakout sessions were organized into overall tracks: Improving Patient Outcomes, Transitions of Care, Technology Innovations, and Leadership. Many of the presentations, discussions, and lessons learned were relevant to the health information exchange (HIE) objectives being pursued by WISHIN and Wisconsin-based healthcare organizations.


Representatives from the Camden, New Jersey, HIE discussed their success in "Hot Spotting" using community-based HIE data. The Camden Coalition of Healthcare Providers began the Camden HIE with basic patient demographic data and applied predictive analytics to identify potential high utilizers of emergency department (ED) services. The overall "Hot Spotting" goal was to "identify in a timely manner patients who are heavy users of the system and their patterns of use, so that targeted intervention and follow-up programs can be put in place to address their needs and change the existing, potentially ineffective, utilization pattern." The HIE data and analytics, combined with the assigned care teams and revised processes, resulted in substantial benefits:  

  • Decrease in hospital utilization (inpatient and ED)
  • Decrease in estimated hospital costs (through hospital receipts paid by all payers)
  • Reduction in risk for re-admission
  • Improvement in the number of physically and mentally healthy days
  • Improvement in mean scores for all three CPCQ sub-scales (Client Perception of Coordination Questionnaire)

Camden's efforts, supported by HIE data and analytics, are similar to those of the Milwaukee Health Care Partnership in Milwaukee, and are the model for Wisconsin Medicaid's "Super Utilizer" project. WISHIN is working with the Milwaukee community on the implementation of WISHIN Pulse, with the goal of supporting Milwaukee's ED Care Coordination initiative and the "ED to Medical Home" process. Objectives of the initiative include decreasing avoidable ED visits and related hospitalizations, decreasing duplicative ED tests and procedures, and connecting targeted Medicaid and uninsured ED patients with medical homes.


A number of HIMSS presentations included the concept of proactive patient activity notifications: notifying a primary-care provider and/or health plan care manager when one of their patients/members was seen in the hospital. Such notifications can be triggered by the ADT (Admit/Discharge/Transfer) interfaces from the healthcare provider organizations to the HIE. These notifications enable the patient's care team to conduct more proactive follow-up, rather than waiting for the subsequent claim and/or office visit. WISHIN will be making this functionality available to customers in 2014.


The conference culminated in a presentation by Judy Murphy, Deputy National Coordinator for Programs and Policy at the Office of the National Coordinator for Health IT: "Using Health IT to Keep the Patient at the Center of All We Do." Murphy began with an update on the progress of the Medicare and Medicaid EHR incentives Meaningful Use program (not surprisingly, Wisconsin is above the national average in the percentage of eligible providers and eligible hospitals receiving incentive payments).   In particular, the Stage 2 Meaningful Use criteria, currently being pursued by many Wisconsin organizations, focus on interoperability: electronic exchange of care summaries for transitions of care, e-prescribing, public health reporting, and other requirements.


Throughout her presentation, Murphy stressed that the patient must be at the center of these efforts. As we pursue more effective transitions of care, patients must be more engaged in the solution. Several current trends support this need for greater patient engagement: 

  • The way we pay for and deliver care is changing.
  • Health IT adoption has reached a tipping point.
  • Technology is getting better, cheaper, faster and more ubiquitous.
  • Consumers increasingly expect engagement online, in all aspects of their lives.

When asked by my family, friends, or colleagues about WISHIN's objectives, I typically start the discussion with the support of clinical decision-making,  i.e., providing the patient's longitudinal clinical record to the providers at the point of care. If I'm in an accident while on vacation up north, I want that ED provider to have access to my electronic health records. However, HIEs also play a critical role in managing transitions of care, as evidenced by these HIMSS examples and many other initiatives across the country. I've been "heads down" in detailed implementation activities, so it was refreshing to take a step back and look at the big picture regarding HIE and its benefits. It's clear that WISHIN's HIE services will play a critical role in the future of Wisconsin's health care.



December 2013
In This Issue
Quick Links
WISHIN Pulse is a community health record that provides an aggregated summary view of a patient's health information from all providers that have seen the patient.  WISHIN Pulse is HIE technology that gives providers secure access to patients' medical information where and when they need it. 
Click here for more information on WISHIN Pulse
WISHIN Direct+
WISHIN Direct+ allows providers to easily connect and communicate with one another electronically across EMR systems.  Direct+ offers a suite of tools including Referrals and Secure Messaging to easily coordinate and exchange patient care. 
Click here for more information on WISHIN Direct+

Click here to view WISHIN's upcoming events.

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Wisconsin Statewide Health Information Network | 608-274-1820 [email protected] | http://www.wishin.org
PO Box 259038
Madison, WI 53725-9038

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