What is HIT?
HIT refers to the electronic systems health care professionals and health plans use to store, share, and analyze health information in continually advancing healthcare and improving patient outcomes. There are several HIT applications that Umpqua Health utilizes and encourages the provider community to use in making sure health information is confidential, readily available and contributing to safer, higher quality, more coordinated, more efficient and less costly care for everyone.
HIT Applications
Below are a few common HIT applications that have been of tremendous value to our community as an investment under our HIT Roadmap.
Arcadia
Arcadia is a healthcare data and software company dedicated to healthcare organizations achieving financial success in value-based care. Arcadia Analytics is a core function in managing population health and delivers enterprise-level transformational healthcare outcomes. Arcadia is the platform utilized by our care coordinators to record physical and behavioral health care coordination efforts. It is used for intradepartmental collaboration across the organization. In the future, we are planning to make this tool available to provider offices.
Point Click Care (PCC)
Point Click Care, formerly known as Collective Medical, helps care teams collaborate to support their most vulnerable patients and those whose needs cannot be met in any single care setting. Using unique technology, PCC unifies a patient’s entire care team including hospitals, primary and specialty care, post-acute care, behavioral health providers, community service organizations, and health plans to collaborate together for better patient outcomes.
PCC delivers real-time notifications with insights at the point of care not just to ED physicians, but to the patient’s entire care team. Provider offices get notifications for patients with patterns of high utilization or complex needs as soon as they register. Notifications are also sent to other members of the patient’s care team, so they can intervene and redirect patients to more appropriate settings for care to avoid misuse of emergency room services.
Community Integration Manager (CIM)
CIM is an online database used by our Third Party Administrator, Ayin (formerly PH Tech). CIM is used to track member eligibility, authorizations, adjudicated claims, and for intradepartmental collaboration across the organization. Providers will use CIM to determine if a member is currently enrolled with UHA, submit and manage service authorizations, and to view claims that have been submitted to Ayin. For more information review the CIM Instructional Guide.
eClinicalWorks Solutions (eCW)
eClinicalWorks is a unified cloud-based solution to control costs, reduce errors, deepen understanding, and improve the quality of care. The tools available bridge the gaps between providers and patients, hospitals and private practices, and healthcare facilities and payers. In the future, we are planning to make this tool available to provider offices. eCW is the preferred electronic medical record for many providers in the community.
Meditech
Meditech is the electronic health record system utilized by the local community hospital. Our Care Coordination team is credentialed for access and utilizes this resource daily to complete discharge planning, transitional care, post-acute care, and integrated and intensive care coordination.
Reliance
Reliance is a health information exchange providing care management teams with patient information to coordinate care across physical, behavioral and dental health via a web-based application or through automated delivery of clinical results for use within an authorized user’s existing care management system. Reliance can support care coordination, hospital notifications, discharge management, HEDIS reporting, clinical quality measurement, and more.
Unite Us (Connect Oregon)
Umpqua Health and Unite Us have been working closely to expand the Connect Oregon coordinated care network of health and social care providers as part of the Community Information Exchange (CIE). Partners in the network are connected through a shared technology platform, Unite Us, which enables them to send and receive electronic referrals, address people’s social care needs, and improve health across communities.
HIT Incentive Program
Since 2006, Umpqua Health has provided an electronic health records (EHR) subsidy to providers who have utilized the Centricity platform. In 2019, we subsidized about $2.2m of the Centricity Platform. Later, it was determined that we would assist in moving providers to eClinicalWorks (eCW) or another EHR vendor, who provide the direct hosting and managing of the actual EHR systems. This change provided cost savings to our EHR subsidy programs. These savings provide the opportunity to reconfigure the subsidy program.
We reinvested the previous EHR subsidy to a broader Health Information Technology (HIT) Incentive program. This provides additional monies to all providers to encourage innovation and collaboration. The HIT Incentive program is intended as an infrastructure development payment. As HIT utilization often requires financial investment on the part of providers, we offer the HIT Incentive Program as a means of offsetting some of that burden. We anticipate that payments under this program will Incentivize providers to enroll in, and to make better use of HIT products and services. The utilization of which, will ultimately lead to improved health outcomes for all of our Members. The HIT Incentive Program is offered by Umpqua Health on an annual basis and it is available to all contracted network providers.
Incentive Criteria for Providers
As part of the OHA required HIT Roadmap, we are committed to providing financial incentives for providers that meet all of the following criteria:
- Providers must remain contracted and in good standing with Umpqua Health.
- Providers must use a CPHL certified EHR system for patient treatment operations and clinical documentation.
- Providers must connect to Reliance eHealth Collaborative (aka Reliance HIE).
- Providers must provide validated, structured clinical/EHR data to Umpqua Health for use in value-based payments (VBPs) and our reporting requirements.
- Providers must participate in Hospital Event Notification programs (aka Point Click Care).
- Providers must see at least 35 Umpqua Health patients within a calendar year.
Note that requirements are at the provider-level, but any payouts through the Incentive Program are made at the organization-level.
HIT Incentive Program FAQs
Required Data Exchange:
- Patient Events and Demographics (ADT)
- Care Summaries (CCD)
Optional Data Exchange:
- Transcribed Reports Lab Results
- Radiology Reports
- Images Claims
- eReferrals
- Community Health Record
Payouts will occur annually, and upon verification the group has met the qualifying criteria listed above.
- Qualifying Provider Types: $7,500 per provider, up to $100,000 per group.
- Hospital Systems: $100,000 per hospital system.
- Dental Care Organization: $100,000 per Dental Care Organization.
To be eligible for any payment your practice must show evidence that all requirements noted above are met on or before December 31st and complete the required reporting during the first quarter of the following year as outlined in the program document.
The HIT Bonus Payment (defined below) is paid for each licensed physician (including psychiatrist) or independent mid-level provider (including physician assistant, nurse practitioner) or mental health provider (psychologist, LCSW, LPC, LMFT, QMHP).
The HIT Incentive Program was attached to your current contract. You may request a copy through our Provider Services team.
Providers will keep accurate records and provide monthly reports to Umpqua Health demonstrating whether each qualifying individual provider is following the criteria set forth in the HIT Bonus Agreement. The reports will be in a form and format requested by Umpqua Health and will include a certification by Provider as to the accuracy of the data. In our discretion, we will have the right to audit the data, and the Provider will provide us with access to all records necessary to determine the accuracy of the Provider’s reports.
Our HIT Bonus program is designed and intended for providers serving our members. We encourage providers to make an independent decision on how they use each platform for their entire census. It is important to note that the required patient information sharing platforms are an added benefit that would be beneficial to your entire census.
Electronic Health Record (EHR)
- A digital record of health information
- Streamlined sharing of updated, real-time information
- Allows a patient’s medical information to move with them
- Access to tools that providers can use for decision making
Electronic Medical Record (EMR)
- A digital version of a chart
- Not designed to be shared outside the individual practice
- Patient record does not easily travel outside the practice
- Mainly used by providers for diagnosis and treatment