Slide 1: Florida Health Information Network Corporation
Business Plan - Version 1 Executive Summary March 2007
Slide 2: Contents
1. 2. 1. 2. 3. 1. 2. Introduction Mission and Vision Business Concept Market Landscape Customer Profile Product Strategy Marketing and Sales 1. 2. 3. 4. 5. Operations Assumptions Financial Plan Risks Next Steps
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Slide 3: Introduction
The Cost of Duplication
•The average first year spend of a start-up RHIO is $2,030,000 to $5,100,000* • 70-80% of that spend is for systems integration (SI)* • In Florida there are: –10 RHIOs in various stages of development –Florida Health Policy Center, an Internet-based think tank, sponsored by six health foundations, calls for 16 Florida RHIOs with an estimated cost of $3 million each
Florida Each RHIOs All 10 RHIOs
Low End Est. 1st year Spend $2M $20M
High End Est. 1st year Spend $5.1M $50M
% SI Costs (est. at 70%) $1.4M - $3.57 $14M - $35M
FHIN Corp can help Florida save millions in duplicated costs.
* Source: Intel
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Slide 4: Introduction
Objectives set for Business Plan Project
• Reduced RHIO startup and operational costs – Shared development and maintenance costs – Efficiency through common infrastructure and architecture – Flexibility to meet new market-driven products • Enable RHIO success – Flexibility to adapt to local needs – Support adoption – Generate sufficient profits to sustain operations and future development • Encourage participation by all stakeholders – Providers – State of Florida – Payers
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Slide 5: Mission / Vision
Connect Florida’s Health Care System
Mission To make health care more efficient and improve patient safety by: • enabling RHIO success • supporting RHIO exchange of health data, • offering a foundational RHIO infrastructure, and • access to state and national health data stores. Vision Real-time delivery to clinicians of patient medical information at the point of care through a secure, integrated statewide network for the communication of electronic health information.
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Slide 6: Business Concept
FHIN Corp Business Concept
• FHIN Corp supplies the local RHIOs technology and business services where significant economies of scale can be achieved: – infrastructure and software, – interface and integration services, – data mapping and standardization, – back office operations, – education (e.g., train the trainer) – second tier end user support, – marketing support (e.g., marketing materials), – data analysis services (reporting and data queries), – discounted services/products (e.g., legal services, EMR light for physicians). • FHIN Corp would also fill in gaps in coverage between local RHIOs (e.g., doctors not within local RHIO coverage), as well as function as the bridge between local RHIOs
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Slide 7: Market Landscape
Competitor Analysis
FHIN Corp strength comes from its State backing and alliance with key stakeholders.
Preliminary Capability Assessment
Quovadx Availity Axolotl
Intersystems
CogonSystems
Cerner
Shared Health
FHIN Corp Strengths • Market Strength • Backing and endorsement from the State • Scale • De facto standards • Ability to develop relationships with all stakeholders
Master Patient Index
Record Locator Service
Connectivity to Payer Data
Registration/Certification
Authentication
Secure Communication
Audit trail and reporting
Disaster Recovery
ePrescribing
Florida Health Information Network Corporation
Interfaces with Data bases
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Slide 8: Market Landscape
Competitor Analysis
FHIN Corp’s strength comes from its State backing and alliance with key stakeholders. FHIN Corp Strengths Financial Strength • capitalized by State • not-for-profit • Target the RHIO as the customer • Pricing is typically based on a subscription model • Annual pricing is generally – $1 per person or – $1000 per physician or – $100,000 per hospital • Most vendors selling to the RHIOs today – Have another core business – View the RHIO market as a possible market expansion opportunity
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Slide 9: Customer Profile
Geography of the FHIN
4. ESSHIN
Florida’s Health Information Networks 1. Big Bend RHIO 2. Central Florida RHIO 3. Community Health Information Organization 4. Escambia HIN 5. Jacksonville Health Information Network 6. Palm Beach County Community Health Alliance 7. Pinellas RHIO 8. Space Coast Health Information Network 9. South Florida HII 10. Tampa Bay RHIO
1. BBRHIO
3. CHIO
5. Jax HIN
FHIN EMPI and RLS Server
2. CF RHIO 8. SC HIN
10. TB RHIO 7. Pinellas RHIO
6. PBCCHA
9. SF HII
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Slide 10: Customer Profile
RHIO Needs and their Customers’ Needs
The RHIOs themselves need • Inexpensive technical infrastructure (solutions) • Legal, security and privacy expertise • Leverage with national or large regional vendors • Ability to focus on the local community and on adoption The RHIOs customers’ needs must be met as well • Easy integration into physician workflow • Meaningful clinical data available • Limited burden on hospital systems IT staff / leverage existing investments • Tangible cost reductions
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Slide 11: Product Strategy
Product Strategy
Make available to RHIOs an infrastructure and critical data sets needed for the RHIOs to quickly establish exchange of data needed for treatment in their community.
• • • Develop technical infrastructure backbone of the statewide exchange system Access aggregated data sources • • • • • • Administrative / claims data Clinical data (e.g., labs, meds, and other components of the minimum data set) Secure Communications of clinical results
Create a center of excellence for integration and data terminology mapping Leverage data collected for re-use to reduce silos of data & duplicative work Leverage combined buying power to obtain discounts Incremental approach to product development and product extensions for revenue opportunities
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Slide 12: Product Strategy
Phased Product Roll-Out
Phase 1: – RHIO Core Capabilities – Delivery of existing administrative/ claims data – Secure Communications of Clinical Results – Negotiate deals for discounted services/products on behalf of RHIOs Phase 2: – Add data collected through secure communication and other data sources – Work with state agencies to support syndromic surveillance efforts – Mandatory reporting to state agencies – Analyze feasibility of statewide e-prescribing effort Phase 3: – Work with stakeholders to provide data analysis for secondary uses – Roll out e-prescribing, if feasible – Develop capability to handle mandatory reporting to state agencies starting with AHCA
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Slide 13: Product Strategy
Timeline of critical products and activities Product Roll Out
Phase 1 RHIO Core Capabilities, Administrative/Claims Data & Secure Communication Phase 2 Add additional data and data sources Phase 3 Mandatory State reporting service
Other feasible services
Other Activities
6 mo
Yr 1
Yr 2
Yr 3
Data analysis for secondary uses Work with state to support syndromic surveillance Evaluate market for e-prescribing Negotiate discounted service/product arrangements Start up Operations 13
Florida Health Information Network Corporation
Slide 14: Sales and Marketing
Sales and Promotion
• RHIO Sales and Promotion: FHIN Corp’s products and services will be sold directly to RHIOs – RHIOs receive sales and marketing support from FHIN Corp – Assist RHIOs in local marketing efforts • Sales strategy • Provider education • Hospital sales • FHIN product and service education – Establish a forum for RHIO collaboration • Statewide Stakeholders: FHIN’s success is also based on participation of stakeholders with statewide interests. FHIN Corp’s Sales and Marketing will also focus on these relationships: – Payers: Contribution of claims data. – State of Florida: Access to state databases. – Labs – Pharmaceuticals – Federal Government – Organized medicine – Researchers
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Slide 15: Sales and Marketing
Sales Plan
Year 1
Year 2
Year 3
Year 4
Year 5
FHIN Sales to RHIOs • 10 RHIO Customers • 60% Market share by Year 5 • Tampa Bay, Palm Beach, and South Florida HII are initial customers.
Big Bend Tampa Bay
Central Florida
Escambia HIN
FHIN Support for RHIO goals • RHIO/Hospitals enroll 60% of area physicians
Northeast Florida
Palm Beach
SFHII
Southwest FL
Florida Health Information Network Corporation
Ocala
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Slide 16: Governance and Operations
A Public/Private partnership – State owned corporation with the ability to generate revenues – Board of Directors appointed from industry leaders – Not for profit Headquartered in Florida – Location would balance the need for State Government interaction with the availability of resources and ease of travel throughout the State Lean staffing model – Envisioned to be under 50 employee company • Estimates show 25 FTEs in the first year, growing to 34 by the third year and then stabilizing Leverage existing vendors in the marketplace – Most technology infrastructure and application software will be purchased from vendors that exist in the marketplace today
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Slide 17: Assumptions
• Commercial payers will make claims data available – Does not conflict with current payer-based health record initiatives currently in place • Secure communications will motivate local hospitals to fund physician participation in local RHIO – Hospitals will recognize cost savings greater than their share of RHIO fees • RHIO/Hospitals enroll 60% of area physicians • Medicaid data will be available – State laws and regulations do not prohibit use • Additional funding required to deliver add on features
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Slide 18: FHIN Corp P&L ($M)
* Does not include capital contribution from State of Florida during Y1-Y3
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Slide 19: Key Risks
Insufficient revenue generated due to lack of paid participation in local RHIO – Mitigation Strategy: Expand / leverage use of the secondary use of data to cover costs of infrastructure, seek additional sources of investment capital Local RHIO closes or folds – Mitigation Strategy: FHIN would encourage another RHIO to expand to that market and offer direct FHIN connectivity until a new RHIO is in place Funding from the State is lower than requested – Mitigation Strategy: Evaluate the best mix of scaling back the FHIN functions and increasing the price point closer to market parity State of Florida Privacy and Security Statutes limit or are interpreted as limiting exchange – Mitigation Strategy: Work with the State to revise the statutes and have FHIN develop a consistent interpretation that can used by the RHIOs with their stakeholders
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Slide 20: Next Steps
• March 27th meeting with RHIO’s • Validate adoption assumptions and refine financial model • Develop and issue RFP
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