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NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation Mosaic Interoperability Initiative Organization Overview • Baylor Scott & White Health is an integrated healthcare system comprising over 900 sites of care with 10,400 active physicians, and serving over 5 million patient encounters annually • The health system operates the Baylor Scott & White Quality Alliance (BSWQA), one of the largest accountable care organizations in the country with nearly 4,600 physicians • Mosaic arose out of BSWQA’s mission to achieve high quality and cost effective care for patients through clinical integration Background The Mosaic initiative, which began in September 2014, was developed to implement an interoperability solution that would support the Health Information Exchange and Population Health Initiatives at Baylor Scott & White, such as BSWQA. Mosaic improves the health system’s ability to deliver the best care possible, as measured and reported through safety and quality key performance indicators. Baylor Scott & White partnered with Allscripts, a vendor of interoperability solutions, to enable the exchange of actionable health information at the point of care within the system using dbMotion. The key stakeholders involved in this initiative from Baylor Scott & White Health were the president of BSWQA, the Chief Medical Information Officer, and the Chief Information Officer. Initiative Details The aim of Mosaic is to improve interoperability within the Baylor Scott & White ecosystem, in order to: • Enhance access to Patient Information for Care Providers • Provide data for analytics to support Population Health A governance body oversees the project, ensuring that the following guiding principles are met: • Prioritize patient safety and quality as highest importance • Pursue a system technology strategy where appropriate • Develop a uniform system build across the enterprise • Drive accountability through clearly defined roles and responsibilities • Listen to the vendor, but take ownership Today, all major systems in Baylor Scott & White’s network are connected to a database storing over 2.7 million patients’ records. The data collection standards for Mosaic are HL7, CCD, and CCDA. Value Delivered Mosaic connects BSWQA physicians with several systems used within the Baylor Scott & White North An Initiative of the 9 | Mosaic Interoperability Initiative
NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation Texas & Central Texas Divisions, as well as those used by multiple joint venture partners. This connection provides a more complete view at the point of care, allowing the care provider to make informed decisions to deliver high-value care. The program also adds value by aggregating data for analytics, enabling Baylor Scott & White to manage populations by focusing on outcomes, driving down cost, and supporting wellness and prevention activities to focus on value-based care. In terms of cost reduction, the system has seen anecdotal savings from a reduced number of diagnostic tests ordered. Path Forward The biggest barriers facing initiatives such as Mosaic are technical barriers of interoperability between data collection standards and electronic medical record (EMR) systems, as well as the high cost. Policies that would help offset the upfront costs for providers would support implementation and use of these programs. Also, the adoption of interoperability standards would be helpful in moving these programs forward. Baylor Scott & White will continue to expand the Mosaic program as new joint ventures and acquisitions arise, connecting all systems within the network. The ultimate goal of Mosaic is to connect systems where the health system’s core EMR products cannot be used, in order to ensure that all sites of care have access to the full spectrum of patients’ data. Mosaic Interoperability Initiative | 10
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