Brooklyn Health Information Exchange

What it reported doing in 2012

The 2012 990 Program Service AccomplishmentsThe Brooklyn Health Information Exchange, Inc. (BHIX), a Regional Health Information Organization (RHIO), was developed through a community-driven collaboration between providers and payers interested in improving patient care through the application of technology across health care settings. Nationally recognized as a leader in advancing health information exchange, BHIX fosters improvements in community health information connectivity. BHIX supports sharing of health care data among patients, doctors and other practitioners, hospitals, long term and home care services, community based organizations, government agencies and insurers. Since its incorporation in 2007, BHIX has been governed by an independent board of directors, accountable to the regional community. BHIX manages data from nearly 2 million patients, representing encounters at dozens of health care facilities and insurers, most of whom feed data to BHIX on a real-time basis.BHIX provides cost effective access to a broad range of clinical information and related functionality to enhance patient care and support emerging models of care. In 2010, BHIX was engaged to support grant projects, led by Maimonides Medical Center, integrating new participant organizations to its roster to facilitate care collaboration for special needs populations. During this period, BHIX launched a secure Clinical Message Center enabling communications among and between BHIX users to facilitate patient referrals. To monitor significant patient events and to improve care coordination, BHIX designed and deployed real-time automated event notifications which are routed to care managers and clinicians, alerting them via email or notification to hand-held devices. These tools continue to enable clinicians to work effectively and collaboratively, providing value-added services to BHIX customers. Additionally, BHIX developed a new user interface or Landing Page, which supports a variety of users involved in many aspects of patient care management. To expand its user-base, BHIX automated its training and provisioning process, thereby creating an efficient, scalable method for training an increasing numbers of users of the BHIX.BHIX has worked to support many user types including providers using interoperable electronic health records. Using national, interoperable standards, BHIX is the first RHIO to support a seamless, bi-directional data flow directly from within the physician's electronic medical record. This enables the physician to query for community-wide health information without leaving his/her application. With the advent of the New York State Medicaid Health Home model of care, BHIX also added a growing number of community and behavioral health organizations, providing a technical framework for supporting Health Home operations and building connections to new care management applications.To date, nearly 2000 clinicians have been provisioned as BHIX users, including incoming hospital residents as part of their training and orientation as well as care managers responsible for coordinating care for high-risk patients who are enrolled in Health Homes. A significant milestone in 2012 was the announcement that BHIX would be the first New York City RHIO to sign-on to support the New York eHealth Collaborative (NYeC) in its efforts to integrate the downstate region, and ultimately the entire state, into a unified network for healthcare records. Furthermore, BHIXs robust infrastructure will be used as a key reference implementation for NYeC initiatives as it moves toward the development of the State Health Information Network for NY (SHIN-NY). Through the BHIX governance structure, input from clinicians, privacy officers and executive leadership continue to inform the evolving look, feel and functionality of the BHIX System. In addition to the increasing number and variety of data elements displayed in the Patient Record, BHIX has added vital signs, r

Financial Efficiency

• Mission deployment rate: Limited
• Program expense ratio: Limited
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 60th percentile among comparable filings
• Pay-setting controls: 2 of 6 controls in place; rating input score 33
  • Compensation committee: Missing
  • Independent consultant: Missing
  • Other Form 990s reviewed: Missing
  • Written employment contract: Missing
  • Compensation survey or study: Pass
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited

Accountability

• Independent voting board: 100%; rating input score 100; 65th percentile among comparable filings
• Governance controls: 9 of 9 controls in place; rating input score 100
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: -82.2%; rating input score 1; 1st percentile among comparable filings
• Total-asset coverage ratio: 1.12; rating input score 48; 48th percentile among comparable filings
• Liabilities to assets ratio: 0.18; rating input score 58; 58th percentile among comparable filings
• Officer compensation ratio: 17%; rating input score 10; 10th percentile among comparable filings

Growth

• Program expense growth: Limited
• Revenue growth: -63% per year; rating input score 0; 1st percentile among comparable filings
• Asset growth: -42% per year; rating input score 0; 2nd percentile among comparable filings