Mike Dittemore from LACIE offers an update on operations and industry outlook, concentrating on the organization's new sustainability model, augmented service agreement with the Tiger Institute, and eHealth Exchange.

1. Kansas City Digital
Drive LACIE Updates
Wednesday September
30th

2. LACIE - Update
Background
• LACIE is a 501(c)(3) Organization
• Operates in both Missouri and Kansas, one of two approved HIOs in Kansas
• Since inception LACIE has received approximately $1.7 million in grant funds
• With judicious utilization of grant funds and monthly user fees LACIE has
sustained operations for more than 8 years
• Fall of 2018 LACIE Board made aware of monthly revenue gap
• Plan developed and put into place to sign additional participants, both
Hospitals and Providers, few organizations opted to participate
• LACIE also shuttered Private Exchange that has been developed to allow data
sharing between specific organizations as well as provide analytics

3. LACIE - Update
Background
• Advent Health Corporate decided to do all connections through eHealth Exchange, no
direct local, regional or state connections. No longer any revenue opportunity
• Provident Saint John stopped participating due to issues with Private Health Exchange
(only minimal data was shared through LACIE public exchange)
• Fall 2019 LACIE revenues continue to not cover expenses. Board was apprised of
situation. Due Diligence was requested on possible options
• The following options were taken to the Board in December of 2019
1. Full merger with another HIO
2. Enhanced relationship with Tiger Network that would take over all technical
responsibilities related to LACIE, Tiger and LACIE share the same HIO platform
3. Cease operations, each participant would be on their own to determine their HIO
strategy

4. LACIE - Update
Cease operations was quickly ruled out as an option
Full merger with another HIO was ruled out do to concerns regarding autonomy for the
Greater Kansas City Area, additional costs for participants, loss of the current
“Community” view available to participants through LACIE, and neither of the considered
HIOs were approved HIOs in Kansas
The Board voted to move forward with an augmented Service Agreement with the Tiger
Institute with additional caveats:
• Each hospital would need to increase monthly fees to put them in line with Tiger’s
pricing. An increase on average of approximately 25% per hospital
• LACIE would retain 2 positions, the Accountant/ Office Manager and the Executive
Director
• All technical contracting would be done through the Tiger Network, they in turn
would contract with Cerner

5. LACIE - Update
Agreements were executed in June of 2020
Migration of LACIE participant data to Tiger is under way. We expect for the data
migration and reconnections to be completed before the end of April 2021.
The LACIE legacy server will remain operational until the migration/ reconnection work is
completed.
Outcomes to Date:
No significant lag noticed in providing customer support through Tiger that had previously
been provided at LACIE
Tiger employees have more access into Cerner than LACIE was able to obtain. This has
improved reporting and response to technical questions
Revenues are up approximately 30% and expenses are down 60% resulting in profitability

6. LACIE - Update
Major LACIE Initiatives Currently Underway:
Mo HealthNet 90/10 Grant Funds for Medicaid Eligible Providers and Hospitals for
Connection or Reconnection to HIO Operating in Missouri, approximately $9 million
dollars available, to date $3.5 have been requested for onboarding. Waiting for results of
RFP to be made available from the state.
Advance Directive Participation/ Utilization – working with Center For Practical Bioethics
and ADvault to promote awareness of how an Advance Directive can be completed
electronically and made available through LACIE
Ongoing Participation in KC Healthcare Collaborative and Community Conversations
Social Determinants of Health – Through Teresa Gerards work a vast array of Social
Service agencies have been identified as well as the technical platforms they operate on
Believe we have found an agnostic solution where data from multiple organizations on
multiple platforms could be shared through LACIE with the assistance of H4T.

7. LACIE - Update
QUESTIONS