Direct Messaging in North Carolina: Current Capabilities & - PowerPoint PPT Presentation

NCHICA Presents the 7 th Thought Leader Forum Direct Messaging in North Carolina: Current Capabilities & Future Directions November 4, 2015  Research Triangle Foundation

Presenters  Dennis Andrison , IS Project Lead II, New Hanover Regional Medical Center  Patty Lewis , Implementation Lead, Coastal Connect HIE  David C. Kibbe, MD , President & CEO, DirectTrust Moderator  Mary McCaskill , Health IT Manager, NC AHEC Program

Dire c t Me ssa g ing • Dire c t me ssa g ing is b a sic a lly a se c ure e ma il syste m • T he visio n o f a Dire c t-e na b le d he a lthc a re syste m is to pro vide a se c ure he a lthc a re ne two rk whe re a ll pa rtic ipa nts a re ve rifie d a nd c a n se c ure ly c o mmunic a te with a nyo ne e lse within this ne two rk. T his c o nne c tivity will e mpo we r c linic ia ns, a dministra to rs a nd syste ms to se c ure ly sha re info rma tio n. (http:/ / h22168.www2.hp.c o m/ d o c s/ o rio n/ RS97 1_De mystifying _DSM_White Pa pe r.pd f ) No rth Ca ro lina Are a He a lth E duc a tio n Ce nte rs

Direct email address from the NCHIE looks like: firstname.lastname@direct.yourdomain.nchie.net http:/ / www.njhite c .o rg / se rvic e s/ dire c t/ No rth Ca ro lina Are a He a lth E No rth Ca ro lina Are a He a lth E duc a tio n Ce nte rs duc a tio n Ce nte rs

Dire c t Me ssa g ing • Sta nda rd Use Ca se s – Re fe rra ls b e twe e n o rg a niza tio ns – Disc ha rg e summa rie s se nt to PCPs a nd pa tie nts – T ra nsmit Ca re Summa rie s – Se c ure pro vide r to pa tie nt c o mmunic a tio ns No rth Ca ro lina Are a He a lth E duc a tio n Ce nte rs

Dire c t Me ssa g ing Cha lle ng e s: • Ma ny imple me nta tio ns fo r e a c h pro vide r • E a c h E HR is diffe re nt in the ste ps ne e de d to ma na g e Dire c t within the E HR a nd in pa c ka g ing info rma tio n fo r se nding via dire c t • No t a ll HI SPS ta lk to e a c h o the r http:/ / www.dire c ttrust.o rg / me mb e r-list/ • No c e ntra l pro vide r dire c to ry No rth Ca ro lina Are a He a lth E No rth Ca ro lina Are a He a lth E duc a tio n Ce nte rs duc a tio n Ce nte rs

Be st Pra c tic e s Building a Community… ove c ommunic ation- Wha t do e s o ur inte rna l te a m lo o k 1. Impr like ? Who a re o ur e xte rna l pa rtne rs? oc e sse s- Wha t do e s a pre fe rre d pa rtne r lo o k 2. Standar dize pr like ? Wha t do e s the wo rkflo w lo o k like ? Ho w do we te st Dire c t Me ssa g ing c a pa b ilitie s? stablish ac c ountability- Wha t a re the ro le s invo lve d? Wha t 3. E ta sks a re a ssig ne d to e a c h ro le ? Wha t do we do whe n we e nc o unte r a pro b le m? manc e - Ho w do we kno w we a re o n the rig ht 4. Me asur e pe r for tra c k? dination- Wha t re so urc e 5. E nc our age str ong c ar e c oor a llo c a tio ns o r po lic y a nd pro c e dure c ha ng e s a re ne c e ssa ry? No rth Ca ro lina Are a He a lth E No rth Ca ro lina Are a He a lth E duc a tio n Ce nte rs duc a tio n Ce nte rs

Direct Messaging in North Carolina Nov. 4, 2015 Dennis Andrison IS Project Lead II

NHRMC • Based in Wilmington, NC and serving 7-county region in southeastern North Carolina (Pender, New Hanover, Brunswick, Onslow, Duplin, Columbus, Bladen) • Regional referral center with: – Level II Trauma Center – Heart Center – Stroke Center – Women's & Children's Hospital – Orthopedic Hospital – Rehabilitation Hospital – Cancer Center – Neonatal, Pediatric and Adult Intensive Care – EMS • Affiliated with NHRMC Physician Group (200+ providers) and Pender Memorial Hospital • Teaching hospital affiliated with UNC School of Medicine • Third largest county-owned public hospital in the United States • ~ 550 Physician Staff • Licensed for 769 beds

Why Direct • To improve care coordination for our patients • Comply with Meaningful Use Stage 2 metric for electronic transfer of SOC (summary of care documents)

Implementation • Concluded many surrounding Practices not ready to electronically send SOC/TOC • Partnered with local CCHIE • Approximately three and a half month implementation

Lessons Learned • NHRMC has two direct domains – Direct.nhrmc.org – Soc.nhrmc.org • Incoming Direct messages had to be uniquely identified • Many different ways to send a Direct message • Testing 12

Success 13

Questions Thank you for your time. Dennis.Andrison@nhrmc.org 910-667-7513 14

Direct Messaging in North Carolina Patty Lewis Implementation Lead Coastal Connect HIE

Coastal Connect Current Footprint HIE to HIE Connection • • 40 Counties • 84 Data Contributors – acute, ambulatory and commercial lab, diagnostic center Total Patients Since Inception: 4,051,703

Regional Interoperability Solution Use Case COMMUNITY HEALTH RECORD Access to data outside your own network : Reduction in duplicate testing and more timely diagnosis and completion of care plan . Access to Acute Care Setting Documents – including ED : Community Practices have a full picture of acute setting care to provide appropriate follow up • Reduction in requests for documents to hospital HIM departments Clinical Inbox – results delivery NOTIFY Alerting Unaffiliated Providers : Notifications are sent for emergency room and inpatient admissions and discharges for their patient population • Allowing for appropriate/timely follow up and in some cases intervention during ED encounter Alerting Hospital Care Team Members (non-provider ): ER and other Case Managers are receiving readmission alerts on top utilizers iNEXX Care Coordination Acute to Ambulatory : Electronic scheduling of ambulatory follow up appointment prior to discharge 17

NHRMC Community Dashboard Community Health Record Utilization 6000 5000 4000 3000 2000 1000 0 Logins Unique Patients Accessed From Sept 15 to Oct 15 – CCHIE Direct Secure 80 practices/ 6444 In September, transition of care was supported for 5,076 transition of care or referral unique patients! documents Direct Trust 34 providers/ 780 . messages As practices get their Direct Trust set up – CCHIE numbers will decline

Batish Family Medicine, Leland, NC sanjay-batish@batishfamily.e-mdsdirect.com Dr. Weckel, Burgaw, NC weckelmd@drweckel.amazing-direct.com Wilmington Access for Teens, (WHAT), Wilmington, NC whatswhat@direct.myezyaccess.com Coastal Internal Medicine, Wilmington, NC Coastal.internal.medicine@direct.coastalinternal.nextgenshare.com ayman.gebrail@direct.coastalinternal.nextgenshare.com feras.tanta@direct.coastalinternal.nextgenshare.com Orthowilmington, Wilmington, Leland, Jacksonville, Supply, Southport, Sunset Beach, NC referral.coordinator@orthowilmington.coastalconnectdirect.org

Document maintained New Hanover Regional Medical Center by Contact info 2131 S. 17th. St. Wilmington, NC 28401 Tel: +1-910-343-2498 Patient MCOne-One Zzzztest Date of birth January 1, 1901 Sex Female Race Ethnicity Author Epic - Version 7.9 Contact info Primary Home: Contact info Encounter Id 207939056 1.2.840.114350.1.13.298.2.7.3.698084.8 UNK Document Id 1.2.840.114350.1.13.298.2.7.8.688883.255988 Performer (primary Encounter Date at October 28, 2014 WILMINGTON, NC 28401, USA care provider) Document Created: October 28, 2014, 13:43:14 -0400 Tel: +1-000-000-0000 Encounter Location id: 14800 1.2.840.114350.1.13.298.2.7.2.688879 Patient IDs 12294425 1.2.840.114350.1.13.298.2.7.5.737384.775029 Continuity of Care Docum ent Table of Contents • Reason for Referral • Encounter Details • Active Allergies - as of 10/ 28/ 2014 • Medications - as of 10/ 28/ 2014 • Active Problems - as of 10/ 28/ 2014 • Social History - as of 10/ 28/ 2014 • Plan of Care • Procedures • Results • Visit Diagnoses

Interoperability Value

David C. Kibbe, MD, MBA President and CEO, DirectTrust Senior Advisor, AAFP November 4, 2015 www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036

Mission and Goals: DirectTrust DirectTrust.org, Inc. (DirectTrust) is a voluntary, self-governing, non- profit trade alliance of 150 organizations dedicated to the growth of Direct exchange at national scale, through the Security & Trust establishment of policies, Framework interoperability requirements, and business practice requirements. EHNAC- Trust Anchor DirectTrust Bundle Accreditation And Network DirectTrust operated under a two- Programs Services year Cooperative Agreement with ONC, 2013-15, to support its work of creating a national network of interoperable Direct exchange services providers. www.DirectTrust.org 28 1101 Connecticut Ave NW, Washington, DC 20036

DirectTrust Network of Networks For Secure, Interoperable Exchange www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036

DirectTrust Network of Networks For Secure, Interoperable Exchange www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036