HIT/HIE Community and Organizational Panel Office of Health - PDF document

2/22/2017 HIT/HIE Community and Organizational Panel Office of Health Information Technology February 22, 2017 Welcome, Introductions, and Agenda Review 1

2/22/2017 Agenda • SHIEC and Patient Centered Data Homes • New member introductions and all member updates • HITOC Strategic Planning Update • HIE Onboarding Program: Update and Discussion • Prescription Drug Monitoring Program Update • Future Topics 3 SHIEC and Patient Centered Data Homes Bob Steffel Dick Thompson Melissa Kotrys Teresa Rivera 2

2/22/2017 Patient-Centered Data Home Oregon Health Authority February 22, 2017 S peaker Introduction Robert Steffel Executive Director Strategic Health Information Exchange Collaborative (SHIEC) Teresa Rivera President and CEO UHIN 3

2/22/2017 The Problem Every patient should have their complete, longitudinal health record available wherever and whenever it is needed for decisions about their care. HIEs: Create and Maintain Critical Infrastructure  Established with a regional / cultural centered view  Developed based on stakeholder centric needs  Built on stakeholder driven business / governance models  Engenders trust – community data trust agents  Strong data use agreements  Privacy and consent models work within the legal framework of the region  Built on platform / technical architecture supporting multiple apps  Robust identity management system and provider directories 4

2/22/2017 HIEs Work Across S ilos of Data, within Communities  Collect, scrutinize, filter data (surveillance), alert  Identify individual, provider and content  Establish relationships (data types, provider index, master person index)  Determine where data needs to go  Determine how it needs to be routed  “Push” – notify and / or deliver content  “Pull” – query access to longitudinal record (i.e. “home” HIE)  Determine when it is needed About S HIEC  Association of HIE Networks  “Where trust relationships and technical standards merge”  Currently 47 members, representing > ½ of U.S. population  SHIEC members share  Common vision  Best practices  Problem solving  Resources  Established national initiatives, e.g. Patient Centered Data Home TM (PCDH) 5

2/22/2017 S HIEC’s Role SHIEC: 47 HIE’s representing >½ of U.S. population The Interoperability Challenge: SHIEC members are “well connected” within their respective communities, but how do we connect the SHIEC member communities… …efficiently and effectively? 6

2/22/2017 The S olution: Patient Centered Data Home TM  SHIEC’s Advanced Interoperability Project  “Exception” event surveillance – across boundaries  Simple and cost ‐ effective – use existing standards and technologies  Scalable  ZIP Code ‐ driven alerts  Providers can complete a targeted query (pull information) from other HIEs based upon a “trigger” event  Patient information is available when and where it’s needed  Data becomes part of the longitudinal record in patients’ home HIE About PCHD  Patient ‐ Centered Data Home TM  Creates THE comprehensive longitudinal patient record in the HIE where the patient resides  Provides real ‐ time clinical data  No matter where care events occurs  Across domain and geopolitical boundaries – “No Wrong Door!”  A cost ‐ effective, scalable method of exchanging patient data  Care events automatically “monitored” by HIEs  Automatic care team notifications “triggered” by an event 7

2/22/2017 PCDH Guiding Principles  Each HIE’s unique policies, technology, and values honored  Governance preserved  Identity management processes sustained  Data use agreements honored and unchanged  Privacy and consent models maintained  Business model unchanged  Technical architecture preserved S hared Vision / S hared S tandards  ADT commonly used among participants  Encounter notification system (alerts)  Zip Code determines patient data home  MPI number added for output to PCDH HIE  Downstream Alert delivery  Determined by each HIE’s unique protocols  XCA query (eHealth Exchange standard)  Targeted query matched to MPI  Triggered by an alert  Records retrieved become part of longitudinal record in HIE 8

2/22/2017 How PCDH Works 4 1 2 3 1. Patient has care event in HIE 2 , 2. HIE 1 receives ADT, adds 3. HIE 2 may query HIE 1 as 4. At any point, HIE 1 may notify patient’s home is determined by Zip code patient info into it’s MPI, needed; Responds when providers via Alert, calculate to be in HIE1’s geography. ADT message, acknowledges patient data queried with complete data eCQM’s or any other advanced with patient MPI#, is immediately pushed availability to HIE 2 and may on correct patient. Response HIE use case applications. to HIE 1 . request data as required. time is optimal and HIE 1 and 2 have needed patient info. Western PCDH Proj ect Arizona: population 6.6M – HIE AzHeC  MPI: 5.9M  21 hospitals and health systems  2 reference labs and imaging centers Utah: population 3M – HIE UHIN Enlarged  MPI: 5.7M Interoperability  All 4 major hospital systems and most clinics / labs ~10 Million Lives  80% of all providers Western Colorado: population .5M – HIE QHN  MPI: .6M with clinical data  12 Hospitals, all reference labs and imaging centers  94% of all providers 9

2/22/2017 Technical Challenges  Ensure that ADTs consistently have hospital identifying information  Notifications from “outside” HIEs  Delivered according to existing protocols  Automatic query – to do or not to do?  Process for identifying when clinical data is available What do Providers S ee? 10

2/22/2017 S ample Detail  Location of care event  Contact information  Providers noted S ample CCD with Live Link Images Live link to image Live link to image 11

2/22/2017 UHIN S tats Improved Workflow  No workflow interruption  Providers receive same notifications they’re used to  Their work with patients isn’t interrupted  Greater insight into patient’s health  Event triggered notifications  Access to more comprehensive records  Reduced time with calls / faxes  Reduction in unnecessary duplicative tests / labs 12

2/22/2017 PCDH: Central Hub Pilot  Phase 1: Basic ADT Routing  Primary Function – ADT Exchange  Originating HIE sends ADT routed to Home HIE  Home HIE acknowledges data on patient  Subsequent Data Exchange  Requires traditional interface (i.e. eHealth Exchange interface or other standard interface) – enriched with 100% matching  Hub Roadmap  Additional transactions  Hub ‐ routed IHE profiles (i.e. eHealth Exchange transactions)  Hub ‐ routed QRY HL7 messages; MDM ‐ wrapped CCD responses  Hub ‐ routed FHIR transactions (by request)  Tokenized patient context PCDH - Central HUB Initial Feature Set • Configurable routing/filtering Patient ‐ Centered Governance controls • • Policy gates – each interface, each Data Home™ direction Central Hub • Field mapping/formulas Status: >65,000 ADT’s exchanged 13

2/22/2017 Future Plans  Connect PCDH initiatives (12 HIEs)  Western  Central  Heartland  Connect additional SHIEC members  Establish SHIEC level governance  Identify and prioritize additional SHIEC use cases PDCH Creating Interoperability Infrastructure 14

2/22/2017 Importance of HIE-to-HIE Exchange  Puts patient in the center of his / her care  Allows timely information to be “centered around” the patient – everywhere  Care teams in divergent geographies can coordinate care  Better results  Lower costs  Simple and comprehensive data collection  Reduces need for unnecessary duplication (e.g. labs & radiology studies)  Better medication management  Builds more comprehensive longitudinal patient record Benefits  Leverages trusted local governance, laws, policies, privacy, security  Best opportunity to quickly achieve nationwide “Alerting”  Cost ‐ effective technology, building on what is already in place  Data aggregated / normalized in “Home” HIE where person resides  Leverages shared trust and shared national standards  Chance for accurate quality measurement (close loop on data quality problems) 15

2/22/2017 Questions Robert Steffel  robertsteffel@gmail.com Teresa Rivera  trivera@uhin.org New HCOP Member Introductions Chuck Fischer, ADIN Nancy Laney, Mercy HIE 16

2/22/2017 ADIN Advanced Dental Information Network Chuck Fischer Advantage Dental Background • Live in 2010 • Publicly accessible via SSL based web service or GUI • MPI • Open query structure • Endpoint agent • Expanded in 2015 and 2016 to store encounters in the field by our EPDH The problem you are aiming to solve • Efficiently handle sharing of data • Meaningful Use compliance was a driving force from the start • Reduce data entry time and errors 17

2/22/2017 The sources of data/participants contributing to your project The users of the data • Providers in all 36 counties are using ADIN • All 43 Advantage Dental clinics leverage ADIN heavily • Over 100 providers are using ADIN in their private practices The use cases/value propositions you have identified thus far • Referrals • Demographics • Treatment History 18