Interoperability to Improve Healthcare HIMSS EHR Vendors - PowerPoint PPT Presentation

Interoperability to Improve Healthcare HIMSS EHR Vendors Association Hugh Zettel Hugh Zettel GE Healthcare GE Healthcare Director, Government & Industry Relations Director, Government & Industry Relations Vice Chair, HIMSS EHRVA Vice Chair, HIMSS EHRVA HL7 HL7 HIMSS Annual Conference HIMSS Annual Conference February 28, 2008 February 28, 2008 1

Today’s Agenda • EHR Vendors Association (EHRVA) Overview • Why Interoperability? • EHRVA Interoperability Roadmap • Where is Interoperability Today? 2

EHRVA Overview • Mission – To improve the quality of patient care and the productivity of the healthcare system through the rapid, widespread adoption of EHRs and interoperable systems • Founded in 2004 – Provides unified voice and a forum for cooperation for the EHR vendor community • All major EHR suppliers in US market – Large and small companies serving ambulatory and acute care provider organizations of all types • Support accelerated EHR adoption – Interoperability Roadmap – Certification – Advocacy / Public Policy 3

4 Member Organizations EHRVA

5 Member Organizations EHRVA

Why Interoperability? • High-quality care across the continuum • Patient safety: reduced medical errors • Clinical decision support: standardized, coded data • Streamlined workflow: results reporting • Population health: quality reporting • Emergency management: disaster response and recovery • Reimbursement: claims attachments • Empowering consumers: personal health records (PHRs) • Local, regional and national networks 6

Industry Engagement • EHR Certification – 3 members appointed as Certification Commission for Health Information Technology (CCHIT) commissioners – >30 members participate in various CCHIT workgroups – 31 member companies certified since 2006 • Health Information Technology Standards Panel (HITSP ) – EHRVA represents vendors on HITSP Board – Member participation in HITSP workgroups • American Health Information Community – Participation in Quality and EHR workgroups 7

Interoperability Initiatives • EHRVA Interoperability Roadmap – Collaboratively developed to provide guidance to EHR vendors and other industry stakeholders – Aligns with CCHIT and HITSP direction • Demonstration/Adoption of Roadmap in Products – Integrating Healthcare Enterprise (IHE) Interoperability National Showcase & Regional Implementations – Implementation in NHIN and international pilots – Building upon IHE to create common immunization registry use-cases, as well as implement HISPC activities (e.g., the consent work in CT, the use of CCD in Iowa) • Outreach to organization and communities • ASTM/HL7 Continuity of Care Document (CCD) Quick Start Guide 8

Interoperability Standards HHS Industry Recognized Interoperability Efforts Efforts • Health Information Standards • IHE Interoperability Panel (HITSP) Showcase – Defines the standards to use – 77 disparate vendors – Interoperability specs • Certification Commission for • EHRVA Interoperability Health Information Roadmap Technology – Outlines path to provide Requires the standards – “ packaged ” interoperability EHRVA Members Working Together to Achieve Interoperability 9

HITSP Readiness EHRVA Member June ’07 Survey * • 76%** have assessed “The survey feedback from our members, especially small HITSP specifications ambulatory vendors that • 76%** expect CCD to comprise the majority of be required in 2008 EHRVA member companies, underscores the growing • 72% see synergy of consensus and collaborative CCD w/ other HL7 effort in our industry to CDA requirements implement a single set of standards using the HITSP • Limited member process.” experience with IHE Don Schoen, CEO, Medinotes Corporation – 32% - 48% with various EHRVA Chair interoperability profiles * 28 total responses; 61% of respondents ambulatory EHR vendors ** Agree or Strongly Agree; 0% Disagree or Strongly Disagree 10 10

Interoperability: An Analogy Phone Network Provider •Phone number •Routing •Call services “Mega-Phone” “Do the Job Phone” •Mute •Speaker •Conference •Speed Dial Rotary Dial 11 11

Health Information Technology Interoperability Interoperability Standards HIT System A HIT System B Network Communication and Services • Patient matching • Information Location Patient Information Patient Information Conformance to interoperability standards “out of the box” reduces communication costs 12 12

EHRVA Interoperability Roadmap – Provides concise, benefit-based, incremental approach – Promotes industry collaboration, standards planning and convergence – Uses industry best practices for profiling and testing standards – Adopts a single set of interoperability standards – Ensures standards support multiple levels of sophistication now and in future 13 13

Requirement 1: Allow “Edge” Systems to Retain Functionality and Autonomy • Leverage functionality of edge systems…where workflow innovation occurs • Cost-effective… minimize core duplication of services Interoperability Functions Defined By Edge System Edge System NCVHS Edge to Edge Communication Edge to NHIN-Core Communication 14 14

Requirement 2: Allow Flexibility to Support Multiple Architectures • Minimize proliferation of interfaces for different data storage schemes • Flexibility to evolve configurations between edge systems & sub-network Edge System e.g., Ambulatory EMR Edge System e.g. Lab Edge to NHIN-Core Communication Edge System e.g., Inpatient EHR Edge System e.g., RHIO Central Repository data data 15 15

Requirement 3: “Thin” NHIN Core • Limit NHIN core functions, ensuring robust interoperability between edge systems • Ensure transparency at the boundaries between core and edge systems, as well as between edge systems Edge System Edge System Interoperability Functions Defined By NCVHS Edge to NHIN-Core and Access Provider Communication 16 16

EHRVA Interoperability Roadmap Phase 4: Active Quality Reporting & Health Surveillance 3 yrs + Phase 3: Advanced Clinical Support and Dynamic Query 6 mos to Phase 2: Share Diagnostic Results & 3 yrs Therapeutic Information Available Phase 1: Share Medical Summary now Information 17 17

EHRVA Interoperability Roadmap Aligns Major Industry Drivers • Office of the National Coordinator for HIT – Open and ongoing dialog • HITSP standards – Supported successful harmonization of care record summary – Developed CCD Quick Start Guide • CCHIT requirements – Collaborative, non-competitive analyses and feedback during all public comment periods • HL7 – Worked to support development of lab result implementation guide to meet AHIC use case requirements • AHIC priorities and use case roadmap 18 18

EHRVA Interoperability Roadmap CCHIT EHR Certification Alignment Development Timetable 2008 2009 Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec 2008 CCHIT dev. Continuity of Care Document (CCD) HITSP-C32 * 2009 CCHIT dev. Share Medical Summaries – CCD + IHE/XDS Transport; HITSP-32 / TP13 * 2010 CCHIT dev. Phase 1: Share Medical Phase 2: Share Diagnostic Phase 3: Advanced Summary Information Results & Therapeutic Info. Clinical Support EHRVA Interoperability Roadmap * Proposed in CCHIT Incremental Adoption of CCD Through HITSP Specifications, Jan. 14, 2008 19 19

Example: Continuity of Care Document Education • June 2007 Internal Survey Highlights Interoperability Training Needs – Standards & Interoperability Workgroup Creates CCD Quick Start Guide Specification – Quick Start Guide delivered to Members in October, 2007 • Collaboration… Share tools with all stakeholders – EHRVA CCD Quick Start Guide Publicly Available Free of Charge November, 2007 Over 800 downloads first four months – • Accelerate Adoption within EHRVA – EHRVA Hosted CCD Web Training – Focused on HITSP Implementation – Over 130 EHRVA Members Attend 20 20

Operational Interoperability Today • South Shore Hospital) and Atrius Health (MA) • Community Hospitals and Physician Practice Systems (CHAPS) project – Serving 600,000 patients with over 2.3 million visits/year – Exchanging records between hospital Emergency Department and physician offices – "Medical Summary" to the hospital that contains patient information including visit history, problems, medications, allergies, immunization history, medical/surgical/obstetrical history, social and family history. • Standards-based approach from MEDITECH and Epic – CDA/CRS Medical Summary exchange profile from IHE – Use HL7 v3 specifications 21 21

In Conclusion, EHRVA is… • Committed to supporting national interoperability and transparency goals • An advocate for standards that meet current market needs • Working to leverage HIE interoperability progress to advance data sharing – Among shared customers – With other HIT suppliers – Within states, regionally and nationally • An active participant in open standards harmonization process • Delivering interoperability based on EHRVA roadmap TODAY 22 22

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