NMHIC HIE Overview NMHIMA Annual Meeting April 12, 2013 Craig Hewitt, Chief Information Officer
It’s about the Patient! ALL Medical Records follow the patient Personal Health Office visits Record Hospital visits Secure access with consent The Circle of Care Diagnostics Medications Lab work Direct Secure Messaging (DSM) Images/X ‐ ray reports Home Home healthcare monitoring /long ‐ term care The Patient State and Federal, DOH Insurance
Health Information Exchange (HIE) An HIE Solution brings health information systems • together across regions and states in order to provide access to a patient’s information in one centralized record . Multiple healthcare providers with access to the • same record of clinical information will make healthcare delivery more robust and efficient with improved continuity, better outcomes, and reduced costs. There are significant benefits to patients, healthcare providers, payers and employers.
Core HIE Functions Provides access to a current patient summary from a variety of sources (from where and when): Problem list/Diagnosis • Medications • Immunizations • Allergies • Procedures • Lab Data • Radiology Data • Encounter Summaries •
Value/Benefits of HIE Access to each patient’s health information from a variety • of healthcare provider sources Improved situational awareness regarding patient’s health • and use of health systems, better coordination of care Better triage and evaluation capability: • Dx/Problem list, prior procedures, Rx/Medications, Allergies, tests; o lab/x ‐ ray, progress note and summaries Improved efficiency in making diagnosis and management • plans Decrease unnecessary duplication of tests • Readmission avoidance • Other Benefits : Data Analytics, Public Health, PCMH, ACO •
Current NMHIC HIE Services NMHIC HIE Portal – view summary patient information: • – Patient demographics, encounter info, physicians, diagnoses, medications, allergies, procedures, immunizations, laboratory results, radiology reports, transcribed notes (i.e. clinic notes, hospital discharge summaries) – Portal Pilots at UNMH ‐ ED, ABQ HP Clinics, Lovelace Med Center ‐ ED NMHIC has been providing Public Health Reporting data to NM DOH since 2010 • – Notifiable Conditions Lab Results – Emergency Department Surveillance Data – Immunizations Data – Forwarding ED Surveillance data to CDC BioSense – Forwarding Healthcare Acquired Infection “LabID” Events to CDC NHSN – NOTE: NMHIC has achieved ONC EHR Modular Certification for Public Health Reporting (participating NM Hospitals can attest to MU PHR requirements) NMHIC has been providing clinical data to SSA for disability determination across • the eHealth Exchange (NwHIN) NMHIC has implemented Direct Secure Messaging to allow NM REC Providers • attest to MU requirements
Who Currently Provides the Data We have about 1million New Mexicans in our MPI as well as collecting millions of clinical encounters Healthcare data providers: – Presbyterian Hospitals (8) and Medical Groups – Lovelace Hospitals (6) – University of New Mexico Hospitals (2) – ABQ Health Partners – CHRISTUS St. Vincent Regional Medical Center – Holy Cross Hospital, Taos – Other health care providers will be added Independent Laboratories: – TriCore Reference Labs – LabCorp (for public health reporting only) – NM Scientific Laboratory Division (SLD) – for public health only
Strategy for Transition to New Platform • Engagement • Embed within workflow • Move to the cloud • Standards for sharing information • Equity based model • Broader service offering • Implementation and administration
Solution: Core HIE – High Level Physic ia ns Priva c y Offic e rs HT T PS HIE Pla tform We b -b a se d a c c e ss to the lo ng itudina l pa tie nt re c o rd De mo g ra phic s • He alth Infor mation L a b s, Ra ds • E nc o unte rs E xc ha ng e (HIE ) • Ho spita l with Alle rg ie s • E MR Dia g no sis • T ra nsc rib e d do c ume nts • Me dic a tio ns • Pro b le ms • Pro c e dure s • I mmuniza tio ns • HL 7/ CCD, XDS, SSO Dire c t Se c ure Me ssa g ing Clinic with Pa tie nt Priva c y & Co nse nt E MR No tific a tio ns & Se a mle ss inte g ra tio n with E HRs Sub sc riptio ns Use r Sub sc rib e d No tific a tio ns • Se c ure Se nd to My E HR • I nb o x Po rta l e mb e dde d within E HR • E -Ma il Othe r HI E s Mo b ile
Cloud Based
Network Architecture
Broader Service of HIE Offerings Orion Health HIE Products Additional Modules HIE Base Solution Case Management Clinical Portal with results Viewer Business Intelligence ‐ Meaningful Use Clinical Data Repository dashboards, HIE Utilization analytics Rhapsody Interface Engine Public Health Reporting EMPI ‐ Enterprise Master Patient Index Electronic Laboratory Reporting (ELR) Health Language (normalization) CSTE Case Reporting CCD Exchange Hospital Acquired Infection Reporting Notifications Biosurveillance Reporting Immunization Registry Reporting Send to my EHR (CCD) Discharge Reporting Direct Secure Messaging + custom reporting Single sign ‐ on from EHRs Patient Portal Privacy and Consent eHealth Exchange (NwHIN) Auditing EHR Lite Diagnostic Orders ePrescribing Enterprise Imaging
NMHIC HIE Product Phases Community Health Record Advanced HIE Patient Portal Case Management EHR Lite Core HIE Business Intelligence – Diagnostic Orders Meaningful Use Clinical HIE Portal Dashboards, HIE ePrescribe Utilization, Analytics Notifications Embed Tele-Health Public Health Reporting CCD Exchange Enterprise Imaging eHealth Exchange Send to my EHR (CCD) Radiology (NwHIN Gateway) • Cardiology Direct Secure Messaging • Dermatology E-Directory (s) • Single Sign-On Ophthalmology • Privacy & Consent
Steps on the Journey 1Q ‘13 2Q ‘13 3Q ‘13 4Q ‘13 1Q ‘14 2Q ‘14 3Q ‘14 4Q ‘14 Core HIE Build Data & Interface Migration User On ‐ Boarding/User Adoption New Participant On ‐ Boarding/Interface Development Advanced HIE & Community Health Record Build GO LIVE
Draft Agreement Elements • Terms and Conditions • Services • Schedules • Support Plan • Participant Roles and Responsibilities • Fees
Current Status of HIE Adoption Map Legend Map Legend CORHIO HIE Connectivity Raton Farmington HITREC Site Taos Clayton Cuba Las Vegas Direct Los Alamos Aztec Connectivity Santa Fe Tucumcari Gallup Santa Anna Grants Albuquerque West Texas AZ HIE Clovis Los Lunas HIE Belen Socorro Magdalena Portales Ruidoso Roswell T or C Lovington Alamogordo Users of the system today : Silver City Hobbs SSA – disability determination Las Cruces Deming NM DOH – eReporting, ED Carlsbad Surveillance, Immunizations Pilot users – UNM ED, ABQ HP, Paso del LHS Norte HIE
Example Integration (Epic) Single Click access to Clinical Portal
Example Integration (Cerner) Single Click access to Clinical Portal
Unified Longitudinal Patient Record
Complete Medical History at a glance
CCD Exchange
Notifications
ROI Audit Log
Automated Measures Dashboard
Quality Measures Dashboards Quality Reporting (currently a prototype) How well are you improving patient outcomes in: Hypertension: Blood Pressure • Management Preventive Care and Screening, • Tobacco Use Weight Screening and • Management Immunizations for Patients over • 50 years Childhood Immunizations • And more … •
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