Hi3 Solutions: Accelerating HIE standards conformance

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Hi3 Solutions: Accelerating HIE standards conformance

  1. 1. Your Healthcare Standards Conformance Partner Accelerating Adoption of Health Information Exchange Standards AbdulMalik Shakir President and Chief Informatics Scientist
  2. 2. Electronic Health Information The use of Electronic Health Records and the demand for electronic exchange of health information from one health care professional to another is growing along with national efforts to improve the quality, safety and efficiency of health care delivery. 2 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  3. 3. National Health Programs  Meaningful use requirements, new payment approaches, and federal financial incentives are all driving the interest and demand for health information exchange.  Similar initiatives are underway in other nations throughout the world. 3 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  4. 4. Healthcare Informatics Standards  Healthcare organizations have found it advantageous to collaborate in the pursuit of solutions to healthcare information management issues.  Healthcare provider, payer, vendor, consulting, and regulatory organizations have formed industry groups to study information management issues and develop standard solutions to their common problems. 4 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  5. 5. Electronic Health Information Exchange Claims/Prescriptions Referral Process Eligibility Claim Status Referral Process Eligibility Claim/Status Payors Pharmacies Physicians Public Health Medical Society Medical Records Patient Data Family Planning Lab results Mental Health Hospitals County/Community Entities Enrollment Orders Insurance Updates Health Information Results Images Testing Organizations Lab/Images 5 of 32 Employers Government Medicare/Medicaid Patients/Consumers Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  6. 6. Healthcare Data Interchange Standards HL7 X12N X12N / HL7 (Non-US only) NCPDP Healthcare Information System HL7 HL7 HL7, X12N DICOM IEEE MIB, ASTM 6 of 32 HL7 Accelerating Adoption of Health Information Exchange Standards HL7, X12N October 14, 2013
  7. 7. Leading U.S. Healthcare Data Interchange SDOs IEEE Institute of Electrical and Electronic Engineers NCPDP National Council for Prescription Drug Programs X12N Insurance Subcommittee of X12 7 of 32 ASTM American Society for Testing and Materials DICOM Digital Imaging and Communications in Medicine HL7 Health Level Seven Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  8. 8. Leading U.S. Healthcare Data Interchange SDOs IEEE Instrumentation communication standards and generalized information interchange standards ASTM Lab reporting standards and standard guide for content and structure of computerbased patient records NCPDP DICOM Standards for communication of prescription, billing, and other pharmacy material Standards for exchanging digital radiology images X12N HL7 Standards for exchange of healthcare insurance and billing information Inter-application interoperability standards for healthcare 8 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  9. 9. HL7 and X12N   HL7 Insurance / Billing X12N Clinical / Administrative   9 of 32 HL7 and X12N are standards development organizations accredited by the American National Standards Institute (ANSI). Each organization adheres to a strict and well-defined set of operating procedures that ensures consensus, openness and balance of interest. HL7 develops standards that enable disparate healthcare applications to exchange key sets of clinical and administrative data. X12N develops specification that enable the electronic interchange of healthcare insurance and claims processing data. Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  10. 10. An X12N Data Interchange Scenario Patient Billing Application System Dataset Program Module Outbound Transformation Inbound Transformation A to B Transformation 10 of 32 Dataset Patient Billing Application System B to A Transformation Inbound Transformation Claims Processing Application System User Interface Outbound Transformation Program Module User Interface Accelerating Adoption of Health Information Exchange Standards Claims Processing Application System October 14, 2013
  11. 11. An HL7 Data Interchange Scenario Order Entry Application System Dataset Program Module Outbound Transformation Inbound Transformation A to B Transformation 11 of 32 Dataset Order Entry Application System B to A Transformation Inbound Transformation Laboratory Application System User Interface Outbound Transformation Program Module User Interface Accelerating Adoption of Health Information Exchange Standards Laboratory Application System October 14, 2013
  12. 12. Reaching the Limits of Application Interfaces Decision Support Electronic Health Record Lab Radiology Pharmacy ? External Systems ? Order Entry ADT ? Administrative Systems Enterprise Systems 12 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  13. 13. HIE Standards: Why • The number of interfaces between N systems is given by the formula (N2-N)/2. • Linking 2 systems only needs 1 interface, (22 – 2) / 2 = 1; • Linking 6 systems needs as many as 15 interfaces, (62 – 6) / 2 = 15 • The benefits of using standard increase rapidly with the number of systems involved. 13 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  14. 14. HIE Standards: Why Interfaces Requirements 120 100 Interfaces 80 60 40 20 0 2 3 4 5 6 7 8 9 10 11 12 13 14 15 W/O HL7 1 3 6 10 15 21 28 36 45 55 66 78 91 105 With HL7 2 3 4 5 6 7 8 9 10 11 12 13 14 15 System s 14 of 32 Tolerable Painful Accelerating Adoption of Health Information Exchange Standards Intolerable October 14, 2013
  15. 15. Health Information Exchange Effective, meaningful health information exchange requires that all parties involved in information exchange adhere to predetermined transaction formats, usage constraints, and encoding rules. 15 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  16. 16. Healthcare Information Integration Infrastructure Your healthcare standards conformance partner  Product Domains   Health Information Integration   Health Information Standards Compliance Healthcare Quality and Performance Measurement Service Offerings  Consulting and Contracted Resources  Education and Training 16 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  17. 17. Health Information Standards Compliance  Hi3 Solutions’ STANDARDS CONFORMANCE VALIDATOR™ (SCV) is a comprehensive suite of application services that validates compliance with healthcare information exchange standard specifications and conformance with related implementation guides and profiles. 17 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  18. 18. STANDARDS CONFORMANCE VALIDATOR  Standard HIE Transaction Specifications  Standard Clinical Terminology Code Systems  Data Item Specific Value Sets  Use Case Driven Specification Profiles  Data Exchange Instance Validation 18 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  19. 19. Short List of HIE Standards Standards  Exchange Structures          HL7 v2.x HL7 v3 Messages HL7 v3 CDA Documents ASC X12 v5010 Code Systems  Profiles / Guides SNOMED CT LOINC CPT ICD 19 of 32 HL7      Case Notification Laboratory Reporting Immunization Consolidated CDA X12    834 Benefit Enrollment 837 Health Care Claim 835 Health Care Claim Payment Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  20. 20. Health Information Integration Hi3 Solutions’ HEALTH INFORMATION INTEGRATOR™ (HII) is a comprehensive suite of application and database services that facilitate the transformation of data structures, translation of clinical terminologies, and integration of health information.  20 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  21. 21. HEALTH INFORMATION INTEGRATOR   Standard structure to local structure transform  Standard structure to standard structure transform  Coded value to coded value translation  21 of 32 Local structure to standard structure transform Integrated health information data repository Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  22. 22. Healthcare Quality and Performance Measurement Hi3 Solutions’ HEALTHCARE QUALITY MONITOR™ (HQM) is a comprehensive suite of data warehousing and business intelligence solutions geared specifically toward monitoring quality and performance in healthcare in accordance with established measurement standards.  22 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  23. 23. HEALTHCARE QUALITY MONITOR    RIM-based Integrated Data Repository RIM-based Star-Schema Business Intelligence database Predefine performance measures and metrics 23 of 32    Drill-down and drillthrough capabilities Information publication and data export capabilities Data visualization and reporting capabilities Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  24. 24. Quality and Performance Measures  CMS: Clinical Quality Measures  NCQA: Healthcare Effectiveness Data and Information Set  JCAHO: National Quality Core Measures  CMS: Physician Quality Reporting System  BC/BS: Pay For Performance 24 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  25. 25. 25 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  26. 26. Hi3 Solutions Products  STANDARDS CONFORMANCE VALIDATOR™ a comprehensive suite of application services that validates compliance with healthcare information exchange standard specifications and conformance with related implementation guides and profiles.  HEALTH INFORMATION INTEGRATOR™ a comprehensive suite of application and database services that facilitate the transformation of data structures, translation of clinical terminologies, and integration of health information.  HEALTHCARE QUALITY MONITOR™ a comprehensive suite of data warehousing and business intelligence solutions geared specifically toward monitoring quality and performance in healthcare in accordance with established measurement standards. 26 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  27. 27. http://54.200.52.82/
  28. 28. Hi3 Solutions Services  Consulting and Contracted Resources [Hi3 Consulting Group]   Consulting personnel provide advisory services and expert strategic guidance, while contracted resources provide staffing for projects to augment internal personnel and fulfill gaps in skills or available bandwidth.   Hi3 Solutions’ CONSULTING AND CONTRACTED SERVICES are provided by a diverse set of HIT professionals with talent and experience in all areas of healthcare informatics, health information exchange, and health information management in general. Contracted services are also available to design and develop of custom turnkey solutions to meet client specific information management needs. Education and Training [Hi3 University]  Hi3 Solutions’ EDUCATION AND TRAINING SERVICES provide the knowledge transfer, skills development, and skills certification required to establish an effective HIT workforce.  Education is provided in the form of instructor lead classroom tutorials, custom on-site training and certification, and online live and pre-recorded webinars.  Hi3 educational offerings include topics in the area of health informatics standards, information modeling and vocabulary management, and healthcare information management tools and technologies. 28 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  29. 29. Hi3 University 29 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  30. 30. www.hi3solutions.com 30 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  31. 31. Hi3 Solutions, 3500 W. Olive Ave, Suite 300, Burbank, CA 91505 ww.hi3solutions.com +1 800 918-6520 31 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013
  32. 32. 32 of 32 Accelerating Adoption of Health Information Exchange Standards October 14, 2013

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