Mobilizing Data for Pressure Ulcer Prevention Challenge Webinar
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Mobilizing Data for Pressure Ulcer Prevention Challenge Webinar






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Mobilizing Data for Pressure Ulcer Prevention Challenge Webinar Mobilizing Data for Pressure Ulcer Prevention Challenge Webinar Presentation Transcript

  • Mobilizing Data for Pressure Ulcer Prevention Challenge Webinar January 23, 2013 Sponsored by the ONC Slide #0
  • Agenda• Welcome & Vision Judy Murphy RN, FACMI, FAAN, Deputy National Coordinator Policy & Programs ONC• Project History & Background Ann O’Brien RN, MSN Kaiser Permanente• Mobile Apps as a Strategy for Quality & Interoperability Tim Cromwell RN, PhD, Veterans Health Administration• Model Development Process Susan A. Matney RN, MSN, FAAN 3M Health Info Systems• Terminology Resources for App Developers Jay Lyle PhD Terminologist• Challenge Details & Evaluation Criteria Hemali Thakkar, Challenger Manager – Health 2.0 1
  • Health IT:Helping to Drive the 3-Part Aim Better healthcare IOM 6 domains of quality: Safety, Effectiveness, Patient- Centeredness, Timeliness, Efficiency, and Equity. Better health Keeping patients well; Increasing the health of populations: focus on preventive care. Reduced costs Lowering the total cost of care while improving quality. $ Health Information Technology 2
  • Patient-Centric health careand health record • Develop a standard, mobile bedside pressure ulcer assessment tool • Promote the integration of nursing assessment into common information models • Lay the groundwork for exchange of nursing assessment data for:  individual patient centric care  cross-patient aggregation for analysis 3 3
  • Objectives forMobile App Challenge• Provide an opportunity for mobile application developers to partner with clinicians to transform care• Describe a future vision where patient-centered data informs the development of information models and results in interoperability and improved care• Invite participation in the vision of mobilizing data to support patient centered care and evidence based practice• Describe the resources for developers to meet the objectives of the mobile challenge 4
  • The Prototype forMobilizing Data• As many as 3 million patients are treated in U.S. health care facilities each year for pressure ulcers• Annual cost of pressure ulcers is $3.2 billion• 60,000 patients die annually from pressure ulcer complications• Most pressure ulcers are preventable.• Per standards of care, patients are assessed for pressure ulcer risk on admission and at prescribed intervals• Quality data for pressure ulcers are already collected but reported in a variety of ways. 5
  • Current State• Patients receive from care in different healthcare organizations and their data does not move with them because it is bound within the proprietary software.• Data is stored in a way that is difficult to share and compare data across patients or episodes of care.• Clinicians do not have the comprehensive view of the single patient’s history and cannot track data over time.• There are not consistent models for collecting and storing data which limits opportunities for comparison and data mining for quality outcomes.• As a country, we are unable to automate evidence based practice and personalize care beyond the borders of a single health system.• It is “organization-centric care” not patient-centered care. 6
  • Background & Overview• KP-VA Collaborative in 2010 defined an information model driven by nursing practice to enable: – Data capture – Data re-use – Data sharing within and outside organizations. – Measurement and extraction of data for meaningful EHR use to support quality, safety, efficiency and decision support.• The American Nurses Association sponsored Tipping Point collaborative meetings with professional nursing leaders 7
  • Mobile App Challenge• The aim of this challenge is to create a free mobile app (for iPhone, Android, or both) that will free information from data silos and promote the development and implementation of common information models.• The goal is to combine reference and authoritative terminologies that free documented observations to move between and among various information systems and organizations.• Encouraging the use of emerging and existing standards, this challenge will demonstrate the value of common models and terminologies to achieve improved information exchange. 8
  • Model Development Process• VA/KP started Mind Map and Model• Interfaced with SDOs – LOINC, SNOMED CT, HL7• LOINC nursing subcommittee accepted the project – recruited nursing informatics leaders – harmonized skin/wound assessment from six institutions• Part of the model taken up by HL7 patient care committee and Pressure Ulcer Risk DAM created – Enhanced with interventions – Vetted through wound care experts – Balloted and approved• SNOMED CT and LOINC content requested 9
  • Skin Inspection Classclass Skin Inspection Detail «enumeration» «enumeration» Pressure Ulcer Risk Assessment Item Skin Condition Skin Moistness Skin Inspection dry normal extremely dry - skin color :Skin Color moist normal - skin moistness :Skin Moistness diaphoretic friable - skin temperature :Skin Temperature clammy - skin turgor :Skin Turgor «enumeration» «enumeration» Skin Temperature Skin Color «enumeration» cool Skin Turgor normal for ethnic group warm (normal) ashen cold good elasticity (normal) cyanotic hot poor, decreased elasticity flushed tenting = not found jaundiced mottled pale 10
  • Terminology CodingType Text Terminology Code FSNQuestion Skin Moisture LOINC 39129-2 Moisture:Type:PT:Skin:Nom::Value Diaphoretic SNOMED CT 52613005 excessive sweating (finding)Value Moist SNOMED CT 16514006 moist skin (finding)Value Clammy SNOMED CT 102598000 clammy skin (finding)Question Skin Temperature LOINC 44968-6 Temperature:Type:PT:Skin:Ord:Palp:Value Consistent With Body Temperature SNOMED CT 297977002 Skin normal temperature (finding)Value Warm SNOMED CT 102599008 warm skin (finding)Value Cool SNOMED CT 427733005 cool skin (finding)Question Skin Turgor LOINC 39109-4 Turgor:Imp:PT:Skin:Nom::Value Good Elasticity (normal) SNOMED CT 297956000 skin turgor normal (finding)Value Decreased Elasticity (Poor) SNOMED CT 425244000 decreased skin turgor (finding)Value Tenting SNOMED CT 297957009 stretched skin (finding) 11
  • Model• Requirements are in Challenge text• Relationships and further details are in the UML model• UML model is analysis level, not design level• UML model supports interoperability, not application design• UML model contains material not relevant to Challenge (Interventions package)• UML model does specify terminology identifiers (also in spreadsheet) 12
  • Model Scope Office of the National Coordinator for 13 Health Information Technology 13
  • Evaluation Criteria• Innovation• Design and usability, including user friendliness and attractiveness of the interface• Use of National Pressure Ulcer Advisory Panel (NPUAP) guidance to improve pressure ulcer prevention and care• Ease of integration with PHR/EHR interface• Application of the HL7 Pressure Ulcer Prevention Domain Analysis Model (DAM)• Application of the LOINC® Nursing Subcommittee and the International Health Terminology Standards Development Organization (IHTSDO) Nursing Special Interest Group (SIG) terminology and candidate models 14
  • Timeline• Submission Period Began: December 5, 2012• Submission Period Ends: April 29, 2013• Evaluation Process Begins: May 3, 2013• Evaluation Process Ends: May 16, 2013• Winners Notified: May 24, 2013• Winners Announced: Conf TBD, in May-June, 2013 15
  • Prizes First Place: $60,000 Second Place: $15,000 Third Place: $5,000 recognition, publicity, credibility and reach! 16
  • Questions? Contact Hemali: 17