All of these sites of care have different systems that identify you as a person. They are not coordinated, may not hold current data, and may even have you identified more than once as transcription errors and system limitations may have the same person identified more than once in the same system. Imagine if you took every card that identified you within your wallet and assume these organizations merged (or perhaps just agreed) to reconcile your demographic record once and to update all the individual systems that identified you when a change occurs. This is largely what is being asked of an EMPI within these new Health Enterprises. Needless to say, this is a daunting and continuous task. Further, it must be a flexible and proven solution that holds data validity as its number one priority. For instance, at Kaiser Permanente in Northern California, they use OPF functionality to reconcile clinical results with person information prior to these being written to its clinical data repository. Thus, the need to ensure the RIGHT person is identified is critical prior to combining and updating clinical records.
Next Steps in Healthcare Beyond EHR/HIE Brian Yeaman MD CMIO NRHS Medical Informatics Officer NPHO
Preparation for “Meaningful Use” and ARRA payments via the government
Local Model Physician Portal https connectivity HIE Server Contains Lab, DI, ICD, CPT, Rx compendiums Primary Care Physician Using EHR application Cardiologist or other Using EHR application Nephrologist or other WITHOUT EHR application Administrative Portal https connectivity Registers new users, sets security
Modeled after NE Oklahoma Network entitled SMRTNET
Low Cost, High Adoption Rate
Begin With Hospital Data and Grow Connections to Other Data Streams
Live October of 2008 SMRTNET
Participating Hospitals in the Oklahoma City Metro
OU Medical Center
Edmond Medical Center
Moore Health Center
Mercy Health Center
Oklahoma Heart Hospital
eHX (NPHO) SMRTNET NEO, Metro, Tulsa Hospitals / CHCs / HAU Free Clinics NRHS eClinicalWorks (Dr. Local EHR) Dynamed Dynamed (EBM content) Citrix / VPN Problematic Transactional HUB (Consults, Lab, Radiology) (In Development) Internet / Free +eHX $25 $20 $45 for Physician Practices to connect to local network and SMRTNET. This cost could be Subsidized $10 by PHO or Hospital; 1 connection to doc EHR to view inpatient, ED results, Metro information, Surescripts, immunizations, pharmacy history and EBM Surescripts (Pharmacy) OSIIS (Immunizations) HIE Norman to OKC to Statewide Adoption (RHIO -> Local Networks/Hospitals -> Community Providers) PSRS (Preventative Care Registry) (Proposed Connection)
30 additional supporters level 2-4 including state agency, the temporary state HIT Coordinator, governor, payers, VA, tribal health, all hospitals in the geographical area and state US congress representatives.