The document summarizes a presentation given by Jeff Miller on the North Carolina Health Information Exchange (NC HIE). The NC HIE is a nonprofit organization established in 2010 to facilitate the secure exchange of health information across the state. It has a 25-member board of directors and four workgroups focused on clinical operations, governance, finance, and legal/policy issues. The goals of the NC HIE are to improve medical decision making, care coordination, health outcomes, and reduce costs by enabling the access, exchange and analysis of health data. The NC HIE provides various services like connectivity with participating systems, a clinical portal, secure messaging, and will expand offerings over time. Benefits include better integrated and coordinated care, improved communication
> Definition of RWD
> RWD - Big Data Characteristics
> Sources of RWD
> Important Stakeholders
> Benefits of RWD
> Why Data Sharing is Important?
> Benefits of Data Sharing
> Who Benefits?
> Ultimate Goals
> Case Studies
> Challenges
> Data Privacy Scenario
> Data Security in India
> Regulatory Perspectives Around RWD
> How to Encourage Data Sharing?
Patient Engagement Power Team Comments – Leslie Kelly Hall, ChairBrian Ahier
The Consumer/Patient Engagement Power Team will assess Standards and Certification Criteria NPRM and provide recommendations for strengthening consumer/patient engagement components. The Power Team will prioritize recommendations to enable patients to participate as partners in their care.
Precise Patient Registries for Clinical Research and Population ManagementDale Sanders
Patient registries have evolved from external, mandatory reporting databases to playing a critical role in internal clinical research, clinical quality, cost reduction, and population health management. This slide deck describes how to design those precise registries.
In search of a digital health compass: My data, my decision, our powerchronaki
Knowledge is power. Despite extensive investments in digital health technology, navigating the health system online is challenging for most citizens. Also for eHealth, the “Inverse Care Law” proposed by Hart in 1971, seems to apply. Availability of good medical or social care services and tools online, varies inversely with the need of the population. The low adoption of eHealth services, and persistent disparities in health triggers a call for multidisciplinary action.
Barriers and challenges are not to be underestimated. Culture, education, skills, costs, perceptions of power and role, are essential for multidisciplinary action. This comes together in digital health literacy, which ought to become an integral part to navigate any health system. Patients living with an implanted device or coping with persistent, chronic disease such as diabetes, as well as citizens engaged in self-care, caring for an elderly relative, a neighbor, or their child with illness or deteriorating health, need a digital health compass.
The panel will engage the audience to elaborate on a vision for this personal, digital health compass and drive advancement in health informatics and digital health standards. The transformative power of health data fueled by targeted digital health literacy interventions can be leveraged by open, massive, and individualized delivery. This way, digital health literate, confident patients and citizens join health professionals, researchers and policy makers to address age-related health and wellness changes to shape the emerging precision medicine and population health initiatives.
From a panel in the eHealthweek 2016. http://www.ehealthweek.org/ehome/128630/hl7-efmi-sessions/
> Definition of RWD
> RWD - Big Data Characteristics
> Sources of RWD
> Important Stakeholders
> Benefits of RWD
> Why Data Sharing is Important?
> Benefits of Data Sharing
> Who Benefits?
> Ultimate Goals
> Case Studies
> Challenges
> Data Privacy Scenario
> Data Security in India
> Regulatory Perspectives Around RWD
> How to Encourage Data Sharing?
Patient Engagement Power Team Comments – Leslie Kelly Hall, ChairBrian Ahier
The Consumer/Patient Engagement Power Team will assess Standards and Certification Criteria NPRM and provide recommendations for strengthening consumer/patient engagement components. The Power Team will prioritize recommendations to enable patients to participate as partners in their care.
Precise Patient Registries for Clinical Research and Population ManagementDale Sanders
Patient registries have evolved from external, mandatory reporting databases to playing a critical role in internal clinical research, clinical quality, cost reduction, and population health management. This slide deck describes how to design those precise registries.
In search of a digital health compass: My data, my decision, our powerchronaki
Knowledge is power. Despite extensive investments in digital health technology, navigating the health system online is challenging for most citizens. Also for eHealth, the “Inverse Care Law” proposed by Hart in 1971, seems to apply. Availability of good medical or social care services and tools online, varies inversely with the need of the population. The low adoption of eHealth services, and persistent disparities in health triggers a call for multidisciplinary action.
Barriers and challenges are not to be underestimated. Culture, education, skills, costs, perceptions of power and role, are essential for multidisciplinary action. This comes together in digital health literacy, which ought to become an integral part to navigate any health system. Patients living with an implanted device or coping with persistent, chronic disease such as diabetes, as well as citizens engaged in self-care, caring for an elderly relative, a neighbor, or their child with illness or deteriorating health, need a digital health compass.
The panel will engage the audience to elaborate on a vision for this personal, digital health compass and drive advancement in health informatics and digital health standards. The transformative power of health data fueled by targeted digital health literacy interventions can be leveraged by open, massive, and individualized delivery. This way, digital health literate, confident patients and citizens join health professionals, researchers and policy makers to address age-related health and wellness changes to shape the emerging precision medicine and population health initiatives.
From a panel in the eHealthweek 2016. http://www.ehealthweek.org/ehome/128630/hl7-efmi-sessions/
Best Practices for Enabling HIE and Incorporating Capabilities into EHR Workf...Justin Campbell
Health Information Exchange (HIE) allows health care providers to access and share a patient’s medical information securely and electronically, providing a unified view of patient data across health care organizations. HIE enhances clinicians’ workflow and their ability to connect, coordinate, and collaborate on patient care quickly and easily. However, health care organizations frequently struggle with last-mile connectivity from their clinical system of record to the receiving system and incorporating HIE capabilities into EHR workflows. This session will provide a framework for successful HIE onboarding including data access, conformance testing & validation, as well as share strategies for implementing HIE capabilities at the point of care. This session will also introduce the concept of Patient Centered Data Home and illustrate how the exchange of information utilizing the PCDH model is a cost-effective, scalable solution to assuring real-time clinical data is available whenever and wherever care occurs to improve the quality of care.
HIMSS15: Trust in Regional Exchange Supports Patient-Centered ResearchIBM Analytics
Thomas F. Check, MA, and Lorraine M. Fernandes, RHIA, gave this presentation at HIMSS15. Inside you will find info on a number of learning objectives including:
1.Explain how HIE patient-matching technology supports the innovative research infrastructure of NYC-CDRN.
2.Identify privacy issues addressed by HIE participants including how the NYC-CDRN infrastructure supports patient privacy.
3.Describe how consumer, patient consent and other concerns of community stakeholders are addressed.
4.Discuss the value of re-using data from Healthix and the Bronx RHIO including costs and technology infrastructure.
5.Illustrate the information data model’s use within NYC-CDRN and its connection to the PCORnet.
Follow @IBM Healthcare on Twitter: https://twitter.com/IBMHealthcare
Johan Vendrig
GM Information Services – healthAlliance
Andrew Terris
Programme Director, Patients First
Darrin Hackett
GM HIQ, Acting CIO Waikato DHB
Martin Wilson
GP, Sexual Health Physician, Clinical Leader
Pegasus, executive NICLG
Tony Cooke
Manager Health Systems Investment and
Planning, Information Group, NHB
(Thursday, 4.15, Panel)
Overview of Stage 2 Clinical Quality Measures for the Medicare and Medicaid E...Brian Ahier
Session provides in-depth overview of clinical quality measures included in the final rule for Stage 2 of Meaningful Use for the EHR Incentive Programs for eligible professionals. Details provided on the measures, the recommended core set for reporting purposes, and the upcoming release of the 2014 electronic specifications for the EHR Incentive Programs.
Best Practices for Enabling HIE and Incorporating Capabilities into EHR Workf...Justin Campbell
Health Information Exchange (HIE) allows health care providers to access and share a patient’s medical information securely and electronically, providing a unified view of patient data across health care organizations. HIE enhances clinicians’ workflow and their ability to connect, coordinate, and collaborate on patient care quickly and easily. However, health care organizations frequently struggle with last-mile connectivity from their clinical system of record to the receiving system and incorporating HIE capabilities into EHR workflows. This session will provide a framework for successful HIE onboarding including data access, conformance testing & validation, as well as share strategies for implementing HIE capabilities at the point of care. This session will also introduce the concept of Patient Centered Data Home and illustrate how the exchange of information utilizing the PCDH model is a cost-effective, scalable solution to assuring real-time clinical data is available whenever and wherever care occurs to improve the quality of care.
HIMSS15: Trust in Regional Exchange Supports Patient-Centered ResearchIBM Analytics
Thomas F. Check, MA, and Lorraine M. Fernandes, RHIA, gave this presentation at HIMSS15. Inside you will find info on a number of learning objectives including:
1.Explain how HIE patient-matching technology supports the innovative research infrastructure of NYC-CDRN.
2.Identify privacy issues addressed by HIE participants including how the NYC-CDRN infrastructure supports patient privacy.
3.Describe how consumer, patient consent and other concerns of community stakeholders are addressed.
4.Discuss the value of re-using data from Healthix and the Bronx RHIO including costs and technology infrastructure.
5.Illustrate the information data model’s use within NYC-CDRN and its connection to the PCORnet.
Follow @IBM Healthcare on Twitter: https://twitter.com/IBMHealthcare
Johan Vendrig
GM Information Services – healthAlliance
Andrew Terris
Programme Director, Patients First
Darrin Hackett
GM HIQ, Acting CIO Waikato DHB
Martin Wilson
GP, Sexual Health Physician, Clinical Leader
Pegasus, executive NICLG
Tony Cooke
Manager Health Systems Investment and
Planning, Information Group, NHB
(Thursday, 4.15, Panel)
Overview of Stage 2 Clinical Quality Measures for the Medicare and Medicaid E...Brian Ahier
Session provides in-depth overview of clinical quality measures included in the final rule for Stage 2 of Meaningful Use for the EHR Incentive Programs for eligible professionals. Details provided on the measures, the recommended core set for reporting purposes, and the upcoming release of the 2014 electronic specifications for the EHR Incentive Programs.
Presentation slides for Dave Whitlinger, Executive Director of the NY eHealth Collaborative, from the HIMSS'12 eCollaborationForum, February 23rd, 2012
> HTA and Real World Evidence (RWE)
> Why RWE? - Limitations with RCT
> RCT v/s RWE
> Definition of RWE
> Sources of RWE
> Advantages of RWE
> Application of Real World Data (RWD) in RWE
> Benefits of RWD in RWE
> Why Data Sharing is Important?
> Important Stakeholders
> How to Encourage Data Sharing?
> Benefits of Data Sharing
> Case Studies
> Data Privacy Scenario
> Data Security in India
> Regulatory Perspectives Around RWD/RWE
> Way Forward
EHRs, PHRs, EMRs: Making Sense of the Alphabet SoupCHI*Atlanta
CHI*Atlanta's October program tackles health records and the potential of user experience to improve their adoption. Panelists include CDC, Kaiser Permanente, and Greenway Technologies. Hosted at Philips Design to cover public, private, and vendor perspectives.
Information+Integration ? Innovation an HL7/EFMI/HIMSS @eHealthweek2015 in Rigachronaki
Join us to explore “Interoperability in action: information + integration = innovation?” and engage in lively debate on how rethinking interoperability standards and continuing education can bridge divides, change cultures, and open markets!
Perspectives from health management, industry, government, health education, and standardization exemplify challenges and opportunities for liberation of data that can drive desired social and technological innovation.
This is a call for action to explore how the partnership of HL7, EFMI and HIMSS can catalyze the equation “information + integration = innovation” to bridge divides, change culture and open markets.
Similar to Dinsdag 21 feb, 11:15-12:00 uur, Jeff Miller (20)
3. NC HIE Overview and Governance
• Nonprofit organization established as a Statewide Designated Entity
(SDE) in April 2010
• Board of directors: 25 CEOs and health care leaders in the North
Carolina community
• Four workgroups: strategy and policy experts on
– Clinical and technical operations
– Governance
– Finance
– Legal and policy
4. Setting the Strategic Agenda – NC HIE Mission
NC HIE will provide a set of secure,
scalable information services that
• Promotes the access, exchange
and analysis of health care
information
• Enables participating organizations
to:
– Improve medical decision-making
and coordination of care
– Improve health outcomes
– Control health care costs
5. Why a NC Health Information Exchange?
Four focus areas for NC HIE initiatives:
7. NC HIE Services Overview
• HIE Connectivity Fabric
– Connectivity with participating systems: CCD,
HL7, SSO, Web Services (Rhapsody™).
– Storage of clinical information (CDR).
– EMPI.
– Data normalization.
– Privacy and consent
• Virtual Patient Record Network
– Web-based access to the longitudinal patient
record (Clinical Portal).
– User subscribed notifications
• Data Delivery Services
–Lab results
• Direct Secure Messaging
– Ability to send/receive secure messages with
other Direct providers
– Support for Direct-enabled EMR systems
8. Timeline
Core Services Phase IA
• EMPI/provider • Medication
directory management
• Security • Immunization registry
• Privacy and consent • Practice analytics
• Clinical messaging • Lab results
• VA Gateway
• DIRECT
• Web-based clinical
portal
• Notifications
• Virtual QO services
• Hosted EMR
Phase IB and Beyond
• Lab ordering • Referrals
• Procedural results • Senior care
• Pharmacy • Mobile gateway
• Consumer portal • Medical device gateway
• Payer gateway • Clinical decision support
• Medical imaging • Vital records
• Population health analytics • Advanced directives
• Syndromic surveillance • Home health
• Public health reporting • NwHIN trading partners
9. Benefits to the Health Ecosystem
Across all insurance types,
North Carolina has an EHR sites were associated
inbound move rate of 55.4%. with significantly higher
According to Forbes, Raleigh achievement of care and
and Charlotte remain two of outcome standards and
the most popular cities for greater improvement in
relocation. diabetes care.
There are almost 200,000
deaths a year from
preventable medical errors, American patients have seen
partly because this an average of 18.7 different
information is not readily doctors during their lives.
available to specialists and
emergency rooms.
By reducing their Only 6.3% of physicians use
dependence on paper a fully-functional electronic
records, a practice seeing health record system in their
3,000 patients annually could practice.
save $24,000.
At the highest level of health Emergency Departments with
IT adoption, only 0.001% of connectivity to an HIE have
prescriptions would require a improved productivity by
phone call between a more than 20%
pharmacist and physician.
10. What’s in it for everyone?
Providing NC with better, safer,
more affordable care
• Integration
• Communication
• Insight
• Agility
• Custom
11. Comparing NC and NL situation
North Carolina Netherlands
• Government actively supporting HIEs • Government in doubt how to support
• Patiënt consent: opt-in needed (for regional and national HIE
sharing, not collecting) • Patiënt consent: opt-in needed (for both
• Healthcare data also used for analysis collecting and sharing)
on population level • Healthcare data only used on patiënt
• Based on international standards (CCD level
/ HL7) • Based on international standards (CCD
• Almost 10 million inhabitants, 3,5 times / HL7)
the area of NL.
12. Prerequisites for successful implementation
• Changing the way of working of a multitude of organizations and
persons, is a tough job.
• Drivers for change are both quantitative and qualitative
– Higher quality of care and lower cost (or more income)
• Even if both are the projected outcome of a network-project, a couple
of objectives must be met to become successful:
– The will to exchange the patients data – and be serious about it
– A compelling business case for the total value chain
– A fair business model promoting the use for each of the participant in the network
– An HIE system that is integrated with the current IS of the caregivers
• Individual healthcare providers have little influence on development roadmap
of ISVs
14. Thank you, Jeff Miller !
• Thanks for sharing your thoughts and experiences with us today.
• "I'm Sure it's No Coincidence that
We're Sitting at this table Together.
Some things cannot be Mere Chance;
everybody has got an example of this.
On the other hand I think it's
Nonsense to Say Chance doesn't Exist.
I mean What's the Chance that
Nothing ever happens by chance"
Text and design by Nicole van Schouwenburg
for Royal Delft – Koninklijke Porceleyne Fles
15. Thank you, and have a great time at HIMSS 2012
Jeff Miller Toon van der Werf
• CEO NC HIE - Health Information • Consultant Vakgroep Zorg Capgemini
Exchange Netherlands
• jeff.miller@nchie.org • toon.vander.werf@capgemini.com
• +31(0)629 056 330
• Booth #13642-12