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MiHIN Health Provider Directory Demo Slides with CQMRR v43 02 18-15
- 1. Michigan Statewide Health Provider Directory Scalable, standards-based, extensible solution for storing and making accessible electronic service information for providers and provider organizations recording providers’ delivery, notification, and routing preferences for accurate and secure exchange of health information Copyright 2014 Michigan Health Information Network Shared Services 1
- 2. What You Are About To See Copyright 2014 Michigan Health Information Network Shared Services 2 • Key benefits of the Michigan Statewide Health Provider Directory (HPD) service • Strategic focus of the HPD service: • Route health records via Electronic Service Information • Overview of architecture: • advanced data model • relationships to standards • Ability to easily integrate with Direct HISPs • Support for Transitions of Care (TOC) Use Cases • Demonstration of Health Provider Directory service • Quality portal(s) for Clinical Quality Measurements
- 3. HPD Key Benefits • Standard: Michigan’s ‘superset-model’ extends Provider Directory standards: • Supports all three leading standards: HPD+ 1.1, ModSpec, IHE/IHR • Supports Use Cases for Meaningful Use and beyond • Populated: Data from multiple sources imported, mapped and de-duplicated: • State and federal provider data • Sub-state HIE / RHIO / PO / NPPES / Payer provider data • Commercial data sources (no longer used) • Deployed: Force.com platform provides production-quality deployment: • Familiar GUI is global and ubiquitous, including mobile devices • Architecture allows easy integration via SOAP & REST APIs • Reliable 24x7 production in Salesforce.com cloud • Robust security augmented by MiHIN additions: • Single-Sign-On with other services (Direct HISPs, EHRs, etc.) • Trusted identity federation at NIST 800 LoA 3) • Extensible and scalable based on provider/user feedback Copyright 2014 Michigan Health Information Network Shared Services 3
- 4. Michigan’s HPD is in Production • Michigan’s HPD is in use and is ready for others to use • Production service deployed in Salesforce cloud > 2 years • Federated with other large provider directories (e.g. Florida HIE and Surescripts via ONC Exemplars Snowbird Pilot) • HISP-neutral directory supports simple integration with HISPs • Multiple states’ provider data in one HPD instance (no federation) • Installable application via Salesforce AppExchange • Others can deploy and administer • No up-front cost to use Michigan’s HPD solution • SaaS subscription model – pay per account as you grow • Accounts range from $25/year (individual )to $3600/year (unlimited) • API accounts allow easy system-system integration (no federation) • Integrated with modernized NPPES for real-time updates • Soon: real-time credentialing transactions Copyright 2014 Michigan Health Information Network Shared Services 4
- 5. HPD Strategic Focus • Electronic Service Information (ESI) is: • “Information for delivering PHI by secure electronic means” • HPD supports multiple types of ESI today: • Most commonly discussed: Direct Secure Messaging • Secure email account id – Example: “dr.thomas.simmer@direct.bcbsm.org” • In more widespread use: IHE/EHR routing information • HL-7 LLP protocol endpoints – Example: “data.hfhs.org:22356” • Future forms of ESI are forthcoming: • Patient preferences for where their PHI is stored (e.g. PHR) • Other federally defined forms of ESI (e.g. VA, SSA) Copyright 2014 Michigan Health Information Network Shared Services 5
- 6. MiHIN Service Oriented Architecture Direct HISP, Search Service, MiDiGate™ TOC (ADTs, MedRecs), Immunizations, Reportable Labs, Syndromics, etc. Context for HPD Use Cases Statewide Health Provider Directory Organization Admins Individual Providers SoM Payers, DSOs Commercial HISP EMR HIE Other Entities Salesforce.com SOAP, REST, https, ModSpec APIs Informatica ETL + MDM HPD Admins Other States Copyright 2014 Michigan Health Information Network Shared Services Population Admins 6 API Readers API Writers
- 7. Organization “Account” Name Identifier Specialty Credential Care Team Electronic Service Provider “Contact”Provider Affiliation 0..n 0..1 HPD Object Model Organization Affiliation Address 1..n Copyright 2014 Michigan Health Information Network Shared Services 7
- 8. HPD Integration Capabilities • HPD API for HISP Integration: • High level, efficient, Restful, query API • Supports ModSpec 7 HPD query definitions • In production and in use by multiple organizations • Health Provider Search Service • Allows any Direct HISP to query Michigan Statewide HPD • Plug-in consists of one page of simple code • Easily inserted to and integrated with HISP client code • Encapsulates HPD query capability using REST API calls • Integrating with other services for full transactional updates • NPPES (NPI) database, credentialing, other services • Monitoring/tracking HPD federation protocols Copyright 2014 Michigan Health Information Network Shared Services 8
- 9. Copyright 2014 Michigan Health Information Network Shared Services 9 Provider Index MCIR Immunizations MDCH Data Hub HSTR Meaningful Use CHAMPS/MMIS Medicaid Submit/Request Submit/Request Submit/Request Submit/Receive/ Request/Review The Open Directory™ LARA Licensing Submit/Request EHR Labs HISP Z directory HISP A directory Health Provider Search Service Request … Qualified Organizations, Network of Networks, HIEs, HINs, RHIOs Submit/ Request MIDIGATE® Credentialing Service Direct Trust Directory Active Care Relationship & Transitions of Care Services NPPES & NPPES Redux Health Provider Directory Other Repositories State of Michigan
- 10. Health Provider Search Service Copyright 2014 Michigan Health Information Network Shared Services 10
- 11. Industry Approach: Federated Directories Copyright 2014 Michigan Health Information Network Shared Services Michigan HPD Florida HPD Surescripts HPD Michigan Provider 1. Michigan HISP user searches for a Florida provider 2. Orchestration service negotiates queries to relevant PDs 3. HPDs return search results and orchestrator merges into single response 4. Michigan HISP user sends Direct message to Florida provider Florida Provider Query Orchestration Service 11 Challenges: 1.Not scalable (too many directories to federate) 2.Standards not fully defined and are inconsistent
- 12. Qualified Sub-state HIE or VQO Qualified Sub-state HIE or VQO How HPD Infrastructure supports Transitions of Care Service Copyright 2014 Michigan Health Information Network Shared Services Patient to Provider Attribution Delivery Preference Lookup 1) Patient goes to the hospital, hospital sends an ADT message to MiHIN 2) MiHIN checks patient attribution lists and identifies three providers 3) Retrieve from HPD the ESI and delivery preference for each provider 4) Notification is routed to the providers based on their ESI and preference Primary Care Specialist Care Coordinator Alerts & Notification DSM 12
- 13. MiHIN Transitions of Care Service (TOC) Copyright 2014 Michigan Health Information Network Shared Services 13 • MiHIN TOC service has been in production since Nov 2013 • 19 Physician Organizations in production • Additional 43 Physician Organizations targeted to go-live • Over 600 hospital & practice organizations in production • Over 1500 providers receiving real-time TOC notifications • Over 3 million TOC notifications transmitted per week • Over 80% of Michigan statewide admissions are shared currently • Over 90% of Michigan Statewide admission expected to be shared by the end of 2014 • Onboarding more hospitals and practices weekly • Excellent source of accurate provider & organization data & affiliations • Processing monthly updates to ACRS data sets in production • Working towards transactional updates
- 14. MiHIN Health Provider Directory Copyright 2014 Michigan Health Information Network Shared Services 14
- 15. HPD Search Copyright 2014 Michigan Health Information Network Shared Services 15
- 16. JCMR Providers Copyright 2014 Michigan Health Information Network Shared Services 16
- 17. Windward General Example Copyright 2014 Michigan Health Information Network Shared Services 17
- 18. Windward ESI Copyright 2014 Michigan Health Information Network Shared Services 18
- 19. Windward Care Teams Copyright 2014 Michigan Health Information Network Shared Services 19
- 20. Windward Diabetes Care Team Copyright 2014 Michigan Health Information Network Shared Services 20
- 21. Dr. Eastman Copyright 2014 Michigan Health Information Network Shared Services 21
- 22. Dr. Eastman’s CV Copyright 2014 Michigan Health Information Network Shared Services 22
- 23. Care Team Connect ESI Copyright 2014 Michigan Health Information Network Shared Services 23
- 24. Clinical Quality Measurement • A new way of assessing the success of medical care • Meaningful Use (MU) Stage 2 requires Medicaid providers to report Clinical Quality Measurements (CQMs) from a certified EHR • A new strategic direction for the HPD • CAT-I reports assess individual patient encounters • CAT-III reports assess organization efficiency & enable cross-clinic comparisons • MiHIN Patient Generator creates test data for large, simulated populations without PHI • Report-once capability for Medicaid and Medicare • Direct submission of CQM reports in pre-production Copyright 2014 Michigan Health Information Network Shared Services 24
- 25. Clinical Quality Measures in HPD: Super Stickiness! • Medicaid providers are required to submit CQMs • Non-Medicaid providers may want to report and analyze their CQMs also, given the appropriate powerful tools • HPD will display CQM data via Clinical Quality Measurement Recovery and Repository (CQMRR) service • All providers and organizations can access reports, dashboards and comparisons for self-analysis to improve outcome trends for their patients/clinics • Allows real-time feedback on clinical and organizational trends • Continuous Process Improvement / Clinical Quality Improvement Copyright 2014 Michigan Health Information Network Shared Services 25
- 26. Reports and Data Analysis: Real-time Quality Comparisons Copyright 2014 Michigan Health Information Network Shared Services • CQMRR: skimming ‘la crème de la crème’ Standard report generation (varies by user) Cross clinical comparisons (Medicaid, Medicare) Self-comparisons (providers) • Can identify best (and worst) Graphical dashboards using Tableau™ • Gartner rated top business intelligence tool • Real-time feedback for Clinical Quality Improvement 26
- 27. MIDIGATE OutboundInbound Copyright 2014 Michigan Health Information Network Shared Services 27 CQMRR – current capability State of Michigan Data Hub Eligible Providers Eligible/Critical Access Hospitals Data Peeler CDA Schema DQA SOM Data Warehouse eCQM Data Mart (Final) cati@direct.mihin.org catiii@direct.mihin.org Health Provider Directory Medicaid Reports, Dashboards, Comparisons, Mining, Q R D A Q R D A popHealth CAT I to CAT III Q R D A QRDA (CAT I & III) Check NPI MiHIN®
- 28. MIDIGATE OutboundInbound State of Michigan Data Hub Copyright 2014 Michigan Health Information Network Shared Services 28 Eligible Providers Eligible/Critical Access Hospitals Data Peeler CDA Schema DQA SOM Data Warehouse eCQM Data Mart (Final) cati@direct.mihin.org catiii@direct.mihin.org Health Provider Directory Medicaid Reports, Dashboards, Comparisons, Mining, Q R D A Q R D A popHealth CAT I to CAT III Q R D A Q R D A CQMRR - future state QRDA (CAT I & III) Check NPI Provider Quality Portal Provider Reports, Dashboards, Comparisons, Mining, any provider (any state) ® CMS Repository Medicare Reports, Dashboards, Comparisons, Mining, Payer Quality Analysis Q R D A Payer Reports, Dashboards, Comparisons, Mining, PQRS Q R D A MiHIN MiHealth Portal Q R D A
- 29. Copyright 2014 Michigan Health Information Network Shared Services 29 Live eCQM data
- 30. Copyright 2014 Michigan Health Information Network Shared Services 30 Live eCQM data
- 31. Copyright 2014 Michigan Health Information Network Shared Services 31 Live eCQM data
- 32. What You Have Seen Copyright 2014 Michigan Health Information Network Shared Services 32 • Key benefits of the Michigan Statewide Health Provider Directory (HPD) service • Strategic focus of the HPD: Electronic Service Information & health information routing • Architectural overview including the data model and relationships to standards • HISP integration capabilities • Transition of Care (TOC) integration • Health Provider Directory service demonstration • Clinical Quality Measurement capabilities
- 33. Questions? Copyright 2014 Michigan Health Information Network Shared Services 33
Editor's Notes
- Note: this is an animation for illustration purposes