Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc.
Integrate with a
Health Information
Exchange
Presenters
      › Dr. Robert White
        Clinical Informatics Director
        Lovelace Clinic Foundation
        ABQ H...
Agenda
      ›          Meaningful Use
      ›          HIE Benefits
      ›          NMHIC Overview
      ›          NMHI...
Meaningful Use
      › ARRA will provide incentives to physicians and
        hospitals for meaningful use of HIT. (2011–1...
HIE Benefits
      ›       Improved care coordination and communication
      ›       Support to public health
      ›    ...
NMHIC Overview
      › The New Mexico Health Information Collaborative
        (NMHIC)
                 − Health Informati...
Technical & Security Fundamentals

                                                    Privacy             Security
      ...
How NMHIC Works
                      State Public                               HIE
                      Health Depts.  ...
NMHIC Federated Architecture




                                                               NHIN




Copyright © 2010 ...
DEMO




Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc.   11
ABQHP AE-EHR <-> NMHIC HIE
      › Existing Health Level 7 (HL7) Data Exchanges
        Developed by Galen
               ...
ABQHP AE-EHR Data Exchanges
      › Built in the ConnectR interface engine
                 − Application Programming Inte...
What/How information is shared
      › Dependent upon clinical data currently captured and
        available in the Enterp...
AE-EHRConnectR Extract Process




Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc.   15
Design Process
      › Technical Design Document (TDD)
      › Provide representative subset of data for analysis by
     ...
Design Decisions
      › Patient identifiers
                 −     Radiology Information System (RIS)
                 − ...
NMHIC: Lesson Learned
      ›       Expansive and inclusive governance participation
      ›       Patience and Persistenc...
The Future: CED

      › A Clinical Exchange Document (CED)
                 − Generally accepted format of patient data u...
Summary
      ›          Pragmatic benefits (both clinical and financially) to
                 exchanging data between th...
Questions / Contact Information
                                                               Questions?

               ...
Brought to you by Allscripts Academy

               Meaningful use begins with education
               Visit the Academy...
Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc.
                                                             ...
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Galen ACE 2010 Presentation

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Galen ACE 2010 Presentation

  1. 1. Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc.
  2. 2. Integrate with a Health Information Exchange
  3. 3. Presenters › Dr. Robert White Clinical Informatics Director Lovelace Clinic Foundation ABQ Health Partners › Justin Campbell Senior Consultant Galen Healthcare Solutions Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 3
  4. 4. Agenda › Meaningful Use › HIE Benefits › NMHIC Overview › NMHIC Architecture & Approach › ABQHP AE-EHR <-> NMHIC HIE › What/How information is shared › Design Process › Design Decisions › NMHIC: Lessons Learned › The Future: CED Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 4
  5. 5. Meaningful Use › ARRA will provide incentives to physicians and hospitals for meaningful use of HIT. (2011–15) › Meaningful Use will require HIE networks to: − Support Electronic prescribing − Exchange summary patient documents − Order laboratory tests and receive results electronically − Electronically submit immunization and reportable conditions/events to public health − Potentially convey quality reports to federal/state authorities 2012 and thereafter Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 5
  6. 6. HIE Benefits › Improved care coordination and communication › Support to public health › Potential for daily emergency responder use › Potential for a natural disaster emergencies › Elimination of duplicate tests › Value (savings/cost reduction) to (New Mexico) payers − $11.9 million per year – extrapolated conservatively from national study − $6 million per year based on very conservative estimates from local data Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 6
  7. 7. NMHIC Overview › The New Mexico Health Information Collaborative (NMHIC) − Health Information Exchange (HIE) development started 2005 − Convenes over 30 hospital, medical practice, laboratory, public health, professional, health plan, and employer organizations in a legal and trusted relationship for sharing patient information − Connects doctors to electronic patient information across different healthcare organizations in community and state › NMHIC will replace fax, phone and mail exchange of medical information with secure and privacy protected electronic systems when it begins operation late 2010. Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 7
  8. 8. Technical & Security Fundamentals Privacy Security Network Subscription Virtual Private Network Agreement tunnels with partners Terms and conditions at first SSL Encryption, Intrusion login Prevention Patient Consent Required Strong passwords, 90 day expirations Comprehensive Auditing Two levels of authentication Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 8
  9. 9. How NMHIC Works State Public HIE Health Depts. Network Hospital Locates the Patient’s Records Patient Clinician Office PRIVACY PROTECTED Clinician Gathers and Assembles Lab the Patient’s Records Emergency Room Nationwide Health Information Network (NHIN) Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 9
  10. 10. NMHIC Federated Architecture NHIN Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 10
  11. 11. DEMO Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 11
  12. 12. ABQHP AE-EHR <-> NMHIC HIE › Existing Health Level 7 (HL7) Data Exchanges Developed by Galen − Registrations − Appointments − Radiology Results − Documents › Up Next (Funded by Social Security Admin. Project) − Appointments − Allergies − Medications − Problems Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 12
  13. 13. ABQHP AE-EHR Data Exchanges › Built in the ConnectR interface engine − Application Programming Interface (API) to the Enterprise EHR (AE-EHR) − Inbound and outbound stored procedures. › Configuration of the interfaces to the particular vendor/client. › Galen’s vast experience and expertise in deploying data exchanges to and from the AE-EHR leveraged. Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 13
  14. 14. What/How information is shared › Dependent upon clinical data currently captured and available in the Enterprise EHR › Current implementation between ABQHP AE-EHR and NMHIC HIE is uni-directional − Outbound from Enterprise EHR to HIE › Reg/Sched data typically comes from the Practice Management system − Pass/Map interface › Extract routines deployed in Enterprise EHR and ConnectR to facilitate extraction of allergies, medications, problems › Data mapped to HL7 messages (ADT, ORU, MDM) Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 14
  15. 15. AE-EHRConnectR Extract Process Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 15
  16. 16. Design Process › Technical Design Document (TDD) › Provide representative subset of data for analysis by NMHIC › Feedback loop − Iterative process until steady-state is reached › Issues and Resolutions List › Timeline & Effort − Staggered, parallel development − Typically 8 week turn-around-time − Design − Build − Unit Test − Validation − Activation Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 16
  17. 17. Design Decisions › Patient identifiers − Radiology Information System (RIS) − Laboratory Information System (LIS) − EHR − PM − Consistency with the Master Patient Index (MPI) across all interfaces. › Filtering − Mental health document types − “Celebrity patients” − Preliminary documents − Unverified results. Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 17
  18. 18. NMHIC: Lesson Learned › Expansive and inclusive governance participation › Patience and Persistence required › Legal agreements take time › Public benefit requires public funding › Steadfast support from NM Department of Health Leadership › Complementary core team skills › Vendor commitment › Federated architecture › Centralized warehouse unacceptable in our community Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 18
  19. 19. The Future: CED › A Clinical Exchange Document (CED) − Generally accepted format of patient data used to share information between systems. − Allscripts term to cover different formats that are supported. › CCR and Medical Summary (a CDA) › Both are xml documents, › Both are essentially encounter summaries containing − Allergies -Problems − Medications -Vitals − Immunizations -Results Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 19
  20. 20. Summary › Pragmatic benefits (both clinical and financially) to exchanging data between the AE-EHR and the HIE › Best practice, iterative design approach utilized › Effort invested in design up-front saves in implementation › Most efficient means of data exchange between the AE- EHR and HIE is CED Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 20
  21. 21. Questions / Contact Information Questions? Contact Information Dr. Robert White Clinical Informatics Director, Lovelace Clinic Foundation Bob.White@lcfresearch.org Justin Campbell Senior Consultant, Galen Healthcare Solutions Justin.Campbell@galenhealthcare.com Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 21
  22. 22. Brought to you by Allscripts Academy Meaningful use begins with education Visit the Academy booth today and enter to win special ACE giveaways! Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc.
  23. 23. Copyright © 2010 Allscripts-Misys Healthcare Solutions, Inc. 23

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