Transcript HIE Background - ConnectHealthcare

Nov 2011
Lyman Dennis
Organizer & Facilitator
What is Health Information
Exchange?
 Exchange of clinical (and administrative) information
among unaffiliated providers
 Push data point-to-point called “clinical messaging”
 Starter approach; will always work but more complex as
add more participating providers
 Options
1. Direct provider-to-provider exchange
2. Provider-to-central HIE; HIE to relevant providers
Hospital
Hospital
Dental Office
Dental Office
Dental Office
Urgent Care
Hospital
Urgent Care
Doctors
Office
Urgent Care
Doctors
Office
HIE
Speciality
Surgery
Doctors
Office
Pharmacy
Speciality
Surgery
Pharmacy
Insurance
HIE Players
 Cal eConnect – State-designated entity
 Active HIEs (e.g.s)
 Standalone HIEs
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Santa Cruz HIE
Western Health Information Network
Redwood MedNet
Orange County Partnership… (OCPRHIO)
 Vertical HIEs
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Kaiser
VA
John Muir
Sutter Health
CHW
Partnership HealthPlan of California
 Startups
Meaningful Use for Incentives
 Stage 1
 EHR
 Basic exchange
 Limited number of clinical measures
 Stage 2, Stage 3
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Use of EHR features for more patients (to 50% to 90%)
Menu items become core items
Electronic medication administration
Chemotherapy automation
Record patient communication preferences
Judge clinician performance based on patient adoption of PHRs
Longitudinal care planning
Public health enhancements
Why bother with HIE?
Cal eConnect – Current Plan
 Focus on what is important to the
stakeholders
 Focus on what is needed to sustain the
grant funding from ONC and the State:
 Provide an ability for ePrescribing
 Receipt of structured lab results
 Sharing patient care summaries
 Enabling data sharing through Direct and
emphasizing importance of and reliance
on local HIEs
Cal eConnect Strategic & Operational Framework
ONC & CHHS Priorities
 Establish Trust Environment
 Robust Support for Ancillary
Services
 Public Health
 Community Pharmacies
 Community Diagnostic
Laboratories
 Coordinate, Monitor,
& Report on HIE Landscape
¹ Policy, Leadership, & Barrier Removal
² Expert support to select or develop solutions to problems
³ Conserving scarce resources and making big impacts
Sustainable HIE
in California
Coordination³
Interoperability
 States’ Vendors’ EHR/HIE Interoperability Project
– Increase the value of the individual EHR systems by
assuring integration with HIE providers
– Create a set of interoperable implementation
specifications not unlike what IHE has developed for the
Interoperability showcase
– Leverage the power of a consortium of states to
influence vendors to adopt the reference
implementations (1/3 to ½ of the US population)
– Encourage vendors to provide these standard interfaces
“out-of-the-box” for all installs
– Encourage other states and vendors to adopt the
reference implementations
Multi State/Vendor Collaborative
EHR Vendors
States
• Allscripts
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• eClinicalWorks
• eMDs
• Greenway
• McKesson
• NextGen
• Sage
• Siemens
California
New York
Maryland
Massachusetts
New Jersey
Ohio
Oregon
Delaware
Colorado
HIE Vendors
New States
• Medicity
• Arizona
• Axolotl
• Florida
• InterSystems
• Virginia
• Maine
New
HIE Vendors • Texas
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• Cerner
Accomplishments
 August: Data and Metadata Workgroup completed work
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on the C32 specifications to create a fully defined and
constrained implementation specification.
September: Push Workgroup completed work on a robust
specification for implementation of NwHIN Direct using
SMTP s/MIME or SOAP/HPD+ with Directory Services.
September: C32 specification fully aligned with Beacons
and ONC S&I efforts.
October: Pull Workgroup completed a constrained
implementation specification for NwHIN Connect using
XCPD and an optional state-wide MPI.
In Process: Alignment of the States’ Interop work with
ONC – ONC statement of support imminent. Pilots being
sought.
Privacy & Security
 Privacy & Security Advisory Board and CalOHII
have led the State in development of guidelines.
 PSAB Eliminated by Gov Brown Exec Order.
 Regulations now in their second draft out for public
comment and input:
http://www.ohi.ca.gov/calohi/
 Committees:
 Privacy Committee: Focused on consent and use of data
http://www.ohi.ca.gov/calohi/eHealthPolicy/PrivacySteeringTeam.aspx
 Security Committee: Focused on securing the data
http://www.ohi.ca.gov/calohi/eHealthPolicy/SecuritySteeringTeam.aspx
Privacy & Security
 Cal eConnect Committees:
 Policy Advisory Group: Focused on policies governing
the use of Cal eConnect funded services. The goal is to
build and leverage HIE policy based on evidence and
supported by consensus.
http://www.caleconnect.org/?page_id=525
 Technology Advisory Group: Provides a neutral forum
for adoption and/or establishment of standards-based
approaches to technical operations for those
organizations that wish to participate in Cal eConnect
services.
http://www.caleconnect.org/?page_id=527