CRISP: Maryland’s Health Information Exchange & REC

Oct 2012

What is CRISP?

CRISP (Chesapeake Regional Information System for our Patients) is Maryland’s statewide health information exchange (HIE) and Regional Extension Center (REC) –

Health Information Exchange

, or HIE, allows clinical information to move electronically among disparate health information systems. The goal of HIE is to deliver the right health information to the right place at the right time —providing safer, more timely, efficient, effective, equitable, patient-centered care. –

Regional Extension Center

(REC) is a program created by the ONC that is funded through the stimulus bill. RECs will offer technical, implementation, and educational assistance to facilitate providers’ adoption and meaningful use of electronic medical records (EMRs).

2

Our Mission

Our mission is to advance the health and wellness of Marylanders by deploying health information technology solutions adopted through cooperation and collaboration.

Our Mandate

To electronically connect all health care providers in the state of Maryland.

Why Exchange Data Electronically?

• More complete view of patient – Better information and the ability to spend more time treating patients translate to better patient care • Improves office efficiency – Less time spent manually locating records or logging into other data sources • Enhanced reimbursement – Electronic patient records and e-prescribing will soon be federally mandated • Coordination of care – Furthers the high standards for quality and cooperation in Maryland’s medical community 5

HIE Benefits For Your Practice

• Avoid delays in obtaining records on referred cases and uncertainties in relying on a patient’s verbal case history • Speed communication between your office and pharmacies with reduced risk of error • Minimal training or changes to existing workflows, whether practice is paper-based or electronic 6

Policy Board and Opt Out Policy

 CRISP was designated as the state’s HIE by the Maryland Health Care Commission (MHCC)  The MHCC facilitates a consumer oriented Policy Board, which advises the MHCC on setting policies, which are then adopted by the HIE  The MHCC’s Policy Board has determined Maryland will be an opt out state for patient participation 7

Current Four Areas of Focus

1. Query Portal Growth

– to give providers access to prior hospital and medication records

2. Direct Secure Messaging

– to enable referrals and other care coordination

3. Encounter Notification System (ENS)

– to notify in real time about patient visits to the hospital

4. Encounter Reporting System (ERS)

– to help hospitals understand readmission patterns

Query Portal

9

CRISP Query Portal

The CRISP Query Portal can make clinical information available at Ambulatory sites

• Access must be part of a treatment encounter.

• Available information generally includes: hospital transcribed reports including discharge summaries, hospital labs, radiology reports, and pharmacy dispensed medications.

• Single sign on integration can be enabled (with some effort) to transparently pass credentials and patient context to CRISP. Physicians in ambulatory offices would click a CRISP button in a patient's chart to see all external data available.

• $$ No current charge for Ambulatory access

Types of data available:

• • • • • • • • Patient demographics Lab results Radiology reports Medication fill history Discharge summaries History and physicals Operative notes Consults

Connectivity Progress to Date

Updated September 2012

Progress Metric

Live Hospitals Live Labs and Radiology Centers (Non-Hospitals) Live Clinical Data Feeds Identities in MPI Active Users (log-in w/in past 60 days) Queries (past 30 days) Lab Results Available Radiology Report Available Clinical Documents Available Opt-Outs 48 – All Hospitals

Result

7 84 (lab, rad, a clinical document feeds) ~4M ~185 ~3000 ~ 17.6M

~ 4.7M

~ 2.1M

1376

CRISP Query Portal

CRISP Direct Messaging

13

CRISP DIRECT Messaging

Direct secure messaging can be used in ways such as:

• To

communicate referrals

and

visit summaries

between Ambulatory practices • To send

relevant patient clinical information

between ambulatory practices and hospitals • To make formal

medical records requests

from Ambulatory practices to the hospital • To receive

encounter alerts

from CRISP’s Encounter Notification System when a patient is hospitalized

CRISP DIRECT Messaging

• • • CRISP can help operationalize a DIRECT infrastructure in a number of different ways: – Assign staff and other ambulatory physicians

@crispdirect.org

secure DIRECT addresses. Low level of effort to assign and implement these addresses.

– Work with our DIRECT solution provider to implement your own DIRECT Domain. (

@myhospitaldirect.com)

Medium level of effort to stand up domain, create cross domain trusts, and to assign and implement these addresses.

• Currently CRISP DIRECT is available via web mail, but there are thin clients that can be installed to receive DIRECT messages on local machines and even to file clinical messages received into select EMR file systems.

$15 a month per address, with some subsidized pilot opportunities Your EMR vendor may offer other options for DIRECT.

CRISP DIRECT Messaging

Encounter Notification System

17

Encounter Notification System

• Encounter Notification System (ENS) is a system built by CRISP to notify a participant in real time when one of its patients has an encounter at any hospital in Maryland. • CRISP currently receives notifications in real time for any patient admissions, intra-facility transfers, and discharges in the state of Maryland. • Using ENS, we have the ability to send notifications of these hospital events to participants who wish to track a certain patient population.

ENS Trigger Event Selection

Trigger Events

• ER admission • Inpatient admission • Intra-hospital transfer • ER discharge • Inpatient discharge • Cancel admission • Cancel transfer • Cancel discharge

Frequency

• In real time • Once a day • Once a week • Once a month

ENS Screenshot

Questions?

21