Transcript Raising Public Health Stake on the National Agenda on HIT

Raising Public Health
Stake on the National
Agenda on HIT Adoption
in Healthcare
Marcy Parykaza, MGA
Chief, Information Management Services Bureau
Delaware Division of Public Health
State HIT Coordinator
President, NAPHIT
National Association for Public Health Information Technology

Effect of Silos
◦ Programs
◦ Funding
◦ Data Standards

Meaningful Use
◦ Siloed agendas
◦ HIT adoption
◦ PH vs CMS
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
What is the PH
Vision for 2020?

How can we get
there?
Standards
◦ Who
◦ What
Our Plan…
Over the next two days……
•
IT Director, PH CIO
•
Public Health
Administrator
•
State HIT Coordinator

HIE

REC

Beacon

State Agencies

Political Appointees

ARRA/ACA/ELC/CMS

Health Reform
Who do we
serve? How is it
Governed? Why
are we doing it?
Public Health
public health

What is the Plan?
◦ For us
◦ For our organizations
◦ For those we serve
Is it technical,
political, social?
 Is it doable?
 Is it transferable?
 What does
interoperability and
integration mean?

Do we need a DoOver?
People are talking
 Data is being shared
 Standards are being
developed
 Infrastructure grant
money is becoming
available

Effect of Silos
•Creating
more technically
confusing data structures
•Creating
non-sustainable data
storage sites
•Creating
countless
communication portals
•Raising
issues of privacy and
•Pushing
the limits of HIPAA
security
•Angering
providers
Child
Support
Office of
Drinking
Water
Vital
Statistics
Public
Health Lab
WIC
Immunizations
Cancer
Registries
New Born
Screening
Clinic
Systems
Bio-T &
Preparedness
NEDSS
based
system
HIV/AIDS
Ryan
White
…silos without standards
Can MU be a catalyst
for:
•Funding
•Standards
•Interoperability
•Integration
•Expansion
•How
can PH get on
the MU “hay wagon”
•Where
does PH fit
within the objectives
of CMS
Meaningful Use – the New Master?

What does it mean to
Public Health?
◦ Stage 1 – EP’s MU of
EMRs
◦ EP reporting:
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
Immunizations
Reportable lab results
Syndromic surveillance
E-prescribing
Reduction of disparities
Public Health in HIE
◦
◦
◦
◦
Planning
Funding
Sustainability
Governance
Public Health

State HIT Coordinator
◦ Who should it be?

Whose agenda?
◦
◦
◦
◦

HITECH
ARRA
ACA
CMS
HIT Adoption
◦ Dog chasing the tail?





Deadline
Money
Implement
Report
redo
Eligibility






Patient(client-centric)
Standardized across
organizations
Shared locally,
nationally, globally
Affordable
Sustainable
Usable
What is the
vision?
Health IT Shared Services
Strategy
Why we need to adopt standards
11
How Delaware Public Health
(DPH) is getting there.
CIO SOA view of DPH
Child
Support
Office of
Drinking
Water
Vital
Statistics
Public
Health Lab
WIC
Immunizations
Cancer
Registries
New Born
Screening
Clinic
Systems
Bio-T &
Preparedness
NEDSS
based
system
HIV/AIDS
…we went from this… (no
standards – no vision)
Ryan
White
Case
Management
Demographics
Enforcement/
Inspections/
Violators
Procurement
Permiting/
Certification/
Licensing
Investigative
surveying
Field
Mobility
MCI
Internal/
external
data
sharing
Inventory
Provider/
Vendor
Lists
compliance
Public Health
Technology Process Functions
Grant
Management
GIS
Registries
Forms
Alerting/
notification
WEB
Payments
Education/
Training
Billing
Record
Archiving
Scheduling
……to this (a vision based on
standards)
Interoperable
Communication Portal
DPH Apps
Hospital
LIMS
Communication
Mapper
Local HIE
(Delaware Health
Information Network)
Rhapsody
MSS
PHIN MS
Regional HIE’s
EMR
)
National HIE’s
Providers
Labs
Lead
LIMS
Surveillance
ADT
Immunization
Cancer
NBS
EMR
Clinical Services EHR View
Dental
WIC
Scholl Based
Wellnes
STD/MIS
HIV/AIDs
Family
Planning
Clinical Services
TB
Home Visit
Mass
Immunization
Schedule
Appointments
Billing
Environmental
Health,
ORC, ODW,
Food,
Plumbing
CHCIS
Case
Management
Well care
Records
Management
Business Processes
Rhapsody
HL7 mapping
Public Health Data store,
EMR database
CCD Data
D
H
I
N
Immunization
Cancer
BT
Diabetes
LIMS
Data
Forms
Reports
(CDC, EPA<
USDA)
..standards based interoperability.
How we are getting our users on
board……
2.0
Bio Surveillance
1.0
3.0
HIE (DHIN)
Clinic Process
4.0
Registries
DPH Integrated Public Health System and Electronic Health
Record System
5.0
Population
Health
8.0
6.0
DPH
Laboratory
7.0
Environmental
Health
What are the public health
functions in DE?
Long Term
Care
External Provider
inventory
Send appt letters
Verify appointment
Schedule next appointment
Letters of ….
Update demographics and
insurance
Request clinet ID
Check MCI number
Provide referrals
Update inforamtion
Update CHCIS, TB database
Pull charts
Follow retention schedules
Checklist
transfer
Send white copy of form
Look up billing info in CHCIS
Fiscal entities
Electronic Health Record
User tasks …..
Take vital signs
Assessment
Provide immunization,
education,
Collect lab sample
Send x-rays
1.0 Clinic Process
te
appropria
Reduce
y
inventor
Inventory databse
Provide Service
y
to
r
is
H
ic
al
ts
ed
m
nt
C
lie
Clos
qu
Set up re
e ou
xt appoin
se
ic ca
pecif
ob
est for ne
and
as
on
r
fo
vi s
it/s
v
er
i ce
ex
c
pe
n
tio
ta
n
tai
ed
m
fro
vi s
it
Pr
o
Manage Case
vi d
l
Invoice
Re
co r
tion
Billing
ds
eq
to
ll
BI
er
efe
r
ra
l to
a
ne
x
ter
na
lp
r
ov
ide
r
qu
or
sf
rd
co
s
Re ing
rd
v
ted hi
co
da Arc
Re
or
tf
es
…related to an IT process.
st
ed
Electronic Medical Record/
Electronic Health Record
ue
in
on obta
formati it
is
form v
Client history
Up
Re
informa
R
qu
ed
e st
New in
Re
Record Archiving
on
ts
Approva
ati
en
Obtain MCI number
ty
Eligibili
Provide
Re
m
for
m
nt
i ce
l in
oi
e rv
i ca
p
Ap
for
s
ed
of
linic
tm
st
to c
en
Li
rra l
cl i
de
refe
ted
vi
Client Eligibility
ide
da
o
Pr
Pro
v
Up
tment
z
finali
e
Appointments
External Provider
Fiscal Entities
Repeatable and Institutionalized:
 “We are part of a client centric, process
driven, interoperable public health
system.”
 “We are more similar than we are
different.”
Without a vision…what are you
leading?