Transcript Document
San Diego Beacon: San Diego Regional Health Information Exchange James Killeen, MD SD Beacon Technical Lead Professor of Clinical Emergency Medicine UCSD School of Medicine Beacon Community Program “These pioneering communities are going to lead the way in bringing smarter, lower-cost health care to all Americans through use of electronic health records” Vice President Joseph Biden, May 2010 White House Announcement of Beacon Community Awardees Overview • Funded by ARRA HITECH Act administered by the Office of the National Coordinator for Health Information Technology • $15 million over three years to use health IT to improve health care delivery in San Diego as model for nation • Transition from a grant-funded initiative to an self-sustaining independent organization providing services to the health care community 4 ARRA & HITECH Act • HITECH Priority Grant Programs nationwide meaningful use – Medicare and Medicaid Meaningful Use Incentive Payments – Health IT Regional Extension Center Program – Grants to states and state-designated entities for Health Information Exchange (HIE) • $20b in Health HIT – electronic health records – e-prescribing, e-care and telemedicine – community health initiatives – foster private sector investment in innovation 5 ONC’s Beacon Community Program – where HITECH comes to life • Beacon Communities funded to: Build and strengthen health IT infrastructure and exchange capabilities - positioning each community to pursue a new level of sustainable health care quality and efficiency over the coming years. Improve cost, quality, and population health - translating investments in health IT in the short run to measureable improvements in the 3-part aim. Test innovative approaches to performance measurement, technology integration, and care delivery - accelerating evidence generation for new approaches. 17 Beacon Communities Western New York Beacon Community Buffalo, NY Beacon Community of Inland Northwest Spokane, WA Utah Beacon Community Salt Lake City, UT San Diego Beacon Community San Diego, CA Southeastern Minnesota Beacon Community Rochester, MN Southeast Michigan Beacon Community Detroit, MI Central Indiana Beacon Community Indianapolis, IN Rhode Island Beacon Community Providence, RI Keystone Beacon Community Danville, PA Greater Cincinnati Beacon Community Cincinnati, OH Colorado Beacon Community Grand Junction, CO Southern Piedmont Beacon Community Concord, NC Great Tulsa Health Access Network Beacon Community Tulsa, OK Hawaii County Beacon Community Hilo, HI Bangor Beacon Community Brewer, ME Crescent City Beacon Community New Orleans, LA Delta BLUES Beacon Community Stoneville, MS 7 San Diego Beacon • Connecting ambulances to emergency rooms • Patient event notification to providers and payors • Wireless cardiac device pilot • Community Health Information Exchange • Patient information available to providers across systems at the point-of-care • Accessible in ED, hospital, clinic • Reporting (Immunizations, Public Health) State/Local Government Community B VA/DOD County PH CDC SD VA/DOD EMS Clinics Community A Build and Strengthen Health IT Hospitals Clinics SD VA/DOD Kaiser EMS County PH Others Suite of Services • Pre-hospital data available to hospitals electronically – Pre-hospital record – ECG, Images – Search capability into the HIE • Immunization – Optimize vaccine administration strategies – Import data from non-traditional settings – Add Immunization Forecasting • Syndromic Surveillance – Enhance reporting capabilities • • Radiology Imaging Import Medical Device Data – Implantable devices – Wireless Devices HIE Construction Pre-Hospital & 911 Clinical Population & Public Health San Diego Beacon • Improve Quality, Population Health, Costs Cardiovascular Dz Childhood IZ Syndromic Surveillance Redundant Tests ED/hospital Readmits Integrated Clinical Experience 14 Immunizations • More than 700,000 Lives • UCSD, Sharp, Rady, Scripps, & Medical Groups within San Diego 15 Immunizations SDB Hosting Immunization Server Provides routing of ADT and MU Reporting messages to SDIR and SD County Lab Data Normalization and ELR Syndromic Surveillance: ADT messages 18 Prehospital HIE • Prehospital data available to hospitals electronically – Prehospital record – Electrocardiograms & Images – HIE also back to field providers • EMS Application Partners – SD City EMS – AMR (Initiated) – Fieldsaver (Initiated) San Diego • 2010 OSHPD Data: – 24% (nearly one in four) of all 30-day readmissions occurs at a different hospital (excluding VA, NMCSD) • 15% of all ED patients and 69% of “frequent fliers” were seen in multiple hospitals eRAP Messaging • Event notification for ED Visit, Admit or Discharge – Providers – Payors – Health Systems – Federal Partners Project 25 • ED visits and charges reduced substantially in 6 month pre/post comparison for enrollees Financial Impact Performance on false positives STEMI EMS EMR incidents, by Quarter vendor 50 40 33.3 Percent 30 False positive STEMI incidents 20 15.8 EMS Hub San Diego 7.7 10 San Diego, CA 0.0 0 Q1 2011 Q2 2011 Q3 2011 Q4 2011 Q1 2012 Smart Analytics Algorithms Identifying Patients with In-Home Difficulties Smart Analytics Algorithms Identifying Patients with Substance Abuse Issues Smart Analytics Algorithms Identifying Patients with Psychiatric/Behavioral Problems 59 y/o Serial Inebriate Patient Serial Inebriate Patient RAP Trigger=SIP counselor sent to ED 40 y/o Post Traumatic Brain Injury 40 y/o Post Traumatic Brain Injury 40 y/o Post Traumatic Brain Injury Arrested P25 Released from Jail Alerts to P25 “ Information should follow the patient, and artificial barriers – technical, business-related, bureaucratic – should not get in the way ” – David Blumenthal, MD, Former Director, ONC www.sandiegobeacon.org San Diego Beacon Questions?