Transcript Document

EHR Implementations:
Revolutionising Health Information Management
Denis Tebbutt
Managing Director, InterSystems ANZ
Software for Connected Healthcare
Regional /
HealthShare – #1 health information
exchange platform
National EHR
Institutional /
Community EPR
Application Level
TrakCare – Advanced Web-based
healthcare information system
Ensemble - #1 rated healthcare
integration software
Caché - #1 database in clinical
applications worldwide
National & Regional Sharing of
Clinical Information
• Around the world healthcare delivery systems are
increasingly focused on the creation of an EHR
– Increases accessibility of important health information
across the spectrum of care
– Improves the quality of care
– Reduces the costs of care through elimination of
duplicate tests and prescriptions
– In emergency situations can literally save lives
– Facilitates the development of integrated community
based care
– Can outreach to health based NGO’s
The EHR Basics
• Identify the patient across
facilities
• Authentication of the requesting
clinician/viewer
• Consent Management
• Security
• Terminology
• Messaging
• Leave clinical data at the source
Technology Challenges
• Clinical access through a ‘Portal’
• There must be an integrated clinical
application that fits all levels of a
facility
HealthShare
Clinical Viewer & Patient Portal
TrakCare
Clinical Patient Record
• A powerful, health focused,
integration platform supporting HL7
and other IT based standards
• A strong standards based approach
• Repository and Record Locator
Service
• Rapid Application development and
deployment with incremental and
massive scalability
Ensemble
HL7/CDA/CCD/DICOM/NCPDP/RLS
EMPI/RLS
Cache
So What is HealthShare?
• Massively scalable integrated
healthcare suite for the deployment of
Regional and National Electronic
Health Records:
– Clinical Viewer
– Enterprise Master Patient Index
– Clinically proven database and
application
– Fully integrated and clinically
proven integration and
development platform
• Harvests the data held in all of the
repositories that support the operation
of a healthcare
facility/state/region/country
The Structure of HealthShare?
• The HealthShare EPR is a sophisticated browser-
based Electronic Patient Record that doctors and other
clinicians use to access patient data
• The HealthShare Hub is a central index of patients and
providers, it uniquely identifies a patient and specifies
which edge Caches maintain data for that patient
• The HealthShare Edge Cache Repository is a clinical
database that holds all of the data that a provider is
willing to share
• The HealthShare Gateway is a health integration
platform optimised for providing multiple provider
organisations
Populating the Hub
Locating Patient Records
HealthShare Patient Viewer
Ensemble at the Heart of HealthShare
• One data model
• One metadata repository
• One development
environment
• One management
environment
• One learning
curve
HealthCare Deployment Examples
Long Island, Rhode Island RHIO’s, Sweden & Netherlands National Systems
Long Island Patient Information eXchange
Mission
• Mission: To create an achievable, sustainable and
replicable model for integrating clinical information across multiple
health care organizations in order to improve access to patient data
at the point of care; improve health care quality; and reduce
inappropriate utilization and cost.
• Focus on support for the “transitions of care”
• Emphasis on infrastructure and Proof of Concept in Phase 1
Benjamin Stein, MD
Chief Executive Officer, LIPIX
Director of CIS, North Shore LIJ Health System
Long Island Patient Information eXchange
Scope
• Clinical Data Exchange (CDE)
– “Data of convenience”
– Workflow integration
• Need to support “pull” and “push” transactions
• Meta - Master Patient Index (M-MPI)
– Supports health information exchange
– Provides patient identification services to individual member organizations
• Future growth
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Public Health module
E-imaging
e-Rx
Ambulatory EMR
PHR
Long Island Patient Exchange (LIPIX)
• 5.2 Million Residents 8,000 GP’s (Assoc with NS-LIJ Health System)
• Connecting 15 healthcare organizations on New York’s Long Island
• Initial LIPIX Deployment
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4 Hospitals
2 Physician Practices
Home Care Agency
Municipal Health Center
EMS Organization
Reference Laboratory
Long Term Care Facility
Public Health Department
Long Island Patient Information eXchange
Scope
LIPIX Phase 1
North Shore University Hospital
HealthShare
Gateway
NSLIJ E-Gate Interface Engine
Siemens
Invision ADT
Eclipsys
Sunrise CIS
Cold Spring Hills
Center for Nursing
and Rehabilitation
GIS
IDX Flowcast
ADT
Reports
LIPIX Independently
Provisioned Users
NSLIJ Faculty Practice Plan
Nassau University Medical Center
HealthShare
Gateway
NSLIJ E-Gate Interface Engine
Public Health Surveillance
Siemens RIS
HealthShare
Gateway
Eclipsys E-link Interface Engine
Eclipsys Sunrise
Ambulatory Manager
Misys LIS
LIPIX HUB (HIE and M-MPI)
NSLIJ Home Care
HealthShare
Gateway
NSLIJ E-Gate Interface Engine
Initiate MPI
Intersystems
HealthShare
Gateway
HealthShare
Gateway
Misys LIS
NSLIJ Center for EMS
Siemens
Invision ADT
Cloverleaf Interface Engine
Misys RIS
Keane Care ADT and CIS
North Shore Staff IPA Practice
HealthShare
Gateway
HealthShare
Gateway
Sansio HealthEMS
(housed in Seattle?)
Med Records Alert PHR Vault
Med Records Alert Chart
Southside Hospital
OpenLink Interface Engine
Suffolk County Dept of Health Services
HealthShare
Gateway
NSLIJ Core Laboratory
Key:
HealthShare
Gateway
LIPIX Vendor Software
NSLIJ E-Gate Interface Engine
Siemens
Invision ADT
Siemens
Eagle ADT
South Nassau Communities Hospital
Intersystems
HealthShare Hub
(RLS)
McKesson Horizon
Home Care
NSLIJ E-Gate Interface Engine
Eclipsys
Sunrise CIS
Misys RIS
HealthShare
Gateway
PICIS PulseCheck
IDX Flowcast
Participant Infrastructure
= existing interfaces
Siemens
Siemens
InvisionSiemens
ADTs
Invision ADTs
Invision ADTs
Cerner Millenium
(housed in Kansas City)
= Interfaces to be built
by System Integration
Consultants
USA Rhode Island
• Having a useful, usable and used interconnected health
information system that:
• A total of 1.1Million Residents 3,000 GP’s
 Puts the right information into the hands of
clinicians and their patients when and where it is
needed
 Allows for population health information to be
analyzed and used for surveillance, health policy,
and research
• Using InterSystems HealthShare for state-wide master patient
index and clinical data exchange
• Connecting 14 healthcare organizations across the state
(85%+ of all lab and medication data)
• Governor has an “Anytime, Anywhere Healthcare” agenda
Sweden - National Patient
Overview (NPO)
• Population 9 million
• 21 healthcare regions
• National EHR
• Carelink is Government appointed
group to manage the project.
• InterSystems in partnership with
Tieto Enator.
• Contract signed March 18th
Netherlands (NICTIZ)
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National Healthcare Messaging Hub
• National solutions for Access, Identity & Consent
• HL7 V.3 for Health Information Exchange
• Strategy of inclusion for existing suppliers and
end-user solutions
• Concept of “well-behaved systems” [GBZ]
• Encouraging utilisation of the infrastructure
EHR Implementations:
Revolutionising Health Information Management
Denis Tebbutt
Managing Director, InterSystems ANZ