Transcript CAREWare Overview Part A Training July 31, 2013 John Milberg Division of Policy and Data U.S.

CAREWare Overview
Part A Training
July 31, 2013
John Milberg
Division of Policy and Data
U.S. Department of Health and Human Services
Health Resources and Services Administration
HIV/AIDS Bureau
Rockville, MD
Presentation Goals
• Provide brief history and context for development of
CAREWare
• Describe main features and software development
model
• Describe users
• Discuss the role and future of CAREWare in a rapidly
changing health information technology (HIT) world
Why CAREWare Was Developed
• Concern over data quality reported to Bureau (19992000)
• Need for a standardized tool to report on services
delivered, demographics, basic clinical information
• Limited resources and time to build and/or purchase their
own system
• Ensure that aggregate data reports were derived directly
from client-level data, resulting in more reliable data
What It Is – What It Does
•
An electronic health and services information system developed by the
HIV/AIDS Bureau made available for free to our grantees and providers
•
First released in 2000 in MS-Access; rebuilt in 2005 in VB .NET with SQL
Server database
•
Allows providers to produce all reports required by HAB and track client
demographics, services, clinical information, referrals, etc.
•
Contains comprehensive customizable reporting functionality, including a
performance measures module to track the quality of care
•
Can be configured to run as a standalone or under a comprehensive wide
area network administered by a state, city, or group of clinics/providers
What It Is Not!
• CAREWare is NOT a certified EMR/EHR
• It is not mandated by the HIV/AIDS Bureau.
HAB only mandates what data are reported to
us, not how you collect and report that data
Features
• Collects:
• Demographics
• Longitudinal data on services, medications, lab, screenings,
diagnoses, immunizations
• Appointment scheduler
• Extensive custom fields
• Referrals
• Reports:
• HAB required outputs (client-level export, ADAP); HOPWA
• Custom reports module
• Performance Measures module, including pre-built HAB
performance measure
• Clinical encounter reports for managing HIV care
Features and Security
Imports:
• Data from EMRs/EHRs
• Labs (HL7-formatted data from LabCorp and
Quest)
Provides security:
• Standard password protection, rule-based access
rights
• Uses native .NET encryption
• Network configurations typically use a VPN, Citrix,
or other private security tools
• Accommodates HIPAA security guidelines
Main Demographic Screen
Performance Measures Module
Performance Measures Module
Who Uses It?
• 51 percent of all Ryan White Program-funded grantees
and providers to submit their required client-level data
(958 of 1870 providers in 2010)
•
56 percent of outpatient ambulatory care providers
• Providers in 48 states, Puerto Rico, Guam, and the U.S.
Virgin Islands
• In 17 states (and PR, VI, and Guam), it was used by 100
percent of providers to submit their data
Who Uses It/How Configured?
• Configured as a centralized network in 21 States:
Arizona, Connecticut, Florida, Georgia, Idaho, Iowa,
Kentucky, Louisiana, Maine, Minnesota, Mississippi, North
Carolina, New Jersey (in process), New Mexico, Nevada,
Ohio (in process), Oregon, Pennsylvania (in process), Puerto
Rico, Tennessee, and Washington
Cities:
Denver, CO; New Haven, CT; Oakland, CA; Philadelphia, PA
• 17 state grantees to manage their AIDS Drug Assistance
Programs
• International clinics funded by PEPFAR in Barbados, Nigeria,
Uganda, and Vietnam
Percent of all Ryan White Program Providers/Grantees (N=1870)
that used CAREWare to submit year-end data report: 2010
P.R
.
Number of (duplicated) clients (N=800,580) reported by Ryan
White Program Grantees/Providers using CAREWare: 2010
How Much Client Data?
• 360,756 duplicated * client records were
submitted from 958 CARE Act-funded
providers using CAREWare in 2010
• That represents 45 percent of all client
records submitted
*A client can visit multiple providers and,
therefore, will have a record submitted from
each, hence his or her record will be
“duplicated”
How CAREWare Fits into the
Larger HIT Environment
• Many agencies import data into CAREWare from
other applications, primarily EMRs
• Electronic download of laboratory test results from
LabCorp and Quest, using data in HL7 format,
active in over 20 sites
• Performance measures module provides
functionality to produce outcome rates with formal
numerators and denominators
A Typical Ryan White Program
Network Configuration
Mental
Health
Provider
Labs
Primary
care
Substance
abuse
counselor
Central
Administrator
(Grantee at
state/city/clinic)
Primary
care
Primary
care
Future Issues and Developments:
Internal and External Factors
• Interoperability-Primary concern expressed on the
CAREWare item on the Listserv
• Patient-centered health information. Giving clients
access electronically to their record
• ICD-10 requirements and “cross-walking” with ICD-9
• Coordinate with Federal HIT initiatives and principles
Contact Information
• John Milberg- HRSA, HIV/AIDS Bureau,
Division of Science and Policy
• Email: [email protected]
• CAREWare Website:
http://hab.hrsa.gov/manageyourgrant/careware.html