Connecting Your Community:
Interoperable Solutions to Mobilize Your Data
John Valutkevich
Senior Marketing Supervisor – EHR Initiatives
MEDITECH
• Surveying the Health Information Exchange
Landscape
• Meeting Industry Demands with Interoperable
Solutions
• MEDITECH Solutions
• MEDITECH/Forward Advantage Solutions
• Choosing the Right Toolsets
The Health Information Exchange
Landscape
History Repeats
HIE’s are maturing
• CHIN - 1990’s Community Health Information
Network
• RHIO – Regional Health Information
Organization
• LHIN – Local Health Information Network(s)
• Canada
Most states have a named Health Information
Exchange entity
Industry mandates are demanding connectivity
Why so few successful HIE’s?
Latest HIE Statistics
The Market Growth is in Private HIE’s
• Triple the number in 2011
• Less red tape among trusted entities
o Readiness
o Security
• Local vs. GRAND scale
o Better support clinician use cases
Public HIE’s growth down 50%
• Questions about future of funding
o Funding by Grants – not sustainable
entities
o Changes in Leadership in 2013 ?
Clinician Adoption is an issue
• Less than half deliver data directly to an EMR
• Data will not be used if workflow is interrupted
o Especially important in fast paced Inpatient
Environment
Meeting Industry Demands, a Health
Information Exchange
Higher Demands on EHR’s
• Meaningful Use requires Exchange
o Capability to exchange key clinical information
(CCD)
o Lab Results
• Physician Practices want better connectivity
from their EHR
o Seamless Order Referral Management
o Discharge/Referral Reports
o Multiple Location Data requirements
• Regional/State mandated participation
o State HIE
o Registry Reporting Requirements
• Payer Systems expecting data
Meeting Demands with MEDITECH
Proven Solutions – HIE components
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Patient Identity Management
Admission DT
Lab Results Outbound
Reports Outbound
CCD Interface Suite
Meaningful Use Public Health Interfaces
o Reportable Labs
o Immunizations
o Syndromic Surveillance
• e-Prescribing
• Ambulatory Orders and Results
• Eligibility/Payer/Financial Interfaces
Managing Patient Identity
• MEDITECH as Enterprise Master Patient Index
o Query
o Bi-Directional EMPI
o Smart Search
• Other Vendor as Enterprise Master Patient Index
o Demographic Update
o Quick Registration
Ambulatory Order Management
Stage 2 Requirement – 40% Ambulatory Lab Orders
CCD Interface Suite
e-Prescribing
• Stage 2 Requirement for Hospitals
• Integrated into MEDITECH’s EDM, PCS/Nursing,
and PCM
• Access medication histories
• Update patients' records
• Check benefits while ordering
• Communicate orders to retail and mail order
pharmacies
• Standards-based NCPDP Script interfaces
• DrFirst as transaction clearinghouse
Other Interoperability Solutions
• General Financial
• Claims
• ANSI 278 - ARM - Authorization and Referrals
• ANSI 270/271 - Insurance - Checks for insurance
eligibility
• ANSI 837 - Electronic Claims Submission
• ANSI 835 - Electronic Payment Remittance
• ANSI 276/277 - Claim Status Inquiry/Response Checks Status of Claims
• Materials Management
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ANSI 810 Invoices
ANSI 832 Catalogue Updates
ANSI 850 Transmit Purchase Orders
ANSI 856 Pre-shipment Notifications
• Payroll
• Time and Attendance vendors
HIE Use Cases
Choosing the Best Model
Centralized - Early Iterations
HL7
• Repository
• HL7 Provided In-bound
• Viewer Access
• Workflow Consideration
Patient
EHR
De-Centralized (Federated)
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Bi-Directional Interface Support
Standards are Imperative
Multiple EHR Coordination
Workflow Benefits
Hybrid – Best of Both
• Federated for those that are closely coupled
together
• Repository for community
HIE Use Cases
Building Your Model
Building Your Model
Inventory systems
Building Your Model
Other Infrastructure Requirements
• Technical Support
• Governance
• Rules
• Who can play
• Finance
Continuing collaboration to develop cost effective
solutions to support customer interoperability initiatives:
• Comprehensive HIE Solution set
• Record Locator Service (RLS)
• Master Patient Index (MPI)
• Healthcare Provider Directory (HPD)
• Flexible configuration to adapt to various use cases
and scenarios
• Policy and Consent Management
• Provider Portal
• Supports IHE and HL7 source and consumer
transactions
• DICOM Image Exchange
• Physician Referral Exchange
• CCD Aggregation
• Secure communications/transactions
• ATNA Support
Planning Your Connected Community
Getting Started
• Inventory Players
• Funding
Short Range (may all need to be met at once)
• Meet MU
• Connect Physicians
• Local/State Network
Long Range
• Connect to Other HIE’s
• Federal Level
Interoperability Futures
Projects under Review – Stage 2
• Discharge Summaries
• CCD’s
• Referral
• Consolidated CDA
• SOAP transport option to Direct