NDHIMA – Fall Conference
September 13, 2013
Agenda
• Participation Update
• Direct Status
• HIE Implementation
• Project Update
• EMR Loan/NDHIN Connectivity Grant Program
• NDHIN – Delivering Value
NDHIN
• 105 Participating Organizations
• http://www.ndhin.org/providers/participating-providers
Provider Education
• http://www.ndhin.org/video/provider-education-video
Push Services
NDHIN Direct Secure Messaging
Adoption of Direct is growing…
State HIE Program Grantees, August 2013
Map Legend
VT
WA
MN
OR
NY
WI
SD
ID
PA
NV
IL
CO
OH
IN
MD
WV
KS
MO
NM
Pilot
NJ
CT
Not implementing
Direct
DE
VA
Other States and
Territories
KY
NC
TN
OK
Not Live
RI
IA
NE
AZ
Live
MA
MI
WY
UT
ME
ND
MT
CA
NH
AK
HI
AS
CNMI
DC
PR
GU
USVI
SC
AR
MS
AL
GA
LA
TX
FL
7
NATE
DirectTrust
Pull (Query based) Services
Integrated Health Data Architecture
Data Feeds to HIE
• VPN Connection to Data Providers
• HL7
• Admission, Discharge, Transfer (ADT)
• Labs (ORU)
• Radiology Reports/Documents (ORU)
• Clinical Documents
• Immunizations (VXU)
• CCD/C-CDA Exchange
Interfaces
Interfaces
Type of Data
Interface Approach
User Interface
(Front end View)
Patient
Demographics
HL7– ADT Demographics to
EMPI
Homepage
Patient Search
Patient Summary - Demographics & Emergency
Contacts
Encounter History
HL7 – ADT (PV1 segment)
Inbound
Laboratory Results
Patient Summary – Encounter History
Windowlet
HL7 - ORU Inbound Numerical and Textual (e.g.
Pathology and
Microbiology)
Document Tree/Results Viewer
Radiology Reports
HL7 - ORU Inbound Textual
Document Tree/Results Viewer
Transcribed Reports
HL7 Or MDM – Inbound or
PDFs/Scanned documents
Document Tree/Results Viewer
Normalized to LOINC
Interfaces
Interfaces Continued
Type of Data
Interface Approach
User Interface
(Front end View)
Allergies
HL7 - ADT (AL1 segment)
Inbound
Patient Summary - Allergies Windowlet
Diagnosis
HL7 – ADT (DG1 segment)
Inbound
Patient Summary – Encounter History
Windowlet
Medications
HL7- RDSO13, RDEO11,
RAS017 and OMPO09 –
Inbound
Patient Summary – Medications Windowlet
HL7-PPR
Patient Summary – Problems Windowlet
(Current Inpatient
and historical)
Problems
Normalized to SNOMED
Normalized to RXNorm or NDC
Normalized to ICD 9/10 or SNOMED
Procedures
CCD – will be parsed from the
CCD into the CDR
Patient Summary – Procedures Windowlet
Normalized to ICD 9/10 or CPT4
Imaging
NDHIN Patient Portal
• Provide patients secure access to their current medical
records from all participating sources
• Improve communication between patients and providers
• Upload relevant documents (such as Advance Directives)
• The NDHIN Clinical Portal will be the statewide Advance Directive
Repository
• View who has accessed their Clinical Portal record
• Providers can:
• Electronically deliver results
• Confirm/Remind upcoming appointments
• Provide patient reference information
Notifications
Subscriptions/Notifications
• Providers can “subscribe” to their patients and be notified
when specific events/triggers happen – based on HL7
messages
• Inpatient Admission
• Inpatient Discharge
• Abnormal Lab Result (includes all abnormal results)
• Above High/Low Abnormal OR Panic Lab Result (subset of
abnormal lab result)
• New Final Radiology Result
• Patient is admitted to the ER
Audit Log
Patient Consent
• Opt Out/Opt In of HIE managed by two methods:
• ADT Message (PD1-11)
• Manually, within HIE
Integration with EHRs
• Direct: NDHIN as HISP
• EHRs will be Direct-Enabled as part of 2014 Certification
• SSO/Clinical Integration with HIE
Example Integration (Epic)
Single Click access to Clinical Portal
Example Integration (Cerner)
Single Click access to Clinical Portal
HealtheWay
Project Status
• Jamestown Regional Medical Center –ADT testing complete,
•
•
•
•
LAB message analysis almost complete, validation planning
underway, eMPI bulk load complete, regular status calls
occurring, and outreach/training activities underway.
Sanford (Fargo) – ADT message analysis continues,
Immunization pass-through to NDIIS in Production, regular
status calls occurring.
St. Alexius - Readiness Assessment submitted, regular status
calls occurring and outreach/training activities underway.
Dept. of Health, Public Health Reporting connection –
connection complete, regular status calls occurring planning for
ELR to be sent through NDHIN from first participant.
Dept. of Health, Immunization Integration – pass-through for
Sanford Fargo in production, testing with Altru, planning with
other participants continues.
Project Status
• Altru Health System – ADT testing almost complete, LAB
•
•
•
•
message analysis beginning, Readiness Assessment
complete.
Sanford (Bismarck) – VPN complete, ADT message
analysis almost complete, LAB message analysis
beginning, outreach/training activities underway.
Catholic Health Initiatives – Participant agreement being
finalized, onboarding planning underway.
Family HealthCare – VPN and Readiness Assessment
feedback in progress.
Trinity and Mid Dakota Clinic – Onboarding in progress.
EMR Loan/Connectivity Grant Programs
• EMR Loan Program – Disbursed $11.5M to date
• NDHIN Connectivity Grants
• Purpose: Provide funds to providers to connect their electronic
health record system to the NDHIN
• Funds Available - 1 to 1.3 Million Dollars (Disbursed $553K to date)
• Hospitals - $30,000
• Clinics and Other Providers - $10,000
• Pharmacies - $5,000
NDHIN – Delivering Value
• What role can NDHIN play?
• Direct Messaging Service Provider (HISP)
• Provide data to Providers from other locations/other EHR Systems
• Direct
• Clinical Portal
• EHR Integration (Epic, Cerner, etc…)
• Provide data from other Providers to you/your EHR System
• Direct
• Clinical Portal
• EHR Integration (Epic, Cerner, etc…)
• Deliver data to State Lab/Registries/Other Sources – Meaningful Use
• Immunizations
• Electronic Lab Reporting
• Syndromic Surveillance
• PCMH
• Analytics/Reporting (ACOs, Community Needs Assessments, etc…)
Agenda
• Participation Update
• Direct Status
• HIE Implementation
• Project Update
• Loan/Connectivity Grant Program
• NDHIN – Delivering Value