CRISP: Maryland’s Health
Information Exchange & REC
Oct 2012
What is CRISP?
CRISP (Chesapeake Regional Information System for our
Patients) is Maryland’s statewide health information exchange
(HIE) and Regional Extension Center (REC)
– Health Information Exchange, or HIE, allows clinical information to
move electronically among disparate health information systems. The
goal of HIE is to deliver the right health information to the right place at
the right time—providing safer, more timely, efficient, effective,
equitable, patient-centered care.
– Regional Extension Center (REC) is a program created by the ONC
that is funded through the stimulus bill. RECs will offer technical,
implementation, and educational assistance to facilitate providers’
adoption and meaningful use of electronic medical records (EMRs).
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Our Mission
Our mission is to advance the health and wellness of
Marylanders by deploying health information technology
solutions adopted through cooperation and
collaboration.
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Our Mandate
To electronically connect all health care providers in the
state of Maryland.
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Why Exchange Data Electronically?
• More complete view of patient
– Better information and the ability to spend more time treating patients
translate to better patient care
• Improves office efficiency
– Less time spent manually locating records or logging into other data
sources
• Enhanced reimbursement
– Electronic patient records and e-prescribing will soon be federally
mandated
• Coordination of care
– Furthers the high standards for quality and cooperation in Maryland’s
medical community
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HIE Benefits For Your Practice
• Avoid delays in obtaining records on referred
cases and uncertainties in relying on a patient’s
verbal case history
• Speed communication between your office and
pharmacies with reduced risk of error
• Minimal training or changes to existing
workflows, whether practice is paper-based or
electronic
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Policy Board and Opt Out Policy
 CRISP was designated as the state’s
HIE by the Maryland Health Care
Commission (MHCC)
 The MHCC facilitates a consumer oriented Policy Board,
which advises the MHCC on setting policies, which are
then adopted by the HIE
 The MHCC’s Policy Board has determined Maryland will
be an opt out state for patient participation
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Current Four Areas of Focus
1. Query Portal Growth
– to give providers access to prior hospital and medication records
2. Direct Secure Messaging
– to enable referrals and other care coordination
3. Encounter Notification System (ENS)
– to notify in real time about patient visits to the hospital
4. Encounter Reporting System (ERS)
– to help hospitals understand readmission patterns
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Query Portal
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CRISP Query Portal
The CRISP Query Portal can make clinical
information available at Ambulatory sites
•
Access must be part of a treatment encounter.
•
Available information generally includes: hospital
transcribed reports including discharge
summaries, hospital labs, radiology reports, and
pharmacy dispensed medications.
•
Single sign on integration can be enabled (with
some effort) to transparently pass credentials and
patient context to CRISP. Physicians in
ambulatory offices would click a CRISP button in a
patient's chart to see all external data available.
•
$$ No current charge for Ambulatory access
Types of data available:
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Patient demographics
Lab results
Radiology reports
Medication fill history
Discharge summaries
History and physicals
Operative notes
Consults
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Connectivity Progress to Date
Updated September 2012
Progress Metric
Result
Live Hospitals
48 – All Hospitals
Live Labs and Radiology Centers
(Non-Hospitals)
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Live Clinical Data Feeds
84 (lab, rad, a clinical document feeds)
Identities in MPI
~4M
Active Users (log-in w/in past 60 days)
~185
Queries (past 30 days)
~3000
Lab Results Available
~ 17.6M
Radiology Report Available
~ 4.7M
Clinical Documents Available
~ 2.1M
Opt-Outs
1376
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CRISP Query Portal
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CRISP Direct Messaging
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CRISP DIRECT Messaging
Direct secure messaging can be used in ways
such as:
• To communicate referrals and visit
summaries between Ambulatory practices
• To send relevant patient clinical information
between ambulatory practices and hospitals
• To make formal medical records requests from Ambulatory
practices to the hospital
• To receive encounter alerts from CRISP’s Encounter
Notification System when a patient is hospitalized
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CRISP DIRECT Messaging
•
CRISP can help operationalize a DIRECT infrastructure in a number of
different ways:
– Assign staff and other ambulatory physicians @crispdirect.org secure DIRECT
addresses. Low level of effort to assign and implement these addresses.
– Work with our DIRECT solution provider to implement your own DIRECT Domain.
(@myhospitaldirect.com) Medium level of effort to stand up domain, create cross
domain trusts, and to assign and implement these addresses.
•
Currently CRISP DIRECT is available via web mail, but there are thin clients
that can be installed to receive DIRECT messages on local machines and
even to file clinical messages received into select EMR file systems.
•
$15 a month per address, with some subsidized pilot opportunities
•
Your EMR vendor may offer other options for DIRECT.
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CRISP DIRECT Messaging
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Encounter Notification
System
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Encounter Notification System
• Encounter Notification System (ENS) is a
system built by CRISP to notify a participant
in real time when one of its patients has an
encounter at any hospital in Maryland.
• CRISP currently receives notifications in real
time for any patient admissions, intra-facility
transfers, and discharges in the state of
Maryland.
• Using ENS, we have the ability to send
notifications of these hospital events to
participants who wish to track a certain patient
population.
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ENS Trigger Event Selection
Trigger Events
• ER admission
• Inpatient admission
• Intra-hospital transfer
• ER discharge
• Inpatient discharge
• Cancel admission
• Cancel transfer
• Cancel discharge
Frequency
• In real time
• Once a day
• Once a week
• Once a month
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ENS Screenshot
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Questions?
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