Solano County Health and Social Services
HIE project - OVERVIEW
• Link primary care, behavioral health, public health, clinical lab,
public health lab: ~17,000 clients of whom ~5,500 have EHR in 2 or
3 systems as of June 2013
• Build HIE while building EHR, using Mirth Connect, a data
channeling system – our provider focused support system
• EHR systems Nextgen, Netsmart Avatar (widget-based),
Persimmone, PHLIMS
• Place and track patients based on level of care utilization system
(LOCUS) while patients move between primary and specialty care
• Status: Test phase
Solano County Health and Social Services
HIE project – LOCUS 1
Acuity levels determine where the 5,500 higher need patients are
placed and what staffing levels are allocated:
Level
%
1 - Minimal 23.5%
2 - Low
38.2%
3 - Moderate 33.6%
4 - Serious
4.5%
5 - Extreme
0.1%
Services
Recovery Maintenance & Health Mgmt
Low Intensity Community Based Services
High Intensity Community Based Services
Medically Monitored Non-Residential
Medically Monitored Residential
Solano County Health and Social Services
HIE project – LOCUS 2
Assessments include:
•
•
•
•
•
•
•
Risk of Impairment
Functioning
Medical, Addictive, and Psychiatric Co-Morbidity
Recovery Environment
Level of Support
Treatment and Recovery History
Engagement and Recovery Status
Solano County Health and Social Services
HIE project – WHO AND WHERE
• 180+ healthcare providers, 80 case managers
• 3 primary care clinics with integrated behavioral health
(LOCUS Level 1-2)
• 1 integrated pediatric clinic (LOCUS Level 1-2)
• 3 Integrated care clinics with emphasis on behavioral
health (LOCUS Level 2-3)
• 16 Public Health Nurses (LOCUS 2-3)
• 68 Supported Services Housing Units (LOCUS 3-4)
• Institutes of Mental Disease (LOCUS 4-5)
• Napa State Hospital (LOCUS 5)
Solano County Health and Social Services
HIE project - COMPONENTS
• e-Prescribing to improve medication reconciliation at local acute care facilities
• Electronic Labs -- Clinic laboratories receive electronic orders from or deliver
electronic test results into certified EHRs at clinics
• Public health laboratory receives electronic orders and post electronic test
results to clinics (present) and local hospitals (future)
• Care Transition Messaging -- Eligible providers receive care summaries for
their patients from specialty care (present) and local hospitals (future); Eligible
providers push patient care summaries to other systems via Mirth Connect;
• IZ Reporting -- Submit immunization reports to the California Immunization
Registry (CAIR) (Future)
• DiSTRIBuTE -- Enable hospitals to publish daily syndromic surveillance signals
to CDC / Public Health (future)
Solano County Health and Social Services
HIE project – Data Fields
Demographics
Patient last name
Medical Record Number (unique)
First name
Submitter
Last name
Coverage/Subscriber #
Middle Name
employer
Address Line 1
Address Line 2
City of residence
veteran status
State of residence
Type of coverage
Zipcode
Group # or name
Date of Birth
Collection date
Gender
Collection time
Social Security Number
Date of birth
Diagnosis list including
past medical history
Provider ID
Provider
Physician name
Physician license /
NPI #
ICD-9 code
DSM IV code
Encounter ID
Solano County Health and Social Services
HIE project – Data Fields
Lab results
Specimen type/source
Specimen description
Test(s) requested
Test results
Test message
Test comments
Date completed
Meds list
Meds Name
Meds Dose
Meds Stop Date
Meds Start Date?
Allergies list
Vital Signs
Blood Sys
Blood Dias
Pulse
Temp
List of hospitalizations
List of therapies client is
currently receiving (CPT)
Health and Social Services
HIE project –
WORK FLOW