Lessons Learned from a Health Information Exchange (HIE ... · HIE Pilot between Military and...

HIE Pilot between Military and Civilian Providers in a SOA Framework

[email protected]/ and [email protected]

Lessons Learned from a Health Information Exchange (HIE) Pilot

between a Military Treatment Facility and its Purchased Care Network (PCN)

Presented By:

LTC Nhan Do, MD, MSChief, Business Process Management,

Office of the Surgeon General, USA

Huy Nguyen, MDCEO, COGON System,

July 13, 2010



AGENDA

• Current state of health information exchange in the Military Health System

• Description of Pensacola Health Information Utility Project– Technical Background – Screen Shot Demo– User Experience and Lessons Learned– Technical Challenges– Business Challenges

• Life in the Healthcare Cloud• SOA What?

Slide 2



Current State of HIE in MHS System

Slide 3



Current system for consult trackingfor military beneficiaries in Pensacola

Primary Care Manager

Referral Manager

Share folder

Tricare Service Center

ConsultWeb site

Patient

Specialist

Fax

Fax

AHLTA

Mail

Archive

Archive

Slide prepared by CAPT Robert Hoyt, NOMI

Slide 4



Changes after HIU

Primary Care Manager

Referral Manager

Tricare Service Center

ConsultWeb site

PatientSpecialist

Fax

AHLTA

Mail

HIE

Consult Notes

Consult Notes

Consult Notes

Archive

Slide prepared by CAPT Robert Hoyt, NOMI

Slide 5


[email protected]/ and [email protected] DRAFT

DoD FHIE/BHIE Framework(VA AITC, Austin TX)

VA

FHIE/BHIEFramework

HL7PDTSSADR

K61Pre/PostPDHRA

-Correlation of Patient Identity-Information Locator-Security-Optimization-Adapter/Connector

RDV & VistAWeb

Query Access

VistALink

PIDS/ Correlation

DoDWeb Server

VitriaIE

HL7/ADT

DMSS

VistAVA Host

(Station 200) VistALocalVAMC

VA MPI

VA Vitria Interface

Engine

FHIE/BHIE Framework

FHIERepository

IDS

MHS Data Repository

WS/XML

WS/XML

CDR

BHIE-AHLTA

TMDS

CHCS

CACHE’HL7/ADT

WS/XML

WS/XML

DoD Web Server

CHCSSharing Facility

SHARE GUI

BHIE-AHLTA Web Server

WS/XML

BHIE/FHIE Architectural Components

VistAWeb

CPRS

WS/XML

MiCare

Slide 6



Pensacola Health Information Utility Project

Slide 7



Overview

• Congressional sponsor is Jeff Miller from Florida (FY07).• Cogon and the DoD entered into a Data Use Agreement, November

2008.• The Pensacola Health Information Utility (HIU) was deployed in the

Spring of 2009, between Sacred Heart (SHH) and Naval Hospital Pensacola (NHP).

• Baptist Health System (BHH) joined the Pensacola HIU May 2010, and both SHH and BH can view the military health records via a common secure portal.

• Through BHIE, DoD users have access to SSH and BH health data.• Pensacola HIU will migrate toward SAS 70 compliant, world-class data

hosting center (Terremark) – ‘cloud computing’

Slide 8



Shared Data

• C32 patient summary specification of CCD• Patient demographic and administrative information• Diagnoses/problem list• Providers • Allergies• Medications• Laboratory results• Radiology results• Previous procedures• Clinical notes such as consult notes

Slide 9



Virtual Health Network (VHN)

• Cogon’s Virtual Health Network employs a service-oriented architecture built upon a Java platform that provides the framework for healthcare data transmission, transformation, and transparency.

• Technical Guiding Principles: • Security, Interoperability, Scalability, Extensibility• Built to support a utility/transaction-based business model

Slide 10



Virtual Health Network Architecture

Slide 11


[email protected]/ and [email protected] Slide 12

HIE (Health Information Exchange )

Baptist All Facilities Sacred Heart

Navy Hospital VA Clinic

Combined

Chronological

Presentation of

Patient’s treatment

from all Facilities

Connection to NHIN (National Health

Information Network)

Connection to Florida Regional Health

Information Network

HEALTH INFORMATION EXCHANGEStrategic Health Intelligence

(Slide - courtesy of Robert Johnson- BH)



Screen shots of health data from SHH through BHIE/SHARE

Slide 13



Laboratory Results

Slide 14



Detail View of Lab Result

Slide 15



Medication Profile

Slide 16



Detail Medication View

Slide 17



Clinical Documentation

Slide 18



C32 Summary

Slide 19



Cardiac Catheterization Report

Slide 20



Cardiac Catheterization Report

Slide 21



Screen shots of health data from DoD through

McKesson Physician Portal

Slide 22



McKesson Physician Portal SHH

Slide 23



Visit Results from the Request

Slide 24



Lab Results from the Request:

Slide 25



Radiology Results from the Request

Slide 26



Patients in HIU

• Sacred Heart Hospital currently has 290,000+ unique patients in the HIU system

• Correlations with 28,400 patients from the Pensacola Naval Hospital.

Slide 27



Lessons Learned

•Clinical relevance•Clinical workflow•Data Critical mass•Marketing •Training

Slide 28



Technical Challenges

• BHIE data integration (not plug and play)• Network connectivity and maintenance• Two different MHS portal (BHIE SHARE, AHLTA 8viewer)• Multiple civilian EHR portal• Integration multiple disparate HIS system with multiple

standard • Integration of mental health data with multiple rule of

governance

Slide 8



Life in the Cloud

• Cost Efficiency• Cost Sharing and Sustainability• Standards-Based Commodity Business Model• Decreased Capital Requirement – Risk Mitigation• Security Recommended on a “Cloud” Level• Scalability and Distributive Network• Extensibility to technology innovation and

collaboration

Slide 30



SOA What?(Meaningful Use)

Clinical TransformationPopulation HealthDisease ManagementPatient Centered Medical Home

End User ExperienceMobilityVoice Technology

Business Process Management (BPM) in HealthcareCase Study: Tissue Organ DonorReferral ManagementMedication ManagementHospital Admissions

Slide 31



Questions?

Slide 32

Lessons Learned from a Health Information Exchange (HIE ... · HIE Pilot between Military and...

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