Lessons Learned from a Health Information Exchange …€¦ · HIE Pilot between Military and...
Transcript of Lessons Learned from a Health Information Exchange …€¦ · 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
HIE Pilot between Military and Civilian Providers in a SOA Framework
[email protected]/ and [email protected]
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?
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Current State of HIE in MHS System
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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
Archive
Archive
Slide prepared by CAPT Robert Hoyt, NOMI
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Changes after HIU
Primary Care Manager
Referral Manager
Tricare Service Center
ConsultWeb site
PatientSpecialist
Fax
AHLTA
HIE
Consult Notes
Consult Notes
Consult Notes
Archive
Slide prepared by CAPT Robert Hoyt, NOMI
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Pensacola Health Information Utility Project
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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’
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Virtual Health Network Architecture
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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)
HIE Pilot between Military and Civilian Providers in a SOA Framework
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Screen shots of health data from SHH through BHIE/SHARE
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Laboratory Results
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Detail View of Lab Result
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Medication Profile
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Detail Medication View
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Clinical Documentation
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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C32 Summary
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Cardiac Catheterization Report
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Cardiac Catheterization Report
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Screen shots of health data from DoD through
McKesson Physician Portal
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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McKesson Physician Portal SHH
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Visit Results from the Request
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Lab Results from the Request:
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Radiology Results from the Request
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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.
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Lessons Learned
•Clinical relevance•Clinical workflow•Data Critical mass•Marketing •Training
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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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
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HIE Pilot between Military and Civilian Providers in a SOA Framework
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Questions?
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