Overview of an Enterprise HIE at Virtua Health

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1 Overview of an Enterprise HIE at Virtua Health Julia Staas IS Director of Integration Virtua January 22, 2014 Page 1

2 About Virtua 4 Acute Care Hospitals 4 Major Outpatient Centers 45 Physician Office locations 2 Long-Term Care Facilities 2 Home Health Agencies 7 Ambulatory Surgery Centers 3 Fitness Centers

3 Virtua HIE Journey 2009 Requirements Gathering and System Selection Voice of the Customer Approach Physician Centric Standards Based Established Governance HIE Policy Committee (now Privacy & Security) HIE Usage Committee (Physicians) HIE Council (Decision making body)

4 Voice of the Customer - Data to be Available in the Virtua HIE 1. ADT (Pt Demographics) 2. Problems 3. Allergies 4. Medication Orders 5. Family History 6. Social History 7. Immunizations 8. Procedures 9. Vital Signs 10. Encounter Documentation (Practice EMR) 11. Lab Orders & Results 12. Radiology Orders & Results 13. Discharge Summaries & Transcribed Reports (from Virtua) 14. RxHub/SureScripts

5 2009 Vision Health Information Exchange PIX PDQ XDS.b Virtua s Hospital Clinical Data CIS Virtua Medical Group NextGen EMR Wellogic EMR-Lite EHS NextGen Pulse Microsoft Amalga Clinical Data Repository & Data Warehouse Real Time HL7 via OpenLink HL7 & CCD Fully integrated HL7 & CCD HL7 & CCD HL7 & CCD Physician Portal CCD HL7 & CCD Internet Interfaces Community Master Patient Index HL7 & CCD Fox Chase HIE MEDecision PIX PDQ XDS.b Security/ Access Control Atlanticare HIE Wellogic HL7 & CCD Virtua HIE Wellogic Usage Logs Camden HIE Noteworthy HL7 & CCD PIX PDQ XDS.b Record Locator Service SJ Healthcare HIE Mobile MD PIX PDQ XDS.b Master Provider index HL7 & CCD Internet Interfaces Virtua PHR (MS HealthVault) DICOM for Image Viewing DICOM for Image Viewing HL7 Virtua PACS & RIS Diagnostic Images GE Centricity DICOM for Image Viewing HL7 HL7 HL7 South Jersey Radiology Assoc PACS GE Integrad RIS Sage Intergy Larchmont Imaging PACS GE Centricity RIS Sage Intergy SureScripts Prescription Database Quest (Lab Results & Orders) Sage STI Chartmaker eclinicalworks Allscripts GE Centricity Lab Corp (Lab Results & Orders) Virtua (Lab Results & Orders)

6 What is the HIE s Policy Structure? The HIE operates under these formal policies and procedures: 1. Applicability and Definitions 2. Patient Participation and Choice 3. HIE Participants 4. Authorized Users 5. Compliance with Law and HIE Policies 6. Notice of Privacy Practices 7. Access 8. Authentication 9. Permitted Uses and Prohibited Uses 10. Information Subject to Special Protection 11. Minimum Necessary 12. Workforce, Agents and Business Associates 13. Security Incidents and Breaches of Unsecured Data 14. Auditing 15. Enforcement and Sanctions 16. Patient Rights 17. Data Quality and Integrity 18. Complaints 19. Governance and Oversight Copies of these documents may be found at

7 Consent Model & Sensitive Data Virtua HIE Consent Model: Opt-Out Patient data is available in the HIE unless the patient Opts-Out How is Sensitive Data Protected? Codified Data Rules Based on codes such as procedure & diagnosis Text Data 40,000+ keywords, phrases, negations rules using EnableCare solution To date over 10,000,000 documents scrubbed with just over 3% identified as sensitive Permitted and Non-Permitted Uses of Data Sensitive Data Categories HIV/AIDS Venereal Diseases Drug or Alcohol Addiction Treatment Records Mental Health Facility Records, Behavioral Health Information Psychotherapy Notes (as defined under HIPAA and HITECH) Genetic Information Minor s Emancipated Treatment Data related to services paid for out-of-pocket in full by a patient

8 Present State - Expanded Needs Seamless Integration for Shared Patient Care Children s Hospital of Philadelphia Pediatric Imaging Population Based Management Accountable Care Organization Patient Centered Permitted Medical and Home Non-Permitted Uses of Data Meaningful Use Transitions of Care Provide Patients the Ability to View Online, Download, Transmit NJ State Connecting NJ s HIOs

9 Pediatric Imaging Integration with CHOP The Need Two health systems sharing the care of mutual patients Virtua providing technical services CHOP providing professional services Clinicians work best in their native systems The Solution Leverage Virtua Permitted HIE technology and Non-Permitted to reconcile Uses of patient Data identity across the two enterprises Leverage CHOP s ScImage solution to share images Leverage both to: Return preliminary report Deliver finalized report Future Integration built to be expandable for future needs

10 Health Information Exchange New IT Landscape State Registries Other HIEs Sample of information systems for independent health care providers Physician Office EMRs Diagnostic Imaging Centers Commercial Pharmacy Data Dentist Office EMRs Nursing Home EMRs Commercial Laboratory Data Health System s Data Warehouse Acute Care EMR Physician Office EMR Pharmacy Patient Billing ER EMR Patient Demographics Laboratory Sample of Virtua information systems Radiology 10

11 Stepwise Path to Accountable Health Permitted and Non-Permitted Uses of Data

12 Comprised of : Jersey Health Connect Health-e-Citi Virtua HIE NJ Shine Camden Coalition of Healthcare Providers Trenton Health Team Purpose: Provide technical services for NJ State s NJHIN Phase 1: Web Services Directory Certificate & Registration Authority CCD exchange across HIOs

13 HIE Expanded Platform To Address the Present Needs, Virtua HIE is being Expanding to Include: Patient Portal DIRECT Messaging Services Permitted and Non-Permitted Uses of Data Analytics to Provide Clinical Decision Support Care Coordination Documentation Functionality Device Integration for Home Monitoring Devices (Glucometers, BP Monitors, etc)

14 Virtua HIE Participants and Data Contributors Virtua HIE Users Consult Applications Quest, LabCorp, Virtua Lab ipad App Alere Engage Alere EHR Alere Patient Portal HIE Portal Physicians, Nurses, Other Care Providers Larchmont Imaging, South Jersey Radiology Associates, Virtua Radiology HIE Database Community Based Health Managers and Care Coordinators Virtua Medical Group and Community Medical Practices DIRECT Secure Alere System Synapse Permitted Alere Analytics and Non-Permitted Uses of Data Messaging Manager Interface Engine Patients Virtua Health, Children s Hospital of Philadelphia, Kennedy Health System, Virtua HIE Connections Rehabilitation and Long Term Care Facilities Alere Connect Device Management SureScripts NJ HealthNet for NJ Health Information Network (NJHIN) Care Provider Ambulatory or Acute Foreign EHR Other Connected Community HIEs Real-time, Bi-Directional HL7 Interfaces Query/Response using IHE profiles such as XDS.b, PIX, PDQ, XCPD, XCA DIRECT Messaging Health.com Patient

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