Santa Cruz HIE Proposal for Demonstrating at California Connects 2014

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1 Santa Cruz HIE Proposal for Demonstrating at California Connects 2014 Use this template to communicate critical information for each demonstration proposed for the 2014 California Connects Interoperability Exhibition, to be held at the Connecting California to Improve Patient Care in 2014 conference sponsored by Redwood MedNet. Prospective participants in California Connects 2014 must complete a proposal following this template for each proposed demonstration, and submit it for approval to the California Connects Steering Committee via c/o Karen Boruff at Please see the California Connects 2014 page at for more information. Direct any questions to Karen Boruff at or Rim Cothren at 1. Demonstration Synopsis Please provide a title for your demonstration and a brief description of the demonstration. Try to limit the description to no more than 100 words. The title and description will appear on our web site in advance of the Exhibition to attract meeting participants to your demonstration. Coordination of Care across Disparate Systems and Care Settings We will demonstrate coordination of care across disparate systems and care settings using the ClearExchange Interoperability Suite of solutions. The latest available standards and capabilities are on display including Blue Button +, Consolidated CDA, Direct Messaging and Provider Directory. 2. Demonstration User Story Please provide a user story describing the demonstration, with specific emphasis on its clinical relevance. Be specific, illustrating how you will weave the technology you are demonstrating into real clinical flow. Application for Demonstrating at California Connects 2014 Page 1 of 5

2 Patients use the services of many providers across varying organizations, communities and specialties. Leveraging ClearExchange HIE technology providers and care teams can share the necessary information, make updates to the data and stay abreast (in real time) with a patient s treatment, health status and care plan. ClearExchange enables the exchange push and pull of standards based clinical and administrative documents. Summary of 5 Use Cases Use Case 1: Patient directed exchange using Blue Button + and Direct Messaging to enable care coordination between multiple providers and facilities in San Diego and Santa Cruz. Use Case 2: Hospital uses Direct to deliver Discharge Summaries to affiliated and unaffiliated providers. Use Case 3: Incorporate paper document delivery and storage via a Health Information Exchange. Use Case 4: Use Direct to manage Care Transition between UC Davis Epic and a Santa Cruz HIE provider. Use Case 5: Provider in Oak Valley Hospital (Live Oak) use HPD+ to find a specialist provider in Santa Cruz (different regions and different systems) and use Direct to send relevant information to support the referral including a Care Summary. Expanded Use Cases Use Case 1: Care coordination between San Diego and Santa Cruz providers using the ibluebutton mobile HIE app platform This demonstration shows a Veteran receiving care at the San Diego VA, at a private clinic, at a military treatment facility, and at the University of California San Diego (UCSD) using the Humetrix ibluebutton app to access, display, aggregate and store health records from the VA, Medicare, DoD with a UCSD C-CDA record transmitted to the app by Direct via the San Diego Health Connect HIE. At an Emergency Department in Santa Cruz, the Veteran transmits these records to the ibluebutton Professional ipad app of an ED physician who then sends back an encounter summary by Direct using the Santa Cruz HIE Use Case 2: Hospital uses Direct to deliver Discharge Summaries Following a hospital stay, communicating the course of treatment, reconciling the medications and communicating follow up actions with providers outside the hospital lead to better outcomes and fewer readmissions. The Santa Cruz Hospital has integrated automated Discharge Summaries sent by Direct Messaging to the patients care team. Application for Demonstrating at California Connects 2014 Page 2 of 5

3 Use Case 3: Incorporate paper document delivery and storage via a Health Information Exchange Important information exists on paper documents. Most EHR systems can incorporate scanned documents however the exchange of those documents across system rarely works due to the proprietary nature of scanning solutions. Here we show a scanned document incorporated into a CDA Level 1 with some structure applied so that this critical data can be exchanged between systems and incorporated into a HIE s Longitudinal Patient Record. Use Case 4: Use Direct to manage Care Transition between UC Davis Epic and a Santa Cruz HIE provider A resident of Santa Cruz is traveling through Sacramento when he is involved in an accident and is seen at UC Davis. A UC Davis provider uses their Epic system to send a Care Summary to the patient s home provider in Santa Cruz. Use Case 5: Directory query to support out of area referral Oak Valley Hospital wishes to refer a patient to a specialist outside of the community. The Hospital has selected to use Direct for the exchange rather than send the patient with printed records or send the records by courier. The Hospital wishes to send structured data, including a care summary, to the specialist before the patient visit using Direct. Oak Valley Hospital is not currently served by an HIE and therefore needs a HISP to serve as information broker for the exchange of secure clinical patient information. The referring Doctor at Oak Valley, using their HISP account, queries the federated CTEN Directory Services for the specialist by searching for an individual by the last name and includes the specialty and known street address to narrow the search. From the names returned, the Doctor verifies that one is associated with the expected clinic, and retrieves the Direct address for the specialist at that location. The Doctor then collects the relevant clinical data, attaches it to a Direct message with a personal note describing the reason for the referral, and sends the message. The HISP verifies receipt, ensuring timely and accurate delivery and allowing the referral to be received quickly and with minimal time expenditure. 3. Goals and Objectives of the Demonstration Please provide a brief description of the goals and objectives of the demonstration, emphasizing what you expect your audience to learn. Be sure to indicate how your demonstration aligns with the objectives and guidelines found in the California Connects Demonstration Charter at Application for Demonstrating at California Connects 2014 Page 3 of 5

4 ClearExchange will show the power of an HIE. The ability for all care team members to have access to all the data, all the time. Whether from within the providers EHR or by a portal to view the longitudinal health record. ClearExchange bridges the gap between traditional providers, hospitals, behavioral health, specialists, ancillary services, emergency services and beyond. 4. Participant Information Please list information about the primary organization and any supporting organizations and/or sponsors for the demonstration. The primary organization will be responsible for creating, testing, and showcasing the demonstration. Supporting organizations might be collaborating to demonstrate the user story or otherwise deserve recognition. A sponsor may be funding or otherwise providing resources for the development of the demonstration Primary Organization Name of the organization Role in the demonstration Santa Cruz HIE HIE/HISP 4.2. Supporting Organization(s) Name of the organization: Role in the demonstration: Inofile, San Diego HIE, Humetrix See above use cases 4.3. Demonstration Sponsor(s) Name of the organization: Role in the demonstration: Axesson the Technology partner behind the HIE infrastructure Core framework built on Mirth and other technologies 5. Technical Information 5.1. Business Workflow Please provide a description of the business workflow for the user story, showing the various actors and systems involved in the health information exchange. A diagram may be used. Diagrams to be provided. Application for Demonstrating at California Connects 2014 Page 4 of 5

5 5.2. Technical Standards Please provide a brief discussion of the technical transport and content standards used in the demonstration. Include security, authentication and authorization standards as necessary. Please review for the technical priorities for California Connects This demonstration illustrates the use of IHE IT Infrastructure Framework Supplement, Healthcare Provider Directory (HPD) Trial Implementation Rev 1.4 and Statewide Send and Receive Patient Record Exchange Technical Specification Appendix, HPDPlus RDB Implementation Guide v1.1. It implements mutual TLS for security. HL7 version 2 and version 3 including Consolidated CDA. 6. Maturity of the Demonstrated Technologies Please describe the maturity of the technologies highlighted in your demonstration, and when they might be available for use, and what barriers there are to reducing them to practice, if any. Technologies in the demonstration might be emerging and experimental, under development and soon to be available, or commercially available now. All of the technology being demonstrated is available and in use. Some are in the early adopter phase. Application for Demonstrating at California Connects 2014 Page 5 of 5

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