Delaware Health Information Network Town Hall Wednesday, November 12, :00 a.m. 11:00 a.m.

Transcription

1 Delaware Health Information Network Town Hall Wednesday, November 12, :00 a.m. 11:00 a.m. Conference Room 107 Wolf Creek Boulevard Suite 2 Dover, DE Meeting Minutes Purpose To keep our public informed. Agenda What we are doing What we will be doing What should we be doing (public feedback) I. CURRENT Activities Update On November 7 th DHIN held its first Privacy and Security Summit. Privacy and compliance officers from all member hospitals attended. DHIN believes it was a valuable Summit and important to establish a standing work group/committee. We need to be respectful of the property rights of the data senders, the privacy rights of the patients and ensure we are taking the proper approach. DHIN is currently summarizing notes and action items for distribution. Public Health Electronic Lab Reporting Bayhealth is the first hospital that has gone into production with HL7 v2.5.1 Electronic Lab Reporting. DHIN continues working on content testing with Nanticoke and Nemours. CCHS is holding off until internal items have been completed. In addition, Atlantic General will soon be moving into production with Syndromic Surveillance. Immunization Reporting An additional ten organizations have moved into production; nine Wal-Mart stores and one Sam s Club, giving us a total of one hundred and twenty organizations in production and actively submitting immunization updates electronically. In previous months, we recorded roughly 20,000 electronic immunization files sent to Public Health. However, in October, 64,000 electronic files were sent and received by Public Health. 1

2 We also have the capability to support electronic queries of the immunization registry, and currently have one practice doing so on a regular basis. DHIN is happy to work with anyone interested. Newborn Screening We continue to work with Public Health on Newborn Screening. Genetic testing has been a primary issue and Public Health is moving forward with the legislation regarding the capability for consent of Newborn Screening. However, we still have a few issues on the pass through and delivery of the information to both the hospital and provider and how long the data can be kept in the system. The data cannot be held in a repository and exposed into the community health record; it is a pass through only and DHIN will not retain the information until/unless legislation is passed that allows consent. St. Francis and Nemours are currently sending their hearing screening results electronically to Public Health; however, not yet in production, is the combining of both tests into one report and sending the report back to the ordering provider and birth hospital. CCDs DHIN continues working with a group of thirty practices on a pilot for Care Summary Exchange. Currently five of those practices and two EHRs (Amazing Charts and Athena) have successfully automated the process of creating a Care Summary at the conclusion of each ambulatory encounter and automatically sending into DHINs document repository. DHIN also continues working with other EHRs and have encountered new/different issues due to not enough uniformity in how they create, store and transport data for each vendor has different tools and methodologies. We are in discussions with Allscripts and are working on pricing and transport methodologies. STI has expressed willingness but does not have immediate availability. We are also in the early stages of discussions with Cerner and eclinical Works. There are now just over 5,000 Care Summaries in our document repository and once the interface is tested all summaries will be pulled into the community health record. Software Upgrade DHIN continues working with Medicity on the software/data base conversion upgrade; and we continue to work on other projects in the current environment. Onboarding Projects Delaware Center for Maternal and Fetal Medicine has gone into production. The studies that DCMFM generate contain genetic information; therefore, at this time, it is passthrough only. Out of State Hospitals DHIN continues working to on-board out of state hospitals. Atlantic General has been sending ADTs and labs for the past year and would now like to expand to include 2

3 radiology reports, pathology reports and transcribed reports for all AGH patients with a Delaware address. Union Hospital is also currently in cert testing. We originally expected a mid-november production date; however, due to resource issues on their end, we are looking at December. DHIN has been exchanging ADT messages with CRISP on residents of each other s state. If a Maryland hospital sees a Delaware resident, CRISP will send the ADT to us and vice versa. If a Delaware hospital sees a Maryland resident, ADTs will be forwarded to CRISP. DHIN now has all Maryland hospitals in production and are receiving ADTs which are both populating the community health record and feeding the Event Notification System. DHIN is also in a very early conversation with our neighbors in Pennsylvania to follow in the same footsteps as CRISP. Direct/Secure Messaging DHIN is in the process of standing up a state wide Health Internet Service Provider (HISP) which will enable every practice in Delaware to be able to have Direct Secure Messaging with other practices in Delaware. Testing is in progress and we are working out a few contract issues with Medicity. State Innovation Model Grant The State of Delaware has applied for a grant through CMMI to test the Health Innovation Model that was developed using a design grant. On October 17 th a group of representatives from Delaware met with CMMI to defend the plan and request for funding. The group was headed by Governor Markel, Secretary Rita Landgraf, Bettina Riveros, Dr. Jan Lee, representatives from each hospital, Highmark, Aetna, Delaware Medical Society and a host of an amazing group of supporters. Payers in Delaware, in collaboration with health care providers, and the clinical community have reached an agreement on a common set of clinical quality metrics that will be used to evaluate providers and their performance. As part of the technical component, DHIN has the responsibility of putting into place the elements to support reporting the scorecard metrics. DHIN has executed a contract with IMAT and the initial kick-off for the Common Provider Scorecard took place yesterday. The intent is to have the pilot ready by spring 2015, allowing us two to three months to work on any problems that arise. And, by July 2015 we expect to be enrolling providers in the new models in which the scorecards will impact their income II. PLANNED Activities Update: DHIN continues working with DMMA on preparing a funding request from CMS. This is not a grant, but a spending authority that will allow the state to draw down funds from 3

4 CMS with an appropriate state match and will be used for specific projects which have been approved in advance by CMS. DHIN is also working with Public Health to incorporate some of their interests as well. We are looking to do this through the CMS funding source: Recruit additional imaging centers to participate in image sharing: Currently there are three organizations that have implemented image sharing; Nanticoke Hospital, Mid Del Imaging and St. Francis. A URL link is embedded into the radiology report which goes directly into the community health record and enables the end user to view images as well as call up older images. In addition, we are exploring a technical and viable solution for St. Francis to expand and view echocardiogram images. DHIN would like to use the CMS funding source to bring the additional eight radiology data senders on board to participate in image sharing. Part of the funding request is for the tools to create the capability for practices to view images through their EHR without having to separately log into the community health record. This is a Meaningful Use Stage 2 menu objective, so that is the justification for requesting CMS funding support. Context sensitive single sign-on to the community health record: Currently, Cerner, two hospitals and nineteen practices have implemented the context sensitive single sign-on to the community health record. In some cases, this may be the best option for implementing image viewing; the ability for the user to click on a link in their EHR which opens that patient s chart in the DHIN community health record. Cerner supports this; however, not all EHRs can and we may not be able to do this universally across our entire group of users. Still, with the EHRs that do support context sensitive single sign-on, it is a huge advantage to have the ability to easily link into the community health record. Electronic clinical quality measure reporting: As part of the Meaningful Use requirements, there are a specific set of clinical quality measures that must be reported. Practices are currently reporting manually to Medicaid; moving to electronic reporting will enable us to simplify and create efficiency for the practices and also create the ability for Medicaid to do more with the data. Addressing the continuum of care: DHIN would like to work with long term post-acute care facilities and organizations to enable them to send information about their patients into the community health record. This can be particularly valuable when there is a transition in care and a patient goes from a nursing home to a hospital emergency department. While paperwork follows the patient, it can be lost or misplaced by the time the patient gets to the next facility; and at that time the paperwork may not be available and important clinical information can be missing. The funding that we are applying for would be used to receive the technology infrastructure to have the data from post-acute care facilities and organizations to be made available through the community health record. 4

5 We are also exploring Public Health s interest in connecting their electronic medical and dental records into DHIN. RSNA (Radiological Society of North America) DHIN is also looking at a grant initiative with RSNA which is intended to support consumer empowerment in enabling them to gain electronic access to their own images; the ability to share images not only with the ordering provider but also to the patient whose image it is and to incorporate those images into a personal health record. The RSNA grant would also provide a companion piece with projects we hope to do with Medicaid. LabCorp LabCorp, one of DHINs original four data senders, has recently implemented sending their data to us with the LOINC codes incorporated; enabling the data to be ingested in an EHR and stored as structured data. This is important, as it complies with technical standards that ONC requires in supporting Meaningful Use Stage 2. III. Public Comments: Q: (Marie Ruddy, Nemours): Great update. Given the success we have had with ADTs and Maryland s HIE CRISP, are you looking to do something with hospitals in Pennsylvania directly or with a Pennsylvania HIE? A: Right now, the conversation is with an HIE. Though we would be willing to work with the hospitals and have made efforts, at this time there is no interest; however, it may just be a matter of time. Pennsylvania, unlike Delaware does not have a single HIE; the conversation is with Health Share which has mostly Philadelphia hospitals. Q: Do you know if Pennsylvania is even at that point or if they would be willing to participate? My understanding is that they are not as far along as DHIN or CRISP and are not exchanging information. A: We are in the very early stages of discussion and will explore any future possibilities. The next Town Hall is scheduled for December 10:00 a.m. 5