HPC CHART Phase 2 RFP Mass HIway: Use Cases, Workflow Implications, Best Practices

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1 HPC CHART Phase 2 RFP Mass HIway: Use Cases, Workflow Implications, Best Practices

2 Meet the speakers Margaret Senese Program Manager for Strategic Investment Health Policy Commission, Commonwealth of Massachusetts Sean Kennedy, MPH, MS, PMP Health Information Exchange Director Massachusetts ehealth Institute at the Massachusetts Technology Collaborative 2 Massachusetts ehealth Institute

3 Learning objectives Communicate the value of HIE Describe how to get started with The HIway Generate a use case Find a trading partner and describe best practices to engaging Use presented use cases and related tools to initiate your HIE efforts The inclusion of specific examples does not imply endorsement by the HPC for CHART Phase 2 funding 3 Massachusetts ehealth Institute

4 Agenda Value of HIE Getting started with HIE & use case overview Find a trading partner and best practices to engaging Using the HIway examples of real-world uses Resources Key Takeaways Questions & discussion 4 Massachusetts ehealth Institute

5 Value of HIE Improves & streamlines care coordination Improves patient safety - fewer medical errors Reduces duplication of tests Supports achieving Meaningful Use Eases & improves public health reporting & analytics Enables inter-and intra-organizational exchange Serves as a foundation for Accountable Care Organizations & value-based healthcare models 5

6 6 Massachusetts ehealth Institute

7 Getting started with HIE & Use case overview

8 Getting Started with HIE A key milestone on the HIway connection path 8

9 Use Case Introduction What is a Use Case? A use case is an easy to understand description detailing the interaction between an actor (human, organization, system) and a system under consideration. For HIway purposes, it identifies a set of trading partners and source and destination systems and describes how they intend to use the Mass HIway. Why do we use them? Use cases are developed with the goal in mind, which makes them a valuable planning tool. A well-crafted use case communicates the functional requirements that may then inform technical planning. Having them available prior to technical discussions helps scope the technical solution and accelerates the technical evaluation process.

10 Use Case Introduction (cont.) How they should help you? Use case development requires an understanding of the business need the issue you seek to resolve or opportunity on which you intend to capitalize. Defining your need early in the process will accelerate later development efforts and provide a basis for evaluating success. Examples: I need to join the HIway» Way too ambiguous Our Practice needs to generate and securely send summary of care records to my patients specialists to meet MU2, Transition of Care criteria.» Provides initial needed details to guide plan development, scope the effort and establish priorities

11 Use Case Elements Use case name Goal Story Trading partners and systems Data to exchange 11

12 Use Case Benefits Identifies the clinical / business need before solution development mitigating rework and delays Facilitates initial scoping, project planning and effort prioritization Supports selling your request to management you have done your due diligence to articulate value, not just functionality Supports identifying the project team / stakeholders 12

13 13 Implementing your use case

14 Implementing your use case There are (2) parts to exchanging via the HIway: From the EHR to the HIway gateway From the HIway gateway to the intended recipient Your implementation approach will establish priority efforts 14

15 Finding a Trading Partner & Best Practices to Engaging

16 Best Practices to Engaging Plan your use of an HIE Mass HIway or other 16 Massachusetts ehealth Institute

17 Use Case Library Work in progress Intended to accelerate connections by sharing use case details Current Library Categories Transitions of Care Lab Data Exchange Public Health Reporting More to come 17

18 Determine Your Use Case Key questions: 1. Why are you connecting to the HIway? 2. What is the scenario? 3. Who is your trading partner(s)? 4. What systems/data sources are involved? 5. What data is being exchanged? 6. Are you sending or receiving or both? If sending, can you create the data set? If receiving, can you digest the data set? 18

19 Best Practices to Engaging Plan your use of an HIE HIway or other Review existing referral and care coordination patterns If using the HIway, determine the status of your trading partner: View the HIway Status map to identify trading partners and check status, If your trading partner has not yet started their HIway connection, refer them to EOHHS/HIway Ops to get connected, 19 Massachusetts ehealth Institute

20 Finding a trading partner HIway Status Map as of June 2014 Organization Name: Milford Regional Medical Center HIway Status: Transacting Billing City: MILFORD Billing Street: 14 PROSPECT ST Use Cases: Discharge summaries from acute care to skilled nursing facility and home health in the form of a CCDA 20 Massachusetts ehealth Institute

21 Best Practices to Engaging Plan your use of an HIE HIway or other Review existing referral and care coordination patterns If using the HIway, determine the status of your trading partner: View the HIway Status map to identify trading partners and check status, If your trading partner has not yet started their HIway connection, refer them to EOHHS/HIway Ops to get connected, Exchange etiquette send messages only with prior coordination The HIway also needs receivers and a greater diversity of participating organizations 21 Massachusetts ehealth Institute

22 Using the HIway

23 23 Massachusetts ehealth Institute

24 FACILITATING PATIENT REFERRALS FROM A COMMUNITY HOSPITAL TO A HIGHER ACUITY MEDICAL CENTER ORGANIZATION Berkshire Health System Suburban Internal Medicine Baystate Medical Center GOAL 1) Reduction of diagnostic tests (e.g., blood work) - with an HIE connection, we can avoid situations where current test results exist but are unavailable; 2) Increase the number of patient files transferred electronically TRADING PARTNERS AND SYSTEMS Berkshire Health System > planned: MEDITECH (via LAND) & Allscripts (via MedAllies HISP); current: HIway Webmail Suburban Internal Medicine > planned: Allscripts (via MedAllies HISP); current: HIway Webmail Baystate Medical Center > planned: Cerner (via PVIX from/to the HIway); current: HIway Webmail STORY Berkshire Health Systems (BHS) will enable health information exchange among its providers, its Electronic Health Record (EHR) systems and with its trading partners. BHS and their trading partners will bidirectionally exchange health information for critical patients, including cardiac patients in the midst of an acute MI who need urgent surgical intervention. These cases call for immediate, comprehensive, compatible, and accurate data sharing. BHS, Suburban Medical and Berkshire OB/GYN will each capture consent at the check-in. Upon seeing the patient, the provider will record the clinical encounter in the respective EHR, then - using webmail - will send health information supporting the referral to Baystate Medical Center. Once care is completed, they will then receive information back from Baystate as the patients are returned to them for continued care. DATA TO EXCHANGE CCD - summary of care

25 FACILITATING PATIENT REFERRALS FROM A COMMUNITY HOSPITAL TO A HIGHER ACUITY MEDICAL CENTER BERKSHIRE HEALTH SYSTEM SUBURBAN INTERNAL MEDICINE BAYSTATE MEDICAL CENTER SUBURBAN INTERNAL MEDICINE BERKSHIRE MEDICAL CENTER BAYSTATE MEDICAL CENTER GOAL 1) Reduction of diagnostic tests (e.g., blood work) - with an HIE connection, we can avoid situations where current test results exist but are unavailable; 2) Increase the number of patient files transferred electronically

26 26 Massachusetts ehealth Institute

27 27 Massachusetts ehealth Institute

28 28 Massachusetts ehealth Institute

29 Reducing readmissions 29 Massachusetts ehealth Institute

30 30 Massachusetts ehealth Institute

31 31 Massachusetts ehealth Institute

32 Lab results 32 Massachusetts ehealth Institute

33 Immunization Data from Ambulatory Practice to Public Health Department ORGANIZATION(s) Ambulatory Practice and the Massachusetts Department of Public Health GOAL To achieve Meaningful Use 2 objective- submission of electronic data to immunization registry and to meet M.G.L. c. 111, s.24m, which requires all licensed health care providers who administer immunizations to report all immunization data to the Massachusetts Immunization Information System (MIIS) TRADING PARTNERS AND SYSTEMS Organization A - ambulatory practice, using EHR interface to submit immunization data to MIIS via the Mass HIway Organization B Mass Department of Public Health using MIIS DATA TO EXCHANGE STORY A provider administers an immunization to a patient and this data is entered into the patient s record within the practice s EHR. The EHR then sends this information as an HL VXU message to the Massachusetts Immunization Information System (MIIS) at the Massachusetts Department of Public Health via the Mass HIway. The message is sent to MIIS s Mass HIway Direct address. MIIS processes the message and determines it was received successfully. At this point an HL ACK message is generated and sent back to the ambulatory practice s EHR to confirm successful receipt of the original message. HL VXU message from ambulatory practice to Mass DPH HL ACK message from Mass DPH to ambulatory Practice

34 Immunization Data from Primary Care Physician to Massachusetts Department of Public Health s Massachusetts Immunization Information System (MIIS) HL VXU message HL Acknowledgement Message (ACK) GOAL To achieve Meaningful Use 2 objective- submission of electronic data to immunization registry and to meet M.G.L. c. 111, s.24m, which requires all licensed health care providers who administer immunizations to report all immunization data to the Massachusetts Immunization Information System (MIIS)

35 Resources MeHI Use Case website MeHI Use Case Library MeHI HIE Case Studies MeHI Use Case Development Guide pdf Form - 20Form_ pdf HIway Implementation Grant Press Release with user story descriptions million-grants-accelerate HIway Interface [Vendor] Grantees Press Release - 35

36 Key Takeaways HIEs enable inter-and intra-organizational exchange To get started, review existing referral and care coordination patterns Use case generation facilitates initial scoping, project planning and effort prioritization. Further, they identify the clinical / business need before solution development mitigating rework and delays Elements of a use case include: 1. Use case name, goal, trading partners 2. Story, systems, data to exchange Engage your clinical and business leaders early discovering what you want to do takes time, pulling the team together takes longer. 36

37 Discussion & Questions Margaret Senese Program Manager for Strategic Investment Health Policy Commission, Commonwealth of Massachusetts Sean Kennedy, MPH, MS, PMP Health Information Exchange Director Massachusetts ehealth Institute at the Massachusetts Technology Collaborative 37 Massachusetts ehealth Institute

38

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