Interoperability and the Surgery Department

Transcription

1 Interoperability and the Surgery Department Anupriyo Chakravarti, Director Systems Architecture Surgery is the economic engine of most hospitals 50% of medical errors occur in the OR The most severe medical errors occur in the OR Primary source of admissions Contributes 60% of a hospital s revenue Contributes 35%- 40% of the hospital s expense About 17 ARRA Stage I MU criteria applies to the OR Contributes 9% of data points for calculating ARRA Stage 1 CQM Clinical Operational Financial 1

2 Key Regulatory Initiatives Impacting Surgery The Surgery is faced with disruptive regulatory changes requiring continuous investment by all US hospitals ARRA Electronic Health Record Joint Commission Accreditation, SCIP FDA Medical Devices CMS Physician Quality Reporting Initiative CDC Surgical Site Infection Guidelines WHO Patient Safety checklist AORN SPF, Syntegrity Interoperability in Surgery is a Critical Success Factor Reduces errors, increasing patient safety and improving patient health through the Surgical process Reduces workload and improves efficiency through reduced documentation, cancelled cases and room turnaround time Improves charge capture & billing, reducing costs through optimized workflows and technology Clinical Operational Financial 2

3 What is Interoperability? Interface» Equipment or programs designed to communicate information from one system of computing devices or programs to another Interoperability» The ability of two or more systems or components to exchange information and to use the information that has been exchanged SIS s Interoperability Strategy Incorporate advanced technology solutions improve syntactic interoperability Adopt standard vocabulary improve semantic interoperability Drive new standards for interoperability 3

4 Patient in SIS Surgery Interoperability Touch Points LAB POS ADT PCD Surgery CHG EHR MAT uling, Preparation & Preoperative Day before Surgery Day of Surgery PreOp IntraOp PostOp PACU ADT SCH SUM Admission, Discharge, & Transfer uling Discreet Data LAB MAT Item Master 4

5 Patient in SIS uling, Preparation & Preoperative ADT Patient Registration LAB Lab Results SCH SUM» HL7 v2.4 ADT (Admission, Discharge, Transfer) OR ule & Case Items» HL7 v2.4 SIU (uling Information)» HL7 v2.4 OMS-O05 (Stock Requisition Order) Patient Summary» HL7 v3 XPHR ((HITSP C32) MAT» HL7 v3 XD-LAB (HITSP C36)» HL7 v2.3.1 ORU (Observation Reporting) Item Master» HL7 v2.3.1 MFN (Master File Notification)» Batch CSV formatted text» HL7 v3 XDS-MS (HITSP C48)» HL7 v2.4 MDM Intraoperative Day before Surgery Day of Surgery PreOp IntraOp PostOp PACU POS Point of Supply LAB PCD Patient Care Devices 5

6 Patient in SIS Intraoperative POS LAB PCD Material Usage and Credits» HL7 v2.4 DFT (Detail Financial Transaction) Lab Results» HL7 v3 XD-LAB (Adopted by HITSP as C36)» HL7 v2.3.1 ORU (Observation Reporting) Device Data Collection» Device Driver Interface technology from leading vendor» HL7 v2.6 ORU (Unsolicited Observation)» HL7 v2.6 & WCTP v1.3 Alarm Communication Postoperative Day before Surgery Day of Surgery PreOp IntraOp PostOp PACU PCD Patient Care Devices SUM Discreet Data CHG Charges MAT Item Master 6

7 Postoperative PCD SUM CHG MAT Device Data Collection» Device Driver Interface technology from leading vendor» HL7 v2.6 ORU (Unsolicited Observation)» HL7 v2.6 & WCTP v1.3 Alarm Communication Patient Summary» HL7 v3 XPHR ((HITSP C32)» HL7 v3 XDS-MS (HITSP C48)» HL7 v2.4 MDM Charges & Credits» HL7 v2.4 DFT (Detail Financial Transaction) Material Requisition» HL7 v2.3.1 MFN (Master File Notification) Privacy, Security & Infrastructure Privacy & Security Standards» ATNA (Audit Trail & Node Authentication)» HITSP T15 Collect and Communicate Security Audit Trail» HITSP T17 Secured Communication Channel Transaction Cross Enterprise Document Sharing» XDS.b» HITSP TP13b Consistent Time» CT, HITSP T16 7

8 How Interoperability is Improving Healthcare Improve usability to increase care team satisfaction Reduce manual entry to make the care team more efficient Improve communication to ensure patient safety Unified desktop experience» Single username and password, single sign-on, single patient select ADT information» Defaults over electronically for the scheduler Discrete data» Vitals, allergies, medications and problem list are already available for preop nurse Radiology and laboratory information» Access any time within the surgery system Patient care device information» Automatically captured instead of the clinician manually writing down this information every five minutes. For the clinical user How Interoperability is Improving Healthcare Improve charging and reimbursement Participate in benchmarking Demonstrate meaningful use to qualify for ARRA funding Supply & medication cabinet information» Automatically recorded to better capture costs Materials» Material use is sent to the inventory control system to reduce days of supplies on hand Charges» Automatically sent to billing to shorten billing cycle Reporting» Standardized information allows for easier cost analysis, benchmarking and proving meaningful use and qualify for funding through ARRA. For the hospital administration 8

9 How Interoperability is Improving Healthcare Reduce the cost of interfaces Eliminate the need for expensive, hard to maintain architecture Standardized information transfer» With standardized structures and vocabularies, interfaces are easier and faster to set up and easier to maintain Allow departments to select the best, most functional systems For the IT department How Interoperability is Improving Healthcare Provide a complete electronic record to the patient Transfer the care record to another provider Increase patient satisfaction Case summary information» Automatically sent to the medical records system so information is available to the patient electronically» Requirement of Stage 1 Meaningful Use Patient identity information» Care record can be follow the patient and be securely transferred from system to system For the IT department 9

10 SIS Interoperability Profile 250+ tests in 3 Connect-a-thons 13 profile/actor pairs, 10 profiles, 3 domains PCD Planning and Technical Committee Member HIMSS Interoperability Showcase Leadership Level Member Domain Profile Description PCD ACM Alarm Communication Management ITI ATNA, T15, T17 Audit Trail and Node Authentication ITI CT, T16 Consistent Time PCD DEC Device Enterprise Communication ITI PAM Patient Administration and Management ITI PIX Patient Identifier Cross-Reference ITI XDS.b, T13b Cross Enterprise Document Sharing PCC C32, XPHR, XDS-MS Exchange of Medical Summaries and Personal Health Record Operational Efficiency Leads to Success Interfacing to Interoperability Interoperability is a Product Feature Independent Verification Minimize Variability 10

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