Texas HIE Interoperability Guidance. Enterprise Architecture Blueprint
|
|
- Shanon Pope
- 7 years ago
- Views:
Transcription
1 Texas HIE Interoperability Guidance Enterprise Architecture Blueprint August 19, 2011
2 Texas HIE Interoperability Guidance Six- Year Vision This (EAB) document contains the architecture vision for the Texas Health Information Exchange (HIE) domain for the next six years, divided into three two- year increments. High Level Use Cases The EAB includes a set of high level use cases chosen to generically reflect the Texas HIE vision and desired capabilities for the next two years (years 1-2). It also includes planning considerations for years 3-4, and a very high- level strategic direction for years 5-6. Texas Health Authority - i - August 19, 2011
3 Notice This document makes reference to trademarks and brands that may be owned by others. The use of such trademarks herein is not an assertion of ownership of such trademarks by Texas Health Authority (THSA) or Accenture and is not intended to represent or imply the existence of an association between THSA, Accenture, and the lawful owners of such trademarks. Any comments on, or opinions stated in this document regarding the functional and technical capabilities of any software, standards or other products referred to in this document, whether or not expressed as being those of THSA or Accenture, are based on the information made publically available by the standards and governmental organizations to THSA and Accenture or provided in other sources and while THSA and Accenture has no reason to believe that this information is in any way inaccurate or incomplete, responsibility for its accuracy and completeness does not rest with THSA or Accenture. The recommendations made in this document are not required by THSA for implementation of health information exchange and are provided free of charge for informational purposes only. BOTH THSA AND ACCENTURE HEREBY EXPRESSLY DISCLAIM AND EXCLUDE ALL WARRANTIES, WHETHER EXPRESS OR IMPLIED BY STATUTE, LAW OR OTHERWISE WITH RESPECT TO THE CONTENTS OF THIS DOCUMENT. Texas Health Authority - ii - August 19, 2011
4 Contents 1 Purpose and Objectives Implications Stakeholder Engagement Process Texas HIE Vision Texas HIE Capabilities Exchange of Patient Clinical Summaries Electronic Prescribing Electronic Submission of Lab Results to Public Health Agencies Electronic Submission to Immunization Registries Quality Reporting Audit and Administrative Reporting Architecture Guiding Principles Assumptions Functional Blueprint Statewide Health Exchange Layer Components Application and Components Database and Repository Components Integration Layer Components Local HIE and Provider Organization Components Application and Components Database and Repository Components Integration Layer Components Functional Blueprint: Years Application and Components Database and Repository Components Integration Layer Components Functional Blueprint: Years Application and Components Database and Repository Components Integration Layer Components Functional Blueprint: Years Texas Health Authority - iii - August 19, 2011
5 6.5.1 Application and Components Database and Repository Components Integration Layer Components Use Cases Clinical Summary Record Creation Query Patient Clinical Summary History Lab Order and Results Delivery eprescription and Dispensing Transition of Care: Direct Project Provider to HIE Submitting Lab Results to Public Health Agencies Submission to Immunization Registries Public Health Quality Reporting Audit and Administrative Reporting Local HIE Certification Process Texas Health Authority - iv - August 19, 2011
6 1 Purpose and Objectives The development of an enterprise architecture vision is a key component of the Statewide Health Exchange Layer. This (EAB) provides a framework for the way information is stored and interchanged. The goal of this is to: Provide an overview of the THSA vision for Texas HIE; Identify use cases which align with the Texas HIE desired capabilities; Provide a functional blueprint for technology components and interfaces required at the clinical, local HIE, and state levels required for the next 1-2 years; Identify and document the planning considerations for years 3-4, and a very high- level strategic direction for years 5-6; and Map process flows for the use cases to the technology components and interfaces described in the blueprint. This document is not intended to be prescriptive of the systems, technologies, or solutions to be chosen by each Local HIE or for the Statewide Health Exchange Layer. Rather, this document shows the individual components and illustrates the interfaces required; providing some information about how the various components should interact. This document is intended to inform the THSA Technical Implementation Specification documents. These Technical Implementation Specification documents will map standards provided in the THSA Technical Standards Landscape Review to the components and interfaces defined in this EAB. 1.1 Implications Provider Organizations For providers, this EAB is meant to demonstrate away to exchange electronic health records with other providers in the State of Texas. The functional components of the solution described in this document are meant to indicate the types of services and data a provider could be expected to implement or produce as a member of an HIE. However, THSA will not require providers to implement all of these components. Above a certain set of core functions (i.e. security and privacy), it will be largely the responsibility of the providers and the Local HIEs to determine which components they would like to implement and how to design their solution. This blueprint is not the only way by which providers can exchange information, however, it does describe generally those interactions that will be supported by the State, and which will have exchange functionality to support such interactions within the anticipated State Health Exchange layer infrastructure. Local HIEs For Local HIEs, this EAB outlines the components necessary to fully utilize the Statewide Health Exchange layer to facilitate patient data exchange between Local HIEs (and their constituent providers). Above a certain set of core functions (i.e. security and privacy), it will be largely the Texas Health Authority August 19, 2011
7 responsibility of the providers and the Local HIEs to determine which components they would like to implement and how to design their solution. Patients While not intended to be a patient facing document, we appreciate that some patients and patient groups may find information contained within this document of interest. Care should be taken when reading this document that the purpose of the EAB is understood, and that for end to end understanding of the Texas HIE the EAB should be read in conjunction with other material issued by THSA, the Texas Health and Human Commission (HHSC), the Office of the National Coordinator for Health Information Technology (ONC), and other resources. Texas Health Authority August 19, 2011
8 2 Stakeholder Engagement Process The production of this document has been an iterative process. This has been to ensure Texas Health Authority (THSA) stakeholders are aware of the approach and content and to, at each step, allow an opportunity for stakeholders to ask questions and provide feedback. The following table contains a summary of the key THSA stakeholder engagements and specifies the stakeholder groups, engagement dates, and content reviewed. Date Stakeholders Draft State Reviewed June 6, 2011 THSA Leadership EAB Strawman June 17, 2011 THSA Leadership Draft EAB V1.0 June 20, 2011 THSA Leadership / Texas HIEs Draft EAB V1.0 June 25, 2011 THSA Leadership Draft EAB V1.1 June 27, 2011 THSA Leadership Draft EAB V1.2 June 28, 2011 THSA Data Standards Task Force and Technical Architecture Task Force Summary July 27, 2011 THSA Leadership Draft EAB V1.3 August 5, 2011 THSA Collaboration Council Draft EAB V1.3 August 19, 2011 THSA Board of Directors Draft EAB V1.3 Texas Health Authority August 19, 2011
9 3 Texas HIE Vision The state of Texas has selected a de- centralized approach to HIE. Texas has and will continue to have, numerous independent HIEs that may exist at either local or regional levels. Each appropriately certified HIE and Health Information Service Provider (HISP) qualified to provide services to rural Texas will be able to access to the Statewide Health Exchange layer. The THSA anticipates building a Statewide Health Exchange layer that will facilitate the transfer of electronic medical records (EMR) from Local HIE to Local HIE, between Texas Medicaid & Healthcare Partnership (TMHP) and the Texas Department of State Health (DSHS) and Local HIEs, and between the Local HIEs and the Nationwide Health Information Network (NwHIN). The Statewide Health Exchange layer will also provide a gateway for exchanging medical records between HIEs and some neighboring states without having to first pass through NwHIN (i.e. Louisiana, Arkansas, and New Mexico). The anticipated information flow would look like the following, although time and experience may further inform this model: Other Federal Agencies (i.e. VHA, DoD, IHS, CDC, Medicare) Other States Texas Statewide Health Exchange Layer (THSA) Texas Medicaid and State Health Agencies (i.e. TMHP and DSHS) Other State Level Data Sources (i.e. Payers) Local HIE Local HIE Figure 3.1: Texas HIE Vision: Federated HIEs connect to a thin state layer in order to connect to Texas Medicaid, DSHS, NwHIN, and other state level data sources Texas Health Authority August 19, 2011
10 3.1 Texas HIE Capabilities THSA has identified the following capabilities as within the initial scope of the Texas HIE. This document will provide a functional blueprint of the components and interfaces necessary to achieve and support these capabilities: 1. Exchange of Patient Clinical Summaries 2. Electronic Prescribing 3. Electronic Lab Ordering and Results Delivery 4. Electronic Submission of Lab Results to Public Agencies 5. Electronic Submission to Immunization Registries 6. Quality Reporting 7. Audit and Administrative Reporting Exchange of Patient Clinical Summaries Clinical Summaries contain a data set of patient- centric clinical information. Clinical Summaries should include the following information: patient s name, date of visit, location of visit, symptoms, vitals information, immunizations and medications administered during the visit, prescriptions, follow- up appointments, lab orders, and other important data and observations. This capability would support the electronic storage, transfer, and interoperability of Clinical Summary information between the Texas Local HIEs and other Local HIEs and trading partners Electronic Prescribing Electronic Prescribing is the set of services necessary to support online prescription message transport and dispensing for patient prescriptions. This capability includes electronic creation of prescriptions, delivery of those prescriptions to specified pharmacies, filling of the prescriptions, and providing notice when a prescription has been filled Electronic Submission of Lab Results to Public Health Agencies An extension of the previous capability, the submission of lab results to public health agencies is often required by state or local governments. At a national level, these public agencies include the U.S. Department of Health and Human (HHS), Veterans Health Administration (VHA), Indian Health (IHS), Center for Disease Control (CDC), and Medicare Electronic Submission to Immunization Registries Immunization Registries are a provider and patient- enabled toolset to collect and distribute immunization data across providers. This capability will ensure providers and HIEs can submit immunization records to Immunization Registries Quality Reporting Quality Reporting captures the integration of data to support quality measurement, feedback and reporting into Clinical Care Applications, begins to use quality measures to support clinical decision making, and allows for the aggregation of quality information across multiple providers and entities to support reporting of healthcare quality. Texas Health Authority August 19, 2011
11 3.1.6 Audit and Administrative Reporting Audit and Administrative Reporting includes messages and documents that are specifically designed to support management, reporting and investigation in the public health context. This includes messages sent to public health regulatory agencies or other patient safety/quality improvement organizations from outside parties and reporting among health care providers, manufacturers, and public health or patient safety/quality improvement organizations. Texas Health Authority August 19, 2011
12 4 Architecture Guiding Principles Architecture Guiding Principles define a framework and a vision that can be applied to evolving technologies in the. They also define how technology can be implemented as a solution to meet the needs of the business. The solutions must be scalable: The architecture provides a baseline to support future business volume growth requirements. The architecture is able scale both horizontally and vertically to meet system requirements that are defined based on business volumes. While a certain amount of scale is needed, solutions should not be over- sized to account for a lack of planning. The solution builds a strong foundation for the future: The architecture establishes the building blocks on which future capabilities can be built. The architecture framework should provide capabilities that can accommodate existing solutions. The solution provides an approach that lets systems share common functionality for integration: The solution provides common integration and data management services across the group. The architecture is based on common standards: The solution will define consistent standards for integration that can be applied throughout various architectures, whereby definitions are understandable and available to all users. Standards will be defined for reusable software components, software delivery and managing information. The solution provides a secure environment: Confidential data will be kept secure, both at rest and in motion, as it flows across the gateway. Below is a statement of the principles that will be used to guide the development of the THSA Enterprise Architecture Blueprint and will serve as a reference throughout the full lifecycle of the blueprint. Principle Ownership Description - Statewide Health Exchange layer is owned by THSA - Local HIE services and capabilities are owned by the Local HIE and / or the providers who are members of the HIE. In order to connect to the Statewide Health Exchange layer they must receive THSA certification (which is outlined later in this document) Business Transformation Stewardship - THSA has a mandate to change or design new services and capabilities with or without involvement of all or any of the Local HIEs. Any new capabilities defined by THSA will be included in the blueprints - Responsibility for data integrity of various information subjects will be assigned to Local HIEs and they will assume the obligation for making this information available to authorized users - Statewide Health Exchange layer will not host clinical data. Where applicable, the Statewide Health Exchange layer will facilitate or mediate record exchange between HIEs Texas Health Authority August 19, 2011
13 Security Multiform Data Definition Flexibility Scalability Reusability Accessibility - Protection of confidentiality and privacy of information will be included in all architectural considerations - Authority to create and maintain the data will reside with Local HIEs and providers, those most knowledgeable about the data or those most able to control its accuracy - THSA will develop architectures to manage information in all necessary forms (data, text, image) - THSA will define the document format and terminology standards necessary for Local HIEs to interoperate with the Statewide Health Exchange layer - The architecture should be flexible to enable innovation around services and capabilities - The architecture will need to be scalable and allow for easy adoption by Local HIEs - THSA will support the sharing and reuse of common application modules or components across various Local HIEs and also use common environments to increase reusability - Statewide Health Exchange layer will provide the confidentiality, privacy, and security of data and THSA will choose a set of access and messaging capabilities which are standards for healthcare IT Texas Health Authority August 19, 2011
14 5 Assumptions The following assumptions were utilized in drafting the and its application in the depicted Use Cases: Each Local HIE will provide and manage an Enterprise Master Patient Index (EMPI) service A statewide capability for patient identification and matching will be achieved by: o o Defining a common set of patient identifiers each Local HIE will be expected to maintain for patient information within its EMPI, and Providing a Patient Matching Service in the Statewide Health Exchange layer that has the capability to query Local HIE EMPIs (based on the common set of patient identifiers mentioned above) and use those retrieved identifiers to provide a common patient context to the Statewide Health Exchange Layer Each Local HIE within Texas should have a level of Direct Health Information Service Provider (HISP) capabilities and Security Certificate, or contract with partners to provide HISPs supporting Texas HIE will establish trusted relationships between each other to enable Direct- to- HIE messaging communications to and from non- HIE provider participants Each Local HIE or provider hosting Clinical Summary data will provide and manage Patient Consent services protecting the confidentiality and privacy required for the data Patient Consent is not federally mandated for all situations, but may be required by state law. Patient Consent can be obtained in various ways. THSA will provide a set of standards for patient privacy and security. Local HIEs will choose and implement their own solution with respect to Patient Consent, which will be conformant with these standards. THSA plans to have a Statewide Health Exchange layer Document containing a patient identifier and document locations. However, Clinical Summaries and other patient data will reside at the Local HIE or provider levels. Laboratory and immunization data may be stored within the Statewide Health Exchange layer, but should be de- identified and is not intended to contain the patient s name or other sensitive patient demographic data, A Local HIE Document is updated when new records are created in applicable data repositories (i.e. Clinical, Medications, and Laboratory repositories) A new entry is created in the Statewide Health Exchange layer Document each time a new entry is created in a Local HIE Document THSA will determine statewide integration for medication query capabilities that will be supported at the Local HIE level Texas Health Authority August 19, 2011
15 6 Functional Blueprint The Texas HIE solution follows a largely federated approach, with independent Local HIEs that interface with a thin Statewide Health Exchange layer. The functional components of the Texas HIE solution are located at three location types: Provider Organizations, Local HIEs, and the Statewide Health Exchange layer. In this functional blueprint section, these components and services chosen for Texas HIE are mapped to each of those three location types. An explanation of each of these components is also provided in this section. This functional blueprint is divided into three two- year phases. The components and repositories listed in this section and throughout the remainder of this document are logical and may be located across multiple databases and/or physical systems. 6.1 Statewide Health Exchange Layer Components Components of the Statewide Health Exchange layer will be deployed over the course of three two- year phases. The following diagram depicts the components as they are expected to come online in each of those phases. There are three types of components: Integration Layer,, and Database/Repository. Below the diagram is an overview of each of these components. Basic Web Service Adaptors Basic Messaging Adaptors Statewide Health Exchange Layer Integration Bus Enhanced Messaging Adaptors Enhanced Web Service Adaptors Year 1 Security Certificate System Certificates Patient Identification Request Service Record Locator Public Health Public Health DW State Health Portal Immunization Transformation and Translation Lab Reporting Content Based Routing Terminology Patient Consent Patient Defined Access Clinical Data Repository Audit Document 1-2 year plan 3-4 years 5-6 years Key Integration Layer Component Component Database / Repository Figure 6.1: State- Level Components for years 1 2, 3 4, and 5 6 Texas Health Authority August 19, 2011
16 6.1.1 Application and Components Statewide Health Exchange Layer Security Certificate (Year 1): This is a key aspect of security for the Statewide Health Exchange layer. Although it contains other components, the most prominent component of the Security Certificate is the Statewide Health Exchange layer Certificate Authority (CA). A CA issues certificates to trusted users and applications and, in turn, allows for validation that the user or application is trusted when they attempt to access the Statewide Health Exchange layer. Other aspects of the Security Certificate include a Certificate Revocation List (CRL) and an Online Certificate Status Protocol (OCSP) Responder. Patient Identification Request Service (Year 1): Each Local HIE is expected to maintain an Enterprise Master Patient Index (EMPI). Each EMPI is expected to support a common set of patient identifiers (i.e. first name, last name, date of birth, etc.). When a provider queries for a patient s medical history (via a Clinical Care Application), the provider is expected to enter those common identifiers. This query is initially handled by the EMPI of which the Local HIE the provider is a member of. In turn, the Local HIE EMPI routes this request to the Patient Identification Request Service located in the State Health Exchange layer. The Patient Identification Request Service will then query other Local HIE EMPIs using this demographic information and return a list of all the possible matches to the provider. The provider can then use this list to select the correct matches and then request the medical history based on those selections. Please see Appendix A for a communication and data flow for querying patient history using the Patient Identification Request Service, EMPI, and Record Locator Service. Record Locator Service (RLS): The RLS is the application component that receives and stores information in the Document. This service, in the Statewide Health Exchange layer, allows providers who are members of a Local HIE to determine the existence and location of patient documents that are located within other Local HIEs. The RLS does not contain clinical data. Rather, it receives information (i.e. patient identifier and record location, but not actual clinical data) about new patient records created at Local HIEs and stores this information in the Document. A new entry is created in the Statewide Health Exchange layer Document each time a new entry is created in a Local HIE Document. The Statewide Health Exchange layer RLS then delivers location information for documents stored in Document when a request is received from a Local HIE. Public Health : Public Health are the front end to a Public Health Data Warehouse. The Texas HIE program is expected to provide data to public agencies such as the Texas Department of State Health (DSHS), the Department of Defense (DoD), the Veterans Health Administration (VHA), the Indian Health Service (HIS), the Center for Disease Control (CDC), Medicare, and Texas Medicaid. Public Health receive this public health data from Local HIEs, modify the data (i.e. reformat and / or aggregate the data) and store it in a Public Health Data Warehouse. State Health Portal: The State Health Portal allows providers and practitioners to connect to state agencies through a consolidated portal. Potential services could include eligibility/benefits verification (MMIS), Medicaid claim history, patient history, and immunization history. Transformation and Translation : These services include capabilities to transform message syntax structures received and sent between partners to conform to specific and evolving standards. Examples are laboratory results, identified and submitted to a public health biosurveillance and Texas Health Authority August 19, 2011
17 epidemiology service. Note that the vocabulary and terminology services differ as they may transform or map between vocabularies (to standard LOINC codes, for example). Content Based Routing: Content Based routing enables the receiving and processing of messages based on the content of the message itself, rather than by its specified destination. In Content Based routing a set of rules is applied to the message s contents to determine the message s intended destination. This frees the sending application from needing some specifics about where a message is headed and helps to ensure message delivery. Content based routing is an important aspect of flexible IT systems. Patient Consent : Patient Consent allow the Statewide Health Exchange layer to enforce privacy for patient medical data (i.e. Clinical Summaries). The foundation of Patient Consent is called Basic Patient Privacy Consents (BPPC). BPPC provides a mechanism to record the patient s privacy consent(s) and a method for the Texas HIE to use to enforce the privacy consent appropriate to the use. The Patient Consent store privacy consent information in the Patient Defined Access Repository. (Patient Consent for Local HIEs is defined in Section 6.2.) Database and Repository Components Statewide Health Exchange Layer System Certificates (Year 1): The System Certificates repository contains the certificates utilized by the Security Certificate to authenticate users and applications at the Statewide Health Exchange layer. Document : The Document is the data repository which contains an identifier and location of documents of patients stored in the Local HIEs. It does not contain clinical data. Data is populated in the Document by the RLS. When the RLS is notified of a new document, a patient identifier and the location of the document are stored by the RLS into the Document. When a provider queries for documents of a given patient the RLS will search this registry and returns a list of documents and their locations found for that patient that are located in the Local HIEs. Audit: The Audit repository contains the data for required Audit reporting. Public Health Data Warehouse: A Public Health Data Warehouse is the repository for information stored by the Public Health. The Public Health store information that the Texas HIE is expected to provide to Public Agencies in a Public Health Data Warehouse. When a public agency seeks to retrieve public health data from the Texas HIE, a Public Health Data Warehouse is queried and provides this data. Immunization : Immunization Registries are confidential, population- based, computerized information systems that attempt to collect vaccination data about all children within a geographic area. It is an important tool to increase and sustain high vaccination coverage by consolidating vaccination records of children from multiple providers, generating reminder and recall vaccination notices for each child, and providing official vaccination forms and vaccination coverage assessments. Lab Reporting Repository: The Lap Reporting Repository contains all data associated with lab reporting (orders and results). The repository provides the data for the electronic format for the laboratory reports (making it human readable and machine readable). Examples of when the Lab Reporting Repository is used includes a laboratory report obtained from a laboratory, a healthcare institution produces a cumulative report of all laboratory tests performed for the patient during the encounter or a public health laboratory shares its reports into a regional repository. Texas Health Authority August 19, 2011
18 Terminology Repository: The Terminology Repository contains a set of approved or standardized vocabulary for accurately describing human anatomy, medical diagnosis and procedures, and medicines, among other things, that should be used within the Texas HIE. Frequently, terminologies are updated and new terms are added to the existing set. Therefore, it is important to have a repository containing an up to date set of terminology. In the first two years of Texas HIE, Terminology Repositories will be managed by the Local HIEs. In years three to four a Statewide Health Exchange layer Terminology Repository will be introduced. Patient Defined Access Repository: The Patient Defined Access Repository contains information stored in it by the Patient Consent. This data in this repository consists of patient privacy consent information for patient documents stored in the Statewide Health Exchange layer. Clinical Data Repository: A Clinical Data Repository (CDR) is a real time database that consolidates data from a variety of clinical sources to present a unified view of a single patient. It is optimized to allow clinicians to retrieve data for a single patient rather than to identify a population of patients with common characteristics or to facilitate the management of a specific clinical department. Typical data types which are often found within a CDR include: clinical laboratory test results, patient demographics, pharmacy information, radiology reports and images, pathology reports, hospital admission, discharge and transfer dates, ICD- 9 codes, discharge summaries, and progress notes Integration Layer Components Statewide Health Exchange Layer Integration Bus: The Integration Bus provides an abstraction layer on top of an implementation of an enterprise messaging system, and acts as a message broker between applications. It provides fundamental services for complex architectures via an event- driven and standards- based messaging engine (the bus). Developers typically implement an ESB using technologies found in a category of middleware infrastructure products, usually based on recognized standards. Basic Web Service Adaptors: Web adapters allow a consistent, standardized Web layer of connections to applications that that were not originally developed with Web in mind, or have non- conformant service layers. Basic Messaging Adaptors: Basic Messaging Adaptors allow communication of types of messages between applications. In general, Messaging Adaptors map messages to API calls and API call responses back to messages once the receiving application has processed the API call. Enhanced Web Service Adaptors: These include adaptors for wrapping the basic HIE functional components (EMPI, RLS, data repositories) as well as adaptors to include future capabilities such as advanced alerts, public health capabilities, advanced patient consent and workflow, etc. Some of these future capabilities may not be known yet, and may require more complex types of interaction. Enhanced Messaging Adaptors: These include adaptors for accommodating new standard types of content and messaging beyond the currently established messaging standards. Future areas of messaging and content types such as biometric identification, device monitoring and others may be required with complex types of interaction. Texas Health Authority August 19, 2011
19 6.2 Local HIE and Provider Organization Components Components of the Local HIEs and Provider Organizations will be deployed over the course of three two- year phases. The following diagram depicts the components as they will come online in each of those phases. There are three types of components: Integration Layer,, and Database / Repository. Below the diagram is an overview of each of these components. 1 2 Years 5 6 Years 3 4 Years Provider Organizations Clinical Care Applications Business Applications Other Applications Emerging Applications Basic Messaging Adaptors Basic Web Service Adaptors Local Integration to Regional HIE Local HIEs / Large Providers EMPI Laboratory Repository Document Provider Directory Security Certificate Service Clinical Documentation Repository Medications Repository Business Intelligence Emerging Applications Patient Consent Record Locator Service Administrative Repository Terminology Basic Messaging Adaptors Basic Web Service Adaptors Statewide Health Exchange Layer Integration Bus Enhanced Messaging Adaptors Enhanced Web Service Adaptors Statewide Health Exchange Layer Security Certificate System Certificates State Health Portal Content Based Routing Immunization Terminology Patient Defined Access Patient Identification Request Service Audit Patient Consent Public Health Transformation and Translation Lab Reporting Public Health DW Clinical Data Repository Record Locator Document Figure 6.2: Provider Organization and Local HIE components for years 1 2, 3 4, and Application and Components Statewide Health Exchange Layer The following components are included in the Statewide Health Exchange Layer. Please reference Section 6.1 for details regarding the below components: Security Certificate Patient Identification Request Service Record Locator Service State Health Portal Public Health Content Based Routing Transformation and Translation Patient Consent Texas Health Authority August 19, 2011
20 Local HIEs and Large Providers Enterprise Master Patient Index (EMPI): The EMPI contains a list of patients and unique patient identifiers for each patient who has received services in the Local HIE. Using the patient identifier located in the EMPI, a provider can locate a patient s identifier number and use this to submit a request via the Clinical Care Application to locate and retrieve a patient s health records (i.e. Clinical Summaries) located in the Texas HIE. EMPIs will also be queried by the Patient Identity Request Service which is located in the State Health Exchange layer. Provider Directory: The Provider Directory contains healthcare provider information for all providers (individuals and organizations) in the Local HIE. Typical provider information maintained by the directory is demographics, address, credential and specialty information as well as the provider s electronic endpoint to facilitate trusted communications with a provider. The directory can also maintain relationship information. Some examples of relationship are: a Health Information Exchange (HIE) and its members: Integrated Delivery Networks and their care delivery members, hospitals and their practitioners, hospitals and their sub organizations including departments, physician Practice Groups and their practitioners, practitioners and the hospitals they are associated with (members of), and Medical Associations and their members. Record Locator Service (RLS): The RLS is the application component that receives and stores information in the Document. This service, at the Local HIE level, allows providers who are members of the Local HIE to determine the existence and location of patient documents that exist in their Local HIE. In addition, the Local HIE RLS can forward document requests to the Statewide Health Exchange layer RLS to identify patient records located within other Local HIEs. The RLS does not contain clinical data. Rather, it receives information (i.e. patient identifier and record location, but not actual clinical data) about new patient records created in the Local HIE and stores these in the Local HIE Document. It then delivers location information for documents stored in Document when a request is received. Security Certificate : This is a key aspect of security for the Local HIE. Although it contains other components, the most prominent component of the Security Certificate is the Local HIE Certificate Authority (CA). A CA issues certificates to trusted users and applications and, in turn, allows for validation that the user or application is trusted when they attempt to access the Statewide Health Exchange layer. Other aspects of the Security Certificate include a Certificate Revocation List (CRL) and an Online Certificate Status Protocol (OCSP) Responder. Patient Consent : Patient Consent allow the Local HIE to enforce privacy for patient medical data (i.e. Clinical Summaries). The foundation of Patient Consent is called Basic Patient Privacy Consents (BPPC). BPPC provides a mechanism to record the patient s privacy consent(s) and a method for the Texas HIE to use to enforce the privacy consent appropriate to the use. The Patient Consent store privacy consent information in the Patient Defined Access Repository. Business Intelligence (BI): The BI component is an application or set of applications to retrieve, analyze and report data meaningful to the Texas HIE program. Two functions of the Local HIE BI component are to compile and send Laboratory Results and also Immunization data to the Public Health Service (which stores this information in the Public Health Data Warehouse). Emerging Applications: Emerging Applications include applications, components, systems, and potentially new processes and standards which are in development, in their infancy, or not yet adopted by most HIEs. Texas Health Authority August 19, 2011
21 Provider Organizations Clinical Care Applications: A Clinical Care Application allows providers to create, manage and view Clinical Summary records. The most basic Clinical Care Applications allow providers to produce and use Clinical Summary records. In addition, Clinical Care Applications can facilitate eprescribing, care management, provider messaging, clinical analytics, and interfacing with laboratories. Business Applications: Business Applications allow providers to submit claims, generate referrals, inquire into patient eligibility, schedule appointments, and produce analytical information. Other Applications: In this case, Other Applications refers to a set of applications necessary to the Texas HIE, but not falling directly into the Clinical Care or Business Applications categories such as Electronic Transmission of Prescriptions (ETP), Laboratory Information Systems (LIS), and pharmacy applications. Emerging Applications: Emerging Applications include applications, components, systems, and potentially new processes and standards which are in development, in their infancy, or not yet adopted by most providers Database and Repository Components Statewide Health Exchange Layer The following components are included in the Statewide Health Exchange Layer. Please reference Section 6.1 for details regarding the below components: System Certificates Audit Document Immunization Lab Reporting Terminology Public Health Data Warehouse Patient Defined Access Clinical Data Repository Local HIEs and Large Providers Laboratory Repository: The Laboratory Repository contains data pertaining to Lab Orders submitted via the Clinical Care Application and Lab Results returned from the Laboratory Information System. It can be queried by the Local HIE via the Clinical Care Application and by other Local HIEs retrieving patient documents. Clinical Documentation Repository: The Clinical Documentation Repository contains data pertaining to Clinical Summaries and immunization records stored in the Immunization, both submitted via the Clinical Care Application. It can be queried by the Local HIE via the Clinical Care Application and by other Local HIEs retrieving patient documents. Document : The Document is the data repository which contains an identifier and location of documents of patients stored in the Local HIE. It does not contain clinical data. Data in the Local HIE Document is populated in the by the RLS. When the RLS is notified of a new document by the Clinical Care Application, a patient identifier and the location of the document are stored by the RLS into the Document. When a provider queries for documents of a given Texas Health Authority August 19, 2011
22 patient the RLS will search this registry and returns a list of documents and their locations found for that patient that are located in that Local HIE. Medication Repository: The Medication Repository contains each patient s medication history including active medications, along with pertinent diagnosis, start and stop dates, ordering providers, frequency of use, and is matched using the national drug code (NDC) id as the standard for passing between clinical information systems. Administrative Repository: This repository is utilized for Audit and Administrative Reporting. Audit and Administrative Reporting includes messages and documents that are specifically designed to support management, reporting and investigation in the public health context. This includes messages sent to public health regulatory agencies or other patient safety/quality improvement organizations from outside parties and reporting among health care providers, manufacturers, and public health or patient safety/quality improvement organizations. Terminology Repository: The Terminology Repository contains a set of approved or standardized vocabulary for accurately describing human anatomy, medical diagnosis and procedures, and medicines, among other things, that should be used within the Texas HIE. Frequently, terminologies are updated and new terms are added to the existing set. Therefore, it is important to have a repository containing an up to date set of terminology. In the first two years of Texas HIE, Terminology Repositories will be managed by the Local HIEs. In years three to four a Statewide Health Exchange layer Terminology Repository will be introduced Integration Layer Components Statewide Health Exchange Layer The following components are included in the Statewide Health Exchange Layer. Please reference Section 6.1 for details regarding the below components: Integration Bus Basic Messaging Adaptors Basic Web Service Adaptors Enhanced Messaging Adaptors Enhanced Web Service Adaptors Local HIEs and Large Providers Integration Bus: The Integration Bus provides an abstraction layer on top of an implementation of an enterprise messaging system, and acts as a message broker between applications. It provides fundamental services for complex architectures via an event- driven and standards- based messaging engine (the bus). Developers typically implement an ESB using technologies found in a category of middleware infrastructure products, usually based on recognized standards. Basic Web Service Adaptors: Web adapters allow a consistent, standardized Web layer of connections to applications that that were not originally developed with Web in mind, or have non- conformant service layers. Basic Messaging Adaptors: Basic Messaging Adaptors allow communication of types of messages between applications. In general, Messaging Adaptors map messages to API calls, and API call responses back to messages once the receiving application has processed the API call. Texas Health Authority August 19, 2011
23 6.3 Functional Blueprint: Years 1 2 In the first two years of statewide Texas HIE a number of key components are expected to be deployed by provider organizations, Local HIEs, and the Statewide Health Exchange layer. The main purposes of these components are to meet three of the desired capabilities of Texas HIE. These include: Exchange of Patient Clinical Summaries Electronic Lab Ordering and Results Delivery Electronic Prescribing Above in this document, these components were briefly outlined. The following diagram provides a more detailed look at some of these components and what constitutes them. Below is an overview of these underlying components. Provider Organizations Local HIEs / Large Providers Statewide Health Exchange Layer Clinical Care Applications Medical Summary eprescribing Care Management Provider Messaging Clinical Analytics Lab Interface ETP Application (Third Party) Laboratory Information System Pharmacy Application Business Applications Referral Generation Claims Submission Provider Credentialing Business Analytics Eligibility & Auth Inquiry Universal Scheduling Basic Messaging Adaptors Basic Web Service Adaptors Local HIE Integration Bus Laboratory Medications Clinical Documentation Administrative Orders Results ETP (Prescriptions) Pharmacy (Dispensing) Clinical Summaries Immunization Audit Administrative Reporting Quality Reporting EMPI Provider Directory Record Locator Service Security Certificate Patient Consent Basic Messaging Adaptors Basic Web Service Adaptors Statewide Health Exchange Layer Integration Bus Certificate Authority Patient Identification Request Service Security Certificate Certificate Revocation List Record Locator Indexing Online Certificate Status Protocol Responder Metadata Document System Certificates Audit Document Terminology Application and Components Figure 6.3: Functional Blueprint for years 1 and Statewide Health Exchange Layer Security Certificate, Certificate Authority: A CA issues digital certificates to trusted users and applications and, in turn, allows for validation that the user or application is trusted when they attempt to access the Statewide Health Exchange layer and Local HIEs. The CA can be a trusted third party vendor. Texas Health Authority August 19, 2011
24 Security Certificate, Certificate Revocation List: A CRL is a file that contains a list of certificates that have been revoked. For each certificate it contains serial numbers and a revocation date. A CRL file also contains the name of the issuer of the CRL, the effective date, and the next update date. By default, the shortest validity period of a CRL is one hour. Security Certificate, Online Certificate Status Protocol Responder: The Online Certificate Status Protocol (OCSP) is an Internet protocol used for obtaining the revocation status of an X.509 digital certificate. It is described in RFC 2560 and is on the Internet standards track. It was created as an alternative to certificate revocation lists (CRL), specifically addressing certain problems associated with using CRLs in a public key infrastructure (PKI). Messages communicated via OCSP are encoded in ASN.1 and are usually communicated over HTTP. The "request/response" nature of these messages leads to OCSP servers being termed OCSP responders. The following components are included in the Statewide Health Exchange Layer as well. Please reference Section 6.1 for details regarding the below components: Patient Identification Request Service Record Locator Service (RLS) Local HIEs and Large Providers The following components are included as part of Local HIE/Large Providers. Please reference Section 6.2 for details regarding the below components: Enterprise Master Patient Index (EMPI) Provider Directory Record Locator Service Security Certificate Patient Consent Provider Organizations Medical Summary: The Medical Summary component of the Clinical Care Application allows providers to create Clinical Summary documents and store them into the Local HIE Clinical Summaries repository. Once in the Clinical Summaries repository, other providers connected to the Texas HIE can view these documents. eprescribing: The eprescribing component of the Clinical Care Application allows providers to interface with an Electronic Transmission of Prescription (ETP) application in order for the prescriber to electronically submit a prescription to pharmacy. The ETP application replaces a paper prescription that the patient would otherwise carry or fax to the pharmacy. It is believed to improve patient safety by reducing the possibility of a prescribing error due to various causes including poor handwriting or ambiguous nomenclature. Examples of universal eprescribing clearinghouses in the US include RxHub and Surescripts. Many Clinical Summary Applications send their prescriptions through these interfaces to the end pharmacy. Care Management: The Care Management component of the Clinical Care Application allows providers to exchange of information between HIT systems and applications used to manage care for specific conditions. Examples of these systems include Cancer Registries, Chronic Disease Management Systems, Disease Registries and Immunization Information Systems. Provider Messaging: Provider messaging includes secure messages sent from provider to provider. Providers could also benefit from message based prompts and reminders, initiated by other clinicians Texas Health Authority August 19, 2011
25 and their staff. Messaging between providers need to be delivered using messages that are communicated in a secure sending and receiving environment, also known as a secured communication channel. Clinical Analytics: The Clinical Analytics component of the Clinical Care Application allows providers to make extensive use of data for statistical and qualitative analysis as well as explanatory and predictive modeling. Lab Interface: The Lab Interface component of the Clinical Care Application allows providers to create Lab Order records and store them into the Local HIE Laboratory repository. Once the Lab Order records are in the Laboratory repository, connected labs will receive these Lab Orders via a Laboratory Information System (LIS). Via the LIS, the lab can submit results of the test to the Lab Results repository. The Lab Interface allows the Clinical Care Application to retrieve the Lab Results for review by the provider. Referral Generation: The referral component of the Business Application allows providers to select a specialty provider, document the reason for the referral request, notate the level of urgency, include any necessary supporting documentation, along with recent results from lab or diagnostic tests and send directly to the specialty provider for appointment and consults either electronically, via fax and/or through the generation of a standard letter. Claims Submission: The claims submission component of the Business Application is the means by which a provider is reimbursed for services. The submission of a claim through a contracted clearing house allows provider organizations the ability to have a limited number of electronic interfaces but a large number of contracted relationships with Health Plans for reimbursement of services. Provider Credentialing: In order for a provider to be reimbursed for services rendered to patients, that provider must first be credentialed with the Health Plan under which the patient is covered. This credentialing process and management activity includes tracking of provider licenses and expirations, national provider id information, tax id number and includes reminders to the administrative department of when a provider needs to update their license and attend certified medical education (CME) classes to maintain their license. Business Analytics: Business analytics allows providers and their respective practices to monitor and track their cost of services against the reimbursements to effectively manage their business. Large provider groups use the financial information to analyze opportunities for new services, negotiations of reimbursement rates with Health Plans, and compensation to their providers using relative value units (RVU). Eligibility and Authentication Inquiry: This eligibility verification part of this function is used to ensure the patient is properly covered by a health plan prior to performing services, along with gaining an understanding of the medication formulary that patient s plan prefers. This is a real time validation process with the plans typically through a third party supplier. Many health plans require prior authorization for services, especially those involving hospital stays, in order to ensure the member is staying within the defined guidelines. Specialty providers request authorization from health plans and record the authorization number prior to performing services to ensure reimbursement from the health plans. Universal Scheduling: This business function permits centralized schedulers the ability to appoint a patient into the continuum of care, from primary care services to specialty and hospital bookings. Electronic Transmission of Prescriptions (ETP) Application: The eprescribing component of the Clinical Care Application allows providers to interface with an Electronic Transmission of Prescription (ETP) Texas Health Authority August 19, 2011
HEAL NY Phase 5 Health IT RGA Section 7.1: HEAL NY Phase 5 Health IT Candidate Use Cases Interoperable EHR Use Case for Medicaid
HEAL NY Phase 5 Health IT RGA Section 7.1: HEAL NY Phase 5 Health IT Candidate Use Cases Interoperable EHR Use Case for Medicaid Interoperable Electronic Health Records (EHRs) Use Case for Medicaid (Medication
More informationEligible Professionals please see the document: MEDITECH Prepares You for Stage 2 of Meaningful Use: Eligible Professionals.
s Preparing for Meaningful Use in 2014 MEDITECH (Updated December 2013) Professionals please see the document: MEDITECH Prepares You for Stage 2 of Meaningful Use: Professionals. Congratulations to our
More informationState of New Hampshire. Phase 3 Converging on Solutions discussion deck Business and Technical Operations Workgroup. July 20, 2010
State of New Hampshire Health Information Exchange Planning and Implementation Project Phase 3 Converging on Solutions discussion deck Business and Technical Operations Workgroup July 20, 2010 Agenda Opening
More informationHL7 & Meaningful Use. Charles Jaffe, MD, PhD CEO Health Level Seven International. HIMSS 11 Orlando February 23, 2011
HL7 & Meaningful Use Charles Jaffe, MD, PhD CEO Health Level Seven International HIMSS 11 Orlando February 23, 2011 Overview Overview of Meaningful Use HIT Standards and Meaningful Use Overview HL7 Standards
More informationCommonWell Health Alliance Concepts. Last Modified: October 21, 2014. 2013 2014 CommonWell Health Alliance Inc. All rights reserved.
CommonWell Health Alliance Concepts Last Modified: October 21, 2014 2013 2014 CommonWell Health Alliance Inc. All rights reserved. 2013 2014 CommonWell Health Alliance Inc. All rights reserved. The CommonWell
More informationOverview of ehr Development. Slide - 1
Overview of ehr Development Slide - 1 Where are we today? Hospital Authority 8 million patient records 800 million laboratory results 340 million prescribed drugs 34 million Xray images 33 million transactions
More informationNew York ehealth Collaborative. Health Information Exchange and Interoperability April 2012
New York ehealth Collaborative Health Information Exchange and Interoperability April 2012 1 Introductions Information exchange patient, information, care team How is Health information exchanged Value
More informationFor ONC S&I DS4P. Dennis Giokas Chief Technology Officer Canada Health Infoway Inc. January 25, 2012
For ONC S&I DS4P Dennis Giokas Chief Technology Officer Canada Health Infoway Inc. January 25, 2012 1 Outline EHR Business Architecture EHR Solution Blueprint EHR Privacy and Security Summary & Conclusion
More informationCosts and Limitations Disclosure For MEDITECH s 2014 Edition Certified Products
Costs and Limitations Disclosure For MEDITECH s 2014 Edition Certified Products Prepared by Medical Information Technology, Inc. (MEDITECH) on May 2, 2016 1 Table of Contents: General Costs and Limitations
More informationMeaningful Use Stage 2 Certification: A Guide for EHR Product Managers
Meaningful Use Stage 2 Certification: A Guide for EHR Product Managers Terminology Management is a foundational element to satisfying the Meaningful Use Stage 2 criteria and due to its complexity, and
More informationParticipating in a Health Information Exchange (HIE) Many Faces of Community Health 2011. 10/27/11 Greg Linden
Participating in a Health Information Exchange (HIE) Many Faces of Community Health 2011 10/27/11 Greg Linden CIO, Stratis Health HIE Subject Matter Expert, REACH Objective This session will outline options
More informationMEANINGFUL USE. Community Center Readiness Guide Additional Resource #13 Meaningful Use Implementation Tracking Tool (Template) CONTENTS:
Community Center Readiness Guide Additional Resource #13 Meaningful Use Implementation Tracking Tool (Template) MEANINGFUL USE HITECH s goal is not adoption alone but meaningful use of EHRs that is, their
More informationExpanded Support for Medicaid Health Information Exchanges
Expanded Support for Medicaid Health Information Exchanges Joint Public Health Forum & CDC Nationwide Webinar April 21, 2016 CDC EHR Meaningful Use Webpage-Joint Public Health Forum & CDC Nationwide Webinars
More informationGoing beyond: Meaningful Use assessments
GE Healthcare Centricity Practice Solution Going beyond Meaningful Use. The IT tools and services you need now. The support you need for the future. GE Healthcare is your strong, stable, strategic partner
More informationGoing beyond: Meaningful Use assessments
GE Healthcare Centricity Practice Solution Going beyond Meaningful Use. The IT tools and services you need now. The support you need for the future. GE Healthcare is your strong, stable, strategic partner
More informationMeaningful Use. Medicare and Medicaid EHR Incentive Programs
Meaningful Use Medicare and Medicaid Table of Contents What is Meaningful Use?... 1 Table 1: Patient Benefits... 2 What is an EP?... 4 How are Registration and Attestation Being Handled?... 5 What are
More informationCMS & ehr - An Update
Health Informatics in Hong Kong CMS & ehr - An Update Dr NT Cheung HA Convention 2010 CMS / epr is essential in the HA Each Day... 12,000 users 90,000 patients 8M CMS transactions 700,000 epr views In
More informationGoing beyond Meaningful Use with EMR solutions from the Centricity portfolio
Going beyond Meaningful Use with EMR solutions from the Centricity portfolio The IT tools and services you need now. The support you need for the future. GE Healthcare is focused on providing customers
More informationHow To Improve Health Information Exchange
Health Information Exchange Strategic and Operational Plan Profile Overview Hawai i is comprised of eight main islands, seven of which are inhabited. With a population of approximately 1.3 million, Hawai
More informationT he Health Information Technology for Economic
A BNA, INC. HEALTH IT! LAW & INDUSTRY REPORT Reproduced with permission from Health IT Law & Industry Report, 2 HITR 23, 01/18/2010. Copyright 2010 by The Bureau of National Affairs, Inc. (800-372- 1033)
More information1. Introduction - Nevada E-Health Survey
1. Introduction - Nevada E-Health Survey Welcome to the Nevada E-Health Survey for health care professional providers and hospitals. The Office of Health Information Technology (OHIT) for the State of
More informationMITA to RHIO: Medicaid Enterprise as a Communication Hub. A CNSI White Paper
MITA to RHIO: Medicaid Enterprise as a Communication Hub A CNSI White Paper Table of Contents 1. Introduction 1 2. Medicaid Enterprise and MMIS A Historical Perspective 2 3. Medicaid IT Architecture 3
More informationHealth Information Exchange in NYS
Health Information Exchange in NYS Roy Gomes, RHIT, CHPS Implementation Project Manager 1 Who is NYeC? 2 Agenda NYeC Background Overview and programs Assist providers transitioning from paper to electronic
More informationSummary of the Proposed Rule for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program (Eligible Professionals only)
Summary of the Proposed Rule for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program (Eligible Professionals only) Background Enacted on February 17, 2009, the American Recovery
More informationMedicaid EHR Incentive Program. Focus on Stage 2. Kim Davis-Allen, Outreach Coordinator Kim.davis@ahca.myflorida.com
Medicaid EHR Incentive Program Focus on Stage 2 Kim Davis-Allen, Outreach Coordinator Kim.davis@ahca.myflorida.com Understanding Participation Program Year Program Year January 1 st - December 31st. Year
More informationOPTIMIZING THE USE OF YOUR ELECTRONIC HEALTH RECORD. A collaborative training offered by Highmark and the Pittsburgh Regional Health Initiative
OPTIMIZING THE USE OF YOUR ELECTRONIC HEALTH RECORD A collaborative training offered by Highmark and the Pittsburgh Regional Health Initiative Introductions Disclosures Successful completion of training
More informationSecond Annual Florida 2008 Electronic Prescribing Report
Second Annual Florida 2008 Electronic Prescribing Report FLORIDA CENTER FOR HEALTH INFORMATION AND POLICY ANALYSIS AGENCY FOR HEALTH CARE ADMINISTRATION JANUARY 2009 Better Health Care for All Floridians
More informationConnectVirginia EXCHANGE Onboarding and Certification Guide. Version 1.4
ConnectVirginia EXCHANGE Onboarding and Certification Guide Version 1.4 July 18, 2012 CONTENTS 1 Overview... 5 2 Intended Audience... 5 3 ConnectVirginia Background... 5 3.1 Federated... 5 3.2 Secure...
More informationMeaningful Use. Goals and Principles
Meaningful Use Goals and Principles 1 HISTORY OF MEANINGFUL USE American Recovery and Reinvestment Act, 2009 Two Programs Medicare Medicaid 3 Stages 2 ULTIMATE GOAL Enhance the quality of patient care
More informationMEDICAL ASSISTANCE BULLETIN
ISSUE DATE April 8, 2011 EFFECTIVE DATE April 8, 2011 MEDICAL ASSISTANCE BULLETIN NUMBER 03-11-01, 09-11-02, 14-11-01, 18-11-01 24-11-03, 27-11-02, 31-11-02, 33-11-02 SUBJECT Electronic Prescribing Internet-based
More informationHealth Information Exchange in Minnesota & North Dakota
Health Information Exchange in Minnesota & North Dakota April 16, 2014 Objectives Learn basic HIE concepts Understand key success factors for HIE Gain an understanding of Minnesota and North Dakota s approach
More informationEMR Technology Checklist
Patient Accessibility/Scheduling/Account Maintenance: Able to interact with schedule through an online portal pre register VIP status to move patient to the front of the line Access and pre registration
More informationEHR Software Feature Comparison
EHR Comparison ELECTRONIC MEDICAL RECORDS Patient demographics Manages the input and maintenance of patient information including demographics, insurance, contacts, referrals, notes and more. Consents
More informationDecember 2014. Federal Employees Health Benefits (FEHB) Program Report on Health Information Technology (HIT) and Transparency
December 2014 Federal Employees Health Benefits (FEHB) Program Report on Health Information Technology (HIT) and Transparency I. Background Federal Employees Health Benefits (FEHB) Program Report on Health
More informationI n t e r S y S t e m S W h I t e P a P e r F O R H E A L T H C A R E IT E X E C U T I V E S. In accountable care
I n t e r S y S t e m S W h I t e P a P e r F O R H E A L T H C A R E IT E X E C U T I V E S The Role of healthcare InfoRmaTIcs In accountable care I n t e r S y S t e m S W h I t e P a P e r F OR H E
More informationHL7 and Meaningful Use
HL7 and Meaningful Use HIMSS Las Vegas February 23, 2012 Grant M. Wood Intermountain Healthcare Clinical Genetics Institute Meaningful Use What Does It Mean? HITECH rewards the Meaningful Use of health
More informationQualifying for Medicare Incentive Payments with Crystal Practice Management. Version 4.1.25
Qualifying for Medicare Incentive Payments with Crystal Practice Management Version 4.1.25 01/01/ Table of Contents Qualifying for Medicare Incentive Payments with... 1 General Information... 3 Links to
More informationuently Asked NextGen Questions Share Frequently Asked uently Asked Questions Frequently Asked FAQ Pre-General Release (April-June 2014)
uestions Frequently Asked Questions Fre uestions Frequently Asked Questions Fre uestions FAQ Frequently Asked Questions Fre uestions Frequently Asked Questions Fre uestions Frequently Asked Questions Fre
More informationSGRP 113 Objective: Use clinical decision support to improve performance on high priority health conditions
January 14, 2013 Department of Heath and Human Services Office of the National Coordinator for Health Information Technology RE: Health Information Technology (HIT) Policy Committee Request for Comment
More informationHL7 and Meaningful Use
HL7 and Meaningful Use Grant M. Wood HL7 Ambassador HIMSS14 2012 Health Level Seven International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International.
More informationDemonstrating Meaningful Use of EHRs: The top 10 compliance challenges for Stage 1 and what s new with 2
Demonstrating Meaningful Use of EHRs: The top 10 compliance challenges for Stage 1 and what s new with 2 Today s discussion A three-stage approach to achieving Meaningful Use Top 10 compliance challenges
More informationPlanning for Health Information Technology and Exchange in Public Health
Planning for Health Information Technology and Exchange in Public Health UC Davis Health Informatics 2009 Seminar Series Linette T Scott, MD, MPH Deputy Director, Health Information and Strategic Planning
More informationMeaningful Use Updates Stage 2 and 3. Julia Moore, Business Analyst SMC Partners, LLC July 8, 2015
Meaningful Use Updates Stage 2 and 3 Julia Moore, Business Analyst SMC Partners, LLC July 8, 2015 Stage 2 Requirements 2015 EPs beyond 1st year of MU must report on a full year of data EPs in 1 st year
More informationMedweb Telemedicine 667 Folsom Street, San Francisco, CA 94107 Phone: 415.541.9980 Fax: 415.541.9984 www.medweb.com
Medweb Telemedicine 667 Folsom Street, San Francisco, CA 94107 Phone: 415.541.9980 Fax: 415.541.9984 www.medweb.com Meaningful Use On July 16 2009, the ONC Policy Committee unanimously approved a revised
More informationDamon A. Ferlazzo, MPA Clinical Use and Benefits of State Immunization Information Systems August 21, 2014
Damon A. Ferlazzo, MPA Clinical Use and Benefits of State Immunization Information Systems August 21, 2014 What are Immunization Information Systems (IIS)? [ ]confidential, population-based, computerized
More informationACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT
ACCOUNTABLE CARE ANALYTICS: DEVELOPING A TRUSTED 360 DEGREE VIEW OF THE PATIENT Accountable Care Analytics: Developing a Trusted 360 Degree View of the Patient Introduction Recent federal regulations have
More informationChildren s Medical Center of Dallas
Dallas, TX Overview (Children s) is an academic medical center with 591 licensed beds. It has campuses in Dallas, Plano and Southlake, Texas, including an outpatient center in Southlake and 16 MyChildren
More informationNortec. ACT Now! Nortec EHR. Qualify & Receive $44,000. An Integrated Electronic Health Record Software. www.nortecehr.com
ACT Now! Qualify & Receive $44,000 Nortec Version 7.0 EHR Visit and Register to learn how to meet Meaningful Use requirements An Integrated Electronic Health Record Software Electronic Medical Records
More informationRecord Locator Service on Trusted, Secure Nationwide Network Can Improve Care Coordination and Enable Meaningful Interoperability
Record Locator Service on Trusted, Secure Nationwide Network Can Improve Care Coordination and Enable Meaningful Interoperability Summary Despite a recent slowdown in the growth of healthcare spending,
More informationPractice Management & Electronic Health Record Systems: School-Based Health Center Requirements & Configuration Considerations.
Practice Management & Electronic Health Record Systems: School-Based Health Center Requirements & Configuration Considerations May 23, 2012 Introduction In today s rapidly changing health care environment,
More informationT h e M A RY L A ND HEALTH CARE COMMISSION
T h e MARYLAND HEALTH CARE COMMISSION Discussion Topics Overview Learning Objectives Electronic Health Records Health Information Exchange Telehealth 2 Overview - Maryland Health Care Commission Advancing
More informationAgenda. What is Meaningful Use? Stage 2 - Meaningful Use Core Set. Stage 2 - Menu Set. Clinical Quality Measures (CQM) Clinical Considerations
AQAF Health Information Technology Forum Meaningful Use Stage 2 Clinical Considerations Marla Clinkscales & Mike Bice Alabama Regional Extension Center (ALREC) August 13, 2013 0 Agenda What is Meaningful
More informationHarmonized Use Case for Electronic Health Records (Laboratory Result Reporting) March 19, 2006
Harmonized Use Case for Electronic Health Records (Laboratory Result Reporting) March 19, 2006 Office of the National Coordinator for Health Information Technology (ONC) Table of Contents American Health
More informationWhat is the Certified Health Record Analyst (CHDA)?
What is the Certified Health Record Analyst (CHDA)? Ellen S. Karl, MBA, RHIA, CHDA, FAHIMA Exam specifics; how long is it, how do I apply, etc.? Exam specifics; how long is it, how do I apply, etc.? Number
More informationMeaningful Use and Lab Related Requirements
Meaningful Use and Lab Related Requirements ONC State HIE / NILA Workgroup August 20, 2013 What is an EHR? Electronic Health Record Information system used by healthcare providers to store and manage patient
More informationehealth and Health Information Exchange in Minnesota
ehealth and Health Information Exchange in Minnesota Connecting Minnesota Providers at the Point of Care Lisa Moon, RN Director Privacy Security and HIE Oversight Program Office of Health Information Technology
More informationOpen Platform. Clinical Portal. Provider Mobile. Orion Health. Rhapsody Integration Engine. RAD LAB PAYER Rx
Open Platform Provider Mobile Clinical Portal Engage Portal Allegro PRIVACY EMR Connect Amadeus Big Data Engine Data Processing Pipeline PAYER CLINICAL CONSUMER CUSTOM Open APIs EMPI TERMINOLOGY SERVICES
More informationUsing e-health: EHRs, HIE and the Minnesota Accountable Health Model
Using e-health: EHRs, HIE and the Minnesota Accountable Health Model Minnesota Rural Health Conference June 24, 2014 Duluth, MN Karen Soderberg and Anne Schloegel Office of Health Information Technology
More informationMISSISSIPPI LEGISLATURE REGULAR SESSION 2016
MISSISSIPPI LEGISLATURE REGULAR SESSION 2016 By: Representative Mims To: Public Health and Human Services HOUSE BILL NO. 1187 1 AN ACT TO AMEND SECTION 73-25-34, MISSISSIPPI CODE OF 1972, 2 TO REVISE THE
More informationHealth Information Exchange (HIE) in Minnesota
Health Information Exchange (HIE) in Minnesota Where have we been and where are we going Jennifer Fritz, MPH Anne Schloegel, MPH Minnesota Department of Health 1 Session Goals Learn about Minnesota s approach
More informationInteroperability: White Paper. Introduction. PointClickCare Interoperability - 2014. January 2014
White Paper PointClickCare Interoperability - 2014 Interoperability: In healthcare, interoperability is where multiple technology platforms and software applications are able to connect, communicate, and
More informationIndiana Council of Community Mental Health Centers. October 14, 2013
Indiana Council of Community Mental Health Centers October 14, 2013 Role of the State HIT Coordinator Develop and advocate for HIT Policy Coordinate efforts with Medicaid, public health, and other federally
More informationRole of Health Plans It s Time to Get out of the Sandbox Health Record Enablement
National Conference of State Legislatures Health IT Champions New Orleans February 2007 Role of Health Plans It s Time to Get out of the Sandbox Health Record Enablement Blue Cross and Blue Shield of Louisiana
More informationRule 5.2 Definitions. For the purpose of Chapter 5 only, the following terms have the meanings indicated:
Part 2635 Chapter 5: Practice of Telemedicine Rule 5.1 Preamble. These regulations are intended to authorize M.D. and D.O. licensees of the Mississippi State Board of Medical Licensure to practice telemedicine
More informationNortec. ACT Now! Nortec EHR. Qualify & Receive $44,000. An Integrated Electronic Health Record Software. www.nortecehr.com
ACT Now! Qualify & Receive $44,000 Nortec Version 7.0 EHR Visit and Register to learn how to meet Meaningful Use requirements An Integrated Electronic Health Record Software Electronic Medical Records
More informationExtracting Value from Secondary Uses of Electronic Health Data
Extracting Value from Secondary Uses of Electronic Health Data The Regenstrief Institute, Indianapolis Indiana Thomas S. Inui, ScM, MD President and CEO, Regenstrief Institute Associate Dean for Health
More informationMeaningful Use Qualification Plan
Meaningful Use Qualification Plan Overview Certified EHR technology used in a meaningful way is one piece of a broader Health Information Technology infrastructure intended to reform the health care system
More informationPublic Health Reporting Initiative Functional Requirements Description
Public Health Reporting Initiative Functional Requirements Description 9/25/2012 1 Table of Contents 1.0 Preface and Introduction... 2 2.0 Initiative Overview... 3 2.1 Initiative Challenge Statement...
More informationPresenters: Laura Zaremba, ILHIE Acting Executive Director Ivan Handler, Chief Technology Officer Kevin Ferriter, InterSystems Corp, Program Manager
Presenters: Laura Zaremba, ILHIE Acting Executive Director Ivan Handler, Chief Technology Officer Kevin Ferriter, InterSystems Corp, Program Manager June 21, 2012 Every provider in Illinois has at least
More informationHow To Qualify For EHR Stimulus Funds Under
BEST PRACTICES: How To Qualify For EHR Stimulus Funds Under Meaningful Use & Certified EHR Technology The American Recovery and Reinvestment Act (ARRA) set aside early $20 billion in incentive payments
More informationVersion 1.0. HEAL NY Phase 5 Health IT & Public Health Team. Version Released 1.0. HEAL NY Phase 5 Health
Statewide Health Information Network for New York (SHIN-NY) Health Information Exchange (HIE) for Public Health Use Case (Patient Visit, Hospitalization, Lab Result and Hospital Resources Data) Version
More informationUsing Health Information Technology to Improve Quality of Care: Clinical Decision Support
Using Health Information Technology to Improve Quality of Care: Clinical Decision Support Vince Fonseca, MD, MPH Director of Medical Informatics Intellica Corporation Objectives Describe the 5 health priorities
More informationHealth Information Technology in Healthcare: Frequently Asked Questions (FAQ) 1
Health Information Technology in Healthcare: Frequently Asked Questions (FAQ) 1 1. What is an Electronic Health Record (EHR), an Electronic Medical Record (EMR), a Personal Health Record (PHR) and e-prescribing?
More informationStrategic Initiative #6: Health Information Technology
Strategic Initiative #6: Health Information Technology Lead: H. Westley Clark, M.D., Director, Center for Substance Abuse Treatment Key Facts Of 175 substance abuse treatment programs surveyed, 20 percent
More informationTable of Contents. Preface... 1. 1 CPSA Position... 2. 1.1 How EMRs and Alberta Netcare are Changing Practice... 2. 2 Evolving Standards of Care...
March 2015 Table of Contents Preface... 1 1 CPSA Position... 2 1.1 How EMRs and Alberta Netcare are Changing Practice... 2 2 Evolving Standards of Care... 4 2.1 The Medical Record... 4 2.2 Shared Medical
More informationThe HITECH Act and Meaningful Use Implications for Population and Public Health
The HITECH Act and Meaningful Use Implications for Population and Public Health Bill Brand, MPH Public Health Informatics Institute Meaningful Use for Public Health Professionals: Basic Training May 16,
More informationMeaningful Use - The Journey Ahead. John D. Halamka MD CIO, Beth Israel Deaconess Medical Center and Harvard Medical School
Meaningful Use - The Journey Ahead John D. Halamka MD CIO, Beth Israel Deaconess Medical Center and Harvard Medical School QUALITY: SAFE CARE EXHIBIT 16 Medical, Medication, and Lab Errors, Among Sicker
More informationHealth Care - Meaningful Use of HITECH
Planning for the Stimulus - Achieving Meaningful Use of Healthcare IT John D. Halamka MD CIO, Harvard Medical School and Beth Israel Deaconess Medical Center My Definition of Meaningful Use Processes and
More informationVIII. Dentist Crosswalk
Page 27 VIII. Dentist Crosswalk Overview The final rule on meaningful use requires that an Eligible Professional (EP) report on both clinical quality measures and functional objectives and measures. While
More informationELECTRONIC HEALTH RECORDS. Nonfederal Efforts to Help Achieve Health Information Interoperability
United States Government Accountability Office Report to Congressional Requesters September 2015 ELECTRONIC HEALTH RECORDS Nonfederal Efforts to Help Achieve Health Information Interoperability GAO-15-817
More informationELECTRONIC MEDICAL RECORDS. Selecting and Utilizing an Electronic Medical Records Solution. A WHITE PAPER by CureMD.
ELECTRONIC MEDICAL RECORDS Selecting and Utilizing an Electronic Medical Records Solution A WHITE PAPER by CureMD CureMD Healthcare 55 Broad Street New York, NY 10004 Overview United States of America
More informationMeaningful Use Stage 1 and Public Health: Lesson Learned
Meaningful Use Stage 1 and Public Health: Lesson Learned NAACR Presentation August 16, 2012 James Daniel, MPH Public Health Coordinator Office of the National Coordinator for Health IT Agenda Overview
More informationHow To Use A Pharmacy To Help Your Health Care System
Pharmacy Health Information Technology Collaborative Shelly Spiro, Executive Director, Pharmacy HIT Collaborative reports no relevant financial relationships. 1. This session will describe the struggles
More informationExtending HIS to Support Meaningful Use. October 21, 2010
Extending to Support Meaningful Use October 21, 2010 Stage 1 Meaningful Use Requirements 15 Core Stage 1 Requirements 10 Requirements (5 can be deferred until Stage 2) Stage 1 Meaningful Use Criteria for
More informationMeaningful Use Stage 2 Administrator Training
Meaningful Use Stage 2 Administrator Training 1 During the call please mute your line to reduce background noise. 2 Agenda Review of the EHR Incentive Programs for Stage 2 Meaningful Use Measures and Corresponding
More informationIBM Software. IBM Initiate: Delivering Accurate Patient and Provider Identification for Canadian Electronic Health Records
IBM Software IBM Initiate: Delivering Accurate Patient and Provider Identification for Canadian Electronic Health Records IBM Initiate: Delivering Accurate Patient and Provider Identification for Canadian
More informationShelly Spiro, Executive Director, Pharmacy HIT Collaborative reports no relevant financial relationships.
Shelly Spiro, Executive Director, Pharmacy HIT Collaborative reports no relevant financial relationships. 1. Discuss the vision, mission, and goals of the Pharmacy HIT Collaborative as it relates to informatics,
More informationMemorialCare Health System: Steven Beal, VP Information Services
MemorialCare Health System: Steven Beal, VP Information Services Serving Our Community Overview - Inpatient Six Hospitals Epic Clinical and Rev Cycle at 5 hospitals MedSeries4 at 6 th hospital Multiple
More informationEHR Incentive Program Focus on Stage One Meaningful Use. Kim Davis-Allen, Outreach Coordinator Kim.davis@ahca.myflorida.com October 16, 2014
EHR Incentive Program Focus on Stage One Meaningful Use Kim Davis-Allen, Outreach Coordinator Kim.davis@ahca.myflorida.com October 16, 2014 Checklist Participation Explanation Program Updates Stage One
More informationMeaningful Use in 2015 and Beyond Changes for Stage 2
Meaningful Use in 2015 and Beyond Changes for Stage 2 Jennifer Boaz Transformation Support Specialist Proprietary 1 Definitions AIU = Adopt, Implement or Upgrade EP = Eligible Professional API = Application
More informationMay 7, 2012. Re: RIN 0991-AB82. Dear Secretary Sebelius:
May 7, 2012 Department of Health and Human Services Office of the National Coordinator for Health Information Technology Attention: 2014 Edition EHR Standards and Certification Proposed Rule Hubert H.
More informationWest Virginia Information Technology Summit. November 4, 2009
West Virginia Information Technology Summit November 4, 2009 WVHIN Background Enabled by W. Va. Code seq. (2006) 16-29G-1, et Managed by 17-member public/private Board of Directors Charged to design, implement
More informationCMS Proposed Electronic Health Record Incentive Program For Physicians
May 7, 2012 Ms. Marilyn Tavenner Acting Administrator Centers for Medicare and Medicaid Services Department of Health and Human Services Attention: CMS-0044-P Mail Stop C4-26-05 7500 Security Boulevard
More informationMedicaid EHR Incentive Program Dentists as Eligible Professionals. Kim Davis-Allen, Outreach Coordinator Kim.davis@ahca.myflorida.
Medicaid EHR Incentive Program Dentists as Eligible Professionals Kim Davis-Allen, Outreach Coordinator Kim.davis@ahca.myflorida.com Considerations Must begin participation by Program Year 2016 Not required
More informationMichigan Medicaid EHR Incentive Program Update November 28, 2012. Jason Werner, MDCH
Michigan Medicaid EHR Incentive Program Update November 28, 2012 Jason Werner, MDCH Program Summary This ARRA funded program provides financial incentives (100% Federal) to eligible Medicaid professionals
More informationSTAGES 1 AND 2 REQUIREMENTS FOR MEETING MEANINGFUL USE OF EHRs 1
STAGES 1 AND 2 REQUIREMENTS FOR MEETING MEANINGFUL USE OF EHRs 1 Requirement CPOE Use CPOE for medication orders directly entered by any licensed health care professional who can enter orders into the
More informationMEDGEN EHR Release Notes: Version 6.2 Build 106.6.22
09/04/2014 MEDGEN EHR Release Notes: Version 6.2 Build 106.6.22 Phone: 516-466-3838 Fax: 516-466-3877 Email: medgensupport@comtronusa.com Please find below recent updates that were made to your Medgen
More informationNorth Shore LIJ Health System, Inc. Facility Name
North Shore LIJ Health System, Inc. Facility Name POLICY TITLE: The Medical Record POLICY #: 200.10 Approval Date: 2/14/13 Effective Date: Prepared by: Elizabeth Lotito, HIM Project Manager ADMINISTRATIVE
More informatione -Prescribing An Information Brief
e -Prescribing An Information Brief Prepared by: Maryland Health Care Commission June 2008 Introduction Technology creates efficiencies and opportunities in almost every industry, and health care is no
More informationMeaningful Use and Engaging Patients: Beyond Checking the Box
RelayHealth Clinical Solutions Executive Brief Meaningful Use and Engaging Patients: Beyond Checking the Box Contents Contents Introduction The term patient engagement has become entrenched in the healthcare
More information