Options for IIS and EHR Feature Overlap
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1 Options for IIS and EHR Feature Overlap Noam H. Arzt, PhD, FHIMSS HLN Consulting, LLC American Immunization Registry Association (AIRA) 2015 National Meeting New Orleans, LA April 21, 2015
2 Table of Contents Background IIS/EHR-S Feature Overlap Five Core Functions Summary: Future Direction Implications for Action Resources 2
3 Background All states/territories have an IIS Provider access: paper web EHR IIS product market consolidation PH agency IT staff consolidation Increasing IIS functionality through program integration, VTrckS 3
4 IIS/EHR-S Feature Overlap Feature Set EHR-S IIS 4
5 Core IIS Functions EHR-S Online data entry to IIS Clinical Decision support (CDSi) Reminder/recall to ensure a patient returns when an immunization is due Practice-level assessment of up-to-date status Patient Access to Immunization Data 5
6 Online Data Entry to IIS Terminal client/server WWW HL7 EHR-S limitations: Patient matching difficult via messaging Support for secondary demographics Support for vaccine inventory/ordering CMS EHR Incentive Programs: strong motivation for greater EHR functionality Coherence at the user site 6
7 CDSi Well-developed in IIS; limited in EHR-S Potential EHR-S CDSi strategies: Natively within the EHR-S, deployed locally: vendor control, but huge investment/maintenance Natively within the EHR-S via a web service accessed by each EHR-S installation: more central management and service options Via HL7 query/response with an IIS: see next slide As a web service provided by the IIS: Less vendor responsibility, but difficult national vendor strategy As a web service provided by an independent organization, public or private: Less vendor responsibility, potentially better reliability, supports a national vendor strategy 7
8 CDSi Via IIS HL7 Query/response Advantages IIS, not vendor, is responsible for rules & algorithms May be required by Stage 3 MU CDSi customized to each jurisdiction Ensures IZ history sent from EHR to IIS Challenges Some IIS may not support query/response IIS response not uniform increasing vendor work Rules and algorithms outside of vendor control may lead to incorrect customer expectations 8
9 Reminder/recall Big interest in patient-focused functions Variability in how IIS projects support these functions MU 2 V/D/T and Direct messaging may increase EHR interest Potential patient confusion if R/R comes from multiple sources Dependent on CDSi, so previous strategy affects feasibility for EHR and IIS 9
10 Practice-level Assessment of UTD Status Related to AFIX, HEDIS, CQMs Relevant at practice, jurisdictional, national level Movement from chart pulls system-driven Phase-out of CoCASA Again, dependent on CDSi AFIX more than just calculation: high priority for IIS projects Lower priority for EHR vendors 10
11 Patient Access to IZ Data ONC/CDC priority Policy, technology, identity, communications challenges Various IIS strategies Modify or supplement IIS Encourage EHR-S to support MU Stage 2: Core measure (V/D/T) Both strategies viable and will likely persist for some time 11
12 Summary: Future Direction IIS Functionality 12
13 Implications for Action Consider investments wisely with an eye to overlap CDSi: Central to most other functions; opportunities for IIS to provide services Online data entry will continue to migrate from IIS to EHR-S Reminder/recall: Toss-up will depend on where patient is comfortable Practice-level assessment: Complex, difficult; tied to CQMs; IIS will dominate but watch out for ACOs! 13
14 Resources HLN White Paper: EHR-Overlap-White-Paper.pdf HLN/Deloitte/ONC/MN Patient Access: patientengage.html (bottom of page) 14
15 Contact Information Noam H. Arzt President, HLN Consulting, LLC (Voice) (FAX) 15
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