Vision of Interoperability Jamie Ferguson, Stan Huff, Cris Ross

Vision of Interoperability Jamie Ferguson, Stan Huff, Cris Ross

Evolu&on of Interoperability As HIE evolves, the interoperability framework standards advance for reliable exchange and data integra=on across the na=on. No EMR EHR Direct Email Exchange Interoperability Rochester and surrounding counties Entire state of Maine Santa Cruz County East & West Washington NE Oregon North Idaho West Montana Minnesota Florida Indiana Massachusetts Hudson Valley region MDs, RNs Patients MDs, RNs California Colorado Hawaii Georgia Mid-Atlantic States Northwest Ohio West Colorado East Utah Oklahoma Cincinnati Northern Kentuky Central Virginia Hampton Roads Fax Paper Records Hospitals, MOBs Health Plans North Texas Direct Email Big Bend region including Tallahassee Semantic Technical Process Non-interoperable medical records sent via fax or email Electronic records contained within various health care sites and organizations Directed push using secure email transport over the Internet Advanced interoperability components using national ehealth standards

Interoperability Defini&on Technical Seman&c Process Technical Interoperability The ability of two or more systems to reliably exchange informa=on so that it is human readable by the receiver. Technical interoperability describes the actual, physical puzzle pieces and their ability to be linked. Seman&c Interoperability The ability of informa=on shared by systems to be understood so that non- numeric data can be processed by the receiving system. SemanDc interoperability describes the image printed on the puzzle and the picture s ability to convey informadon to people. Process Interoperability Focuses on methods for the op=mal integra=on of computer systems into actual work selngs. Process interoperability describes the methods and strategies used by those assembling the puzzle, perhaps grouping pieces with straight sides, grouping pieces by color, etc. Source: Coming to Terms, Scoping Interoperability for Health Care Health Level Seven EHR Interoperability Work Group: 2/7/2007

Vision of Interoperability: Kaiser Permanente With an industry- leading, at- scale connected system, Kaiser Permanente is seeking to define transforma=onal connec=ons across our enterprise, with our members and the na=on. Connec&ng Kaiser Permanente a modern health care system Connec&ng The World a global impact Personal data Interna=onal standards Clinical Medical Terminology KP HealthConnect Integrated ancillary systems Infrastructure founda=on Connected Health Connec&ng Members & Customers Pa=ent- Centered Focus KP.org Telehealth Mobile Applica=ons Connec&ng The Na&on a na=onal system Care Connec&vity Consor&um Virtual Life=me Electronic Record Social Security Administra=on Connec&ng Our Communi&es community partnership Safety net sponsorship Regional/local exchanges

What Does CCC Mean For KP? Expand connec=vity to all 50 states Address key challenges facing HIE today Provide development playorm and connec=vity to make advanced interoperability easily achievable Provide a model to innovate while maintaining compliance with na=onwide exchange standards

Vision of Interoperability: Intermountain Healthcare Data modeling to ensure compa=bility A[ribute deriva=on and inference to ensure completeness Contextual valida=on (conflict checking) to ensure physiologic compa=bility Data relevancy: integra=ng the right data at the right =me

Order Entry API: Different Server, Same Client (adapted from Harold Solbrig) Applica&on Interface Service Any EMR COS Services Update Medica&on Order Update PharmacyOrder WHERE ordernumber = 4674 Data Repository

Order Entry API (adapted from Harold Solbrig) Applica&on... Interface COS Service Data

What Does CCC Mean for Intermountain Healthcare? Clinical workflows with op=mum pa=ent data Trusted external data integra=on Pa=ent- directed disclosures Managed HIE risks

Interoperability at Mayo Clinic Every year, more than a million people from all 50 states and nearly 150 countries come to Mayo Clinic for care Connec=vity with any referring physician or pa=ent seeking care Connec=vity with the Mayo Clinic Care Network

Interoperability at Mayo Clinic Goals: Health informa=on exchange is in the best interest of the pa=ent Help clinical staff see a new pa=ent for the first =me Reduce the administra=ve paperwork in registering a new pa=ent Use unique pa=ent iden=fiers for pa=ent matching Automate the process of a pa=ent giving authoriza=on and consent for health informa=on exchange Guiding Principles: Build a single health informa=on exchange u=lity serving all of Mayo Clinic To the highest degree possible use open source, open standard sofware Be fully compliant with the Federal standards

What Does CCC Mean For Mayo? Fostering ongoing innova=on in interoperability Prac=cal lessons from working with real exchange opera=ons and observa=ons Create a test bed for discovery and innova=on of new features The challenges get bigger: from Push to Query

Expanding Connec&vity and Exchange Outreach Representa&on: 18 states to 50 states Affilia&on: 5 organiza=ons to 45 organiza&ons Coverage: 40 hospitals to 500+ hospitals

CCC Pathway to Integra&on: Value Added Services Build on the founda=on expanding on data content and offering value added services to enhance the exchange experience. Shared Services Decision Support Terminology Services Future 100+ par=cipants Shared Services Required Internal Services Only Iden=ty Management Services Controlled Query Consent Management Services Exchange Gateways CCC 2.0 5-100 par=cipants CCC 1.0 5 par=cipants 1 Step 1: Founda&on 2 Step 2: Founda&on & Iden&ty Management Data Content Sharing Documents Addi=onal Content Areas, Discrete Data More Discrete Data with Rules

Care Connec&vity Consor&um The Road Ahead The CCC will con=nue to pursue learning and innova=on to support advancements in HIE and interoperability on a broad scale. Value of HIE Realized BETTER INFORMED CARE FOR PATIENTS ACROSS THE NATION Strengthen founda=onal components Innovate via learning lab Collaborate w/hie associa=ons & regulatory bodies Deliver solu=ons on a broad scale

Q&A Jamie Ferguson Kaiser Permanente Vice President Health Informa=on Technology Strategy & Policy Stan Huff, MD Intermountain Healthcare Chief Medical Informa=cs Officer Clinical Professor University of Utah Cris Ross Mayo Clinic Chief Informa=on Officer For more Informa&on: www.careconnec&vity.org info@careconnec&vity.org