Improving the quality, safety, and efficiency of health care in South Carolina SCHIEx: The South Carolina Health Information Exchange Update May 22, 2012 SCHA HIT Summit Dr. David Patterson Chief, Health and Demographics SC Office of Research and Statistics State HIT Coordinator Adriane Able SCHIEx Executive Director
Brief overview & Early Adopter Program SCHIEx DIRECT Questions SCHIEx Update
A set of technology services, standards, & policies that enable participating providers to electronically exchange clinical information regarding shared patients. Part of the ONC State HIE Cooperative Agreement Program. Maintains compliance with Nationwide Health Information Network (NwHIN) specifications for secure data exchange & nationally recognized interoperability standards.
SCHIEx a network of networks CDC VA Federal Health Architecture Nationwide Health Information Network CONNECT Compliant Gateway DoD Other State HIEs Core Technology SSA CMS Pharmacies RX Hx. RLS/MPI Audit/Log Terminology Standards Secure Transport: Encryption & Authentication Claims Data HITSP/IHE Compliant Standards PIX/PDQ, XDS/CCD (HL7 2.x, 3.x) MPI Public Health SC DHEC Immunization Registry Disease Reporting Community #1 CHCs Clinics Integrated Delivery System Community #2 4
Benefits Information about services previously rendered informs medical decision making, care coordination & care transitions, disease & population management, quality reporting & analysis, & enhances the patient s health care experience. Efficiencies gained through shared statewide governance, technology services, gateways, & open-standards architecture. Reduces need for each organization to build out connectivity with each EHR system & develop HIE policy/legal framework. Assists with addressing HIE-related MU requirements in Medicare/Medicaid EHR Incentive Programs. Statewide, collaborative approach fosters participation needed to optimize the clinical value of exchange for all providers & patients.
Technical Readiness Integrating the Health Enterprise (IHE) Cross Document Sharing PIX: Patient Identity Source Is your application capable of sending a PIX patient identity feed (ITI-8)?(Yes/No) PIX: Patient Identity Consumer Is your application capable of sending a PIX query (ITI-9)?(Yes/No) XDS: Xds.b Repository & Document Source XDS: Document Consumer Is your system capable of Sending a Register Document transaction (ITI-42) to the state Xds.b registry? (Yes/No) Responding to a Retrieve Document Set (ITI-43)? (Yes/No) Is your application capable of sending a Registry Query (ITI-18)?(Yes/No) Is your application capable of sending a Registry Query, including querying for On-demand documents? (Yes/No) XDS: Document Consumer XDS: Document Source ATNA: Secure Node/Node Authentication BPPC : Privacy Content Profile Is your application capable of sending a Retrieve Document Set (ITI-43)? (Yes/No) Is your application capable of building CDA R2 compliant documents? (Yes/No) If so, please list those that you plan to share via the exchange. (e.g. HITSP C32, XPHR, XDS-MS, Immunization Content etc.) a. <Doc Type1> b. <Doc Type 2> Is your application capable of TLS 1.0 secured communication? (Yes/No) Are you able to create and register BPPC document from your edge application? (Yes/No) SCHIEx Interoperability Services Guide published at www.schiex.org. PIX Patient Identity Cross Reference XDS Cross-enterprise Document Sharing BPPC Basic Patient Privacy Consents
Early Adopter Program Waive SCHIEx fees for all interested providers at least through December 2012. Achieve critical mass needed to help urge technology vendors to accelerate product roadmap & help customers connect. Collaborate with states that share the same technology platform more synergy. Streamline process for vendors & providers. Accelerate HIE connectivity across all 3 states. Continue to leverage stakeholder support huge!
56 Organizations Representing Over 250 Facility Locations/1800 physicians
Early Adopter Ambulatory Systems Physicians 1192 15 7 1 35 31 15 7 51 65 ecw - 9 Allscripts - 10 Success EHS - 5 79 GE -1 NextGen - 3 Medinformatix -2 McKesson - 3 Soapware -1 Greenway -1 e-mds -1 886 Sevocity -1
Early Adopter Inpatient Systems ADC 3758 906 1226 Meditech-7 Siemens -2 McKesson -2 Cerner -1 982 980 Population Served 2,318,495 559,360 452,628 Meditech -7 Siemens -2 McKesson -2 Cerner -1 603,496 703,011
SCHIEx DIRECT www.schiex.org
SCHIEx EXCHANGE SCHIEx DIRECT Set of technology services, standards, & policies that enable participating providers to electronically exchange clinical information regarding shared patients. Participants use an EHR system to connect & seamlessly discover & exchange key clinical information about shared patients. Fully automated & robust HIE. Requires standards-compliant EHR system. Information content is user defined but format must comply with national standards. Data may only be shared for certain permitted purposes. Always On Health care providers have medical information available real time at the place of care. Tool to improve continuity of patient care across providers/health care system. SCDHEC Gateway- bi-directional exchange with state Immunization Registry NwHIN Gateway - participation in VA Pilot Simple form of point-to-point electronic communication directly between a sender & a receiver. Open-standards health email. Requires no specialized equipment or interface. Information content & format are user defined. Data may be sent for permitted purposes allowed by law. A great way to get started exchanging information electronically. Method for SCHIEx EXCHANGE Participants to communicate electronically with providers without an EHR or not yet connected. Exchange tool for select use cases such as sending sensitive information that cannot be shared via SCHIEx EXCHANGE.
Potential SCHIEx DIRECT Use Cases Primary care provider sends referral/care summary to specialist. Primary care provider sends referral/care summary to hospital. Specialist sends care summary information back to referring provider. Hospital sends discharge information to referring provider. Hospital emergency department sends care summary to primary care provider. Laboratory sends lab results to ordering provider. Pharmacist sends medication therapy management consult to primary care provider Hospital discharge planner sends referral/care summary to rehabilitation, skilled nursing, home health, hospice, dialysis facility, etc. A patient navigator or disease manager communicates with team of care providers. *Adapted from Nationwide Information Network DIRECT Overview, May 19, 2012.
What is needed to enable DIRECT? Direct Addresses (used to route information) Look like email addresses/used for health information adriane.able@schiex.direct.org Message Security & Trust Services Message Transport & Delivery User Interface DIRECT-enabled EHR Client server e-mail (e.g.outlook/groupwise) SCHIEx DIRECT portal
Join In! South Carolina Health Information Exchange (SCHIEx) Connecting to SCHIEx Weekly Technical Q&A Sessions What: Informal Discussion of Technical Questions Related to SCHIEx Onboarding with Bindu Bolisetty, SCHIEx Interoperability Lead When: Tuesdays at 11:00 A.M. EST - Weekly Office Hours Format Call In Number: 1-866-502-8312 Participant passcode: 381813 SCHIEx Interoperability Services Guide Draft v1.5.5 The session is scheduled for one hour but will conclude sooner if all questions have been discussed
QUESTIONS? Let s Get Connected! Email: schiexinfo@ors.sc.gov Phone: 803.898.9962 Adriane Able Email: adriane.able@ors.sc.gov Phone: 803.898.7883